Exam 3: Cardiac Flashcards
Aldosterone
Mineralocorticoid: Steroid hormone; produced by adrenals, regulates Na+ and H20
Aneurysms:
Weakening of the artery wall that causes a localized area of bulging or dilation. This weakened segment creates an outpouching and causes turbulent blood flow in artery and the outpouching is susceptible to rupture. Brain and aorta are the typical sites for aneurysm.
Artery:
muscular walled blood vessels ; strong contractility and elasticity properties; transports blood out of heart to the tissues and organs; maintains BP
Atherosclerosis:
chronic progressive disease; characterized by the buildup of atherosclerotic plaque on the lining of arterial wall; results in thickening and hardening of walls
Arteriosclerosis:
Hardening and stiffening of the arteries.
Baroreceptor:
BP “pressure sensitive receptors” sensors in the walls of the artery; particularly in carotid artery and aortic arch; stimulate SNS when low BP is “sensed”
Bruits:
Turbulent blood flow often produces whooshing sounds that can be heard through the stethoscope
Chemoreceptors
Chemical sensitive receptors
Ankle-Brachial index:
Comparison of the blood pressure in the leg vs. the arm; normal ratio is greater than 1
Endothelium:
Inner lining of the arterial walls made up of endothelial cells; inner lining of heart endocardium also made of the endothelial cells.
where vasoconstriction and dilation occurs
Familial hypercholesterolemia (FH):
genetic disorder of elevated cholesterol
Hyperlipidemia:
elevated lipid levels in the blood stream; fundamental condition responsible for atherosclerosis
Hypertension:
elevated BP causing direct and indirect cardiovascular damage
Orthostatic hypotension: (postural hypotension)
drop in BP that occurs when changing position from lying to standing; usually 20mmHg drop in SBP or 10mmHgin DBP
Intermittent claudication:
characteristic symptom of reduced arterial flow in Peripheral Vascular disease; cramping leg pain that occurs with exertion and usually relieved with rest
Low density lipoprotein(LDL):
Liver synthesizes cholesterol and releases it as a LDL. LDL transports cholesterol to the tissues where it is deposited within arterial walls
Left Ventricular Ejection Fraction (LVEF)
The percent of blood in the LV that leaves the Left Ventricle and is pumped to the body with each contraction; Normal is 50-65%
High-density lipoprotein (HDL):
lipoprotein that takes cholesterol from the bloodstream and returns it to the liver for excretion
Heart Failure with Preserved Ejection Fraction (HFpEF)
Clinical heart failure with a Left Ventricular Ejection Fraction of >=50%
Heart Failure with Reduced Ejection Fraction (HFrEF)
Clinical heart failure with a Left Ventricular Ejection Fraction of <=40%
Heart Failure with mildly reduced Ejection Fraction, (HFmrEF)
Clinical heart failure with a Left Ventricular Ejection Fraction of 41-49%
Heart Failure with improved Ejection Fraction (HFimpEF)
Clinical heart failure with a Left Ventricular Ejection Fraction that was previously <=40% but has improved on subsequent EHCO’s to >40%
Triglycerides:
large lipid molecules acquired through diet and stored as fat tissues
Natriuresis:
Natural diuresis promoted by the heart and the brain.
Atrial Natriuretic peptide (ANP):
Peptide released by heart in response to excess fluid; peptides act on nephrons to release water.
Brain Natriuretic peptide (BNP):
Peptide released by heart and brain in response to excess fluid; peptides act on nephrons to release water.
Renin Angiotensin Aldosterone System (RASS)
key role in regulation of BP. Multi-steps in process activated with decrease in BP
Renin:
Enzyme released by juxtaglomerular apparatus of the nephrons in response to decreased perfusion. First in RAAS
xanthoma and xanthelasma:
yellowish cholesterol deposits under the skin and around the eyes
Pulse Pressure:
difference between Systolic and Diastolic (ideal= 40 mmHg)
Stroke Volume (SV):
amt. of blood ejected per contraction from L Ventricle- SV is approx. 70ml
Cardiac Output (CO):
amount of blood that the heart pumps out of the left ventricle each minute; SV X HR; Normal CO= 5 liters/min
C-reactive protein (CRP):
An acute phase protein produced by liver and released with inflammation; associated with increased risk of CV event or stroke. Lab measured: high sensitivity CRP (hs-CRP)
Blood pressure:
determined by CO X Peripheral Vascular Resistance (PVR); BP = CO X PVR
Systole:
period of cardiac contraction
Diastole:
period of cardiac relaxation
Foam Cells:
LDL-lipid laden macrophages; accumulation of foam cells from atherosclerotic plaque
Mean Arterial Pressure (MAP):
Average pressure in the arterial system ; estimates pressures during ventricular contraction and relaxation. MAP= 2xDBP – SBP
Nitric Oxide (NO)
Potent vasodilator produced by endothelium; acting on VSM of arterials; may be decreased in atherosclerosis
Angina pectoris:
Also called “angina”: chest pain of cardiac origin; described as a squeezing pain in the chest that occurs when there is lack of blood flow to the myocardium (termed myocardial ischemia). Classified as stable or unstable
Stable angina:
predictable chest pain that the patient has experienced in the past and feels similar to past episodes
Unstable angina (UA):
new or changing chest pain caused by ischemia
Acute Coronary Syndrome (ACS):
is a term used for ischemic disorders of the heart that occur suddenly and require immediate treatment
Non-ST-segment elevation myocardial infarction (NSTEMI)
ST-segment elevation myocardial infarction (STEMI)
Stress test:
A diagnostic test used specifically for angina is a thallium stress test, which is a nuclear scan used to show myocardial perfusion during exercise
Cardiac Troponins:
Serum biomarkers measured in CAD, high specificity for myocardial tissue ; an indication of the extent of myocardial cell death
Thrombus:
a clot that remains attached to a vascular wall
Embolus:
Mobile aggregate of a variety of substances that occludes the vasculature. Emboli can include blood clots, air, amniotic fluid, bacteria, fat, and foreign matter
Thromboembolism:
blood clot detached from vessel wall
Infarction:
death of myocardial tissue
Dysrhythmia (or arrhythmia):
A disturbance of heart rhythm.
Varicose vein:
distention in vein caused by pooling of blood
Pericardial effusion:
Fluid may collect within the pericardial sac
Cardiomyopathies:
Group of primary myocardial disorders that are usually the result of remodeling, neurohumoral responses, and hypertension. The cardiomyopathies are categorized as dilated (or congestive), restrictive (or rigid and noncompliant), and hypertrophic (or asymmetric)
Pericarditis:
Inflammation of the pericardium and epicardium (membranes that surround the heart)
Endocarditis:
infection and inflammation of the endocardium, especially the cardiac valves
Aortic stenosis:
narrowing of the aortic outflow tract
Pulmonic stenosis:
narrowing of the pulmonary outflow tract
Heart Failure: “pump failure”;
in ability of the heart to maintain adequate cardiac output to meet the metabolic demands of the body, results in inadequate tissue perfusion
Preload:
defined as the volume of blood in the heart at the end of diastole: refers to the volume of blood that enters the right atrium from the venous system
Afterload:
Amount of resistance that the ventricle must overcome in order to pump blood out of the heart. The greater the systemic arterial vascular resistance, the greater the afterload against the left ventricle
Pulmonary Edema:
fluid extravasation into the pulmonary interstitial and intracellular spaces
Cardiogenic shock:
Decreased cardiac output, tissue hypoxia, and the presence of adequate intravascular volume.
Hypovolemic shock:
Result of large volume loss; blood or fluid. The use of compensatory mechanisms may be vigorous, but tissue perfusion ultimately decreases and results in impaired cellular metabolism.
Neurogenic shock
Results from massive vasodilation, causing a relative hypovolemia even though cardiac output may be high, and results in impaired cellular metabolism.
Anaphylactic shock:
Is caused by physiologic recognition of a foreign substance. The inflammatory response is triggered, and a massive vasodilation with fluid shift into the interstitium. The relative hypovolemia leads to impaired cellular metabolism.
Septic shock:
Severe sepsis (infection) with hypotension refractory to fluid replacement and vasopressors; begins with impaired cellular metabolism caused by uncontrolled septicemia. The infecting agent triggers the inflammatory and immune responses. This inflammatory response is accompanied by widespread changes in tissue and cellular function.
Triad of Virchow:
Risk assessment for DVT
venous stasis
venous wall injury
hypercoagulability
Shunt
a passage by which blood moves from one area (blood vessel or heart chamber) to another in a pattern that isn’t normal
Neural vs. humoral mechanisms
