Heart and Blood Vessels Flashcards by Louise Cave

Cardiac Failure

Heart unable to pump blood at rate required for normal functioning
Initially the heart ‘Compensates’
Leads to cardiac hypertrophy and/or dilatation, and eventual inability to maintain normal

How well did you know this?

Not at all

Perfectly

What happens when the heart does not pump as effectively as it should?

Oedema – pulmonary and peripheral

Tiredness

How well did you know this?

Not at all

Perfectly

Signs/Symptoms of Cardiac failure

Shortness of breath (SOB)
Fatigue
Fluid in lungs (Pulmonary Oedema)
All-over, excessive, fluid-filled veins (Systemic Venous Congestion & Oedema)

How well did you know this?

Not at all

Perfectly

Valvular Heart Disease - Mechanisms

Stenosis - Failure to open completely, impeding forward flow
Incompetence/Regurgitation - Failure to close, allowing reverse flow
Vegetations – abnormal tissue growth on valve (fibrin, platelets & bacteria)

How well did you know this?

Not at all

Perfectly

Valvular Heart Disease – Underlying Causes

Infection – Endocarditis/Rheumatic disease 
Calcific aortic valve disease 
Age-related degeneration
Carcinoid Syndrome
Fibrosis &amp; muscle rupture after MI
Heart failure
Hypertension
Congenital 
Prosthetic Heart Valves
Connective Tissue Disorders 
IV Drug use

How well did you know this?

Not at all

Perfectly

Symptoms/Consequences of Valvular disease

Differ with the site/type lesion
Stroke 
Arrythmias
Ventricular hypertrophy
Angina (Chest pain)
Syncope (Fainting)
Heart failure
Infarcts to kidneys and spleen
Poor prognosis once symptoms

How well did you know this?

Not at all

Perfectly

Infective Endocarditis

Endocardium is the inner lining of the heart and its valves.
Endocarditis is when this lining becomes infected/inflamed
Infection occurs on the edge of heart valves
Vegetation is a mass of bacteria, fibrin, platelets
Right-sided in IV drug use
Left-sided in others
Colonization of the heart valves or mural endocardium usually by bacteria
Streptococci (α haemolytic) affects abnormal valves usually after dental extraction / cleaning / bronchoscopy / tonsillectomy
Staph aureus affects previously normal valves, usually IV drug abusers

How well did you know this?

Not at all

Perfectly

PROPHYLAXIS

Imperative to give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia

How well did you know this?

Not at all

Perfectly

Pericarditis & Myocarditis Causes

Viral
Bacterial
Parasitic
TB
Uraemia (urine products in blood)
Carcinoma
MI
Post surgery
Drugs
Connective tissue disease
Radiation

How well did you know this?

Not at all

Perfectly

Pericarditis &Myocarditis Types

Acute

Chronic

How well did you know this?

Not at all

Perfectly

Pericarditis & Myocarditis Symptoms and Signs

Chest Pain

Cardiac Failure

How well did you know this?

Not at all

Perfectly

Pericarditis & Myocarditis Treatment

Anti-inflammatory Drugs

Surgical Excision of the Pericardium

How well did you know this?

Not at all

Perfectly

Unusual Cardiac Diseases

Cardiomyopathy
Multisystem Diseases – like Sarcoidosis &amp; Amyloidosis
Thyrotoxicosis
Myxoedema
Alcoholism
Pregnancy
Iatrogenic (drug-induced) disease

How well did you know this?

Not at all

Perfectly

Cardiomyopathy

Disease of the heart muscle

How well did you know this?

Not at all

Perfectly

Hypertrophic Cardiomyopathy

Heavy, muscular, hypercontracting
Abnormal diastolic filling
1/3 have intermittent left ventricular outflow obstruction
End stage dilatation can occur
Myocardial hypertrophy, disarray

How well did you know this?

Not at all

Perfectly

Clinical Features of Hypertrophic cardiomyopathy

SOB, chest pain, palpitations, black-out
Sudden death
Atrial fibrillation

50% Familial, autosomal dominant with variable expression
Genetic defect in 1 of 4 genes that encode cardiac contractile elements

Aneurysms

Localised, permanent, abnormal dilatation of a blood vessel

Types of Aneurysm

Atherosclerotic
Aortic Dissection
Berry
Micro-Aneurysms
Syphilitic
Mycotic (infective)

Hypertension

BP is recorded as two numbers—the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats)
Measured in millimeters of mercury - mmHg
eg 120/80 mm Hg
120/80mmHg or lower is classed as normal BP
No universal definition of what exactly is high
BP 140/90 offered 24hr ambulatory monitoring
Categories:
Mild: diastolic 95 – 104mmHg
Moderate: 105 – 114mmHg
Severe: >115mmHg

Benign Hypertension

Most remain stable over many years
live a relatively normal life
until/unless complications arise

Malignant Hypertension

Accelerated Hypertensive disease
5% of cases
Rapidly rising blood pressure
90% die in the first year!

Complications of Hypertension: Blood Vessels

Large Blood Vessel disease (Macroangiopathy)
Atherosclerosis
Small Blood Vessel disease (Microangiopathy)
Arteriolosclerosis
Increased risk of rupture
and dissection, & MI

Complications of Hypertension: Heart

Heart disease:
Left ventricular hypertrophy
Cardiac Failure
Myocardial Infarction

Complications of Hypertension: Kidney

Benign nephrosclerosis

Renal failure

Complications of Hypertension: Eyes (Retina)

Hypertensive retinopathy Retinopathy Grades: Grade I Thickening of arterioles Grade II Arteriolar spasms Grade III Hemorrhages Grade IV Papilloedema (seen in Malignant Hypertension)

Complications of Hypertension: Brain

Cerebral haemorrhage | Cerebral infarction

Factors Indicating Adverse Prognosis in Hypertension

``` Male Young Black Ethnicity Smoker Persistent diastolic BP > 115 mm Hg Diabetes Hypercholesterolemia Obesity Excess alcohol Organ damage: Heart, Kidney, Eyes, Brain ```

Diabetic Vascular Disease

``` Damage to Vessels Generally - Atherosclerosis Damage to Kidneys Damage to Nerves Damage to Retinas Complications such as: Gangrene Renal failure Blindness Effective control of Diabetes reduces disease! ```

Venous Thrombosis | eg DVT

When normal venous return is impeded, predisposes to Thrombosis

Varicosities

``` Common Problem Tortuous and Distended veins Cause Incompetent valves in legs Impaired venous return stasis oedema fibrin deposits around veins Often associated Ulceration – ankles and lower legs ```

Congenital Cardiovascular Disease – Commonest Types

Septal defects - Atrial or Ventricular Failure of blood vessel closure at birth - Patent Ductus Arteriosus Narrowed Aorta - Coarctation of the Aorta Valvular Abnormalities Vessels the wrong-way round - Transposition of the great vessels Coronary artery defects Multiple defects - Fallot’s Tetralogy

Causes of aneurysms

Causes: Age, Atherosclerosis, Ischaemia, Hypertension, Inflammation, Diabetes, Autoimmune diseases, Bacteria, Bacterial Endocarditis, Fungus, Marfan’s Syndrome, Syphilis

Treatment of Aneurysms

Treatment: Stents, Surgery, reducing arterial pressure

Causes of Venous Thrombosis | DVT

``` Causes: Immobility Malignancy Pregnancy & Childbirth Oestrogens Haematological disorders IV cannulas Danger of PE ```

Brainscape's Knowledge GenomeTM

Heart and Blood Vessels Flashcards

Brainscape's Knowledge Genome^TM