Heart | The Cardiovascular System Flashcards
In coronary artery disease, arteries that supply the myocardium with oxygen become narrowed due to ____ over time, causing temporary cardiac ischemia, and eventually myocardial infarction (MI)
atherosclerotic deposits
Coronary artery disease is caused by deposits of fat-containing substances called plaque in the ____ of the arteries that results in atherosclerosis
lumen
What causes plaque?
diabetes, age, dietary and lifestyle factors, etc
What are the common symptoms of CAD?
angina, burning, squeezing, crushing pain in neck or jaw (mostly men)
What are the risk factors of CAD?
lifestyle, age, HTN, diabetes, smoking, genetics
What is the difference between atherosclerosis and arteriosclerosis?
atherosclerosis = coronary arteriesarteriosclerosis = other arteries, unless aorta, then arteriosclerosis
Treated with pharmacotherapy and surgical interventions
CAD
What surgical interventions are used to treat CAD?
PTCA (percutaneous transluminal coronary angioplasty) and CABG (coronary artery bypass graft)
Angina pectoris is chest pain due to ____ during or shortly after exertion; results from reduced oxygen supply to the myocardium
ischemia
Caused by atherosclerosis, spasms of the coronary arteries, prolonged tachycardia, some forms of anemia, respiratory disease
angina pectoris
Treated by nitroglycerin sublingually
angina pectoris
Myocardial infarction is the death of _____ caused by the development of ischemia
myocardial tissue
Caused by insufficient oxygen supply due to thrombus, atherosclerotic plaque, and myocardial muscle spasm
myocardial infarction (MI)
Treatment includes 1. lab testing of CPK and troponin, LDH, and AST 2. thrombolytic drugs 3. PTCA 4. CABG
MI
Arryhthmia that often results from the damage causing most related deaths
VFIB
Sudden, unexpected cessation of cardiac activity
cardiac arrest
Caused by anoxia or interruption of the electrical stimuli to the heart due to respiratory arrest, cardiac arrhythmia, MI, electrocution, drowning, severe trauma, massive hemorrhage, drug overdose
cardiac arrest
Treatment includes CPR, AED and cardiac drugs
cardiac arrest
A condition caused by chronically elevated pressure throughout the vascular system; can be divided into secondary HTN or benign essential HTN
hypertensive heart disease
Essential hypertension is an abnormally high blood pressure in the arterial system with a reading of over ___ mmHg
140/90
Essential hypertension has an ____ onset; the patient has few, if any, symptoms until permanent damage has occurred
insidious
Cause unknown but contributing factors include heredity, stress, age, smoking, obesity, sedentary lifestyle, poor dietary habits
essential hypertension
Treatment includes pharmacotherapy, dietary management (limiting sodium intake), exercise and weight loss
essential hypertension
____ is a severe, life-threatening form of hypertension with a blood pressure reading of ___ mmHg or higher
malignant hypertension, 200/120
Cause unknown but extreme stress is thought to be a contributing factor
malignant HTN
Treated by aggressive intervention with IV hypertension drugs
malignant HTN
Congestive heart failure (CHF) is an acute or chronic inability of the heart to ____ blood throughout the body
pump enough
Caused by MI most commonly; also: hypertension, CAD, COPD, cardiac valve damage, arrhythmias, cardiomyopathy
CHF
Name the two types of CHF.
- left-sided CHF2. right-sided CHF
Congestive heart failure in which left ventricle does not empty; blood backs up in the pulmonary circulation causing ____
left CHF; pulmonary congestion
Congestive heart failure in which the right ventricle can’t empty; blood backs up in systemic circulation causing ___ in the legs and digestive system
right CHF; edema
Treated by drugs to reduce the workload on the heart and increase efficiency, restricting of fluid and sodium intake, pacemaker or defibrillator for some patients, heart transplant in extreme cases
CHF
Cor pulmonale is an enlargement of the ____ due to a primary lung disease (sequela)
right ventricle
Caused by acute or chronic pulmonary disease and pulmonary hypertension
col pulmonale
Treatment must be directed at both the lung problem and the cardiac sequela
cor pulmonale
Cor pulmonale treatment focus is on reducing the ____ of the heart, and increasing the heart’s efficiency to reduce _____
workload, hypoxemia
Pulmonary edema is fluid shifting into the ___ of the lungs (overload of pulmonary circulation)
extravascular spaces
Caused by left-sided CHF and mitral valve disease, pulmonary embolism, systemic HTN, arrhythmias, renal failure, head trauma, drug overdose, exposure to ___
pulmonary edema; high altitudes
Treated by placing the patient in Fowler’s position, oxygen therapy, diuretics, ventilation
pulmonary edema
Cardiomyopathy is a noninflammatory disease of the cardiac muscle resulting in enlargement of ___ and ___
enlargement of the myocardium and ventricular dysfunction
What are the 3 types of cardiomyopathy?
- dilated2. hypertrophic3. restrictive
T or F. Causes and treatment of cardiomyopathy are based on type
T
Cardiomyopathy type: degeneration of myocardial fibres caused by chronic alcoholism, autoimmune processes, or a virus
dilated cardiomyopathy
Cardiomyopathy type: hypertrophy of left ventricle caused by genetic factors or can be idiopathic
hypertrophic cardiomyopathy
Cardiomyopathy type: caused by an infiltrative process of the heart that causes fibrosis and thickening of the myocardium
restrictive cardiomyopathy
Acute or chronic inflammation of the pericardium
pericarditis
Idiopathic cause, inflammation or infection elsewhere in the body, virus or bacteria, trauma, rheumatic fever, malignant neoplasm
pericarditis
Treated by management of underlying disease and reduce the inflammation and pain
pericarditis
Inflammation of the muscular walls of the heart
myocarditis
cardiomyopathy vs myocarditis
disease vs inflammation
Caused by a viral, bacterial, fungal or protozoal infection, but can also be idiopathic, a complication of influenza, diphtheria, mumps, and rheumatic fever
myocarditis
Treatment includes anti-infective agents for infectious causes, rest, analgesics and oxygen administration
myocarditis
Inflammation of the lining and the valves of the heart and characterized by ___
endocarditis; vegetations
Infectious growths on the valves that can be released into the bloodstream as emboli
vegetations
Caused by bacteremia (most commonly staph aureus, Group A Beta-hemolytic streptococci and E. coli)
endocarditis
Treatment is anti-infective therapy
endocarditis
Rheumatic fever is a systemic inflammatory and autoimmune disease involving ___ and ___
joints/cardiac tissue
Generally preceded by sore throat caused by group A beta-hemolytic streptococcus (strep throat) which causes an autoimmune reaction that affects the ____ and ____
rheumatic fever; affects the endocardium and the mitral valve
Treatment is antibiotics for strep throat to prevent rheumatic fever
rheumatic fever
The cardiac manifestations that follow rheumatic fever
rheumatic heart disease
Caused when the vegetations that follow rheumatic fever become enlarged or the valves may scar, causing stenosis for the valve openings
rheumatic heart disease
Treatment is to reduce stenosis and prevent further damage; may require surgery to replace the valve
rheumatic heart disease
An acquired/congenital disorder involving any of the 4 valves of the heart
valvular heart disease
What are the 4 valves of the heart?
pulmonarymitralaortictricuspid
What is the most common valve to be affected by valvular heart disease?
mitral valve
Hardening of the valve cusps in valvular heart disease
valvular heart disease: stenosis
Causes include rheumatic heart disease, age, and presence of a malformed valve
valvular heart disease: stenosis
Treatment includes limitation of sodium intake, diuretics, anticoagulants, commissurotomy or balloon valvuloplasty, surgical valve replacement
valvular heart disease: stenosis
The valve fails to close completely
valvular heart disease: insufficiency/regurgitation
Causes include rheumatic heart disease, prolapse, MI
valvular heart disease: insufficiency/regurgitation
Treatment includes bed rest, surgical valve replacement
valvular heart disease: insufficiency/regurgitation
One or more of the cusps of the valve protrude back into the chamber
valvular heart disease: prolapse
Causes include long or short chordae tendinae, malfunctioning papillary muscles, genetic tendency and some connective tissue disorders
valvular heart disease: prolapse
Treatment isn’t required when the patient is asymptomatic, beta-blockers
valvular heart disease: prolapse
Any deviation from the normal heartbeat (sinus rhythm); also called irregular heartbeats
arrhythmias
Reflects disturbances in the normal conduction system that can be caused by ischemia, drugs, failure of the SA node
arrhythmias
Treatment depends on cause; can be pharmacotherapy, pacemakers, cardioverter defibrillators
arrhythmias
Collapse of the cardiovascular system, including vasodilation and fluid shift accompanied by inefficient cardiac output
shock
Treatment includes first aid, placing the patient in the supine position with the legs elevated, keeping the patient warm, and calling EMS
shock
Causes of shock
–
Inadequate output of blood by the heart when the myocardium fails to pump effectively
cardiogenic shock
Caused by anything that damages the heart’s ability to pump including MI, heart failure, certain arrhythmias, valve failure
cardiogenic shock
Compression of the heart muscle and restriction of heart movement caused by blood or fluid trapped in the pericardial sac
cardiac tamponade
Caused by an insult to a vessel in the pericardium which allows blood to fill the pericardial space
cardiac tamponade
Treatment is pericardiocentesis and often surgery to repair the leak
cardiac tamponade
Clots of aggregated material (usually blood) that can lodge in a blood vessel and inhibit the blood flow
emboli
Severity depends on the location of the vessel and the area of tissue supplied by vessel
emboli
Other causes (besides a clot) include air bubbles, fat globules, bacterial clumps and pieces of tissue
emboli
Treatment is to restore blood flow, often using thrombolytic drugs (tPA) for clots
emboli
Most common cause is a blood clot that has formed in the deep veins of the legs, also called a DVT (deep vein thrombosis)
emboli
A condition that occurs when walls of arterioles thicken, with loss of elasticity and contractility
arteriosclerosis
Thickening and hardening of the vessels that occurs when plaques of cholesterol and lipids form in the arterial tunica intima
arteriosclerosis: atherosclerosis
Cause is multifactoral; risk factors include heredity, sedentary lifestyle, diet high in rich lipids and cholesterol-producing foods, smoking, diabetes mellitus, HTN, obesity
arteriosclerosis: atherosclerosis
Treatment includes dietary changes, smoking cessation, treat and control hypertension and diabetes, hyperlipidemic drugs (Lovastatin)
arteriosclerosis: atherosclerosis
Weakening and resulting local dilation of the wall of an artery
aneurysm
Prognosis depends on the location of the artery and the extent
aneurysm
Caused by a build-up of atherosclerotic plaque that weakens the vessel wall
aneurysm
Treatment depends on size, location, likelihood of rupture; can include surgical repair before the aneurysm leaks or ruptures if known
aneurysm
Inflammation of a vein that occurs most often in lower legs but any vein may be affected
phlebitis
Cause is uncertain and may be idiopathic; possible causes include venous stasis, obesity, blood disorders, injury, surgery
phlebitis
Treatment is symptomatic
phlebitis
The result of an inflammation of a vein w formation of a thrombus on the vessel wall
thrombophlebitis
Causes include venous stasis, blood disorders that cause hypercoagulation, injury to venous wall
thrombophlebitis
Treatment includes immobilizing the affected part, and administering heparin to prevent the clot from enlarging
thrombophlebitis
Swollen, tortuous, and knotted veins that usually occur in the lower legs
varicose veins
There is no clearly identifiable cause, but is suspected to be due to defective/absent valves
varicose veins
Treatment includes stripping and ligation, sclerosing injections
varicose veins
Inflammation of peripheral arteries/veins of extremities w clot formation that can lead to ulcers and gangrene
thromboangiitis obliterans
Primary cause is long-term tobacco use
thromboangiitis obliterans
Treatment includes immediate smoking cessation, medication to improve circulation, surgery to detour around or bore through a clot, amputation of gangrenous tissue
thromboangiitis obliterans
Primary vasospastic condition of the fingers, hands, or feet, causing pain, numbness and sometimes discoloration
Raynaud’s disease
If Raynaud’s disease occurs secondary to another disease, it is called ______
Raynaud’s phenomenon