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module 103 - theme 3 > how the CV system fails > Flashcards

how the CV system fails Flashcards

1
Q

what is a haemorrhagic stroke?

A

cerebral blood vessel rupture

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2
Q

what is an ischaemic stroke?

A

cerebral blood vessel blockage

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3
Q

what causes a blood vessel to burst?

A
  • stresses

- damage

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4
Q

in a cylinder what is the vessel wall tension?

A

proportional to P x radius

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5
Q

what are the activities of the endothelium?

A
  • blood vessel tone
  • fluid filtration
  • haemostasis
  • white cell recruitment
  • angiogenesis
  • hormone trafficking
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6
Q

what is an acute myocardial infarction?

A

a region of heart tissue that is dying or dead

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7
Q

what causes an acute myocardial infarction?

A

usually due to a blocked coronary artery

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8
Q

what is atherosclerosis?

A

a disease process that results in the furring of the arteries

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9
Q

what causes atherosclerosis?

A

hyperlipaemia, immune action of unknown aetiology

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10
Q

what is coronary artery disease?

A

a disease process resulting in obstruction of the arteries supplying the heart tissue

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11
Q

what are the symptoms of coronary artery disease?

A

angina or asymptomatic

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12
Q

what is the cause of coronary artery disease?

A

atherosclerosis

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13
Q

what is plaque rupture?

A

a fibrous cap of plaque that burst open

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14
Q

what does the sympathetic nervous system do during an acute MI?

A

releases adrenaline and noradrenaline in response to pain and haemodynamic abnormalities

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15
Q

what does the sympathetic nervous system do during heart failure?

A

increases heart rate and increases contractility, increases peripheral resistance and increases risk of arrhythmia

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16
Q

what is pulmonary oedema?

A

fluid accumulation in lungs

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17
Q

what does pulmonary oedema lead to?

A

impaired gas exchange

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18
Q

what causes pulmonary oedema?

A

left heart failure

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19
Q

what are the symptoms of pulmonary oedema?

A

dyspnoea/orthopnoea which leads to hypoxia

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20
Q

what is ascites?

A

accumulation of fluid in the peritoneal cavity

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21
Q

what is peripheral oedema?

A

swelling of tissues especially in ankles

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22
Q

what is compensation?

A

maintaining homeostasis of physiological function despite stressors or malfunctions which happens via endogenous physiological feedback

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23
Q

what is decompensated heart failure?

A

the failure of the heart to maintain adequate blood circulation, after long-standing vascular disease causing respiratory distress

24
Q

what causes cardiac remodelling?

A

injury: MI, hypertension, valve disease, response to increase afterload or preload

25
Q

what is the result of cardiac remodelling?

A

hypertrophy or dilation

26
Q

what are the treatments for cardiac remodelling?

A

ACE inhibitors or spironolactone

27
Q

what is eccentric ventricular hypertrophy?

A

dilation due to volume overload

28
Q

what is concentric ventricular hypertrophy?

A

thickening due to pressure overload

29
Q

what is another name for ADH?

A

vasopressin

30
Q

what is aldosterone?

A

a steroid that causes kidneys to reabsorb more NaCl and therefore more water

31
Q

where is aldosterone secreted from?

A

the adrenal cortex

32
Q

what does angiotensin II do?

A
  • causes vasoconstriction
  • increased fluid retention
  • increases ADH secretion
  • contributes to ventricular hypertrophy and remodelling
33
Q

what does thiazine do?

A

blocks reabsorption in the distal convoluted tubule

34
Q

what does K+ sparing diuretics do?

A

inhibits aldosterone receptors in cortical collecting duct

35
Q

what causes left sided heart failure?

A

the right heart pumps into lungs but the left atrium its too full

36
Q

what symptoms do you get from left sided heart failure?

A

respiratory symptoms

37
Q

what is congestive heart failure?

A

pulmonary vasculature is congested and in extreme fluid leaks out of blood vessels into lungs

38
Q

what symptoms do you get with right sided heart failure?

A

systemic symptoms

39
Q

what happens with right sided heart failure?

A

increase in central venous pressure leading to peripheral oedema or ascites

40
Q

what are symptoms of heart failure?

A
  • fatigue
  • peripheral oedema
  • dyspnoea
41
Q

what is a key difference between and MI and heart failure?

A

MI is anatomical and heart failure is physiological

42
Q

what unites all forms of heart failure?

A

fluid retention

43
Q

what is cardiogenic shock?

A

critically low perfusion due to low cardiac output leading to insufficient perfusion of tissues especially the heart

44
Q

how does cardiogenic shock progress?

A

positive feedback

45
Q

how do you treat cardiogenic shock?

A

aggressive intravenous fluid and oxygen and airway maintained

46
Q

what are treatments of chronic heart failure?

A
  • ACE inhibitors
  • diuretics
  • beta blockers
47
Q

what are the 2 methods for low cardiac output?

A
  • increase sympathetic activity

- kidney accumulates fluid

48
Q

what happens when you increase sympathetic activity?

A
  • the fast response
  • increases heart rate, increases heart contractility
  • vasoconstriction
49
Q

what happens when the kidney accumulates fluid?

A
  • the slower response
  • decreases glomerular filtrate rate
  • increased central venous pressure
  • increased venous return and increased preload
50
Q

what happens with heart failure or infarct?

A
  • normal pressure
  • ends with shock
  • rare before age of 50
51
Q

what happens with haemorrhage?

A
  • loss of fluid leads to loss of pressure
  • ends with shock
  • any age
52
Q

what are the 4 main ways the body tries to decompensate heart failure?

A
  • the kidney increases plasma volume
  • the heart is unable to pump extra fluid
  • the capillaries leak fluid into tissues
  • the lungs cannot exchange oxygen and carbon dioxide
53
Q

why does the kidney increase plasma volume?

A
  • to compensate for poor perfusion of renal tissue
  • the kidney responds to it as if it a haemorrhage
  • this leads to fluid overload
54
Q

why is the heart unable to pump extra fluid?

A
  • fluid damming leads to increased venous hydrostatic pressures
  • increased back pressure further damages heart
  • positive feedback loop leads to rapid deterioration
55
Q

what are the treatments for low output heart failure?

A
  • prevent acute decompensated heart failure
  • counteract cardiac remodelling
  • minimise symptoms

module 103 - theme 3 (17 decks)

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