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Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is normal systemic arteriole SYSTOLIC pressure?

A

120mmHg

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2
Q

What is normal systemic arteriole DIASTOLIC pressure?

A

80mmHg

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3
Q

What is the difference in pressure between LA and LV

A

Systolic
LA = 10
LV = 120

Diastolic
LA = 0-5
LV = 10

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4
Q

What is systemic hypertension?

A

Persistently elevated systemic blood pressure
Systolic >160mmHg
Diastolic >100mmHg

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5
Q

Why might an animal have an increased blood pressure?

A

Fear/excitement
Old age
Drugs
* Fluid therapy
* Steroids
* Cyclosporin A
* Phenylpropanolamine
Underlying disease
* Renal disease
* Hyperadrenocorticism (DOG)
* Hyperthyroidism (CAT)
* Diabetes mellitus
* Hyperaldosteronism
* Phaechromocytoma
Obesity
Breed - sighthounds have increase of 10-20mmHg

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6
Q

How does HAC lead to systemic hypertension?

A

Increases renal retention of salt and water
Overproduction of renin = vasoconstriction

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7
Q

How does hyperthyroidism lead to systemic hypertension?

A

Increases sensitivity of myocardium to catecholamines

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8
Q

How does diabetes lead to systemic hypertension?

A

Volume expansion due to hyperglycaemia
Overproduction of renin = vasoconstriction

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9
Q

Phaechromocytoma

A

Tumour in adrenal gland

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10
Q

Hyperaldosteronism

A

Adrenals release to much aldosterone
Secretes potassium in to DCT
Aldosterone causes sodium potassium pump to work harder
Results in retention of Na and water

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11
Q

What influences blood pressure?

A

Cardiac output and peripheral vascular resistance

BP = CO X PVR

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12
Q

What factors influence CO?

A

Stroke volume and heart rate

CO = SV X HR

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13
Q

What factors influence stroke volume?

A

Stroke volume = EDV = ESV

Preload (EDV)
Afterload
Contractility (ESV)

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14
Q

Preload

A

Volume of blood in ventricles at the end of diastole
EDV

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15
Q

Afterload

A

Resistance to ventricular ejection
The pressure in arterial vasculature

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16
Q

Contractility

A

Force by which ventricle contracts
Determines volume of blood in ventricle at the end of systole
ESV

17
Q

Initiating causes of systemic arterial hypertension

A

Chronic fluid accumulation
* Increases preload (EDV)
Persistently high HR
Chronic vasoconstriction

18
Q

Perpetuating causes of systemic arterial hypertension

A

Extravasation of plasma into vessel wall
Vascular smooth muscle hypertrophy
Renal disease

19
Q

How does renal disease perpetuate arterial systemic hypertension?

A

When arterial pressure increases, the nephron reduces sodium and water reabsorption thus increasing sodium and water excretion to compensate
* High GFR

Results in RAAS activation

20
Q

Which organs are effected by arterial systemic hypertension?

A

Clinical signs only present with end organ damage
Eyes
CNS
Kidneys
Heart

21
Q

Ocular signs of arterial systemic hypertension

A

Acute blindness
Retinal detachment
(Blood vessels can burst in eye)

22
Q

CNS signs of arterial systemic hypertension

A

Disorientation
Ataxia
Stupor
Seizures

23
Q

Renal signs of arterial systemic hypertension

A

PUPD
Proteinuria

24
Q

Cardiac signs of arterial systemic hypertension

A

Left ventricular hypertrophy
Murmurs
Arrhythmias
CHF

25
Q

Methods of measuring arterial systemic blood pressure

A

Direct methods
* Invasive - arterial catheter
Indirect methods
* Non-invasive - compression cuff
* Doppler
* Oscillometric

Avoid using sedation

26
Q

Doppler BP measurement

A

Manual
Requires more training
More user variability
Only provided systolic BP

27
Q

Oscillometric BP measurement

A

Automatic
Time consuming
Provides systolic, diastolic and mean

28
Q

Where should you place a cuff on a cat vs dog

A

Cat - forelimb
Dog - Tail

29
Q

What are catecholamines?

A

Catecholamines are neurotransmitters produced by adrenals
(Epinephrine, dopamine, norepinephrine etc)

Act on sympathetic nervous system
Adrenergic receptors

30
Q

How do levels of catecholamines affect BP?

A

Cause increase in HR/CO and systemic vascular resistance by causing vasoconstriction

A1 Constricts heart
A2 Constricts lungs
B1 Dilates heart/vasculature
B2 Dilates lungs

31
Q

When to treat arterial systemic hypertension

A

When there has been end organ damage
When there is underlying disease identified

High risk to EOD when >180mmHg

Cardiology (18 decks)

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