Hypotension, Thrombosis, Embolism & Infarction Flashcards
what is systole
left vent cotract
what is diastole
left vent relax
BP is —-
CO x peripheral ritnce
Co consists of
heart rate
contractility
Blood vol
peripheral resist consist of
constrictor (angiotensin 2)
dilators ( Nitric oxide)
what is hypertension
disorder in which level od sustained arterial pressure i higher than expected for age, sex and race
high bp =
consistently >140/90 mmHg
when does BP inc
on standing on exercise and on expo to cold and emothion
indiv with larger than normal pressure rise in response to stimuli have inc risk of
permanent hypertension - labile hypertension
prevalence of hypertension UK
20%
what are the classficiatons of hyeprtension
primary
secondary
benign
malignant
95% cases hyperT =
no detectable cause
primary
essential
what’s primary hypertension induced by
interplay genetics and enviro factors race stress diet alcohol exercise
what is secondary hyperT
renal disease
endocrine disorders
aortic disease
what is coarctation of aorta
onental narrow of segments aorta
what are some endocrine causes of hyper T
adrenal gland tumour
conns syn - excess dlosterone
cashing syn - excess corticosteriod
prognosis of pt with hyperT dept on
height and rate of pressure rise
bening hyperT
prognosis measured in decades
malignant hyperT
accelerate from fatal within 2 years if untreat
benign causes of hyperT
ischaemic heart disease heart fail stroke acceleration renal disease malignant hyperT
does benign hyperT symptomatic
no
BP rises slowly over the years
what does benign hyperT have an affect
heart and arteries
taggert heart, brain and kidneys
ischeamic heart disease
how does benign hyperT affect CVD
inc pressure hypertrophy arteries and heart
resist in arteries - thicker walls more narrow
longstand hyperT aggravaties atherosclerosis = aneurysm and disscetions
how does benign hyperT affect the heart
left vent hypertrophy - diastole
inc muscle mass and intersistial fibrosis
poor canary artery perfusion
myocardial infart
how does benign hypertension affect the brain
micro aneurysm ina arteries supply baal gala and pons and cerebellum
rupture = hypertensive cerebral haemohhae
cerebral infarction - stroke
how does benign hyperT affect kinds
hyperT aggravates many renal diseases but only in severe cause = renal fail
what are the definitive reading of benign hyper
every 10 mmHg diastole above 85 - double MI risk
every 8 mmHg diastole above 85 - inc stroke
what is the basics of malignant hyperT
life threat
diastole >130 mmHg
what can malgganat lead to
retinal changes haemorrhages cerebral oedema heart fail acute stroke acute renal fail blood vessels fibrinoid necrosis
what does maligannayt dev from
benign ot secondary hyperT
who is affected by malignant
30-40 yrs
needs urgent treat
what is blood clotting
defence mech ag haemorrhage
solid mass blood external to vessel
what is blood clot imp for
imp for trauma and surgery
what is athormbus
solid mass IN the vessel
common found veins but sometimes in arteries
what causes thrombus
rik inc by VIRCHOWS TRAID
what is virchow train
injury to vessel walls
alter blood flow
alter blood constituents that in coagulability
how is the vessel affected in virchows
loss end surface
inflam
what is the flow affects in vrichow
stasis
turbulence
what is constiunets affects in virchows
platelets
coat proteins
visc
thowmus formation
platelets
coat cascade
fibrinolytic cascade
what is the events of thrombus form
rapid flow blood vasc injury for platelet rich thrombus build up \+ platelets and fibrin tick to end coat cascade = fibrin strands
what does a thrombus do
occludes vessel
blood flow slow adhere to thrombus surface = RED THROMBUS
what does red thrombus lead to
propagation of further affects
what si the fate of thrombus
lysed into anticlht factors
larger thumb - infiltrate macrophages and ends cells - racanlise and restore blood flow
embolism
what is an embolus
abnormal material carries in blood may cause block downstream - dept on site and nature of material
what does a large emboli =
infarction of tissue
brain - stroke
what are some examples of major types of embolism
thromboembolism atheroembolism fat embolism air embolism tumour embolism septic embolism amniotic fluid
if embolism on arterial side =
heart to brain nd kidney
if embolism on venous side
pulmonar circ
DVT =
deep vein thrombosis
PTE =
pulmonary thromboembolism
when can DVT occur
post op
bed bound
travel
what can DVT cause
unilateral leg swell
oedema
pain
what is pTE
sudden onset life threat haemoptysis breathlessness CVD collapse and shock cardiac arrest
what is ana infarction
zonal necrosis due to sudden occulsion of blood supply
- atheroma
- embolism
what si the nxrosis in an infarction due to
lack oxygen and nutrients
what is the fate of an infarction
can be fatal
re perfusion injury
diff tissues have diff susceptibility
what is an MI
death myocardial tissue caused by ischaemia
persistent ischaema - death myocytes
most due to thrombus over atherosclerotic plaque
what is ischeamia
reduction or cessation of blood flow
is ischaemia reveille
initially stable engine but if persist - death of myocytes
what are some complications assc with MI
atthythmias cariogenic shock caria rupture ventricular septal defects heart fail
what is re-perfusion injury
result in injury to cells not prev afffetsd
what is re-perfusion injury due to
due to toxic oxygen sp that over prod on restoration of blood supply
