Lecture 7: Cardiovascular System Flashcards
What is the function of the cardiovascular system?
To maintain an adequate supply of blood to all the tissues of the body
How does the cardiovascular system work?
Through the rhythmic contractions of the heart
What is heart rate controlled by?
Autonomic nervous system
What are congenital heart diseases?
- Left to Right shunt
- Tetrology of fallot
- Coarction of the aorta
What are left to right shunts?
The most common congenital cardiac lesions that permit mixing of blood in systemic and pulmonary circulation
What happens when patients have left to right shunts?
The lungs become overlaoded with blood because they move from a high pressure circulation to low pressure pulmonary ciculation
What re the 3 types of left to right shunts?
- Atrial septal defects
- Ventricular septal defects
- Patent ductus arteriosus
What is atrial septal defect?
The most common left to right shunt disorder that is characterized by a hole in the wall that separates the upper chambers of the heart
What does ASD cause?
Allows for abnormal blood flow between the two atria, which mixes oxygenated and deoxygenated blood
What is ventricular septal defect?
A hole in the heart that is present at birth between the lower chambers of the heart (left/right ventricle)
What does a VSD cause?
Causes oxygen-rich blood to move back into the lungs instead of being pumped to the rest of the body
What is patent ductus arteriousus?
A persistance of fetal ductus arteriosus
What is tetrology of fallout?
The most common cause of cyanotic congenital heart disease that impacts the flow of blood through the heart
What is Tetrology of fallot characterized by?
Four specific defects including VSD with pulmonary stenosis, with the aorta overriding the VSD and with RV Hypertrophy
How does tetrology of fallot show on an x-ray?
Heart is boot shaped due to RVH
What does the obstruction of blood flow from Tetrology of Fallot lead to?
Blood being diverted through the VSD to the aorta, reducing flow in the lung circulation and causing the child to appear blue (cyanosed)
What is coarction of the aorta?
The narrowing or constriction of the aorta
Where does coarction of the aorta most commonly occur?
Just beyond the branching of the blood vessels to the head and arms
What is a classic sign of coarction of the aorta?
Normal blood pressure in the arms but very low pressure in the legs
What is coarction of the aorta the most frequent cause of in children?
Hypertension
What are the treatment options of coarction of the aorta?
Surgery or catheterization to repair the narrowing and restore normal blood flow
What modality best diagnosis coarction of aorta?
MRI
What are Acquired Vascular diseases?
- Coronary artery disease
- Congestive heart failure
- Pulmonary edma
- Hypertension
- Hypertensive heart disease
- Aneurysm
- Traumatic aortic rupture
- Aortic dissection
- Atherosclerosis
- Thrombos and Embolism
What is coronary artery disease?
Narrowing of the lumen of one or more of the coronary arteries that results in oxygen deprivation of the myocardio and ischemic heart disease
What is the most common cause of coronary artery disease?
Athersclorosis which is the deposit of fatty material on the inner arterial wall
What are predisposing factors to coronary artery disease?
Hypertension, obesity, smoking, high cholesterol diet, lack of exercise
What is congestive heart failure?
The inability of the heart to propel blood at a rate and volume sufficient to provide adequate supply to the tissues
What are the causes of congestive heart failure?
- Intrinsic cardiac abnormality
- Hypertension
- Any obstructive process that increases peripheral resistance to bloodflow
What are the signs of congestive heart failure?
- Enlarged heart
- Edema in the legs and feet
- Excess fluid around the lungs and shortness of breath
What is pulmonary edema?
An abnormal accumulation of fluid in the extravascular pulmonary tissue
What is another term for pulmonary edema?
Wet lung
What are the most common causes of pulmonary edema?
An elevation of the pulmonary venous pressure due to left sided heart failure or obstruction
What are other causes of pulmonary edema?
Uremia, narcotic overdose, exposure to noxious fumes, high altitudes, ARDS
What are symtoms of pulmonary edema?
Pain in chest, shortness of breath and water retention
What is hypertension?
High blood pressure, which is the leading cause of strokes and CHF
What is hypertensive heart disease?
Long standing high blood pressure that causes narrowing of systemic blood vessels and increased resistance to blood flow
Which part of the heart is primarily affected by hypertensive heart disease?
Left ventricle since its forces to increase its workload and causes hypertropy (double thickness of normal wall)
What is an aneurysm?
A localized dilation of an artery that mostly involves the aorta
What are the two types of aneurysms?
Saccular and fusiform
What is a saccular aneurysm?
Involves only one side of the arterial wall
What is a fusiform aneurysm?
Is a bulging of the entire circumference of the vessel wall
What are aneurysm treatments?
Open repair, stenting, coiling and clipping
What is traumatic aortic rupture?
A potentially fatal complication of closed chest trauma such as rapid deceleration, blast or compression
What happens in a traumatic aortic rupture?
Usually the aortic tear occurs distal to the left subclavian artery at the site of the ductus arteriosis
What is an aortic dissection?
A potentially life-threatening condition in which disruption of the intima permits blood to enter the wall of the aorta and separate its layers
What does an aortic dissection create?
True and false lumen in the aorta
What patients are aortic disection most common in?
Patients with arterial hypertension
What are other causes of aortic dissection?
Trauma and congenital defects like Marfan syndrome
What is the term used to distinguish location and types of aortic dissection?
Stanfor DeBakey
What is artherosclerosis?
A condition where the arteries become narrowed and hardened due to the buildup of plaque in the artery wall
What is artherosclerosis characterized by?
Thickening, hardning and loss of elasticiy in the arterial walls
What is artherosclerosis the major cause of?
Vascular diseases
What is a thrombus?
An intravascular clot
What causes a thrombus?
Stasis, endothelium injury or inflammation, blood changes
What is an embolism?
Part or all of a thrombus that becomes detached from the vessel wall and enters the bloodstream
What are types of emboli?
Fat, Septic and air
What is an acute embolic occulsion?
A thrombus that becomes detached from the lt atrium in cardiac arrhythmia
What is a thromboembolism?
Blood clot breaks loose and causes an embolus
What is atheroembolism?
Cholesterol crystals break loose and enter circulation
What are valvular diseases?
- Rheumatic heart disease
- Mitral stenosis
- mitral valve insufficiency
- Aortic stenosis
- aortic insufficiency
- inefective endocarditis
- Pericardial effusion
What is rheumatic heart disease?
A group of heart disorders caused by rheumatic fever, which can damage the heart valves
When does rheumatic heart disease normall occur?
10-20 years after the initial illness
What is rheumatic fever?
An autoimmune disease that results from a reaction of the patient’s antibodies against antigens from a previous strep infection
What heart valves are damaged the most from rheumatic heart disease?
Damage to the mitral and aortic valves
What type of damage to the valves does rheumatic fever cause?
Stenosis - open too narrowly
Insufficient - does not close completely
What is miral stenosis?
A valvular heart disease characterized by the narrowing of the opening of the mitral valve
What does mitral stenosis cause?
Obstruction of blood flow from leaving the left atrium and passing into the left ventricle during diastole causing enlargement of this chamber
What is mitral valve insufficency?
An insufficient closing of the mitral valve that causes regurgitation of blood into the left atrium during systole causing overfilling
What does mitral valve insufficency lead to?
A decrease in ventricular stroke volume and cardiac output
What is aortic stenosis?
Stenosis of the aorta specifically, that causes obstruction to the left ventricle
What are the causes of aortic stenosis?
Rheumatic heart disease, congenital valvular deformity or degenerative process of aging
What is aortic insufficiency?
Reflux of blood from the aorta during diastole that cause volume overloading the left ventricle
What are the causes of aortic insufficency?
Rheumatic heart disease, syphillis, infective endocarditis, dissecting aneurysm or marfan syndrome
What is infective endocarditis?
The development of nodules on heart valves caused by deposits of bacteria or fungi
What are the issues with the nodules that are formed in infective endocarditis?
They are filled with bacteria and can break apart easily and form septic emboli
What is pericardial effusion?
The accumulation of fluid within the pericardial space surrounding the heart that interferes with cardiac function
What does pericardial effusion result from?
Bacteria, viruses, neoplastic involvement or idiopathic pericardial effusion
What is deep vein thrombosis?
A condition where a blood clot forms in a deep vein, usually in the leg
What are the precipitating factors of DVT?
Trauma, bacterial infection, prolonged bed rest and oral contraceptives
What is DVT the earliest symptom of?
Unsuspected malignancy of the pancreas, lung or gastrointestinal system
What are varicose veins?
Dilated, elongate and torturous vessels that most commonly involve superficial veins of the leg
