M5: Cardiovascular System Flashcards by LENNIE BELLE PORTENTO

Hardening of Large & Medium Arteries

Atherosclerosis

How well did you know this?

Not at all

Perfectly

Hardening of Small Arteries

Arteriolosclerosis

How well did you know this?

Not at all

Perfectly

Inflammation of Any Artery

Arteritis

How well did you know this?

Not at all

Perfectly

What Pathogenesis of Atherosclerosis?
(HTN/Smoking/DM/Turbulence/Toxins/Infection/Immune)

Endothelial Injury & Activation

How well did you know this?

Not at all

Perfectly

What Pathogenesis of Atherosclerosis?
(Macrophage & Smooth Muscle Migration)

Endothelial Inflammation

How well did you know this?

Not at all

Perfectly

What Pathogenesis of Atherosclerosis?
Fatty Streak Formation

Accumulation of Lipoproteins

How well did you know this?

Not at all

Perfectly

What Pathogenesis of Atherosclerosis?
(Conversion of Fatty Streak into a Mature Atheroma)

Proliferation & Fibrosis

How well did you know this?

Not at all

Perfectly

What Pathogenesis of Atherosclerosis?
(Thin Fibrous Cap > Rupture > Thrombus >
ACS, Acute Coronary Syndrome)

Complicated plaque formation

How well did you know this?

Not at all

Perfectly

A Progressive Chronic Inflammatory Disease of
the Blood Vessel Wall.

Characterized By Accumulation of:
1. Lipids (Cholesterol Esters & Cholesterol in Cells)
2. Fibrous Elements (Conn. Tissue Matrix/Collagen/Elastin) &
3. Local Inflammatory Response (Macrophages
engulf LDLs > “Foam Cells”)

Atherosclerosis

How well did you know this?

Not at all

Perfectly

Consistent Systolic of +140mmHg.
AND/OR
Consistent Diastolic of +90mmHg

HYPERTENSION

How well did you know this?

Not at all

Perfectly

95% causes of Hypertension: Likely multifactorial (not curable) HBP due to other conditions.

Risk factors for HT:
GENETICS/FamHx, High Cholesterol/Salt Diet, Diabetes/Obesity, Smoking/Alcohol, Stress, Age

c. Subtypes:
§ Isolated Diastolic HTN (Typically Older Men)
§ Isolated Systolic HTN (Eg. >160/<90)
* In Young Adults - (Due to Overactive Sympathetic ns > inc CO)
* In Older Adults - (Due to dec Arterial Compliance (Calcification/Fibrosis)

Primary “Essential”ͬ Idiopathic
Hypertension

How well did you know this?

Not at all

Perfectly

5% of causes of hypertension: cardio, renal, endocrine, neurologic, pre-eclampsia (10% of pregnancies).

Secondary Hypertension

How well did you know this?

Not at all

Perfectly

Rapid inc in BP (>200/120mmHg) Sufficient to
cause Vascular Damage:
- Retinopathy ʹ (Papilledema,
Hemorrhages, Bulging Discs)
- Brain ʹ (Mental Status Changes)
- Renal ʹ (Creatinine Rise)
- Rapid Organ Failure

Symptoms Include:
- Vision Disturbance (Papilledema/Retinal
Bleed)
- Headache, Drowsiness, Confusion
- Nausea, Vomiting

Management:
- Smoothly Reduce BP over 24 to 36 hours
to <150 / 90
** Excessive reduction may > Coronary /
Cerebral /Renal Ischemia)

Accelerated “Malignant” Hypertension

How well did you know this?

Not at all

Perfectly

A “FLOW” Limitation, Typically due to Coronary Artery Stenosis (Narrowing)

condition characterized by a restricted blood supply to a specific organ or tissue, resulting in a reduced supply of oxygen and nutrients.

Ischemia

How well did you know this?

Not at all

Perfectly

An oxygen limitation, Typically due to High-Altitude/Respiratory Insufficiency/etc.

condition where there is a deficiency of oxygen in the body tissues.

Hypoxia

How well did you know this?

Not at all

Perfectly

Irreversible Cell-DEATH, Typically
due to sustained Ischemia.

refers to the death of tissue or cells due to a lack of blood supply, typically caused by a blockage in the blood vessels.

Infarction

Local Atherosclerosis/Thrombosis > Ischemia
Confined to Specific Region of Heart

Regional Ischemia

Severe Hypotension/Aortic Aneurysm > Ischemia
of Entire Heart

Global Ischemia

is a condition where the blood flow to the heart muscle is reduced or blocked, usually due to the buildup of fatty deposits (atherosclerosis) in the coronary arteries.

Global Autonomic Symptoms:
- Tachycardia, Sweating, Nausea

Ischemic Heart Disease

chest pain or discomfort that occurs when the heart muscle doesn’t receive enough oxygen-rich blood.

Etiology:
- Decreased Myocardial Perfusion (relative to demand) due to Coronary Insufficiency

Causes:
- Atherosclerosis / Vasospasm / Embolism /
Ascending Aortic Dissection

ANGINA PECTORIS

Due to: Stable Atherosclerotic Coronary
Obstruction (No Plaque Disruption)

Presentation: Chest Pain on Physical Exertion,
which fades quickly with Rest (minutes)

Stable Angina

Due to: Coronary Vasospasm (May not be
Atheroma).

Presentation: Angina Unrelated to Activity
(Ie. At Rest)

Variant/Prinzmetal Angina

Due to: Unstable Atherosclerotic Plaque (+/-
Plaque Disruption & Thrombus).

Presentation: Prolonged Angina @ Rest
(Either New Onset /inc Severity/inc Frequency).
Red Flag that MI may be Imminent

Unstable Angina “Pre-Infarction Angina”

Due to: Ischemia masked by neuropathy (eg.
Diabetes/dec. B12/etc)

Presentation: Painless, but may have Nausea,
Vomiting, Diaphoresis + Abnormal ECG

Silent Ischemia

3 Medical Therapy (Maintenance) for Angina Pectoris

Anti-Anginal Therapy Antiplatelet Therapy Lipid-Lowering Therapy

Can lead to long-term damage to the heart valves, causing rheumatic heart disease. It is more common in children and can result in symptoms such as joint pain, fever, skin rash, and heart inflammation. Inflammatory reaction that may lead to long term heart damage. Delayed Autoimmune Complication of a GROUP A BETA HEMOLYTIC STREPTOCOCCI Tonsillo - Pharyngitis.

Rheumatic Fever

Jones Criteria Rules - Must Have: a. Evidence of Previous GABH-Strep (Strep. Pyogenes) Infection b. (2x Major Criteria) OR (1 Major + 2 Minor) (Evidence of Previous Strep Infection): a. Anti-Streptolysin-O Titre b. Anti-DNaseB Antibodies c. Positive Throat Swab Culture is an inflammatory condition that can occur after a group A streptococcal throat infection. can lead to lasting damage to the heart valves, resulting in rheumatic heart disease.

Acute Rheumatic Fever

Cardiac Murmurs (Typically L-Heart): - Mitral Stenosis (+/- Regurg) - Aortic Stenosis (+/- Regurg) - Mitral Stenosis The inflammation caused by rheumatic fever can lead to scarring and deformation of the heart valves, impairing their function.

Chronic Rheumatic Heart Disease

Inadequate Perfusion of Vital Organs (Heart/Brain/Kidneys). It is a critical medical condition in which there is insufficient blood flow to meet the body's demand for oxygen and nutrients. Body is overwhelmed, stressed and can't recover

Shock

Severe Dehydration - (Eg. Sweating, Vom/Dia, DKA & Diuresis, Seeping Burns) - Severe Blood Loss/Hemorrhage

Hypovolemic Shock

Heart Failure - (Eg. Acute MI, Valvular, Cardiomyopathy, Myocarditis) It is a critical condition in which the heart is unable to pump blood effectively, leading to inadequate circulation and organ perfusion.

Cardiogenic shock

Is a type of shock characterized by widespread dilation of the blood vessels, leading to inadequate blood flow to organs and tissues despite normal or increased blood volume. This type of shock is often associated with a sudden and significant decrease in peripheral vascular resistance.

Distributive shock

(Extracellular Fluid Shift > Hypotension > Shock) condition that occurs as a complication of a severe infection, often caused by bacteria. the body's response to the infection becomes dysregulated, leading to widespread inflammation and a systemic inflammatory response syndrome

Septic shock

(Extracellular Fluid Shift > Systemic edema & Hypotension) The immune system responds excessively to the allergen, releasing large amounts of chemicals like histamine.

Anaphylactic shock

(Sudden loss of Vasomotor Tone > Massive VenoDilation) There is a sudden loss of sympathetic nervous system activity. Characterized by organ tissue hypoperfusion due to disruption of normal sympathetic control over vascular tone.

Neurogenic Shock

(15-40% (750-2000mL) Blood Loss): - Unstable, Decompensating, Reversible. Signs of Decompensation: - Hypotension - Delayed CRT (dec Peripheral Perfusion) - Tachycardia - Organ Failure (Anuria, Confusion/ALOC, Heart Failure, Tachypnoea, Acidosis) - But Still Reversible with Treatment: a. Reverse Causative Agents + Volume Replacement; Otherwise, Fatal if Untreated

Progressive Stage

- Massive PE - Cardiac Tamponade - Tension Pneumothorax Occurs when there is physical obstruction to blood flow, leading to inadequate circulation and organ perfusion.

Obstructive shock

(<15% (<750mL) Blood Loss): - Stable & Reversible. - Signs of Compensated Hypovolemia: - Tachycardia - Oliguria (Low Urine Production)

Non-Progressive Stage

(>40% (>2000mL) Blood Loss): - Unstable, Irrecoverable Organ Failure. - Pt WILL Die - Treatment will delay death, but NO treatment will save patients life. Symptoms: - Multi-Organ Failure (Renal/Cardiac/Pulmonary/CNS) - Acidosis - Anuria. - Coma.

Irreversible Stage