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Pathophysiology > M5: Cardiovascular System > Flashcards

M5: Cardiovascular System Flashcards

1
Q

Hardening of Large & Medium Arteries

A

Atherosclerosis

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2
Q

Hardening of Small Arteries

A

Arteriolosclerosis

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3
Q

Inflammation of Any Artery

A

Arteritis

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4
Q

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

A
  1. Endothelial Injury & Activation
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5
Q

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

A
  1. Endothelial Inflammation
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6
Q

What Pathogenesis of Atherosclerosis?
Fatty Streak Formation

A
  1. Accumulation of Lipoproteins
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7
Q

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

A
  1. Proliferation & Fibrosis
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8
Q

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

A
  1. Complicated plaque formation
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9
Q

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”)

A

Atherosclerosis

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10
Q

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

A

HYPERTENSION

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11
Q

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)

A

Primary “Essential”ͬ Idiopathic
Hypertension

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12
Q

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

A

Secondary Hypertension

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13
Q

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)

A

Accelerated “Malignant” Hypertension

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14
Q

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.

A

Ischemia

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15
Q

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

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

A

Hypoxia

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16
Q

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.

A

Infarction

17
Q

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

A

Regional Ischemia

18
Q

Severe Hypotension/Aortic Aneurysm > Ischemia
of Entire Heart

A

Global Ischemia

19
Q

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

A

Ischemic Heart Disease

20
Q

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

A

ANGINA PECTORIS

21
Q

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

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

A

Stable Angina

22
Q

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

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

A

Variant/Prinzmetal Angina

23
Q

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

A

Unstable Angina “Pre-Infarction Angina”

24
Q

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

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

A

Silent Ischemia

25
Q

3 Medical Therapy (Maintenance) for Angina Pectoris

A

Anti-Anginal Therapy
Antiplatelet Therapy
Lipid-Lowering Therapy

26
Q

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.

A

Rheumatic Fever

27
Q

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.

A

Acute Rheumatic Fever

28
Q

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.

A

Chronic Rheumatic Heart Disease

29
Q

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

A

Shock

30
Q

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

A

Hypovolemic Shock

31
Q

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.

A

Cardiogenic shock

32
Q

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.

A

Distributive shock

33
Q

(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

A

Septic shock

34
Q

(Extracellular Fluid Shift > Systemic edema & Hypotension)

The immune system responds excessively to the allergen, releasing large amounts of chemicals like histamine.

A

Anaphylactic shock

35
Q

(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.

A

Neurogenic Shock

36
Q

(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

A

Progressive Stage

36
Q
  • Massive PE
  • Cardiac Tamponade
  • Tension Pneumothorax

Occurs when there is physical obstruction to blood flow, leading to inadequate circulation and organ perfusion.

A

Obstructive shock

36
Q

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

A

Non-Progressive Stage

37
Q

(>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.

A

Irreversible Stage

Pathophysiology (7 decks)

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