PVD & Dissection Flashcards
What effect does increase peripheral vascular resistance have on the heart
Increases the afterload = increase how much the heart has to work / pump against
What factors increase SVR
Atherosclerosis
HTN
Blood Viscosity
vasoconstriction / dilation
What is normal systolic BP
120mmHg
Where are baroreceptors located
carotids
aorta
What is elevated systolic BP
120-129mmHg
What is stage 1 HTN systolic BP
130-139mmHg
What is stage 2 HTN systolic BP
> 140mmHg
What is stage 1 HTN diastolic pressure
80-89mmHg
What is stage 2 HTN diastolic pressure
> 90mmHg
How does the body balance out blood pressure
baroreceptors and feedback info from those receptors
What do the baroreceptors stimulate with increased BP
Increase vagal stimulation which will cause the release of acetylcholine
What receptors are stimulated on the SA and AV nodes when acetylcholine is released
M2 = decrease HR, decrease CO and decrease BP
What will be inhibited during times of HTN to decrease the production of catecholamine
adrenal medulla
What happens in the kidneys during times of HTN
Pressure will increase within the glomerular filtration which will increase Na+/H2O secretion = decrease BP
What is the most common type of hypertension
essential
What factors increase HTN
sympathetic activation = B1 activation with increase HR = Increase CO = Increase BP
Why does Nicotine cause HTN
Nicotine causes release of catecholamines
Why does obstructive sleep apnea cause HTN
hypoxemia and hypercarbia cause catecholamine release
What are hypertensive vasculopathies
vascular remodeling
endothelial dysfunction
inflammation
What is malignant hypertension
bp>180/110
What is hypertensive emergency indicative of
acute end organ damage secondary to elevated BP
What is a hypertensive urgency
Stable end organ disease
What type of hypertension has no end organ damage but has highly elevated BP
Severe uncontrolled HTN
What are some downstream effects of chronic HTN
Ischemic heart diease
AKI/CKD
Encephalopathy
Hypertensive retinopathy
atherosclerosis
SAH/Ruptured aneurysm/lacunar infart
Where does a dissection occur in the aorta
Separation of tunica intima and media allowing for an accumulation of blood
What are dissections most commonly associated with
HTN
Smoking
advanced age
hyperlipidemia
What causes an aortic dissection
a supply/demand mismatch= stiffening of vascular wall = increase stress & decrease compliance, increase risk of endothelial damage = increased risk of dissection
What are some risks for dissection
CT disorders
bicuspid aortic valve
coarctation of aorta
What kind of trauma can cause an aortic dissection
acceleration/deceleration injuries
How will an aortic dissection present
abrupt onset of chest /abdominal pain described as tearing
widened mediastinum
pulse/ BP difference in extremities
What vessel layers are effected by an aortic aneurysm
all layers
What are the causes of aortic aneurysms
CT disorders
Trauma
Aortits
**atherosclerosis
What is a ruptured AAA presentation
abdominal / back pain
hypotension
pulsatile abdominal mass
What can chronic venous disease lead to
varicose veins
What pressure is considered critical in compartment syndrome
10-30mmHg
What is ABI
ankle brachial index
*take BP in both places and compare to determine the severity of PVD
ankle BP/Brachial BP
What might a patient with critical PVD present with
persistent claudication
gangrene
skin breakdown
What is the initial treatment of claudication
walking program
**allows for angiogenesis
