quiz #4 - cardiovascular Flashcards
angina pectoris
chest pain caused by reduced blood supply to heart, can also be symptom of coronary artery disease (CAD)
stable angina
-most prevalent
-predictable pattern
-triggered by emotional stress, cold temperatures or physical exertion
-resolves with rest or nitroglycerin
unstable angina
-may signal imminent heart attack
-not in a predictable pattern
-not triggered by above
-prolonged pain at rest
-does not resolve with rest or nitroglycerin
variable angina
-coronary artery spasm narrows lumen
-reduces blood supply to heart muscle
-pain reduced by medication
myocardial ischemia
-blood flow to heart reduced causing mm myocardial tissue to be depleted of oxygen
-usually due to partial/ complete blockage of artery
-heart unable to pump blood may lead to abnormal heart rhythms/ myocardial infarction/ heart attack
*most common cause of angina
arrhythmias / dysrhythmias
dysfunction of heart’s conduction system creating abnormal heartbeat or rhythm
too fast - arrhythmias
over 100 = tachycardia
too slow - arrhythmias
under 50 = bradycardia
normal - arrhythmias
50-100 beats per minutes
what does an abnormal heart rate do?
reduces the heart’s efficiency and it’s pumping capability
arrhythmia
variation in normal rhythm
dysrhythmia
abnormal disturbed rhythm
pacemaker
small device placed in chest under skin to help control abnormal heart rhythms
uses electrical impulses to stimulate heart to beat at normal rate
congestive heart failure
inability of heart to pump blood to meet body’s demands
blood backs up & congests ventricles of the heart (60% of time it is on the LEFT side of heart) or lungs
left-sided heart failure (left ventricle can’t pump out to aorta): clinical features
congestion in lungs, pulmonary congestion & edema, shortness of breath, coughing (may produce foamy, frothy pink-tinged sputum), awaking in panic gasping for air, fatigue, exercise intolerance, cold intolerance, dizziness and tachycardia
right-sided heart failure (right ventricle can’t pump out to the lungs): clinical features
congestion in liver (liver enlarges-hepatomegaly), GI tract & lower extremities
-heart may enlarge-cardiomyopathy, venous congestion & distension in jugular vein, abdominal ascites
-spleen may enlarge-splenomegaly, may also progress to renal failure
rheumatic fever
-rare inflammatory condition, develops after untreated streptococcal throat infection (usually group A)
-may cause autoimmune reaction that can cause damage to heart, joints, CNS or skin -mostly in children 5-15 yrs & only in susceptible people
rheumatic heart disease
after rheumatic fever infection (strep throat), infection can manifest in all three layers of heart (endocarditis, myocarditis, pericarditis)
-endocarditis may lead to valve damage = vegetations
cardiomyopathy
disease of heart muscle that changes in myocardium, associated with inadequate heart pumping - ay lead to heart failure
-3 types: dilated, hypertrophic, restricted
dilated (cardiomyopathy)
dilated left ventricle, decreases heart’s contractility so blood is pumped less forcefully, predisposes to thrombi & emboli
hypertrophic (cardiomyopathy)
thickening of left ventricle, interferes with heart’s ability to expand & fill up before contraction
restricted (cardiomyopathy)
myocardium becomes rigid & less elastic, also interferes with heart’s ability to expand & fill up before contraction
cor pulmonale
right ventricle becomes enlarged & eventually dysfunctional due to pulmonary artery hypertension
-causes right ventricular failure, usually chronic
endocarditis (infective endocarditis)
infection & then inflammation of interior lining of heart (endocardium) from bacterial infection
myocarditis
-inflammation of heart mm/ myocardium caused by infection of viruses/ parasites, related to cardiomyopathy
-may affect myocardium & heart’s conduction system
pericarditis
-inflammation of pericardium surrounding heart
-causes a fluid build up in pericardial space which can compress heart
-pericardial layers may become adhesed, impairs function
mitral stenosis
(bicuspid (mitral) valve stenosis)
narrowing of bicuspid valve, causing abnormal opening & blocking blood flow from left atrium to left ventricle
aortic stenosis
narrowing of aortic valve, preventing valve from opening, fully reducing or blocking blood flow into aorta & onward to rest of body
myocardial infarction - heart attack
heart attack, death of myocardial tissue from interrupted blood supply causing ischemia & hypoxia, tissue dies in 20 min &
does not regenerate, infarcted tissue
what 3 things cause coronary artery blockages which disrupt the heart’s blood supply?
- thrombus buildup from atherosclerosis
- thromboemboli
- vasospasm (often from drugs)
cardiac arrest
heart stops, stops all cardiac output, stops blood pumping through circulation depriving body tissues of oxygen & allowing waste products to build up
cardiovascular pathologies - thrombosis
-formation of blood clot in arterial wall
-clot made of blood cells in a fibrin network
three factors cause thrombosis: known as “Virchow’s Triad”
- endothelial cell injury
- blood stasis
- hypercoaguability of blood
cardiovascular pathologies Embolism
embolus may be any floating matter in bloodstream, if it occludes/ blocks a vessel = embolism
may be venous or arterial depending on where embolus is flowing
arteriosclerosis
“hardening” of smaller arteries, process of deposits on inside lining of arteries that causes walls of artery to thicken & lose elasticity
atherosclerosis
type of arteriosclerosis, made of fatty plaques that form on inside of middle to large size arteries
4 named localized forms of atherosclerosis
-coronary artery disease
-cerebrovascular disease
-atherosclerosis of the aorta (causing aortic aneurysm)
-peripheral artery disease
coronary artery disease
-atherosclerosis in coronary arteries
-plaque deposits that forms fatty streak which narrows lumen & reduces blood flow to myocardium
-fatty streak made of lipids, cholesterol, other cells
coronary bypass
surgeons use healthy vein from leg, an artery in chest or artery in wrist to bypass occluded vessel in heart
peripheral arterial disease (PAD)
-atherosclerosis of peripheral artery causing narrowed lumen & reduced blood supply
-usually affects arteries of legs & feet
hypertension (high blood pressure)
“silent killer”: asymptomatic until severe
-persistently high BP, very common
-normal BP is 120/80, if over 140 = hypertension
primary hypertension
90 % of cases, not linked to underlying disease
secondary hypertension
5-10 % of cases, results of coexisting disease (sleep apnea, kidney, thyroid, medications, drugs)
malignant hypertension
severe, uncontrollable, rapidly progressing
hypotension (low blood pressure)
low BP, usually asymptomatic, below 90/60 is = low
aneurysm
blood vessel wall weakness forms pouch outward enlarging artery
-also creating thrombus formation & later embolus
*most common = abdominal aortic aneurysm
2 types of aneurysm’s
TRUE: weakness & damage involves all 3 arterial layers
FALSE: tear in artery, blood collects just outside wall but remains in surrounding tissues
thoracic aneurysm
may cause difficulty swallowing (dysphagia) or difficulty breathing (dyspnea)
abdominal aneurysm
may result in abdominal or back pain with palpable pulsing mass in abdomen
cerebral aneurysm
may cause headaches or a stroke
cerebrovascular accident - CVA or stroke
disruption of blood flow into cerebrum or brain, causing infarction of brain tissue within minutes
20% of all CVA’s die within 2 days, other 80% have variable complications from mild to severe
ischemic - cerebrovascular accident
80% of all, artery is occluded by a thrombus or embolus (atherosclerosis)
*common cause: atherosclerosis
hemorrhagic - cerebrovascular accident
20% of all, artery ruptured & is bleeding directly into brain tissue, blood liquefies brain tissue on contact leaving behind mushy filled cavity of dead brain tissue
-involves larger area of brain & more severe
*common cause: hypertension/ cerebral aneurysm
orthostatic hypotension or postural hypotension
form of low BP/ sudden drop in BP
-causing lightheadedness & loss of balance
-from sitting up/ standing up after laying down for long time, systolic BP drops by 20 & diastolic BP drops by 10
acute - orthostatic hypotension or postural hypotension
slow reaction time for regulatory mechanisms that compensate in postural changes, common with elderly & causes falls
chronic - orthostatic hypotension or postural hypotension
may be related to underlying disease like Diabetes, Parkinson’s or Addison’s Disease
raynaud disease/ syndrome/ phenomenon
arterial vasospasms in superficial tissues of fingers & toes, (may also affect tip of nose, ears, parts of cheek& tongue)
-they are periodic & temporary
thromboangiitis obliterans (TAO) or Buerger’s disease
rare pathology, inflammation of small to medium sized arteries in extremities, sometimes include nearby veins & nerves causing them to swell
-damages skin tissues
cardiovascular pathologies - blood Vessel pathologies - venous (3 types)
-phlebitis
-thrombophlebitis (deep vein thrombosis, thromboembolic disease, venous thrombosis)
-varicose Veins
phlebitis
inflammation of a vein, usually in extremities, but could be anywhere
thrombophlebitis (DVT)
inflammation of vein with formation of a thrombus that restricts blood flow, can be in superficial or deep veins
3 causes of DVT
- venous stasis
- vessel wall injury
- hypercaogulable blood
varicose veins
-veins dilated & twisted because of damaged walls & incompetent valves
-usually irreversible, causes varicosities to form where blood flow is slow & turbulent
-affect superficial / deep veins
-spider veins = superficial varicose veins
-most often in lower extremities, may also form in esophagus & rectum
