Systemic effect of Cardiovascular disease Flashcards
define cardiac failure
failure of heart to pump sufficient blood to satisfy metabolic demands
what does cardiac failure result in?
under perfusion: primary arterial problem- not getting blood in in time
primary venous problem- not getting blood back
causes fluid retention and increased blood volume
what are the features of acute cardiac failure?
rapid onset of symptoms, no time to compensate
MI
what are the features if chronic heart failure?
slow onset, allows time to initiate compensatory mechanisms
can acutely deteriorate
ischaemic or valvular heart disease
describe main features of systolic cardiac failure
- reduced ejection fraction due to blood retention in LV
- ventricular circulation may be reduced or aortic stenosis
- causes: MI, ischaemia, infective myocarditis or deuchans muscular dystrophy
- reduced CO, leads to pulmonary oedema due to increased back pressure in atria and R side of heart
describe the main features of diastolic cardiac failure
-failure of wall to relax
-scarring and infiltrative disease
may have oedema and arrhythmias
how does bi-ventricular hypertrophy occur?
- as a result of LV failure, RV pumping against back flow of blood into LV working harder against a greater pressure
- systemic hypertension
what causes L and R ventricular failure?
Coronary heart disease-abnormal flow, abnormal coagulation of blood, causes chronic due to lack of O2, systolic since it affects pump function
hypertension- increased workload
cardiomyopathies
drugs- b blockers, calcium antagonists, antidysrhythmics
toxins
nutritional
infiltrative
what are the consequences of L ventricular failure?
- dilated vessels
- frothy fluid in lung
- oedema filling airspaces in lung and in bronchi
how would a patient with L ventricular failure present?
short of breath, even more when they lie flat orthopnoea
what are the consequences of R ventricular failure?
-getting blood to head is difficult
-fluid accumulates in veins then leaves because o high pressure causing ankle/ foot oedema
liver will get dilated vessels since blood is stuck there congested large and tender liver
what should you look for at the external jugular vein?
can be dilated
elevated JVP= R side failure
describe forward failure
reduced perfusion to tissues
describe backward failure
R failure
fluid retention and tissue congestion
what is pulmonary hypertension?
raised pressure in lung circulation
can get atherosclerosis in pulmonary arteries
how does systemic hypertension differ from pulmonary/
much greater pressures than pulmonary circulation
describe the features of systemic hypertension
-secondary hypertension is common (as result of another cause)
increases risk of: cardiovascular disease, ischaemic disease and it accelerates atherosclerosis
what is secondary hypertension usually caused by?
renal disease
endocrine disease
narrowing of aorta- pressure to some areas low and others high
what is the end organ effect of primary hypertension?
slow changes in vessels
increased risk of: atherosclerosis and LV hypertrophy
blood vessels: brain, heart, kidney, eyes
what are the end organ effects of malignant hypertension?
rapid changes in blood pressure
can blow vessels in brain or in kidney
fibrinoid necrosis of kidney vessels can precede dislodging of lumen wall of vessels
what is the effect of systemic hypertension on the kidney?
nephrosclerosis: protein uria, haematouria, drop out of nephrons due to vascular narrowing
chronic renal failure- can lead to hypertension
what is the effect of systemic hypertension on the brain?
atherosclerosis
ischaemia, transient ischaemic attack (TIA)
infarct
haemorrhage: sub-arachnoid or intracerebrel
what is the effect of systemic hypertension on the eyes?
narrowing of vessels in eyes by protein exudates
oedema
haemorrhage
what are the ed effects of pulmonary hypertension?
pulmonary vascular resistance leading to increased pressure
problem in lung due to fever channels leading to COPD
left and right shunts in kidney by raising pressure
what is the end organ effect of pulmonary hypertension?
heart = cor pulmonale
pulmonary arteries
