Systemic effect of Cardiovascular disease

Question 1

define cardiac failure

Answer 1

failure of heart to pump sufficient blood to satisfy metabolic demands

Question 2

what does cardiac failure result in?

Answer 2

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

Question 3

what are the features of acute cardiac failure?

Answer 3

rapid onset of symptoms, no time to compensate

MI

Question 4

what are the features if chronic heart failure?

Answer 4

slow onset, allows time to initiate compensatory mechanisms
can acutely deteriorate
ischaemic or valvular heart disease

Question 5

describe main features of systolic cardiac failure

Answer 5

• 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

Question 6

describe the main features of diastolic cardiac failure

Answer 6

-failure of wall to relax
-scarring and infiltrative disease
may have oedema and arrhythmias

Question 7

how does bi-ventricular hypertrophy occur?

Answer 7

• as a result of LV failure, RV pumping against back flow of blood into LV working harder against a greater pressure
• systemic hypertension

Question 8

what causes L and R ventricular failure?

Answer 8

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

Question 9

what are the consequences of L ventricular failure?

Answer 9

• dilated vessels
• frothy fluid in lung
• oedema filling airspaces in lung and in bronchi

Question 10

how would a patient with L ventricular failure present?

Answer 10

short of breath, even more when they lie flat orthopnoea

Question 11

what are the consequences of R ventricular failure?

Answer 11

-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

Question 12

what should you look for at the external jugular vein?

Answer 12

can be dilated

elevated JVP= R side failure

Question 13

describe forward failure

Answer 13

reduced perfusion to tissues

Question 14

describe backward failure

Answer 14

R failure

fluid retention and tissue congestion

Question 15

what is pulmonary hypertension?

Answer 15

raised pressure in lung circulation

can get atherosclerosis in pulmonary arteries

Question 16

how does systemic hypertension differ from pulmonary/

Answer 16

much greater pressures than pulmonary circulation

Question 17

describe the features of systemic hypertension

Answer 17

-secondary hypertension is common (as result of another cause)
increases risk of: cardiovascular disease, ischaemic disease and it accelerates atherosclerosis

Question 18

what is secondary hypertension usually caused by?

Answer 18

renal disease
endocrine disease
narrowing of aorta- pressure to some areas low and others high

Question 19

what is the end organ effect of primary hypertension?

Answer 19

slow changes in vessels
increased risk of: atherosclerosis and LV hypertrophy
blood vessels: brain, heart, kidney, eyes

Question 20

what are the end organ effects of malignant hypertension?

Answer 20

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

Question 21

what is the effect of systemic hypertension on the kidney?

Answer 21

nephrosclerosis: protein uria, haematouria, drop out of nephrons due to vascular narrowing
chronic renal failure- can lead to hypertension

Question 22

what is the effect of systemic hypertension on the brain?

Answer 22

atherosclerosis
ischaemia, transient ischaemic attack (TIA)
infarct
haemorrhage: sub-arachnoid or intracerebrel

Question 23

what is the effect of systemic hypertension on the eyes?

Answer 23

narrowing of vessels in eyes by protein exudates
oedema
haemorrhage

Question 24

what are the ed effects of pulmonary hypertension?

Answer 24

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

Question 25

what is the end organ effect of pulmonary hypertension?

Answer 25

heart = cor pulmonale

pulmonary arteries