Unit 4: Cardiovascular Flashcards
Edema
Abnormal accumulation of interstitial fluid due to force imbalances.
Increased vascular permeability, change in oncotic pressure, or lymphatic obstruction
Exudate
Fluid with higher protein and cell content. Usually results from increased vascular permeability
Inflammatory
Transudate
Lower protein and cell content. Usually a result of changes in pressure.
Hypervolemic
Hydrostatic
Oncotic
Right ventricular congestive heart failure
Congestion of peripheral organs and extremities
Increased hydrostatic pressure, fluid overload
Peripheral edema (pitting, painless)
Enlarged liver
Ascites
Left ventricular congestive heart failure
Transudation into alveoli Pulmonary congestion and edema Pleural effusion (dyspnea)
Renal edema
Often caused by nephrotic syndrome
Decreased plasma oncotic pressure
Diffuse generalized edema
Ascites
Periorbital
Virchow’s Triad
Three broad categories of factors that lead to thrombosis:
- hypercoagulability
- hemodynamic changes (stasis, turbulence)
- endothelial insult, injury
Thrombi
solid mass of blood cells and fibrin attached to the vessel wall
Occur when there is an interaction of coagulation proteins, endothelial cells and platelets
Fate of thrombi
- lysis and repurfusion
- organization
- recanalization
- embolism
Infarct
Localized tissue death, often resulting from ischemia
Thrombophlebitis
Blood clot in a vein with inflammation
Usually extremities
Sx: red and swollen limb
Thrombophlebitis: risk factors
immobilization trauma congestive heart failure respiratory failure obesity pregnancy recent childbirh CA, cancer therapy
Embolism
Freely movable intravascular mass
Embolism: categories
Classified by origin
Arterial Pulmonary Thrombo Gas Fat Tumor
Atrial Septal defects
Congenital
Often asymptomatic, but may lead to thrombosis/CVA
Usually failure of foramen ovale to close
Ventricular Septal defect
Congenital
Most common congenital heart defect
Defect in septum between left and right ventricle
Pulmonary hypertension
Heart murmur
Cyanosis
Right sided heart failure
VSD pathogenesis
Greater left ventricle pressure causes left-to-right shunt
Now right ventricle has to work harder –> right ventricle hypertrophy –> increased blood flow to pulmonary arteries–> pulmonary hypertension
Narrowing of pulmonary artery –> increased right side pressure —> right-to-left shunt
BUT the blood going to the left ventricle is deoxygenated –> cyanosis
Teratology of Fallot
Congenital heart defects
Pulmonary valvular stenosis
Ventricular septal defect
Dextroposition of the aorta
Hypertrophy of right ventricle
Presents with heart murmurs and cyanosis shortly after birh
Patent ductus arteriosis
Ductus arteriosis between pulmonary artery and aorta fails to close after birth
Coarctation of the aorta
Congenital narrowing of the aorta
Can lead to hypertension
Rheumatic fever
Systemic autoimmune disease which occurs a few weeks after strep throat; antibodies damage heart tissue in 10% of cases
Rheumatic fever: Sx
Carditis Acute migratory joint pain Heart murmurs Skin manifestations (erythema marginatum or subQ nodules) Chorea
Pancarditis
Inflammation of cardiac tissue; can result from rheumatic fever, TB
Includes: endo, myo, and pericarditis
Pericarditis
Inflammation of peri and epicardium
Can result from rheumatic fever, TB, viral infection
Can become chronic/constrictive
Sx can include chest pain, fever, joint pain, dyspnea, dysphagia
Endocarditis
Inflammation of the endocardium
Can result from rheumatic fever, IV drug users, septicemia, damaged heart valves which invite bacterial infecton
May lead to destruction of heart valves
Variably (but usually poor) prognosis
Myocarditis
Uncommon inflammation of muscular walls of the heart
Usually viral, parasitic. May also result from SLE, drugs, sarcoidosis
Usually results in dilated myopathy; may also cause ventricular arrhythmias
Mitral regurgitation
Incompetency of the mitral (bicuspid) valve
Backflow from left ventricle to left atrium
Often a sign of left heart failure
Mitral Stenosis
Narrowing of mitral valve
Impeded blood flow from left atrium to left ventricle
Often a sign of left heart failure
Mitral Valve prolapse
Most common heart valve abnormality
Thicker, weaker mitral valve
Usually benign but can increase mortality 15-20%
Palpations, chest pain, dypnea
Aortic regurgitation
incompetency of aortic valve
Backflow from aorta to left atrium
Sign of left heart failure
Aortic stenosis
Narrowing of aortic valve, obstructing blood flow from left ventricle to aorta
Angina, dyspnea, heart failure, palpation a, heart murmur
Symptoms of pulmonary and tricuspid valve pathology
Same as for right sided heart failure
Peripheral Edema
Ischemic heart disease
Inadequate O2 supply to the myocardium
Can be asymptomatic, or cause angina, dyspnea, fatigue, palpitations, congestive heart failure
Most common cause of ischemic heart disease
Atherosclerosis
Ischemic heart disease: pathogenesis
Either slow progressive narrowing of the arteries or sudden occlusion
Stable angina pectoris
Ischemia heart disease
Discomfort with exertion, relieved with rest and/or nitroglycerin.
Rarely associated with infarction
Unstable angina
Occurs early in morning
Unrelated to activity
Rapid narrowing coronary artery
Not associated with infarction
