Week 10: Cardiovascular Disorders Flashcards
What is congenital heart disease?
Abnormality of the heart that is present from birth
Different congenital heart anomolies result in two primary pathologic processes which are?
- Shunting of blood through abnormal pathways in heart or great vessels
- Obstruction to blood flow because of abnormal narrowing
What are some abnormalities that heart defects are commonly associated with during embryologic development?
Development of atrial septum
Development of the ventricular septum
Division of the main outflow tract (truncus arteriosus) into the pulmonic and aortic arteries
Development of the valves
What is the most common heart disorder in children?
Congenital heart disease
What are 3 attributions that congenital heart disease may be related to in childrem?
Maternal rubella during first trimester of pregnancy
Exposure to cardiac teratogens (exposure to harmful things like drugs, chemicals during pregnancy etc)
Genetic influences
Difference between cyanotic vs acyanotic congenital heart defects?
Cyanotic: Lowers amount of oxygen in blood
Acyanotic: Doesn’t lower amount of oxygen in blood
Acyanotic congenital defects include:
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Coarctation of the aorta
Pulmonary and aortic stenosis or atresia
Cyanotic congenital defects include:
Tetralogy of Fallot, Transposition of the great arteries
What is atrial septal defect?
Majority of atrial septal defects occur at the location of the foramen ovale
Long-term increase in pulmonary blood flow may eventually lead to pulmonary hypertension, right ventricular hypertrophy, and reversal to a right-to-left shunt
What is ventricular septal defect?
Most common congenital cardiac anomaly
Typically located in the membranous septum, near the bundle of HIS???
Increase in pulmonary blood flow can result in pulmonary hypertension, right ventricular hypertrophy, and reversal of the shunt
What is patent ductus arteriosus?
Conditions that cause low blood oxygen tension may contribute to continued patency
No clinical significance in early life
Continued patency identified by harsh, grinding systolic murmur or thrill
Results in pulmonary hypertension, and can lead to right-sided heart failure
What is coarctation of the aorta?
Narrowing or stricture of the aorta that impedes blood flow
Commonly located just distal to the left subclavian artery
Usually accompanied by systolic murmurs and ventricular hypertrophy
What is pulmonary stenosis or atresia?
Pulmonary atresia: blood must enter the lungs by traveling through a septal opening and/or a patent ductus arteriosus because valve to pulmonary arteries is shut
Pulmonary stenosis: usually due to abnormal fusion of the valvular cusps and can lead to right ventricular hypertrophy
What is aortic stenosis or atresia?
Aortic atresias are not compatible with survival because the aorta is closed off (i.e. no blood to myocardium or rest of body)
Aortic stenosis may involve the valvular cusps or the subvalvular fibrous ring and results in high left ventricular afterload with left ventricular hypertrophy
What are four defining features of tetralogy or fallot?
- Ventricular septal defect
- Aorta positioned above the ventricular septal opening (overriding aorta)
- Pulmonary stenosis that obstructs right ventricular outflow
- Right ventricular hypertrophy b/c of pulmonary stenosis
Aorta and pulmonary artery arise from where?
Aorta from right ventricle
Pulmonary artery from left ventricle
- Resulting in two separate non-communicating circulations
What is a commo factor among all types of shock?
HYPOperfusion and impaired ability of cells to use oxygen
What may inadequate cellular oxygenation result from?
- Decreased cardiac output
- Maldistribution of blood flow
- Reduced blood oxygen content
Impaired tissue oxygen results in what?
Cellular hypoxia
What are 3 things that cellular hypoxia may cause?
Anaerobic metabolism
Free radical production
Macrophage induction
Failure of microcirculation to ______ leads to activation of coagulation
autoregulate blood flow
What is the compensatory stage of shock?
homeostatic mechanisms are sufficient to maintain adequate tissue perfusion despite a decrease in cardiac output
SNS activation attempts to maintain blood pressure even though cardiac output has fallen
Progressive stage of shock is marked by what?
Hypotension and tissue hypoxia
What is refractory shock?
occurs when the person does not respond to medical interventions.
