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Pathophysiology > Week 3: Cardiovascular > Flashcards

Week 3: Cardiovascular Flashcards

1
Q

varicose veins

A

vein in which blood has pooled

distortion, leakage, increased intravascular hydrostatic pressure, and inflammation

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2
Q

varicose veins cause

A

incompetent valves, venous obstruction, muscle pump dysfunction, or combination

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3
Q

chronic venous insufficiency

A

persistent ambulatory lower extremity venous hypertension

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4
Q

chronic venous insufficieny treatment

A
  • weight loss
  • decrease time standing
  • leg elevation, compression stocking, and physical exercise
  • endovenous ablation or foam sclerotherapy
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5
Q

deep venous thrombosis

A

clot in large vein

obstruction of venous flow leading to increase in venous pressure

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6
Q

prevention of dvt

A
  • mobilization after surgery, illness, injury

- prophylactic low molecular weight heparin or direct thrombin inhibitors

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7
Q

treatment of dvt

A
  • low molecular weight heparin
  • direct thrombin inhibitors
  • aspirin therapy
  • catheter directed thrombolytic therapy
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8
Q

superior vena cava syndrome

A

progressive occlusion of the SVC that leads to venous distention in the upper extremeties and head

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9
Q

leading cause of SVC syndrome

A

nonsmall cell lung cancer, small cell lung cancer, lymphoma

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10
Q

SVC syndrome clinical symptoms

A
  • edema
  • venous distension of face neck trunk or upper extremities
  • cyanosis
  • dyspnea, dysphagia, hoarseness, stridor, cough, and chest pain
  • CNS changes
  • respiratory distress
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11
Q

SVC symdrome treatment

A

radiation & chemo

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12
Q

primary hypertension

A

genetic and environmental factors

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13
Q

secondary hypertension

A

caused by altered hemodynamics from an underlying disease

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14
Q

systolic hypertension

A

affects entire cardiovascular system

most sig. in causing target organ damage

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15
Q

hypertension increased risk for

A

myocardial infarction, kidney disease, and stroke

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16
Q

hypertension risk factors

A
  • Positive family history
  • Advancing age
  • Gender: female >70 years of age; male >55 years of age
  • Race: black
  • ↑Sodium (Na+) intake
  • Glucose intolerance (diabetes mellitus)/insulin resistance
  • Heavy alcohol use
  • Obesity
  • Cigarettes
  • ↓Potassium (K+), magnesium (Mg++), calcium (Ca++)
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17
Q

hypertension caused by

A

increases in cardiac output or total peripheral resistance

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18
Q

complicated hypertension

A

hypertrophy and hyperplasia with assoc. fibrosis of the tunica intima and media in a process called vascular remodeling

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19
Q

malignant hypertension

A

rapidly progressive hypertension
diastolic pressure is usually > 140 mmHg
can lead to encephalopathy

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20
Q

hypertension dx

A

Measurement of blood pressure on at least two separate occasions averaging two readings at least 2 minutes apart with the individual seated, the arm supported at heart level, after 5 minutes of rest, with no smoking or caffeine intake in the past 30 minutes

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21
Q

hypertension tx

A

Reducing or eliminating risk factors
Dietary approaches to stop hypertension (DASH)
Cessation of smoking
Exercise program that promotes endurance and relaxation

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22
Q

hypertension pharmacologic tx

A

ace inhibitors
arbs
calcium channel blockers
thiazide diuretics & antihypertensives

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23
Q

othostatic hypotension

A

Decrease in the systolic and diastolic blood pressures on standing by 20 mmHg or more and by 10 mmHg or more, respectively
Lack of normal blood pressure compensation in response to gravitational changes on the circulation, leading to pooling and vasodilation

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24
Q

othostatic hypotension clinical manifestation

A

fainting upon standing

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25
Q

othostatic hypotension tx

A

Liberalize salt intake, raise the head of the bed, wear thigh-high stockings, expand volume with mineralocorticoids, and administer vasoconstrictors (midodrine)

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26
Q

true anuerysm

A

Involvement of all three layers of the arterial wall
Fusiform aneurysms
Circumferential aneurysms

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27
Q

false aneurysms

A

Leak between a vascular graft and a natural artery

Saccular aneurysms

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28
Q

clinical manifestations of aneurysm

A

Heart: Include dysrhythmias, heart failure, and embolism of clots to the brain or other vital organs
Aorta: Is asymptomatic until it ruptures, then it becomes painful
Thoracic: Dysphagia (difficulty in swallowing) and dyspnea (breathlessness) are caused by the pressure
Abdomen: Flow to an extremity is impaired, causing ischemia

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29
Q

aneurysm tx

A

Maintenance of low blood volume and low blood pressure to decrease the mechanical forces
Smoking cessation
β-Drenergic blockage
Surgery

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30
Q

aortic dissection

A

Is a devastating complication that involves the aorta (ascending, arch, or descending); can disrupt the flow through the arterial branches
Is a surgical emergency

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31
Q

arterial thrombus formation

A

Activation of the coagulation cascade: caused by roughening of the tunica intima by atherosclerosis

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32
Q

arterial thrombus formation tx

A

Heparin, warfarin derivatives, thrombin inhibitors, or thrombolytic agents
Balloon-tipped catheter used to remove or compress an arterial thrombus
Various combinations of drug and catheter therapies sometimes concurrently used

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33
Q

embolism

A

Bolus of matter circulates in the bloodstream and then lodges, obstructing blood flow.

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34
Q

peripheral vascular disease

A

Occurs mainly in smokers
Is an inflammatory disease of the peripheral arteries
Digital, tibial, plantar, ulnar, and palmar arteries
Obliterates the small- and medium-sized arteries
Pain and tenderness develop in the affected part.
Sluggish blood flow, rubor, and cyanosis result

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35
Q

peripheral vascular disease tx

A

Smoking cessation

Vasodilators, sympathectomy, exercise, immunomodulation, spinal cord stimulation, bone marrow transplantation

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36
Q

artherosclerosis

A

Form of arteriosclerosis
Thickening and hardening caused by the accumulation of lipid-laden macrophages in the arterial wall
Plaque development
Process that occurs throughout the body
Leading cause of coronary artery and cerebrovascular disease

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37
Q

artherosclerosis tx

A

Focuses on reducing risk factors, removing the initial causes of vessel damage, and preventing lesion progression
Exercising, smoking cessation, and controlling hypertension and diabetes when appropriate while reducing LDL cholesterol levels by diet or medications or both

38
Q

peripheral artery disease

A

Atherosclerotic disease of arteries that perfuse limbs, especially lower extremities
Prevalent in people with diabetes or who smoke
Intermittent claudication- Obstruction of arterial blood flow in the iliofemoral vessels, resulting in pain with ambulation

39
Q

peripheral artery disease tx

A

Vasodilators, antiplatelet or antithrombotic medications (e.g., aspirin, cilostazol, ticlopidine, clopidogrel), cholesterol-lowering medications, and exercise rehabilitation

40
Q

coronary artery disease

A

any vascular disorder that narrows or occludes the coronary arteries

41
Q

LDL

A

mainly cholesterol plus a carrier protein

Are responsible for the delivery of cholesterol to the tissues

42
Q

HDL

A

mainly phospholipids plus a carrier protein
Are responsible for “reverse cholesterol transport,” which returns excess cholesterol from tissues to the liver, where it is eliminated as bile or converted to cholesterol-containing steroids
Can remove excess cholesterol from arterial walls

43
Q

transient myocardial ischemia

A

Develops if the supply of coronary blood cannot meet the demand of the myocardium for oxygen and nutrients

44
Q

stable angina

A

causes predictable chest pain

45
Q

myocardial ischemia tx

A

Nitrates, β-adrenergic-receptor blockers, calcium channel blockers, statins, antithrombotics, sodium ion channel inhibitors
Percutaneous coronary intervention
Coronary artery bypass graft (CABG)
Minimally invasive direct coronary artery bypass (MIDCAB)
Gene and stem therapy for myocardial angiogenesis and spinal cord stimulation

46
Q

MI manifestation

A

1st and classic is: sudden & severe chest pain
Heavy & crushing - not relieved by nitrates
Radiates to neck, jaw, back, shoulder, L. arm (referred pain)
N & V may occur (usually from pain), diaphoresis, cool clammy skin

47
Q

MI dx

A

ECG, serial enzyme alterations, (CK, LDH, troponins), clinical findings

48
Q

myocardial stunning

A

is the temporary loss of contractile function that persists for hours to days after perfusion has been restored

49
Q

hibernating myocardium

A

tissue that is persistently ischemic undergoes metabolic adaptation to prolong myocyte survival

50
Q

angiotensin II effects

A

Systemic effects: peripheral vasoconstriction and fluid retention
Local effects: growth factor for vascular smooth muscle cells, myocytes, and cardiac fibroblasts; promotes catecholamine release; causes coronary artery spasms

51
Q

two major types of MI

A

subendocardial

transmural

52
Q

MI tx

A

Hospitalization
Immediate administration of supplemental oxygen and aspirin
Morphine sulfate
Bed rest
Cardiac medications: thrombolytic, antithrombotic, vasodilators
Percutaneous coronary intervention (PCI)
Surgery

53
Q

MI complications

A

dysrhythmias, hf, cardiogenic shock, pericarditis, ventricular aneurysm

54
Q

acute coronary syndromes

A

sudden coronary obstruction bc of thrombosis formation over a ruptured atherosclerotic plaque

55
Q

unstable angina

A

reversible myocardial ischemia and a harbringer of impending infarction

56
Q

unstable angina tx

A
  • immediate hospitalization
  • admin of nitrates, antithrombotics, and anticoagulants
  • beta blockers & ace inhibitors
  • emergent PCI
57
Q

acute pericarditis

A

acute inflammation of the pericardium

58
Q

acute pericarditis clinical manifestations

A

fever, myalgias, and malaise, followed by sudden onset of severe chest pain

59
Q

acute pericarditis tx

A

rest, salicylates, and nonsteroidal anti inflammatory drugs, combined nonsteroidals and colchicine

60
Q

pericardial effusion

A

accumulation of fluid in the pericardial cavity

61
Q

constrictive pericarditis

A

fibrous scarring with occasiunal calcification of the pericardium causes the visceral and parietal pericardial layers to adhere

62
Q

cardiomyopathies

A

effects of neurohumoral responses to ischemic heart disease or hypertensino on the heart muscle cause remodling

63
Q

dilated cardiomyopathy

A

impaired systolic function, leading to increases in intracardiac volume, ventricular dilation, and systolic heart failure

64
Q

hypertrophic cardiomyopathy

A

Hypertrophic obstructive cardiomyopathy

Hypertensive or valvular hypertrophic cardiomyopathy

65
Q

hypertrophic obstructive cardiomyopathy

A

common inherited heart defect of thick septal wall

66
Q

hypertensive or valvular hypertrophic cardiomyopathy

A

Hypertrophy of the myocytes: attempts to compensate for increased myocardial workload

67
Q

restrictive cardiomyopathy

A

Myocardium becomes rigid and noncompliant, impeding ventricular filling and raising filling pressures during diastole.

68
Q

valvular dysfunction

A

Stimulates chamber dilation and/or myocardial hypertrophy

69
Q

valvular stenosis

A

valve orifice is constricted and narrowed

70
Q

valvular regurgitation

A

valve fails to shut completely

is also called insufficiency or incompetence

71
Q

aortic stenosis

A

orifice of the aortic semilunar valve narrows causing diminished blood flow from the left ventricle into the aorta

72
Q

aortic stenosis clinical manifestations

A

angina, syncope, and heart failure

73
Q

mitral stenosis

A

impairment of blood flow from the left atrium to the left ventricle

74
Q

mitral stenosis cause

A

acute rheumatic fever

75
Q

aortic regurgitation

A

inability of the aortic valve leaflets to close properly during diastole

76
Q

aortic regurgitation manifestations

A

widened pulse pressure as a result of increased stroke volume. and diastolic

77
Q

mitral regurgitation common cause

A

mitral valve prolapse, rheumatic heart disease, infective endocarditis, MI, connective tissue disease, dilated cardiomyopathy

78
Q

tricuspid regurgitation

A

leads to volume overload in the right atrium and ventricle, increased systemic venous blood pressure, and right heart failure

79
Q

mitral valve prolapse syndrome

A

anterior and posterior cuscps of the mitral valve billow upward into the atrium during systole

80
Q

rheumatic fever

A

is a diffuse, inflammatory disease caused by a delayed immune response to infection by the group A beta-hemolytic streptococci

81
Q

rheumatic fever is the abnormal immune resopnse to

A

the M proteins that cross react with normal tissues

82
Q

rheumatic fever clinical manifestations

A

carditis, polyarthritis, subq nodules, chorea, eythema marginatum

83
Q

infective endocarditis clinical manifestations

A

Fever
New or changed cardiac murmur
Petechial lesions of the skin, conjunctiva, and oral mucosa

84
Q

osler nodes

A

painful erythematous nodules on the pads of the fingers and toes

85
Q

janeway lesions

A

nonpainful hemorrhagic lesions on the palms and soles

86
Q

infective endocarditis tx

A

Antibiotics
Antimicrobial therapy is generally administered for
several weeks.
Surgery to repair or replace the valve, as prescribed

87
Q

heart failure is a

A

pathophysiologic condition in which the heart is unable to generate adequate cardiac output, resulting in an inadequate perfusion of tissues or an increased diastolic filling pressure of the left ventricle, or both

88
Q

systolic hf clinical manifestations

A

dyspnea, orthopnea, cough of frothy sputum, fatigue, decreased urine output and edema

89
Q

diastolic hf clinical manifestations

A

dyspnea on exertion and fatigue

90
Q

right hf clinical manifestations

A

jugular venous distension, peripheral edema, hepatosplenomegaly

91
Q

systolic hf is associated with the activation of the

A
  1. parasympathetic ns
  2. hypothalamic pituitary adrenal axis
  3. renin angiotensin aldosterone system
  4. antidiuretic hormone vasopressin aldosterone system

Pathophysiology (12 decks)

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