Week 6 Flashcards
describe the anatomy of the artery/vein
intima
media
adventitia
the layer of endothelial cells covered in glycosaminoglycans (GAGs)
intima
protect endothelial cells from damage and promote repair
glycosaminoglycans (GAGs)
smooth muscle cells that contain GAGs
media
very elastic membrane of connective tissue
adventitia
leading cause of death in the US for men and women
atherosclerosis
how does atherosclerosis develop?
1- lesions in the intimate weaken GAG layer
2 - the lesion site is more permeable to lipoproteins. binding of GAG to lipoprotein attracts cholesterol. monocytes, t-cells and others bind
3-cells migrate from media to intima
4- steps 2,3 form debris, and plaque
5- fat and cholesterol deposit on the plaque which grows until the artery is blocked
Sx of atherosclerosis
sometimes nothing
MC angina pectoris
shortness of breath, fatigue with activity, weakness
what causes atherosclerosis?
hypercholesteromia, HTN (risk factor and consequence), diabetes, physical inactivity
low antioxidant status, low essential FA, elevated CRP, elevated homocysteine, Type A personality, and so on
risk factors of atherosclerosis
Smoking
Hypercholesterolemia
High levels of lipoprotein A, or Lp(a)
Genetic inherited disease e.g. familial hypercholesterolemia, familial combined hyperlipidemia, familial triglyceridemia
Hypertension (risk factor and consequence)
Physical inactivity
Chronic inflammation (CRP)
tests to assess for atherosclerosis
Coronary angiography Echocardiogram Electrocardiogram Electron-beam computed tomography Exercise stress test on a treadmill Nuclear stress test
what is angina pectoris
chest pain d/t lack of O2 in the heart
what causes angina pectoris
obstruction of blood to the heart as a result of atherosclerosis, spasms of coronary arteries, constriction of small blood vessels
Sx of angina pectoris
pressure, tightness, burning in chest with or w/o radiation to neck, arms, upper chest
shortness of breath, lightheadedness, fainting, anxiety, sweating
what is stable angina
Sx occur with exertion and disappear with rest
what is unstable angina
Sx occur with or without exertion/rest. Sx get worse, last longer, happen more often, happen at rest.
risk factors for angina pectoris
similar to atherosclerosis
tests for angina pectoris
Electrocardiogram (EKG) Exercise stress test Chest xray CT angiography Blood tests - Tg, cholesterol, CRP
what is congestive heart failure (CHF)?
body cannot pump sufficient blood so blood is retained in the legs/feet and causes edema (as on Sx)
CHF Sx
fatigue dyspnea orthopnea edema pulmonary edema
what class of CHF is this? physical activity not limited by Sx
class I
what class of CHF is this? physical exertion mildly limited by Sx with typical daily activities
class II
what class of CHF is this? physical activity severely curtailed and Sx with any kind of activity
class III
what class of CHF is this? sx of physical discomfort even at rest
class IV
what stage of CHF is this? at risk, no CHF Sx
stage A
what stage of CHF is this? structural heart disease without CHF Sx
stage B
what stage of CHF is this? structural heart disease with prior or current Sx of CHF
stage C
what stage of CHF is this? refectory heart failure requiring specialized intervention
stage D
CHF risk factors
similar
Tests for CHF
EKG
chest xray
exercise stress test
what is blood pressure
force of blood against the wall of arteries as blood passes through it
measures the pressure in arteries when heart contracts
systolic
measures pressure in the arteries between heart contractions
diastolic
what is HTN?
contributor to CAD, CHF, renal failure, unstable angina pectoris, stroke
Sx of HTN
headache, fatigue, chest pain, irregular pulse, blood in urine, vision problems
what is hypertrophic cardiomyopathy
genetic disorder that results in asymmetric enlarged heart
Sx of hypertrophic cardiomyopathy
shortness of breath, angina, CHF, sudden death
leading cause of death among young athletes
hypertrophic cardiomyopathy
tests for hypertrophic cardiomyopathy
physical exam (auscultation) blood tests chest xray EKG Holter and event monitors (wear on your body) Echocardiography Stress test Cardiac Catheterization Myocardial biopsy Genetic testing
