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Body Systems > When The Cardiovascular System Goes Wrong > Flashcards

When The Cardiovascular System Goes Wrong Flashcards

1
Q

What is the global prevalence of cardiovascular disease?

A

Affects 1 in 14 people worldwide, kills 1 in 3 people worldwide

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2
Q

What is the biggest single cause of death in Europe?

A

Ischaemic Heart Disease

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3
Q

What percentage of deaths from cardiovascular disease are associated with modifiable risk factors?

A

4 out of 5

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4
Q

List some major cardiovascular disorders.

A
  • Myocardial Infarction
  • Stroke
  • Arrhythmias
  • Valvular Disease
  • Hypertension
  • Heart Failure
  • Coronary Heart Disease
  • Thrombosis
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5
Q

What diastolic blood pressure mmHg is classified as hypertension?

A

Higher than 13 mmHg

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6
Q

How many people in the UK are affected by hypertension?

A

15 million

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7
Q

What are some diseases that hypertension puts you at risk for?

A
  • Coronary Artery Disease
  • Myocardial Infarction
  • Stroke
  • Heart Failure
  • Chronic Kidney Disease
  • Aneurysms
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8
Q

What is primary hypertension also known as?

A

Essential or Idiopathic Hypertension

This is the most common type of hypertension

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9
Q

What are some contributing factors to primary hypertension?

A
  • Genetic Predisposition
  • High Alcohol Consumption
  • Sedentary Lifestyle
  • Obesity
  • Diabetes
  • Intrauterine Environment
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10
Q

What are the main treatment strategies for hypertension?

A

Thiazide diuretic
- increases water loss
- inhibits renal Na+ reabsorption to increase water loss in urine
- so reduced venous return EDV
- results in reduced CO

Ca2+ channel blocker
- inhibits Ca2+ entry in cardiac and vascular muscle cells
- reduces muscle contraction
- so reduced contractility SV
- so decreased vasoconstriction
- results in reduced CO

RAAS inhibition
- angiotensin converting enzyme inhibitor (ACEi) = potent vasoconstricter
- angiotensin II receptor blocker (ARB)
- aldosterone antagonist (spironalactone)
- so reduced vasoconstriction
- so reduced Na+ & H2O absorption
- results in reduced CO

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11
Q

What is a major treatment for atherosclerosis?

A

Statins

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12
Q

What can thrombosis lead to?

A
  • Deep Vein Thrombosis (DVT)
  • Pulmonary Embolism
  • Stroke
  • Myocardial Infarction
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13
Q

What is the primary pathogenesis of coronary heart disease?

A

Atherosclerosis of Coronary Artery = can restrict myocardial blood flow = chest pains = angina

Treated with GTN spray (nitric oxide = opens coronary vessels and increases vasodilation)

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14
Q

What is the most common artery affected in myocardial infarction?

A

Left Anterior Descending Coronary Artery

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15
Q

What are the two types of valvular disease?

A

Regurgitation
- valves fail to close properly
- results in backflow of blood
- reduces stroke volume & cardiac output

Stenosis
- thick/stiff valves fail to open properly
- increases afterload, reducing ejection
- leads to LV hypertrophy and eventually failure

Treated with surgery to repair or replace damaged valves

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16
Q

What happens in heart failure?

A

Cardiac output is inadequate to meet the body’s demands

Preserved ejection fraction
- diastolic
- stiff and thick chambers
- heart can’t fill
- reduced filling & EDV stroke volume

Reduced ejection fraction
- systolic
- stretched and thicken chambers
- heart can’t pump
- reduced contractility and stroke volume

17
Q

What are common symptoms of heart failure?

A
  • Breathlessness
  • Exercise Intolerance
  • Fatigue
18
Q

What is the most common arrhythmia?

A

Atrial Fibrillation (AF)

19
Q

What are the heart rates defining bradycardia and tachycardia?

A

Bradycardia: <60 bpm, Tachycardia: >100 bpm

20
Q

What mechanical device can assist heart failure?

A

Left Ventricular Assist Device

21
Q

Fill in the blank: Hypertension can narrow the renal arteries and reduce the blood supply to the _______.

A

kidney

22
Q

True or False: Chronic hypertension can lead to heart failure.

A

True

23
Q

What type of hypertension is known as having a known medical cause?

A

Secondary Hypertension

24
Q

What are some examples of secondary hypertension?

A

Chronic Kidney Disease
- reduced Na+ excretion & fluid retention
- increased RAAS activity

Endocrine Disorders
- Diabetes = increased fluid, arterial stiffness
- crushing’s syndrome = increased ACTH and RAAS

Pheochromocytoma (adrenal tumour)
- increased catecholamine production

25
Q

What is a major risk factor for atherosclerosis?

A

High LDL cholesterol

26
Q

What is the role of ACE inhibitors in treating hypertension?

A

Inhibit the RAAS system to lower blood pressure

27
Q

What is a stroke?

A

Damage to endothelial cells in cerebral arteries due to hypertension = increases the risk of haemorrhagic and ischaemic stroke

  • increased risk of embolism
  • vessels more likely to burst
28
Q

What is heart failure?

A

Chronic hypertension puts more strain on the ventricles by increasing afterload and reducing cardiac output

To compensate, the heart remodels and hypertrophies to increase contractility but this deteriorates over time (stretches too much)

29
Q

What is chronic kidney disease?

A

Hypertension can narrow the renal arteries and reduce the blood supply to the kidneys

This damages the nephron and kidney function declines (so blood pressure is even higher)

30
Q

What are aneurysms?

A

Increased wall stress can lead to aneurysms = weakness in artery walls = more prone to bursting

Hypertension also increases the risk of rupture
- saccular aneurysms (in brain)
- aortic aneurysm

31
Q

What is coronary heart disease & myocardial infarction?

A

Biggest killer worldwide

Increased pressure in hypertension accelerates atherosclerosis by increasing stress and damage to endothelial walls of coronary arteries

32
Q

What are the triggering factors and treatment for atherosclerosis?

A

Narrow vessels restrict blood flow and increase likelihood of thromboembolism

Triggering factors:
- endothelial damage
- high LDL cholesterol
- forms plaque (macrophage & lipid accumulation)
- risk of ulceration and thrombus formation

Consequences:
- stroke
- vascular dementia (lose their blood supply in brain)
- coronary heart disease (i.e. angina pectoris or ischaemic heart disease)

Treatment:
Statins
- inhibit cholesterol synthesis = reduced LDL
- most prescribed class of drugs in UK

33
Q

What can thrombosis lead to and how is it treated?

A

Blood clots can form in the circulatory if lack of blood flow

  • stroke
  • myocardial infarction
  • atria don’t contract properly
  • deep vein thrombosis (in leg veins) = pulmonary embolism

Treatment:
Blood thinning medicines
- anticoagulants (warfarin)
- anti-platelet therapy (aspirin)

34
Q

What are the causes & consequences of heart failure?

A
  • diseases increasing workload (pressure overload) = aortic stenosis, hypertension
  • damage to myocardium = myocardial infarction
  • right sided failure = blood pools in periphery due to increased pressure in systemic veins = peripheral oedema
  • left sided failure = congestion in lungs due to pressure in pulmonary veins = pulmonary oedema
  • both sided failure = congestive heart failure
35
Q

How is heart failure treated?

A

primary treatments

Beta-blockers
- B-adrenoreceptor antagonists
- reduce SNS activity to reduce workload
- prevent desensitisation

Anti-hypertensives
- ACEi, ARB, CCB, diuretics
- reduce fluid to relieve symptoms
- reduce vasoconstriction
- reduce workload

other treatments

Left ventricular assist device
- mechanical heart pump
- surgical risks
- immunorejection

Heart transplant
- low availability
- surgical risks
- immunorejection

36
Q

What is arrhythmia?

A

A deviation of the heart’s normal sinus rate or rhythm

Symptoms range from asymptomatic to palpitations, fainting, heart failure, cardiac arrest & death

37
Q

How is bradycardia treated?

A

Slow heart rate (<60 bpm)

Causes:
- slow signals from SA node
- block of signals due to SA node, AV node or conductive tissue damage

Treated with pacemakers (regulate heart rate)

38
Q

How is tachycardia treated?

A

Fast heart rate (>100 bpm)

Causes:
- congenital
- cardiomyopathy
- ischaemia

Treatment:
- Sinus tachycardia = drugs (caffeine, amphetamine), hormones (increased thyroid activity)
- Non-sinus tachycardia = additional abnormal impulses in ECG

39
Q

What are the types of arrhythmia?

A

Atrial Fibrillation (AF)
- most common
- rapid impulses in atria = quiver but can’t contract
- can go undetected or cause palpitations or fainting
- increases risk of stroke

Ventricular Fibrillation (VF)
- known as cardiac arrest
- ventricles quiver but don’t pump blood
- rapidly leads to death
- treatment = defibrillation

Long QT Syndrome (LQTS)
- mainly affect the young (<25s)
- inherited ion channelopathies
- iron channels not working properly (take longer to depolarise)
- can cause additional ventricular depolarisations
- LQTS can lead to VT

Ventricular Tachycardia (VT)
- early depolarisation leads to premature ventricular contractions
- prolonged VT can lead to to VF

Body Systems (19 decks)

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