Lecture # 7 - Chapter 30 & Chapter 31 - Alterations Of The Cardiovascular System In Adults & Children

Front 1

Arteriosclerosis

Back 1

is hardening and thickening of the arterial walls which narrow the lumen

Front 2

Atherosclerosis

Back 2

is when lipid-laden macrophages form plaque on the endothelial surface of the vessels

Front 3

How many adults have hypertension in the United States?

Back 3

1 out of 3

Front 4

Hypertension is defined as

Back 4

when the average of two blood pressures on consecutive visits show diastolic 90 mm Hg or greater and systolic of 140 mm Hg or greater

Front 5

Stage II hypertension

Back 5

is when the SBP is greater than or equal to 160 and the DBP is greater than or equal to 100

Front 6

Hypertension results

Back 6

from an increase in cardiac output, total peripheral resistance, or both

Front 7

Secondary hypertension

Back 7

is caused by primary disease such as renal disease

Front 8

Primary (essential) hypertension

Back 8

is the result of genetic and environmental factors - the disruptions to the mechanisms that the body uses to keep blood pressure normal

Front 9

Non-modifiable risk factors (8) for primary hypertension include:

Back 9

family history of HTN, age, gender (men get it younger than women), black race, and alterations of the genes that control sodium metabolisim, Sympathetic Nervous System function, renin-angiotension-aldosterone system (RAAS), and insulin sensitivity

Front 10

Modifiable risk factors include:

Back 10

high dietary sodium, smoking, obesity, alcohol abuse, sedentary life style, and low intake of potassium, magnesium and calcium

Front 11

What does inflammation in Primary hypertension cause?

Back 11

a remodeling of the blood vessels

Front 12

What is complicated hypertension?

Back 12

it is when there is organ damage, such as left ventricular hypertrophy, kidney, liver, or eye problems, or congestive heart failure

Front 13

Malignant hypertension is?

Back 13

a rapidly progressing disease that can lead to encephalopathy and death

Front 14

What is an aneurysm?

Back 14

It is a localized dilation of a vessel wall or cardiac chamber

Front 15

What is a thrombus?

Back 15

it is a blood clot attached to a blood vessel wall

Front 16

What is a thromboembolus?

Back 16

it is a detached thrombus (a blood clot that was attached to a blood vessel wall and became detached)

Front 17

An embolus can be made up of?

Back 17

a blood clot, air, fat, bacteria, amniotic fluid, or foreign matter

Front 18

Peripheral vascular disease (PVD)

Back 18

is atherosclerotic disease of the limbs - especially lower extremities

Front 19

Peripheral artery disease (PAD)

Back 19

causes pain with ambulation (claudication) - it can be treated with vasodilators

Front 20

What do we treat PAD with?

Back 20

vasodilators

Front 21

Deep vein thrombosis (DVT)

Back 21

occurs primarily in the lower extremity - platelets and clotting factors accumulate causing thrombus formation in the vein

Front 22

What causes DVTs?

Back 22

venous stasis (immobility, CHF), endothelial damage (trauma, medications), and hyper-coagulable states (malignancy, inherited disorders, pregnancy, oral contraceptive use, and hormone replacement)

Front 23

Modifiable risk factors for coronary artery disease (CAD) include:

Back 23

dyslipidemia, HTN, smoking, DM and insulin resistance, obesity, sedentary life style, and diet

Front 24

Non-modifiable risk factors for coronary artery disease (CAD) include:

Back 24

advancing age, male gender, women after menopause, and family history (genetics)

Front 25

Low density Lipoproteins (LDLs) cause

Back 25

endothelial injury, inflammation, and immune responses - which contribute to atherosclerosis and coronary artery disease

Front 26

Myocardial ischemia

Back 26

is a lack of oxygen to the heart

Front 27

What can cause myocardial ischemia?

Back 27

atheroscerotic plaques can narrow the lumen and partially occlude the vessel - cells become ischemic within 10 seconds of occlusion - anaerobic metabolism takes over producing lactic acid - and this produces pain

Front 28

How long can cardiac cells remain viable in ischemic conditions?

Back 28

20 minutes

Front 29

If blood flow is restored in the heart after an ischemic event?

Back 29

aerobic metabolism resumes and cellular repair begins

Front 30

What happens if there is a continued lack of oxygen to the heart?

Back 30

myocardial infarction

Front 31

Mitral valve prolapse

Back 31

is when the valve cusps are enlarged and thickened and prolapsed into the atrium during systole - mitral regurgitation can occur - may be due to an autosomal dominant connective tissue disorder - seen most commonly in young women

Front 32

What causes cardiomyopathies?

Back 32

they can be due to ischemic heart disease, hypertension, infectious disease, toxins, connective tissue disease, and nutritional deficiences - most are idopathic

Front 33

Dilated cardiomyopathy

Back 33

has dilated ventricles and is associated with heart failure

Front 34

Hypertrophic cardiomyopathy is due to

Back 34

thickening of the myocardium

Front 35

Hypertensive type of hypertrophic cardiomyopathy is due to

Back 35

an increased resistance to ventricular ejection

Front 36

Restrictive cardiomyopathy is usually caused by

Back 36

an infiltrative disease of the myocardium - the muscle becomes non-compliant

Front 37

Aortic valvular stenosis can be caused by

Back 37

rheumatic fever, congenital malformation, or degeneration and calcification

Front 38

Aortic valve stenosis causes

Back 38

Left ventricular hypertrophy (LVH)

Front 39

Mitral stenosis can be caused by

Back 39

rheumatic fever or bacterial endocarditis

Front 40

Mitral stenosis causes

Back 40

atrial enlargement, pulmonary congestion, and right heart failure

Front 41

Mitral regurgitation is

Back 41

a slow progression to pulmonary hypertension and right heart failure

Front 42

Mitral regurgitation can come from

Back 42

rheumatic fever, infective endocarditis, or mitral valve prolapse

Front 43

Tricuspid regurgitation can be caused

Back 43

by hypoxic lung disease or pulmonary emboli

Front 44

Infective carditis causes

Back 44

endothelial damage - which leads to bacterial colonization and vegetations

Front 45

What is the other name for right sided heart failure?

Back 45

Cor-pulmonale

Front 46

Right sided heart failure (cor pulmonale) is due to?

Back 46

a backup starting with high left ventricular filling pressure - pulmonary pressure increases - right ventricle dilates and fails - this causes peripheral edema and hepatosplenomegally

Front 47

Right sided heart failure (cor pulmonale) can also be caused by?

Back 47

COPD, CF, and ARDS

Front 48

High output failure is caused by?

Back 48

anemia, septicemia, and hyperthyoroidism - metabolic acidosis occurs

Front 49

Risk factors for congenital heart defects are:

Back 49

maternal drug use (dilantin, warfarin, lithium, speed, alcohol), maternal age greater than 40, diabetes, rubella infection, and CMV virus

Front 50

Atrial septal defects are usually

Back 50

asymptomatic

Front 51

Ventricular septal defects (VSD) causes

Back 51

left atrial enlargement, left ventricular enlargement, increased pulmonary resistance, and cyanosis

Front 52

Tetralogy of Fallot is the most common

Back 52

cyanotic congenital heart defect - it involves 1. High Ventricular septal defect (VSD) 2. Overriding aorta 3. Pulmonary stenosis 4. Right ventricular hypertrophy - NEEDS SURGICAL REPAIR