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87 Cards in this Set
- Front
- Back
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What are the symptoms associated w/ poor perfusion?
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change in color, skin, nails, esp extremities pain or fatigue
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Define aneurysm?
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Local dilation of vessel wall or heart chamber
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Some causes of aneurysm?
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Arteriosclerosis, infection, trauma, congenital
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Infections that may cause an aneurysm?
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Syphilis
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How can trauma cause an aneurysm?
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Cause a false or saccular aneurysm w/ dissection of wall
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What can eventually happen w/ aneurysm?
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dissection, rupture and hemorrhage
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Define varicose veins?
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pooling of blood in vein causes distension like an aneurysm but it occurs in the veins where they become overstretched.
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What are some causes of varicose veins?
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Trauma or gradual venous distension that will eventually damage vein valves & leading blood pooling in the veins
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How can varicose veins lead to edema?
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Since we’re increasing pressure in the veins, it will cause increased hydrostatic pressure in the capillaries w/c causes edema of surrounding tissue
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What is the complication w/ varicose veins?
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may progress to chronic venous insufficiency‑ inadequate venous return over long period
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Who is more proned to getting varicose veins?
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Men & women are both affected equally, multiple pregnancies, & those who stand for long periods. Also there is a familial link
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How do the vein appear in varicose veins?
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Tortuous & palpable
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How do limbs look that are involved in varicose veins?
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Hyperpigmented w/ reddish blue color from blood pooling
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People w/ varicose veins are at increased for what?
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venous stasis ulcers, infections
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Define vasculitis?
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inflammation of vessel wall due to immune/autoimmune response
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Vasculitis may be related to what?
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may be related to other immune dysfunction-associated with autoimmune diseases
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What is the effect on the tissues w/ vasculitis?
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reduces tissue perfusion by causing vessel necrosis or thrombosis
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What are 3 examples of vasculitis?
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Polyarteritis nodosa, takyasu’s arteritis, & temporal arteritis
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Which vessels are affected in polyarteritis nodosa?
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medium sized, esp renal, coronary, hepatic, skeletal muscle
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w/c vessels are affected in takyasu’s arteritis?
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aorta and branches off the aorta.
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w/c vessels are affected in temporal arteritis?
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cranial vessels, also retinal vessels where it can lead to irreversible blindness.
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Who is more affected w/ vasculitis?
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Usually occurs in middle aged people & older… not very common in younger people
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Who is more affected in buerger’s disease?
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Generally male & a smoker
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What is a possible component in causing buerger’s dz?
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probably some agent in smoke acts as inflammatory agent, but also a genetic component
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What are the signs & symptoms of buerger’s dz?
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Reduced or absent pulses in lower leg & feet, Bruits in lower legs, Rubor of lower leg, smooth skin, & Aching pain (not muscle pain)- intermittent claudication
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Buerger’s dz affects w/c vessels?
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Smaller arteries more than the larger ones
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What are the complications of buerger’s dz?
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Necrosis; ulcers, gangrene, Neuropathies, Thrombosis/phlebitis
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What is the pathology of raynaud’s dz/phenomenon?
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attacks of vasospasm in arteries and arterioles of fingers (and toes)
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What are some causes of Raynaud’s?
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secondary to pulmonary hypertension, scleroderma, myxedema, or long term exposure to cold or segmental vibration. Raynaud’s disease‑ pathogenesis unknown‑ vasospasm induced by cold or emotional stress
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Raynaud’s is seen more frequently in w/c group of people?
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More common in women & w/ those that have autoimmune dzs
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What are the sign/symptoms of Raynaud’s?
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ischemia‑ changes in skin color, sensation, numbness, sensation of cold (vasospasm), cyanosis followed by rubor of fingertips‑ sluggish flow, then engorgement with blood, thickening of skin, brittle nails d/t chronic episodes
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Oxygenated blood goes to w/c side of the heart?
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Right side
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In fetal circulation, where is the foramen ovale?
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It’s an opening between the left & right atrium
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In fetal circulation, what type of blood is coming to IVC & where is it coming from?
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Mostly oxygenated & it’s coming from the placenta
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In fetal circulation, what & where does blood come into RA & what is its course?
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It comes from the placenta to the IVC & also comes from other organs & SVC (w/c drains the head) then some of it goes to the RV but a lot of goes thru foramen ovale to LA.
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In fetal circulation, what happens in LA?
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There is oxygenated blood coming from RA & de-oxygenated blood from PV. Oxygenated & de-oxygenated blood gets mixed & then will go to the LV & aorta.
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In fetal circulation how does blood get to the aorta?
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It gets there from LV to the aorta but also comes from RV where a majority of blood from RV goes to the aorta thru ductus aretiosus & a small amount goes to the PA
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In fetal circulation, w/c side of the heart does more work & why?
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The right side; this is b/c the fetus has very high resistance in the lungs since we don’t want to put much blood in the lungs.
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In fetal circulation does the heart work in parallel or in series & why?
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It works in parallel d/t all of the shunts
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What is the pathology in ASD?
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Foramen ovale doesn’t close off or closes partially
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What usually happens at birth w/ pressure?
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At birth there is a decrease in resistance w/c causes a decrease in RV pressure & an increase in LV pressure.
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In ASD, what happens w/ pressure & flow?
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If it stays open, this means we have an opening between our left & right heart. In the fetus, the pressure in the right is greater than in the left & therefore the flow is from right to left. After birth, the pressure in the left is greater so the flow is from left to right.
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Normally when does the ventricular septum close?
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During early fetal life so it would be abnormal to have it open during fetal growth
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What happens in VSD?
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There will be blood flow between the ventricles w/c is more serious than ASD
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In what direction is there flow in VSD?
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Flow can be in either direction but since pressure is greater on the left side, there is usually a flow from left to right.
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What are 3 things that can be seen w/ septal defects?
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It will cause blood to shunt from 1 side of the heart to the other (usually left to right). It will also reduce CO & result in less perfusion of tissues. Murmurs can also be heard.
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In septal defects, what happens to the work of the heart?
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There will be an increase in work on the right side b/c more blood is being shunted to the right side. Eventually this will lead to right heart failure.
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What happens in patent ductus arteriosus (PDA)?
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Post-natally, the PDA becomes a shunt that takes blood from the aorta (higher pressure) to the PA
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What normally happens to the ductus areterosus?
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It closes off & becomes the ligamentum arteiosum
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How soon after birth does the DA close off?
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w/n 72 hours
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What is the flow & characteristics w/ PDA?
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Flow will be from aorta to the PA & murmur will heard?
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What happens if there is a persistent pulmonary HTN after birth?
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This means that their lungs have not dilated so they are not getting enough blood to their lungs. Also they are shunting blood to the aorta from the PA b/c they have a right to left shunt.
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What is the treatment for PDA?
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Administration of COX inhibitors causes closure in about 80% of full term infants
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What is been found out to be the cause for DA arteriosus?
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Closure occurs w/ decreased PG & increased O2 at birth. Apparently in fetal circulation, there is a great deal of PGE2. after birth, these PG levels drop dramatically & therefore help to close the DA.
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Define coarctation of the aorta?
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Narrowing of aorta before or after DA
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What is the etiology of coarctation of aorta?
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Congential defect that is associated w/ mitral &/or aortic valve defects, septal defects, PDA, & Turner’s syndrome
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COA is more common in w/c gender?
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More common in men
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Majority of COA is found where?
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98% of cases is post-ductal
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What are the s&s seen w/ COA?
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BP in left arm > BP in left leg, murmur, pain in leg w/ exercise
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Describe the aortic valve in COA?
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It should be a tricuspid valve but instead it’s bicuspid
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How are kidneys involved in COA?
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Since there is less pressure in the lower body, there will be decreased renal arterial flow. This causes a release in renin w/c releases AT II w/c causes more vasoconstriction & cause more increase in pressure.
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What is the risk for an aortic bicuspid valve?
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Infective endocarditis
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How do u describe the ribs in COA?
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U see rib notching on chest x-ray. This is d/t the high upper body pressure
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In COA, why is there a murmur?
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It’s produced by turbulent flow at the site of the coarctation
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To compensate for the coarctation, what happens in the body?
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There will be volume expansion & increased BP
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In COA, there is __________ flow to the legs & ___________ flow to the upper body.
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Reduced, increased
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What are 3 complications of COA?
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HTN, Heart failure d/t increased afterload & increased LVP, & aneurysm d/t the high pressure proximal to the coarctation point
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Define acute pericarditis?
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It’s an inflammation of the pericardium
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What are the causes of acute pericarditis?
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Infection, after MI, uremia, tumors, radiation, autoimmune dz, drugs
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What are some drugs that may cause acute pericarditis?
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Procainamide & hydralzine
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What are some autoimmune dz where acute pericarditis may be seen?
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Lupus or arthritis
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What is the pathology in acute pericarditis?
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Results in increased fluid in pericardial sac w/c may include leukocytes since it’s an inflammation
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What are the s&s of acute pericarditis?
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It may cause pain, fever, friction rub w/c can be heard b/c the 2 layers are rubbing against each other
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How is the ECG in acute pericarditis?
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It’s abnormal in 90% of the time
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How is pericardial effusion different from acute pericarditis?
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There is a much greater increase in fluid volume in the pericardial sac
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What are some causes of pericardial effusion?
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Heart failure, severe hypthyroidism, cirrhosis or nephrotic dz, & TB or neoplasms
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What is the greatest effect w/ pericardial effusion?
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U will see more symptoms when it occurs rapidly
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What are some S&S of pericardial effusion?
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causes ache, may compress other structures where it will cause hiccups, hoarseness, shortness of breath, & difficulty swallowing
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What is seen on echo w/ pericardial effusion?
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The separation of the 2 layers can actually seen filled w/ fluid
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What is cardiac tamponade?
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Accumulation of fluid that compresses the heart & limits CO that may lead to hypotensive shock
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What happens w/ dilated cardiomyopathy?
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There is ventricular dilation w/ increased mass & volume of ventricles
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What is impaired in dilated cardiomyopathy?
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Impaired systolic function
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What is the pathology in D. cardio?
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There is an impaired contractility w/c results in decreased EF, SV, & CO
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What are some causes of dilated cardio?
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Alcoholism, peripartum, recurrent extensive MI, viral, bacterial, parasitic infections, autoimmune dz, or idiopathic d/t cardiotoxic drugs such as anticancer agents
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What are the functional changes that occur in dilated cardiomyopathy?
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There is a decrease in CO that leads to decrease in arterial pressure. This will turn on the reflexes that will increase HR & cause vasoconstriction. There will also be a decrease in SV w/c will lead to increase in filling pressure since there will be blood left in the heart after systole. This will increase pressure that will lead to increase in pressure in the ride & left side of the heart & therefore edema in lungs & systemically will eventually be seen.
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What are the S&S of dilated cardio?
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Fatigue, weakness, syncope d/t to decreased CO. there will also be an S3 since the heart is dilated and murmurs may be heard d/t mitral regurg that can develop from the dilated ventricle
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What are the complications that may arise in dilated myopathy?
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Arrythmias such as A fib & V tach. Also left sided heart failure d/t pulmonary congestion or less often RHF d/t systemic congestion.
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