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123 Cards in this Set
- Front
- Back
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What did the ancient egyptians think of the heart?
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The ancient egyptians were fascinated by the heart, believing it was the centre of emotions and intellect. When mummifying people, they would remove the heart, put it in a jar to preserve it, and then put it back inside
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How did ancient roman physician Galen study the heart and what were his beliefs?
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He studied the open chest cavities of wounded gladiators.
He believed that the heart made blood and then delivered the vital spirits to the rest of the body. |
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What were signifigant about Leonardo daVinci's drawings of the heart?
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They were so detailed that they allowed for the development of a novel surgical procedure
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What was Mr Francis Well's technique for heart surgery, who inspired it, and what did it aim to fix?
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In Well's tecnhique, the surgery is done by robots controlled by the doctors. Unlike open heart surgery, it only requires a few insicions.
It was developed from Leonardi daVinci's detailed drawings, and was created to fix the mitral valve which controls blood flow btw the upper atrium and lower ventricle |
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Who was the first scientist to realize the heart was a pump, what two functions was it believed to have, and in what century did this discovery occur?
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In the 17th century, William Harvey realized the heart was a pump which would circulate blood through the lungs to be come oxygenated, and secondly, pump this oxygenated blood throughout the body as all parts required a constant supply of oxygen
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How big is the heart and where is it located ?
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The heart is the size of a fist and located in the centre of cavity.
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How many litres of blood does the heart pump per minute?
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5-6 litres of blood per minute
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How many times does the heart beat per lifetime?
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The heart beats 2 and 1/2 billion times per lifetime
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What three factors cause the heart's rate of beating to change?
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Periods of activity, periods of rest, and the environment.
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How does the heart work?
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-blood flows in through superior and inferior vena cava
- into right atrium - into right ventricle - blood flows through pulmonary artery and into the lungs - flows out of the lungs through the pulmonary vein and into the left atrium - then flows to the left ventricle where it exits the heart and flows to the rest of the body via the aorta. |
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What type of blood to arteries carry and what type of blood to veins carry? Which artery is an exception?
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Arteries carry oxygenated blood away from the heart and to the body.
Veins carry deoxygenated blood to the heart The pulmonary artery carries deoxygenated blood to the lungs to be oxygenated. |
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Why is the circulatory system called so?
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Because its a loop
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How does the aorta spread blood throughout the body?
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It continually divides into smaller arteries until it becomes tiny capillaries.
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What are capillaries?
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Named after capilla, the latin word for hair, capillaries are the smallest arteries in the body, so narrow that only one red blood cell can pass through at a time as its width is near to that of an individual red blood cell.
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How does blood return to the heart before veins?
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Capillaries start to coalesce back into veins
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What are the four main things which can go wrong in the heart
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- failure to pump enough blood
( starving some cells of oxygen) - impaired electrical signal ( if the pacemaker, group of cells in the heart's top right corner which tells the heart when to beat, works ineffectively) - reduced blood flow through coronary arterties ( coronary come from latin corna = crown, these arteries form a crown around the heart.) If these arteries are blocked, the heart is deprived of O2 and cells can be permanently damaged - impaired value function, slowing or speeding blood flow or causing leaking |
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What are the risk factors predisposing heart disease?
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- family history
- downward crease in earlobe( same gene manifests as in heart disease) -baldness -male -smoking -obesity |
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Why is smoking such a risk factor for heart disease?
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The carbon monoxide found in cigarette smoke displaced oxygen from hemoglobin, deoxygenating blood
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Pre menopausal women are protected from heart disease. Can they take estrogen afterwards to protect themselves?
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Tests have indicated taking estrogen did not help and people taking it were just as at risk for heart disease as those not.
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What do diabetics have problems producing and what does this lead to?
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Diabetics do not produce enough insulin, which breaks down blood glucose.
Excess glucose is broken down into compounds which are toxic to muscle cells |
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What is the only way of knowing one is diabetic?
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Test blood sugar levels, or measuring levels of blood glucose
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What are the two systems of measuring blood glucose and what os the conversion factor btw them?
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-milligrams per decilitre (mg/dL, US)
-millimoles per litre ( mmol/L, Europe and Can) conversion factor : mg/dL= mmol/L (18) |
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You are diabetic after an over night fast if your blood glucose is over what number?
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7
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What is prediabetes?
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when a patient has blood glucose of btw 5.5-7 mmol/L and has a 50% chance of becoming diabetic
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What happens in a OGTT ( Oral glucose tolerance test) ?
What does it test |
A fixed amount of glucose is given in a solution to drink, and if after an hour your result is above 11mmol/L you have diabetes
It tests your body's insulin production |
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What does the hemoglobin A1C test give you an idea for, what does it check and how is it administered?
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The hemoglobin A1C test checks your blood glucose levels over 2-3 months, used to check if long term regimes are working
It works by analyzing how much hemoglobin reacted with the breakdown compounds of glucose. 7% |
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Target blood glucose levels fasting or premeal? (ideal, inadequate)
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ideal: 4-6
inadequate: >10 |
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Target blood glucose levels 1-2 hours post meal? (ideal, inadequate)
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ideal : 5-8
inadequate: >15 |
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What is cholesterol, how do we obtain it, and what positive role does it have in the body?
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Cholesterol is a biochemical essential to and produced by the human body, which is used to synthesize a variety of steroidal hormones.
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What will cholesterol form if it ends up inside the coronary arteries?
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deposits called atherosclerotic plaque
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Why do animal foods contain cholesterol?
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Because animals need cholesterol as well so it is preformed within their bodies before consumption
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What is the main food cause of cholesterol?
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saturated fats
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What fraction of heart attacks and strokes could have been prevented by the intake of statins?
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1/3
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What are statins?
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drugs which reduce cholesterol
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How do statins work to lower cholesterol and which is the most popular>
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Most cholesterol is made in the liver, so statins stop the liver from producing it.
Lipitor is the most common statin |
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Does homocysteine cause heart disease?
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No, it is associated with heart disease but does not cause it. It is a risk factor and only a marker as it is not clear whether it causes the disease or the disease triggers greater production of it. Thus, it is only a marker
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What forms homocysteine within the body, what metabolizes it, and what can happen if it is not metabolized?
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An animno acid called Methionine forms Homocysteine in the body. Vitamin B metabolizes it. Therefore, inadequate vitamin B intake can lead to high levels of homocysteine which can be toxic to the cells which line blood vessels.
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What three symtpoms characterize inflammation?
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pain ( if not internal), swelling,high temperature
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Which protein is a marker of inflammation? ( High levels indicate higher risk of heart disease )
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CRP, C-reactive protein
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What does CRP of C-reactive protein tell us is going on in the body?
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CRP tells us that there is inflammation somewhere in the body.
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Which is better for treating people with risk of heart disease : anti-inflammatory drugs or food?
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Changes in diet are more effective as anti inflammatory drugs come with many side effects which outweigh the benefits.
Omega 3 fats ( fish oil, canola, flax) are anti inflammatory Omega 6 fats ( corn oil, sunflower oil, safflower) are pro inflammatory |
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What two types of infection can cause inflammation?
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bacterial and viral
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When does autoimmunity occur?
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When the body's immune system misdiagnoses an invader and accidentally targets itself.
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One should possess a diet with what ratio of Omega 3 and Omega 6 fats? the typical American diet possesses what ratio?
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Should be 1:1
Americans are O.6: O.3, 9:1 |
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Why is dental health a risk factor for heart disease? (2)
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Bad dental health or infected bleeding gums, open an entry way for bacteria to get into the bloodstream and potentially flow to the heart
Such infections can also cause inflammation, which elevates heart disease and risk |
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What is hypertension? Is it always caused by stress?
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Hypertension is elevated blood pressure which is sometimes caused by stress but can also occur in the perfectly calm
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What two numbers are used to measure blood pressure, and what unit of measurement is used?
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To measure blood pressure, one measures systolic/diastolic in mm HG ( millimeters of mercury)
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What was the traditional instrument which measured blood pressure, and how does it effect the name of the measurement unit still used for blood pressure ( millimeters of mercury)
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A manometer, the instrument wrapped around one's arm to take blood pressure, used to be connected to a vertical tube containing mercury which would gauge blood pressure. This is still used but mercury is not; however, the unit of millimeters of mercury is still used.
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What is white coat hypertension, and why does it prove that one measurement of blood pressure is not significant?
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White coat hypertension is when people become sressed about having their blood pressure taken so it goes up. Therefore, one measurement is inconclusive and several must be taken to classify high blood pressure as a condition
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What are the two types of hypertension?
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Mental stress caused hypertension
and essential hypertension ( cause unknown) |
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What is cut off blood pressure, or the average?
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130-135/85-90
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What are two ways of reducing blood pressure without taking medication and how do they work?
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- exercise ( 30 min, 5 times a week)
- diet (DASH - diertary approach to stop hypertension) rich in whole grains, fruits, and veggies and low in red mean and animal fat bananas are important as potassium can reduce blood pressure salt should be reduced as it increases blood pressure |
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What are the five types of medication one can take to reduce blood pressure?
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-direutics
- ace inhibitors -beta blockers -calcium channel blockers - angiotensin II receptor antagonists |
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How do diuretics reduce blood pressure?
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Blood contains a lot of water, and by increasing excretion and urination, water is removed from the blood, lowering the total amount of liquid and thus decreasing the pressure in your circulatory system
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What are ACE inhibitors and how do they decrease blood pressure?
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ACE or angiotensin converting enzyme inhibitor blocks the formation of the enzyme which produces angiotensin II which raises blood pressure. It does not block the production of angiotensin II, but rather the enzyme which makes it.
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Why are things such as angiotensin II needed in the body to increase blood pressure?
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Because increased blood pressure is due when muscles or the body need more oxygen, like during exercise.
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What is one example of an ACE inhibitor?
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Vasotec
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what are the negative side effects of ACE inhibitors?
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lowered white blood cell count weakening the immune system and causing a greater risk of infection. Also kidney damage. This is because angiotensin creates an equilibrium in the body and causes arteries to tighten and increase pressure when needed by the body.
Ace inhibitors cause blood pressure to drop quickly, causing these side effects |
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What do Beta Blockers do?
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Reduce the amount of adrenalin secreted by preventing the heart from being stimulated by adrenalin. In times of fight or flight when higher blood pressure is needed, adrenalin stimulates the heart and causes it to beat faster, raising blood pressure.
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What do calcium channel blockers do?
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Calcium channel blockers relax and dilate arteries as calcium is important for nerve cell function, especially those which cause increase in blood pressure by artery contraction.
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What is the commercial drug which acts as an angiotensin II receptor antagonist and what does it do?
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valsertan blocks the receptor angiotensin usually binds it to halt its production, not the enzyme which creates it.
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What is angina and when does it occur?
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Angina is a painful constricting of the chest which occurs when coronary arteries, divisions of the aorta surrounding the heart which bring it o2, are blocked.
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What causes the pain of angina?
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Low supply of o2 to the heart
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What are the artery passages like when a.) normal, b.) in early cardiovascular disease, c.) in atheromas
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normal : not blocked whatsoever
early cardiovascular disease: fatty streaks cause a prelimiary build up of fats plaque but is not yet dangerous c.) an atheromas is a plaque build up of calcium, fats and cholesterol which is signifigantly large and hinders blood flow. |
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What can happen if one exercises and has a serious build up of plaque in their arteries?
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the heart will not be able to meet its own o2 requirements as not enough blood can flow through the coronary arteries
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What is the complete blockage of an artery called?
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Occlusion
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What happens when plaque build up inside a coronary artery bursts?
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- when it bursts, the body perceives it as a cut
- therefore, red blood cells rush to the area to form a clot - platelets release fibral proteins which tangle together to form a web/net - this web is the clot, which blocks the artery completely - as the artery is already restricted, the clot more easily blocks the entire artery |
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What usually causes angina?
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exercise, as not enough o2 is supplied
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What is Vasospastic Angina, and when does it occur?
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Vasospastic angina occurs when the body is at rest and arteries spasm, choking blood flow. Small spasms can prove more serve when blockages are already present in the arteries.
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What are the two ways of testing for angina?
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A stress test which monitors heart activity through electrodes when the patient is on a treadmill
Injection and tracked movement of radioisotopes |
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How does nitroglycerin treat angina symptoms and what are the four methods of taking it?
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Nitroglycerin dialtes blood vessels,and is released into the body slowly and in a timed fashion.
It can be taken by - sublingual spray -under the tongue -cream -patch |
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does nitroglycerin cure angina?
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No, it does not treat it as it does not remove plaque build up; rather it provides temporary relief by dilating blood vessels.
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What is a symptom of nitroglycerin treatment and why?
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a symptom is headaches as more than just the blood vessels around the heart but also those around the head will dilate.
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What drugs which also reduce blood pressure can be used to treat angina, and why?
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Beta blockers can treat angina because they reduce the contraction force of the heart by blocking stimulation of the heart by adrenalin. If the heart contracts more slowly, it needs less o2
calcium channel blockers relax arteries, providing relief. can be used in conjunction |
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What produces adrenalin?
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The cortex of the adrenal gland
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What amino acid can reduce the incidence of angina and how?
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Arginine is an amino acid that can reduce the incidence of angina by promoting the formation of nitric oxide which widens blood vessels,
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Congestive heart disease occurs when what two symptoms are not addressed?
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angina and heart disease
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What part of the heart is usually effected in congestive heart failure?
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left ventricle which is the most important part as it sends blood to the aorta to be pumped to the rest of the body
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What is congestive heart failure?
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Inefficiency of the heart which renders it unable to properly fill or emphy of blood
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What happens to the blood if heart pumping is not efficient?
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Serum, the liquid part of the blood in the heart begins to seep out into surrounding tissue, causing them to retain water and swell
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What is dropsy?
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when the serum of the blood seeps out into tissues and causes them to swell and retain water
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What are the five main causes of congestive heart disease?
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coronary artery disease
high blood pressure heart value problems hyperthyroidism abnormal heart rythms |
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What brew from the leaves of a plant did Wlliam Withering discover to treat dropsy?
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brewed foxglove leaves
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What are the active ingredients in the foxglove plant called, what compounds are they a mix of, and which has been isolated as a prescription drug?
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Foxglove - digitalis - cardiac glycosides - Digoxin W
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What does Digoxin, found in foxglove plant, cause the heart to do?
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beat more forcefully
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What three drugs which treat high blood pressure can also treat congestive heart failure, and how?
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- direutics : reduce fluid build up
- beta blockers : improve pumping function - ace inhibitors : relax constricted vessels |
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What OTC can be useful in treating congestive heart failure and why?
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Coenzyme Q-10 can be used to treat chf because it is one of the essential enzymes that work together to synthesize ATP and therefore increasing the amount in our body will increase ATP synthesis and therefore energy that can be made by cardiac muscle cells
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How many mgs of Coenzyme Q-10 do tablets contain? is this enough?
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30mg
probably not enough |
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What happens during cardiac arrhythmia?
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the heart beats irregularly
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If the many drugs prescribed to treat cardiac arrhythmia fail, what electrical device can be used?
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pacemaker
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What does a pacemaker do, where is it implanted?
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Artificial pacemakers use batteries and electrical stimulus to preform the job of the natural pacemaker, telling the heart when to beat even during exercise!
It is inserted under the skin, and the 5 year battery can be changed or charged by magnetic induction |
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What is the scientific name for a heart attack?
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Myocardial infraction
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Why are heart attacks considered the most severe heart problem?
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Because they come on suddenly and can kill people quickly
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pains in which three spots are usually indicative of a heart attack?
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Arm,chest, back
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Why do heart attacks occur?
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when there are plaque blockages in the coronary artery and a blood clot forms a net adhering to the site of the injury, choking off blood to the heart and causing a heart attack
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What determines whether a heart attack is considered "mild" or "severe"
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the exact location of the blockage
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How many heart attacks occur each year in North America? What percentage of individuals die immediately and what percentage are not aware they suffered a hearth attack?
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25% and 25%( silent heart attack is when the sufferer is unaware)
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In dealing with heart attacks, what is the golden hour?
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if one can get the patient to the hospital in time to administer o2 and clot disolving drugs on time, serious damage can be prevented.
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At the hospital, what is the usual immediate 4 part treatment for a heart attack?
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Morphine
Oxygen Nitroglycerin ( dilate blood vessels) Aspirin ( dissolves blot clots) |
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What causes ventricular fibrillation, and what happens to the heart?
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It is caused by blockage of one of the coronary arteries, and causes the heart to fibrillate. It is still beating, but very inefficiently
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What two measures can treat ventricular fibrillation?
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CPR, or a defibrilator which has two paddles with electric shocks that sense how much current is needed to bump the heart back into proper rhythmic beating
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Which two chemicals are sometimes injected directly into the heart during a heart attack to immediately increase the force of contraction in the heart?
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adrenalin and atropine
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what does an EKG show us?
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whether there is any damage to the heart muscle
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Once at the hospital for a heart attack and ater MONA, what three things are done?
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EKG
blood test thrombolytics and other methods to dissolve clots |
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What enzymes does blood drawn from heart attack victims contain and why?
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Blood drawn from heart attack patients contain Troponin and Create Kinase, which are both released from damaged tissues.
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What drug aside from aspiring can be used to prevent further clots?
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Heparin, another carb polymer
It does not dissolve the clot but prevents future ones |
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How does TPA ( tissue plasminogen activator) work to dissolve clots?
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TPA ( tissue plasminogen activator) interact with the proteins in our blood called plasmogens, breaking them up into plasmins which dissolve clots.
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What is an example of a drug containing TPA ?
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Activase
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What can doctors physically do in a CATH lab?
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dissolve the blood clot
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What is balloon angioplasty?
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When a catheter is inserted into the leg and snaked up to the heart while looking through an x ray device, and once the catheter reaches the heart a balloon on its tip is inflates to physically open the site of blockage.
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What is a stent, what does it prevent, what are the risks associated with in and how are these combatted?
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a stent is a metal spring which can be wrapped around a balloon in balloon angiplasty so once the balloon deflates the spring stays.
As the spring stays, it aids in further damage. However it is not a permanent solution and can irritate artery walls. To combat this, some drug eluting stents have been created which contain an anti-inflammatory coating |
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Why do people experience a 15-25% renarrowing of their arteries after in-stent restenosis?
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Most because of scar tissue triggered by the stent
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What is radiation `therapy and what is another name for it?
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Brachytherapy or radiation is achieved by inserting a radioactive pellet into the artery which will destroy tissue and prevent new plaque masses from forming.
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What is laser Endarterectomy?
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A procedure inwhich via a catheter a laser burns through tissue deposits.
Too risky as the laser could burn the artery. Developed by a Canadian surgeon |
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What happens during a bypass surgery?
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- chest is opened and heart is exposed
-arteries are taken from the leg and sewn on to the heart, by passing the clogged arteries |
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What machine is imperative to a bypass surgery and why?
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A heart-lung machine is necessary as during the surgery the heart must stop beating so the heart-lung machine pumps deoxygenated blood into the lungs to send to the rest of the body during the operation
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What is the difference btw a single, double, triple, bypass?
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one re-sewn vein, two re-sewn veins, etc
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Which two groups perform bypass surgery at once?
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One group opens up the chest and the other harvests an artery from the leg
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Why do patients need to take anticoagulants after bypass surgery?
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heart tissue has been injured and clots could form
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What two types of valves can replace human values during valve surgery?
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Pip valves
simple values such as those in snorkeling masks |
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What are the three main difficulties with artificial hearts?
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- heart to mediate the slowing and quickening of blood flow needed
- hard to find a power source great enough to power the pumping of the heart as batteries are not sufficiant ( often people have to carry an external power source like compressed air) - blood can form clots as it pushes against the artificial material of the heart |
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Are artificial hearts short term or long term replacements
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short term
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When was a first heart transplant and what kind of opposition did the surgeon face?
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1967, 40 years ago, moral opposition ie against God's will to put someone else's heart into another body.
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