CLS 308: Ch. 7 The Cardiovascular System

• Tunica intima

• Tunica media (smooth muscle, larger in arteries)

• Tunica adventitia (fibroblasts and connective tissue)

The layers of the blood vessels (3)

Cardiovascular disease (50%)

Most of the deaths in the U.S. are due to…

• Viruses

• Alcohol

• Chromosomal abnormalities

Most common causes of congenital heart diseases (3)

• Ventricular septal defect

• Atrial septal defect

• Tetralogy of fallot

Most common congenital heart diseases (3)

Cyanosis

(Ventricular septal defect) Hole in the septum between the ventricles cause deoxygenated and oxygenated blood to mix, eventually leading to…

Foramen oval

Atrial septal defects typically occur when the (——) remains open after fetal development

Stenosis of heart valves

Involved in tetralogy of fallot where the heart valves narrow and blood cannot flow normally

• Coronary heart disease (→ myocardial infarction)

• Cerebrovascular disease (→ stroke)

• Atherosclerosis of aorta (→ aortic aneurism)

• Peripheral vascular disease (→ gangrene)

Examples of localized atherosclerosis and possible outcomes (4)

• Stress test

• Stent or bypass

What test is used to find the competency of coronary arteries; how is coronary heart disease treated

Left coronary artery (muscular side of heart)

What is known as the widowmaker artery?

1. Lifestyle change (diet,, physical activity)

2. Statins (reduces cholesterol and triglycerides from liver)

Prevention of atherosclerosis of aorta (2)

Foam cells

Type of macrophage that localize to fatty deposits on blood vessel walls

• PLT activation is procoagulant

• Site of injury is very soft

Characteristics of atherosclerosis that leads to clot formation and aneurisms

• Lipid metabolism (age)

• Hypertension

• Clotting factors

• Cigarette smoking

• Behavior

Changeable risk factors for atherosclerosis (5)

Estrogen and exercise

Protective factors for atherosclerosis

High blood glucose causes cell damage to blood vessels, allowing for fat deposits

How does diabetes mellitus lead to atherosclerosis

• Saccular aneurism (bulge)

• Fusiform aneurism (bilateral - abdominal aorta)

• Dissecting aneurism

Different structures of aneurisms (3)

• Atherosclerosis of renal arteries

• Atherosclerosis of intestinal arteries

• Atherosclerosis of extremities (diabetes mellitus - gangrene)

Different types of peripheral vascular disease (3)

Congestion in the renal artery → false hypotension in the kidney → release of renin (glomerulus), aldosterone (adrenal gland water retention). and vasoconstriction → hypertension → dissection

How does atherosclerosis of renal artery dissect

(10-25, 50-70, 100% occlusion)

• Asymptomatic

• Angina pectoris (treat w/ nitroglyceride - artery dilation)

• Congestive heart disease (failure to pump blood)

• Myocardial infarction (heart attack)

Clinical presentations of coronary heart disease (4)

Hematopericardium

Presence of blood in the sac surrounding the heart due to heart rupture

• Ischemia - reduced bloodflow

• Infarction - complete cutoff of blood

Ischemia vs. infarction

• Myoglobin (first)

• Troponin T or I (specific)

• Creatine-kinase enzymes (CK-MB)

• Alanine transaminase (ALT)

• Lactic dehydrogenase (LDH)

Components of cardiac profile indicative of myocardial infarction

• Troponin T (ventricular infarction)

• Troponin I (atrial fibrilation)

Protein that is specific to myocardial infarction, involved in the activation of muscles (follows after myoglobin)

• Cardiac hypertrophy

• Congestive heart disease

• Renal insufficiency

• Hypertensive encephalopathy (severe headaches)

• hypertensive retinopathy (one of first places hypertension)

Pathogenesis of hypertension (5)

Streptococcus pharyngitis (Strep throat)

Bacteria that causes rheumatic heart disease

• Myocarditis (rigid walls)

• Prevent relaxation in diastole

• Calcification of valves (chordae tendon doesn’t work)

Strep bacteria presence in the heart valves leads to… (3)

• Endocarditis (inner lining of heart chamber and valves)

• Myocarditis (heart muscle)

• Pericarditis (outer lining of heart)

Infectious diseases of the heart (3)

• Viruses (most common)

• Bacteria (immunocompromised or septic)

• Parasites and protozoa (Trypanosoma cruzi - Chagas disease)

Causes of infectious myocarditis (3)

• Viruses (most common)

• Bacteria

• Fungi (rare)

• Rheumatic heart disease

• Uremia (blood urea - kidney failure)

• Open heart surgery (foreign agents and inflammation)

Causes of pericarditis (6)

• Atherosclerosis

  Arteritis

  • Polyarteritis nodosa (hypersensitiity III)

  • Giant cell arteritis (granuloma in temporal artery)

  • Reynaud’s disease

Arterial diseases (4)

• Genetic

• Arteries in extremities contract

• Exacerbated by cold temperature and cigarette smoking

Characteristics of Raynaud’s disease (3)

• Vericose veins

• Thrombi

• Thrombophlebitis (infection in leaky valves → inflammation)

Diseases of veins (3)