Cardiovascular Pathophysiology: Disorders, Heart Disease & Congenital Defects

Cardiovascular disease (CVD)

Diseases affecting the heart and blood vessels.

Atherosclerosis

Most common cause of CVD.

Impaired perfusion

Not enough blood reaching tissues and organs.

Organs especially affected by poor blood flow

Brain, heart, and kidneys.

Arteries

Carry blood away from the heart.

Veins

Carry blood toward the heart.

Pulmonary arteries

Carry oxygen-poor blood.

Pulmonary veins

Carry oxygen-rich blood.

Blood vessels

Have 3 layers: intima, media, and adventitia.

Intima

Inner layer of blood vessels.

Media

Middle layer of blood vessels.

Adventitia

Outer layer of blood vessels.

Coronary arteries

Supply blood to the heart muscle.

Brachiocephalic trunk

Divides into the right common carotid and right subclavian arteries.

Edema

Excess fluid in body tissues.

Effusion

Excess fluid in a body cavity.

Hemorrhage

Bleeding.

Thrombosis

Formation of a blood clot inside a blood vessel.

Thrombus

Blood clot.

Embolism

Blockage caused by material traveling through the bloodstream.

Infarction

Tissue death caused by loss of blood supply.

Ischemia

Inadequate blood supply to tissues.

Shock

Inadequate tissue perfusion that causes cellular hypoxia.

Peripheral edema

Swelling in arms or legs.

Pulmonary edema

Fluid in the lungs.

Pleural effusion

Fluid around the lungs.

Pericardial effusion

Fluid in the sac around the heart.

Ascites

Fluid in the abdominal cavity.

Pitting edema

Indentation remains after pressing swollen tissue.

Hemothorax

Bleeding into the chest cavity.

Hemopericardium

Bleeding into the pericardial sac.

Hemoperitoneum

Bleeding into the abdominal cavity.

Hemarthrosis

Bleeding into a joint.

Hemostasis

Normal process that stops bleeding.

Primary hemostasis

Platelets form a platelet plug.

Secondary hemostasis

Coagulation cascade forms fibrin.

DVT

Blood clot in a deep vein.

Pulmonary embolism

Blockage of a pulmonary artery by an embolus.

Fat embolism

Fat droplets enter blood circulation.

Air embolism

Air enters circulation.

Decompression sickness

Nitrogen bubbles form during rapid ascent from diving.

Amniotic fluid embolism

Amniotic fluid or fetal material enters maternal circulation.

Symptoms of amniotic fluid embolism

Sudden dyspnea, cyanosis, shock, seizures, or coma.

Epidural hematoma

Bleeding between the skull and dura mater.

Classic epidural hematoma presentation

Loss of consciousness, lucid interval, then deterioration.

Lucid interval

Temporary period of alertness after injury.

Subdural hematoma

Bleeding between dura and arachnoid mater.

Peritonsillar abscess

Also known as quinsy.

Quinsy symptoms

Fever, throat pain, neck pain, headache.

Quinsy treatment

Drainage and antibiotics.

Normal female heart weight

250-300 g.

Normal male heart weight

300-350 g.

Right ventricular wall thickness

0.3-0.5 cm.

Left ventricular wall thickness

1.3-1.5 cm.

Cardiomyocytes

Heart muscle cells.

SA node

Primary pacemaker of the heart.

SA node intrinsic rate

70-80 beats/min.

AV node

Delays electrical signals between atria and ventricles.

AV node intrinsic rate

40-60 beats/min.

His-Purkinje system intrinsic rate

20-40 beats/min.

P wave

Atrial depolarization.

QRS complex

Ventricular depolarization.

T wave

Ventricular repolarization.

Systole

Ventricles contract and eject blood.

Diastole

Ventricles relax and fill with blood.

Heart failure

Inability of the heart to pump enough blood.

Common causes of heart failure

MI, hypertension, arrhythmias, valve disease, pulmonary hypertension.

Heart failure symptoms

Shortness of breath, fatigue, edema, ascites, nocturia.

Nocturia

Frequent urination at night.

Atrial myxoma

Most common primary tumor of the heart.

LDL

Low-density lipoprotein, known as bad cholesterol.

HDL

High-density lipoprotein, known as good cholesterol.

CAD

Coronary artery disease, also called ischemic heart disease.

Angina

Chest discomfort caused by myocardial ischemia.

Myocardial infarction

Death of heart muscle due to prolonged ischemia.

Troponin

Important cardiac biomarker for MI.

STEMI

ST-elevation myocardial infarction, usually involves complete coronary artery occlusion.

NSTEMI

Non-ST-elevation myocardial infarction.

Cardiogenic shock

Heart cannot pump enough blood.

Hypovolemic shock

Loss of circulating blood volume.

Hypovolemic shock causes

Bleeding, burns, trauma.

Septic shock

Severe infection-related circulatory failure.

Important cytokines

TNF, IL-1, IL-6.

Septic shock symptoms

Hypotension, tachycardia, rapid breathing, confusion.

Oliguria

Decreased urine production.

Congenital heart disease

Heart defect present at birth.

Left-to-right shunts

Initially acyanotic.

Acyanotic

No bluish discoloration.

Right-to-left shunts

Cause cyanosis.

Cyanotic

Bluish discoloration due to low oxygen.

VSD

Most common congenital heart defect.

DiGeorge syndrome

22q11 deletion.

Fetal circulation

Before birth, oxygen comes from the placenta.

Foramen ovale

Opening between right and left atria.

Ductus arteriosus

Connects pulmonary artery to aorta.

Ventricular Septal Defect (VSD)

Hole in the interventricular septum.

Eisenmenger syndrome

Reversal of a long-standing left-to-right shunt.

Atrial Septal Defect (ASD)

Opening in the atrial septum.

Patent Foramen Ovale (PFO)

Fetal foramen ovale remains open after birth.

Patent Ductus Arteriosus (PDA)

Ductus arteriosus remains open after birth.