(9)Diseases of the Heart and Blood Vessels

Chapter 9

What makes you predisposed to heart conditions?

High blood pressure, drug abuse, high cholesterol, tobacco use, physical inactivity, poor nutrition, obesity and diabetics

What is congestive heart failure?

An inability of the heart to pump as much blood as the venous system supplies. residual blood congests the ventricles and the venous system

What results from congestive heart failure?

Insufficient amounts of oxygenated blood enter the arterial system. Fluid collects in the nervous system causing adjacent tissues to become edematous

WHat happens to the heart in congestive heart failure?

becomes overburdened and gradually weakens. CHF often results in cardiac failure of the left, right or entire heart. Left sided heart failure is a result of a weakening left ventricle.

What are the most common causes of left sided cardiac failure?

High blood pressure, mitral or aortic valve diseases, coronary artery disease and diseases of the myocardium

what are expected factors of left sided cardiac failure?

pulmonary edema and shortness of breath (or dyspnea)

What does decreased left sided output result in?

Less blood entering the kidneys, which respond by reabsorbing more sodium and water into the blood vascular system. Increased blood volume results which forces the heart to work harder.

Congested blood easily becomes clotted, which does what?

makes emboli a danger

What does right sided heart failure cause?

Anasarca

Chronic right sided heart failure also entails what?

Enlargement of abdominal organs such as the liver

What does CHF eventually lead to?

Failure of the heart to beat properly

Sudden death occurs when the heart undergoes what?

Fibrillation and arrhythmia

Chronic heart failure results in neurological changes that cause what?

The heart rate to change and its contractions to become more forceful

Hypertrophy and dilation are both what?

Enlargements of the heart

What is cardiac hypertrophy the result of?

Increasingly larger muscle fibers

What is cardiac dilation?

A stretching of cardiac muscle fibers

____ is a positive, adaptive response to an increased cardiac workload whereas ____ is a result of a pathological condition

cardiac hypertrophy ; cardiac dilation

What is the fancy term for a heart attack?

Myocardial infarction

What causes infarctions?

An area of tissue is denied oxygenated blood (ischemia) which results in necrosis

WHat is hypoxia?

Tissue becomes infarcted when a vein taking blood away becomes occluded

What causes most heart attacks?

Blood clot develops within the coronary artery which denies oxygen rich blood to the heart muscle

Which sex is at higher risk of myocardial infarction?

Men

Why are nearly half of all cases of myocardial infarction fatal?

Acute cardiac failure (a total occlusion of the coronary artery)

What is the chest pain associated with heart attacks?

Angina- a dull, aching, throbbing pain. Not exacerbated by breathing deeply, coughing or swallowing

How long may angina occur before an acute myocardial infarction?

Days or weeks

What are the classic symptoms of myocardial infarctions?

Sensation of crushing behind breastbone, chest pain radiating to neck, jaw, abdomen, shoulder or left arm, nausea, vomiting, difficulty breathing, anxiety or fear

What is endocarditis?

Inflammation of the endocardium and/or the valves of the heart as well as the cardiac septum

When does endocarditis happen?

When blood clots damage the lining of the heart followed up by bacterial infection

What is pericarditis?

Inflammation of the pericardium

What are the common causes of pericarditis?

Infections and blunt force trauma

What is cardiac tamponade?

Excessive amounts of fluid that accumulate within the pericardial sac -can be a result of pericarditis.

What is cardiomyopathy?

Disease of the heart muscle itself.

What are the two types of cardiomyopathy?

Primary and secondary

What is primary cardiomyopathy?

Idiopathic in nature

What is secondary cardiomyopathy?

Associated with toxic chemicals, metabolic disorders like diabetes or inherited cardiac disorders

What are valvular defects?

Deformations or defects in the valves of the heart that can be acquired or congenital

What is true of patients with valvular defects?

Aortic and mitral valves are usually deformed. Tricuspid and pulmonic valves become more prone to disease

What are two mechanisms by which deformed cardiac valves cause disease?

Defects cause obstructions to blood flow and deformed valves are more susceptible to infection

What are the three ways blood flow can be disrupted in cases of deformed cardiac valves?

Valvular insufficiency, valvular stenosis and valvular prolapse

What is valvular insufficiency?

A congenital disorder where valves of the heart fail to form properly in fetus

What is valvular stenosis?

Narrowing of the valvular orifice, disrupting blood flow

What is valvular prolapse?

excessive stretching of the valves preventing them from closing properly

What does rheumatic fever often result in?

rheumatic heart disease

Which valve is most commonly affected in rheumatic heart disease?

Mitral (leads to endocarditis)

High blood pressure often causes what in the left ventricle?

Hypertrophy

What happens as the left ventricle becomes larger?

It requires more nutrients than can be delivered. It becomes tighter and less efficient at pumping. Often accompanied by atherosclerosis

What is an atrial septal defect?

Failure of the foramen ovale to completely close at birth. The hole allows too much blood to bypass the right ventricle and therefore the lungs

What is blue baby syndrome?

When a newborn isn't receiving enough oxygenated blood- result of atrial septal defect

What is coronary artery disease?

An ischemic heart diseasee that is the most common cause of death in economically developed countries. Characterized by a narrowing of the lumen of the coronary arteries due to atherosclerosis

What is arteriosclerosis?

Hardening of the arteries. Marked by a thickening, hardening and loss of elasticity in arterial walls

What are the three kinds of arteriosclerosis?

Atherosclerosis, sclerosis of arterioles and monckeberger's calcification

What is atherosclerosis?

Process whereby deposits of fatty substances like cholesterol, cellular waste and calcium build up inside the lining of an artery forming plaque

What is the real danger of atherosclerosis?

When fragmentation occurs and emboli travel through the blood stream

What is a common complication of atherosclerosis?

Gangrene in the extremities

What is believed to cause atherosclerosis?

Elevated levels of cholesterol and tryglycerides in the blood, hypertension, tobacco use and diabetes which damage the arterial walls

What predisposes a person to atherosclerosis?

Hypertension, obesity, family history of cardiovascular disease, physical inactivity

What is an aneurysm?

The abnormal enlargement or bulging of an artery caused by damage to or weakness in the blood vessel wall

Where are aneurysms likely to form?

Aorta or the larger arteries of the legs (peripheral aneurysms)

A ruptured aneurysm can be

fatal

What is a cerebral aneurysm?

Aneurysm in the cerebral arteries of the brain which can lead to brain damage, paralysis, comas or death.

How can cerebral aneurysms be detected?

Imaging tests like MRIs, CAT scans an angiograms

What are characteristics of cerebral aneurysms?

Headaches, drowsiness, neck stiffness, nausea, vomiting, mental confusion, vertigo, loss of consciousness

What is hypertension?

High blood pressure

What conditions may hypertension contribute to?

Coronary artery disease, strokes, kidney failure, sudden rupture of the aorta

What blood pressure is considered hypertension?

140/90

What percent of hypertension cases are idiopathic?

90-95%

What has been consistently linked to hypertension?

High sodium intake

What is arteritis?

Idiopathic inflammation of the arteries. Accompanies infections caused by bacteria, fungi and viruses. Common when suffering autoimmune diseases

What is temporal arteritis?

Most common form of arterial inflammation (also known as giant cell arteritis) and is idiopathic in nature. Affected cells are infiltrated by immune cells. Loss of vision is present in half of cases

How can temporal arteritis spread?

From temporal arteries to the ophthalmic arteries to the carotid arteries and finally the aorta

What is phlebitis?

Inflammatory condition of the veins of the legs. Blood clots form along the walls and valves of the veins

What can phlebitis cause?

Deep venous thrombosis

What are varicose veins?

Enlarged, superficial veins usually in legs and feet and occasionally the esophagus

What are varicose veins caused by?

Excessive venous blood pressure and certain cancers. Other factors include age, pregnancy, obesity and sitting or standing for long periods of time

What is arrhythmia?

The loss of normal beating rhythm of the heart

What is fibrillation?

Quivering or spontaneous contraction of the individual cardiac muscle cells

What is hypertensive heart disease?

High blood pressure leading to enlargement of the heart