[PPT] Cardiovascular Disorders
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Questions and Answers

What is the main focus of the Clinical Consult featuring Caren Kristia Adora?

  • Myocardial Ischemia
  • Familial Dyslipidemia (correct)
  • Stages of Atherosclerosis
  • Heart Failure

Which topic is discussed immediately after the break in Module 3?

  • Fetal Heart Development
  • Myocardial Ischemia, Necrosis (correct)
  • PAD/DVT
  • Clinical Consult- Hypertension and ACE Inhibitors

How long is the discussion following the Clinical Consult on Hypertension and ACE Inhibitors?

  • 20 minutes
  • 10 minutes
  • 5 minutes (correct)
  • 15 minutes

Which cardiovascular issue is NOT explicitly mentioned in the Module 3 outline?

<p>Aneurysm (D)</p> Signup and view all the answers

What is the total duration allocated for the Module 3 overview's check-in and quiz review?

<p>15 minutes (C)</p> Signup and view all the answers

What is one of the primary functions of the pericardial sac?

<p>Provides stability of the heart within the thorax (A)</p> Signup and view all the answers

How does the pericardial sac contribute to heart function?

<p>By reducing friction between the heart and mediastinal structures (A)</p> Signup and view all the answers

What is an arrythmia?

<p>An abnormal heart rate or conduction of electrical impulses (A)</p> Signup and view all the answers

Which layer of the heart wall is the thickest?

<p>Myocardium (C)</p> Signup and view all the answers

Which function does the pericardial sac NOT perform?

<p>Acts as a storage area for blood (A)</p> Signup and view all the answers

What role do the pain and mechanoreceptors in the pericardial sac serve?

<p>To detect changes in heart rate and blood pressure (D)</p> Signup and view all the answers

Which of the following accurately describes the pericardial sac?

<p>It stabilizes and protects the heart. (C)</p> Signup and view all the answers

What is NOT a function of the pericardial sac?

<p>Regulating body temperature (B)</p> Signup and view all the answers

What is cardiac output primarily dependent on?

<p>Heart rate and stroke volume (C)</p> Signup and view all the answers

What does the Frank-Starling Law state about stroke volume?

<p>Stroke volume increases with increased left ventricular volume (D)</p> Signup and view all the answers

What term describes the resistance the ventricle faces when ejecting blood?

<p>Afterload (B)</p> Signup and view all the answers

Which layer of the heart wall is the innermost layer?

<p>Endocardium (C)</p> Signup and view all the answers

What does preload refer to in cardiac physiology?

<p>The volume and pressure in the ventricle at the end of diastole (A)</p> Signup and view all the answers

What does diastole represent in the cardiac cycle?

<p>Filling of blood into a chamber of the heart (B)</p> Signup and view all the answers

What is the function of valves in the heart?

<p>To help keep the blood moving forward (D)</p> Signup and view all the answers

Which type of valve does not close tightly, allowing blood to flow backward?

<p>Regurgitant valve (C)</p> Signup and view all the answers

During which phase does the heart muscle contract and eject blood?

<p>Systole (A)</p> Signup and view all the answers

What is a stenotic valve characterized by?

<p>Failure to open completely (A)</p> Signup and view all the answers

What is the role of electrical activity in relation to the heart?

<p>It generates and spreads the heartbeat (C)</p> Signup and view all the answers

What happens during systole?

<p>Blood is ejected from the heart (A)</p> Signup and view all the answers

What physiological process directly contributes to coronary artery circulation?

<p>Muscle contraction (C)</p> Signup and view all the answers

What are the functions of the pericardial sac?

<p>Limits heart chamber size and reduces friction (C)</p> Signup and view all the answers

Which layer of the heart wall is primarily responsible for the heart's contraction?

<p>Myocardium, composed of cardiac muscle (D)</p> Signup and view all the answers

What does an arrhythmia indicate about the heart?

<p>There is an abnormal heart rate or conduction (B)</p> Signup and view all the answers

Which of the following components is NOT part of the heart wall structure?

<p>Pericardium (B)</p> Signup and view all the answers

Which symptom is primarily associated with left-sided heart failure?

<p>Orthopnea (B)</p> Signup and view all the answers

What condition is indicated by elevated filling pressure in the left ventricle?

<p>Heart failure with preserved ejection fraction (C)</p> Signup and view all the answers

Which symptom is NOT typically associated with right-sided heart failure?

<p>Cough (A)</p> Signup and view all the answers

Which factor can exacerbate the situation in heart failure with preserved ejection fraction?

<p>Reduced left ventricular compliance (A)</p> Signup and view all the answers

What major consequence arises from impaired ventricular filling due to high filling pressures?

<p>Blood backing up into the left atrium (D)</p> Signup and view all the answers

What occurs during systole in the cardiac cycle?

<p>Ejection of blood from a chamber (C)</p> Signup and view all the answers

Which valve is located on the right side of the heart?

<p>Pulmonic valve (D)</p> Signup and view all the answers

What describes a stenotic valve?

<p>It does not open fully (D)</p> Signup and view all the answers

During ventricular diastole, which valves are open?

<p>Only the tricuspid and mitral valves (D)</p> Signup and view all the answers

What is the function of heart valves?

<p>To keep blood moving in one direction (C)</p> Signup and view all the answers

What characterizes a leaky (regurgitant) valve?

<p>It does not close tightly (A)</p> Signup and view all the answers

Which valves are closed during ventricular systole?

<p>Mitral and tricuspid valves (B)</p> Signup and view all the answers

What happens to the blood flow during a cardiac cycle?

<p>It moves unidirectionally due to valve actions (B)</p> Signup and view all the answers

What is considered a normal heart rate for a Normal Sinus Rhythm?

<p>60-100 beats/minute (B)</p> Signup and view all the answers

Which condition is characterized by an ejection fraction (EF) of ≤ 40%?

<p>Heart failure with reduced EF (C)</p> Signup and view all the answers

Which of the following is NOT a common symptom of heart failure?

<p>Cognitive impairment (C)</p> Signup and view all the answers

What does bradycardia refer to?

<p>Heart rate below 60 beats/minute (A)</p> Signup and view all the answers

Which of the following is a risk factor for heart failure?

<p>Hypertension (C)</p> Signup and view all the answers

Heart failure with preserved ejection fraction (HFpEF) is characterized by which of the following?

<p>EF ≥ 50% (D)</p> Signup and view all the answers

Which atypical symptom may be more commonly presented in elderly patients with heart failure?

<p>Cognitive impairment (D)</p> Signup and view all the answers

What is the heart rate classification for tachycardia?

<blockquote> <p>100 beats/minute (D)</p> </blockquote> Signup and view all the answers

What is the left ventricular ejection fraction (LVEF) percentage that characterizes heart failure with preserved ejection fraction?

<p>Greater than or equal to 50% (B)</p> Signup and view all the answers

What primarily causes heart failure with reduced ejection fraction (HFrEF)?

<p>Myocardial cell death or damage (C)</p> Signup and view all the answers

In heart failure with preserved ejection fraction, what contributes to reduced cardiac output?

<p>Filling problems of the ventricle (D)</p> Signup and view all the answers

What physiological response occurs in the body in reaction to decreased cardiac output in HFrEF?

<p>Increased preload and heart rate (B)</p> Signup and view all the answers

What exacerbates the condition in heart failure with preserved ejection fraction?

<p>Increased afterload due to hypertension (C)</p> Signup and view all the answers

In heart failure with reduced ejection fraction, what is the main issue with the heart's contractility?

<p>The heart muscle is weakened (A)</p> Signup and view all the answers

What is a consequence of an elevated heart rate in the context of heart failure with preserved ejection fraction?

<p>Reduced time for ventricular filling (A)</p> Signup and view all the answers

Which of the following is NOT a causing factor for reduced ejection fraction in heart failure?

<p>Increased ventricle size (A)</p> Signup and view all the answers

What compensatory mechanism is activated due to reduced cardiac output in heart failure?

<p>Renin-Angiotensin-Aldosterone System (RAAS) activation (C)</p> Signup and view all the answers

What effect do naturetic peptides have on the sympathetic nervous system in heart failure?

<p>Decrease sympathetic activity (D)</p> Signup and view all the answers

What is the primary role of neprilysin in the context of heart failure?

<p>To break down naturetic peptides (A)</p> Signup and view all the answers

Which combination of drugs is associated with improving heart failure symptoms through neprilysin inhibition?

<p>Sacubitril and Valsartan (B)</p> Signup and view all the answers

What does 'reverse remodeling' in heart failure mean?

<p>Improvement in ejection fraction (D)</p> Signup and view all the answers

What is a primary characteristic of heart failure with reduced ejection fraction (HF-rEF)?

<p>LVEF less than or equal to 40% (B)</p> Signup and view all the answers

What function do diuretics serve in the management of heart failure?

<p>Relieve fluid overload (A)</p> Signup and view all the answers

What is the consequence of vasoconstriction due to catecholamines in heart failure?

<p>Increased afterload (D)</p> Signup and view all the answers

How do naturetic peptides contribute to heart failure management?

<p>They promote natriuresis and vasodilation (C)</p> Signup and view all the answers

What is the main impact of left heart failure on renal function?

<p>Reduced cardiac output to kidneys (C)</p> Signup and view all the answers

Flashcards

Mechanical function of the heart

The heart's ability to move blood through the circulatory system, including the valves and chambers.

Electrical function of the heart

Refers to the heart's electrical system, which controls the rhythm and pace of the heartbeat.

Atherosclerosis

A buildup of plaque inside the arteries, narrowing them and restricting blood flow.

Myocardial Ischemia

A condition where the heart muscle doesn't get enough oxygen, leading to pain and potential damage.

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Myocardial Necrosis

When the heart muscle is permanently damaged due to lack of blood supply, often resulting from a heart attack.

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What is the mechanical function of the heart?

The mechanical function of the heart describes the pumping action that moves blood through the body.

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What is the electrical function of the heart?

The electrical function of the heart refers to the system that controls the rhythm and pace of the heartbeat.

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What is diastole?

Diastole is the period when the heart chambers relax and fill with blood.

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What is systole?

Systole is the period when the heart chambers contract and pump blood out.

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What are valves in the heart?

Valves are gates that open and close to ensure blood flows in the right direction through the heart.

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What is a stenotic valve?

A stenotic valve doesn't open fully, limiting blood flow.

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What is a leaky valve?

A leaky, or regurgitant, valve doesn't close tightly, allowing blood to leak back.

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What are coronary arteries?

The coronary arteries provide a vital blood supply to the heart muscle.

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Stroke Volume

The amount of blood pumped out of the heart with each beat.

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Cardiac Output

The amount of blood pumped out of the heart per minute.

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Preload

The volume and pressure inside the ventricle at the end of diastole.

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Afterload

The resistance the heart faces when pumping blood out of the ventricle.

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Frank-Starling Law

The relationship between the ventricle's stretch and its strength of contraction - a stretched ventricle contracts more forcefully.

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What is the pericardial sac?

The fibrous sac that encloses the heart, providing stability, reducing friction, limiting its size, and acting as a barrier against infection.

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What is the myocardium?

The thickest layer of the heart wall, composed of cardiac muscle.

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What is an arrhythmia?

An irregular heart rhythm due to problems with the heart's electrical system.

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What are pain receptors in the pericardial sac?

Pain receptors in the pericardial sac that can cause reflex changes in blood pressure and heart rate.

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What are mechanoreceptors in the pericardial sac?

Mechanoreceptors in the pericardial sac that sense changes in pressure and can also cause reflex responses.

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How does the pericardial sac reduce friction?

The pericardial sac helps reduce friction between the heart and surrounding structures.

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How does the pericardial sac limit the heart's size?

The pericardial sac limits the size of the heart, preventing it from expanding too much.

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How does the pericardial sac act as a barrier?

The pericardial sac acts as a barrier, preventing infections from reaching the heart.

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Myocardium

The thickest layer of the heart wall, primarily composed of cardiac muscle. This layer is responsible for the heart's powerful contractions.

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Pericardium

A double-walled sac that encloses the heart, providing stability within the chest, reducing friction, limiting the heart chambers' size, acting as a barrier to infection, and containing pain receptors and mechanoreceptors.

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Arrhythmia

Abnormal heart rate or conduction of the electrical impulse through the heart. This can lead to irregular heartbeats, a condition that may require medical attention.

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Cardiac Conduction System

Specialized cells within the heart that generate and conduct electrical impulses, regulating the heart's rhythm and coordinating contractions.

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Name the four valves in the heart.

The tricuspid, pulmonic, mitral, and aortic valves are all vital for maintaining the forward flow of blood through the heart, preventing backflow.

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During ventricular diastole, which valves are open and which are closed?

During ventricular diastole, the mitral and tricuspid valves are open, allowing blood to flow from the atria into the ventricles. The aortic and pulmonic valves are closed, preventing blood from flowing back into the ventricles.

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During ventricular systole, which valves are open and which are closed?

During ventricular systole, the aortic and pulmonic valves are open, allowing blood to be ejected from the ventricles into the aorta and pulmonary artery. Mitral and tricuspid valves are closed, preventing backflow into the atria.

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What is the function of the tricuspid valve?

The tricuspid valve separates the right atrium from the right ventricle, preventing blood from flowing back into the right atrium during ventricular systole.

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Tachycardia

A heart rate above 100 beats per minute.

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Bradycardia

A heart rate below 60 beats per minute.

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Ejection Fraction (EF)

The ability of the heart to pump blood effectively. It's measured as a percentage.

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Heart failure with preserved ejection fraction

A type of heart failure where the left ventricle doesn't relax properly, leading to stiffness and difficulty filling with blood during diastole.

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Ejection fraction

The amount of blood ejected from the left ventricle with each heartbeat.

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Diastole

The period when the heart muscle relaxes and refills with blood.

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Heart failure

A condition where the heart can't pump efficiently due to a weakened heart muscle.

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What is HFpEF?

Heart failure with preserved ejection fraction (HFpEF) occurs when the heart can't fill with enough blood during diastole, leading to a reduced cardiac output. This is despite a normal or even above-normal ability to pump blood out of the heart.

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What is HFrEF?

Heart failure with reduced ejection fraction (HFrEF) occurs when the heart muscle is weak and cannot pump blood out of the heart effectively, leading to a reduced cardiac output. This is indicated by a low ejection fraction (EF) below 40%.

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How does the body try to compensate for HFrEF?

In HFrEF, the body tries to compensate by increasing preload and heart rate to increase cardiac output, but this ultimately wears out the failing heart muscle further. The decreased cardiac output also leads to other compensatory mechanisms that tire out the heart over time.

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What factors worsen HFpEF?

Increased afterload in HFpEF, such as from high blood pressure, makes it even harder for the heart to pump blood out. Similarly, a fast heart rate (tachycardia) decreases the time for the heart to fill with blood, further reducing cardiac output.

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What's the key difference between HFpEF and HFrEF?

In HFpEF, the heart's reduced cardiac output is primarily due to impaired filling, rather than a weakened heart muscle. This is unlike HFrEF where the problem lies in the heart's ability to pump blood out.

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What is the Frank-Starling Law?

The Frank-Starling law describes the relationship between the volume of blood in the ventricle at the end of diastole (preload) and the strength of the heart's contraction. A stretched ventricle contracts more forcefully, resulting in a greater stroke volume. This law is important for understanding how the heart adapts to different pressures and volumes.

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What is ejection fraction?

Ejection fraction (EF) is a measure of the heart's pumping efficiency. It represents the percentage of blood pumped out of the ventricle with each heartbeat. A normal EF is generally between 50% and 70%.

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What is cardiac output?

Cardiac output is the amount of blood pumped by the heart per minute. It is influenced by factors like heart rate, stroke volume, and preload. In both HFpEF and HFrEF, cardiac output is reduced.

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Compensatory Responses to Left Heart Failure

A group of physiological responses that occur in the body to try and compensate for a reduced ability of the heart to pump blood, often seen in left heart failure.

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Increased Afterload in Heart Failure

Increased afterload is a condition where the heart has to work harder to pump blood out, due to increased resistance in the blood vessels. This is often a response to reduced blood flow to the kidneys and the activation of the RAAS system.

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Ventricular Remodeling in Heart Failure

Ventricular remodeling is a process where the heart's chambers change in size and shape as a result of compensatory mechanisms. This can lead to a decrease in the heart's function.

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Sympathetic Nervous System Activation in Heart Failure

The sympathetic nervous system (SNS) is a part of the autonomic nervous system, which helps control blood pressure and heart rate. In heart failure, the SNS is activated due to reduced blood pressure, leading to vasoconstriction and increased blood pressure.

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RAAS and Heart Failure

The Renin-Angiotensin-Aldosterone System (RAAS) is a hormonal system that helps regulate blood pressure. In heart failure, the RAAS is activated due to reduced blood flow to the kidneys, leading to vasoconstriction and fluid retention.

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Naturetic Peptides in Heart Failure

Naturetic peptides are small protein-like molecules that work in the body to promote vasodilation, decrease fluid retention and counter the effects of the SNS and RAAS.

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Neprilysin and Heart Failure

Neprilysin is an enzyme that breaks down naturetic peptides, which are molecules that help improve heart function. When neprilysin is blocked, naturetic peptides stay in the body longer

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Sacubitril and Heart Failure

Sacubitril is a drug that blocks neprilysin, an enzyme that breaks down naturetic peptides, leading to their increased levels in the body.

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Valsartan and Heart Failure

Valsartan is a drug that blocks angiotensin II receptors in the body. By blocking angiotensin II, the blood vessels relax and blood pressure decreases (reducing afterload).

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Study Notes

Cardiovascular System Disorders - Module 3

  • Date: October 10, 2024
  • Module: 3
  • Topic Overview: The module covers disorders of the cardiovascular system, including a review, structure and function of the heart, atherosclerosis, familial dyslipidemia, hypertension, ACE inhibitors, peripheral artery disease (PAD), deep vein thrombosis (DVT), congenital heart disease, acute coronary syndromes (ACS)/myocardial infarction (MI), and various other cardiovascular-related topics.

Schedule

  • 10:00-10:15: Check in and Module 1 quiz review (15 min)
  • 10:15-10:30: Structure and function of the heart (15 min)
  • 10:30-10:50: Clinical consult - Familial Dyslipidemia (15 min + 5 min discussion); Presented by Caren Kristia Adora
  • 10:55-11:15: Clinical consult - Hypertension and ACE Inhibitors (15 min + 5 min discussion); Presented by Stephanie Wood
  • 11:20-11:30: PAD/DVT (10 min)
  • 11:30-11:45: Break (15 min)
  • 11:45-12:05: Clinical Consult- Fetal Heart Development (15 min + 5 min discussion); Presented by Amanda Rideout
  • 12:10-12:25: Myocardial Ischemia, Necrosis (15 min)
  • 12:25-12:50: Heart Failure (15 min)
  • 12:50-1:00: Practice quiz (10 min)
  • 1:00-1:10: Letter of Information and Wrap Up (10 min)

Additional Information

  • Module 2 Quiz: Scheduled
  • Lichen Planus: A YouTube video discussion of the condition
  • Heart Anatomy: Diagrams show the inside and outside anatomy of the heart
  • Blood Flow: Video diagrams illustrate blood flow through the heart and the role of valves
  • Heart Valves: Four valves (tricuspid, pulmonary, mitral, aortic) are discussed; their function, when open and closed during the cardiac cycle
  • Valve Problems: Examples of aortic stenosis and regurgitation are provided
  • Factors Affecting Cardiac Output: Preload, afterload, contractility, heart rate, and the role of the central and autonomic nervous systems are detailed explaining factors affecting cardiac output
  • Frank-Starling Law: Illustrated; describing the relationship between the stretch of cardiac muscle fibers and stroke volume, a key principle in cardiac output regulation
  • Heart Wall: The three layers (epicardium, myocardium, and endocardium) and their functionality of the pericardium, are explained
  • The Electrical System of the Heart: The anatomy and function of the SA node, AV node, bundle of His, and Purkinje fibers
  • Depolarization and Repolarization: The five phases of the cardiac action potential are detailed, including the key ion movements
  • Electrocardiogram (ECG): Describes the ECG and how it relates to cardiac events- with examples
  • Coronary Circulation: Explains the coronary arteries and veins- with an emphasis on their function and importance
  • Coronary Anatomy: Diagrams illustrate the coronary artery course and branching; location in the heart and surrounding structures
  • The Circulatory System: Diagram illustrating the pulmonary and systemic circulations and showing blood flow
  • Blood Vessels (Arteries): Anatomy and types of arteries (elastic and muscular) and their functions
  • Atherosclerosis: Factors, pathophysiological mechanisms, and progression of atherosclerotic plaques. Discusses causes and consequences of plaque rupture and risk factors that contribute to disease. Detailed illustrations of stages.
  • Risk Factors for Atherosclerosis: Lists non-modifiable and modifiable factors; including details about metabolic syndrome
  • Familial Hypercholesterolemia: Specific clinical consult on this condition
  • Cholesterol: The roles of cholesterol in the body, different types of lipoproteins, and their cholesterol content
  • Dyslipidemia: Guideline discussion and screening recommendations
  • Apo B vs LDL: Further explanations and support for understanding cardiovascular risk via ApoB
  • Lipoprotein(a): Supplemental information regarding its relationship to LDL, risks, screening/diagnosis, and management.
  • ORION Trial: Information about an ORION Trial- including inclusion criteria
  • Smoking and Alcohol Consumption: Explanation of how these increase cardiovascular disease risk (through ROS)
  • Hypertension: Risk factors, pathophysiology, primary vs secondary, and complications are detailed
  • Malignant Hypertension: Description and factors associated with it
  • Cardiovascular Society Guidelines: Specific guidelines from the Canadian Cardiovascular Society for PAD (Peripheral Artery Disease), Peripheral and Artery Disease, Hypertension
  • Peripheral Arterial Disease (PAD): Risk factors, pathophysiology, clinical presentation with discussion of the 6 P's, claudication, risk assessment- and supplemental learning resources (videos)
  • Deep Vein Thrombosis (DVT): Risk factors, pathophysiological mechanisms behind DVT and Virchow's triad
  • Clinical Presentation of DVT: Signs such as swelling, pain, and redness; and related diagnostic tools (Well's criteria)
  • Congenital Heart Disease: Overview, classifications (acyanotic vs cyanotic), specific examples like tricuspid atresia, tetralogy of Fallot, patent ductus arteriosus, and ventricular septal defect. Diagrams illustrate anatomy, implications, clinical course, and outcomes.
  • Coronary Artery Disease, Myocardial Ischemia, Acute Coronary Syndromes (ACS)/ Myocardial Infarction (MI): Pathophysiology of CAD, risk factors, different types of angina, common symptoms, complications, and management- detailed with diagrams and illustrations
  • Reactive Oxygen Species (ROS) and Oxidative Stress: Definition and mechanisms- pathophysiology, role in cell injury, detailed diagrams/figures, with relation to atherosclerosis
  • Myocardial Infarction (MI): Structural and functional heart changes- detailed discussion of zones of infarction, injury, and ischemia- with specific ECG changes described regarding each zone
  • Heart Failure: Overview, with distinctions between left-sided and right-sided heart failure- discussion of systolic vs diastolic heart failure- and compensatory mechanisms explained.
  • Naturetic Peptides: Explanation of naturetic peptides and mechanism in heart failure treatment, including new medications

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Related Documents

Module 3. Cardiovascular System Disorders Seminar Slides (October 10, 2024) PDF
Module 3 CV Slides-UPDATED PDF

Description

Test your knowledge on the key concepts from Module 3 of the Cardiology course. This quiz covers topics such as hypertension, cardiac output, and the functions of the pericardial sac. Enhance your understanding of cardiovascular anatomy and physiology.

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