Cardiology Quiz on Heart Conditions and Atherosclerosis

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Questions and Answers

What is the initial stage of atherosclerosis?

  • Fatty streaks of lipids (correct)
  • Inflammatory effects on the arterial wall
  • Thrombus formation
  • Ruptured plaque

Which of the following is NOT a risk factor for stable angina?

  • Pericarditis (correct)
  • Smoking
  • Elevated blood lipids
  • Diabetes mellitus

What is the immediate consequence of a ruptured plaque in atherosclerosis?

  • Thrombus formation (correct)
  • Dysrhythmias
  • Heart failure
  • Angina

Which type of heart failure is characterized by an ejection fraction (EF) less than 40%?

<p>Left heart failure with reduced ejection fraction (HFrEF) (B)</p> Signup and view all the answers

What does the term 'preload' refer to in the context of heart failure?

<p>The amount of blood in the ventricle at the end of diastole (D)</p> Signup and view all the answers

What is the main cause of right heart failure?

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

Which of the following is a long-term effect of a myocardial infarction (MI)?

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

What is the primary function of the ejection fraction (EF) measurement?

<p>To measure the volume of blood ejected by the ventricles per beat (A)</p> Signup and view all the answers

What is the main consequence of forward heart failure?

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

What is the most common type of heart failure?

<p>Left heart failure (C)</p> Signup and view all the answers

Which of the following symptoms are characteristic of restrictive cardiomyopathy?

<p>Dyspnea, angina, fatigue, syncope, palpitations (A)</p> Signup and view all the answers

What is the primary characteristic of restrictive cardiomyopathy that differentiates it from other cardiomyopathies?

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

Which of the following conditions can lead to restrictive cardiomyopathy?

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

What is the typical range for ejection fraction in patients with restrictive cardiomyopathy?

<p>25-50% (D)</p> Signup and view all the answers

What is the most common dysrhythmia associated with restrictive cardiomyopathy?

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

Which of the following is a potential complication that can develop due to restrictive cardiomyopathy?

<p>Right heart failure (D)</p> Signup and view all the answers

What is the primary difference between restrictive cardiomyopathy and dilated cardiomyopathy?

<p>Restrictive cardiomyopathy causes increased ventricular compliance, while dilated cardiomyopathy causes decreased ventricular compliance. (D)</p> Signup and view all the answers

Which of the following is a potential clinical manifestation of peripartum cardiomyopathy (PPCM)?

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

What is a potential laboratory test used to assess the severity of PPCM?

<p>Brain natriuretic peptide (BNP) (B)</p> Signup and view all the answers

When does peripartum cardiomyopathy (PPCM) typically present?

<p>Third trimester of pregnancy (D)</p> Signup and view all the answers

Which of the following is NOT a modifiable risk factor for Peripheral Arterial Disease (PAD)?

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

What is a common clinical manifestation of a thoracic aortic aneurysm?

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

Which of the following is a characteristic difference between PAD and PVD?

<p>Presence of spider veins or varicose veins (A)</p> Signup and view all the answers

Which of the following is a clinical manifestation of rheumatic fever?

<p>Tender and swollen lymph nodes (B)</p> Signup and view all the answers

Which of the following is a potential consequence of PAD?

<p>All of the above (D)</p> Signup and view all the answers

What is the most common cause of acquired valve dysfunction?

<p>Rheumatic heart disease (B)</p> Signup and view all the answers

What is the primary symptom of aortic stenosis?

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

Which of the following is NOT a risk factor for an aortic aneurysm?

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

What is the most common location for an aortic aneurysm to occur?

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

What is the most common consequence of untreated mitral stenosis?

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

Which of the following clinical manifestations is most likely associated with a ruptured aortic aneurysm?

<p>Severe pain and hypotension (A)</p> Signup and view all the answers

Which of the following is a clinical manifestation of aortic regurgitation?

<p>Bounding peripheral pulses (C)</p> Signup and view all the answers

What is the primary cause of tricuspid valve regurgitation?

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

Which of the following is NOT a commonly used assessment tool for PAD?

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

What is the definition of mitral valve prolapse?

<p>One or both cusps of the mitral valve billow upward into the left atrium during systole (B)</p> Signup and view all the answers

What is the most serious risk associated with an undiagnosed and untreated PAD?

<p>Limb ischemia and lower limb amputation (A)</p> Signup and view all the answers

Which of the following is a non-modifiable risk factor for PAD?

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

Which of the following causes can be attributed to mitral valve regurgitation? (Select all that apply)

<p>Dilated cardiomyopathy (A), Mitral valve prolapse (B), Connective tissue disease (D), Rheumatic heart disease (E)</p> Signup and view all the answers

What condition is characterized by the inability of the leaflets to close properly during diastole, resulting in backflow from the left ventricle to the left atrium?

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

What are the clinical manifestations of mitral stenosis?

<p>All of the above (D)</p> Signup and view all the answers

What is the main difference between aortic stenosis and aortic regurgitation?

<p>Aortic stenosis involves a narrowing of the valve, while aortic regurgitation involves a leaking valve (A)</p> Signup and view all the answers

What is the main effect of valve regurgitation?

<p>Increased pressure in the heart (A)</p> Signup and view all the answers

What is a common complication of mitral valve prolapse?

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

What is the most common cause of endocarditis?

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

What is the most common type of valve stenosis?

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

Regarding the clinical manifestation of valvular disorders, which of the following is associated with AORTIC regurgitation?

<p>Bounding Peripheral Pulses (A)</p> Signup and view all the answers

What is the primary concern regarding the higher incidence of PAD in Indigenous populations?

<p>Increased risk of developing other chronic diseases (C)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with Peripheral Arterial Disease (PAD)?

<p>Swelling in the lower extremities (C)</p> Signup and view all the answers

Which of the following statements is TRUE regarding PAD in Indigenous populations?

<p>PAD is more likely to develop in Indigenous people with diabetes than in non-Indigenous people with diabetes. (A)</p> Signup and view all the answers

What is the main implication of a full head-to-toe assessment in evaluating PAD?

<p>Understanding the patient's overall health status. (C)</p> Signup and view all the answers

Which of these is NOT a characteristic symptom of Peripheral Arterial Disease (PAD)?

<p>Excessive sweating in the lower extremities (A)</p> Signup and view all the answers

What is the primary reason for the higher incidence of PAD in Indigenous populations with diabetes?

<p>Higher prevalence of risk factors associated with PAD in Indigenous populations with diabetes (B)</p> Signup and view all the answers

Which of the following is NOT a key point to remember when assessing patients with PAD?

<p>Assessing the patient's mental health status (B)</p> Signup and view all the answers

Why is it important to understand the physiological landmarks and anatomy related to various body systems when assessing PAD?

<p>To accurately diagnose the severity of PAD (B)</p> Signup and view all the answers

Which of the following is NOT a known risk factor for primary hypertension?

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

What are the main physiological changes that contribute to sustained blood pressure elevation in hypertension?

<p>Changes in vascular tone and/or blood volume (A)</p> Signup and view all the answers

Identify the specific pathological process that characterizes secondary hypertension.

<p>Underlying disease or medication (A)</p> Signup and view all the answers

What is the most common vascular complication associated with complicated hypertension?

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

Which of the following is a characteristic feature of malignant hypertension?

<p>Diastolic blood pressure above 140 mmHg (C)</p> Signup and view all the answers

What is the primary distinction between primary and secondary hypertension in children and adolescents?

<p>Secondary hypertension is always caused by an identifiable cause (B)</p> Signup and view all the answers

What are the clinical manifestations of hyperaldosteronism?

<p>Low blood pressure, high aldosterone, low renin levels (A)</p> Signup and view all the answers

What is the primary cause of pheochromocytoma?

<p>Excessive release of epinephrine and norepinephrine (B)</p> Signup and view all the answers

Which of the following is NOT a characteristic clinical manifestation of pheochromocytoma?

<p>Sudden low blood pressure (D)</p> Signup and view all the answers

What is a defining feature of Metabolic Syndrome?

<p>A clustering of clinical traits that accelerate cardiovascular disease and type 2 diabetes mellitus (B)</p> Signup and view all the answers

Which of the following is a known risk factor for Metabolic Syndrome?

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

In patients with Post Myocardial Infarction, what is the main contributing factor to vascular complications?

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

Which of the following factors does NOT directly contribute to the pathogenesis of Coronary Atherosclerosis?

<p>Elevated levels of Vitamin D (C)</p> Signup and view all the answers

What is the primary pathological change underlying coronary atherosclerosis?

<p>Abnormal accumulation of fatty deposits in the artery wall (B)</p> Signup and view all the answers

What is the significance of understanding the pathogenesis of coronary atherosclerosis?

<p>It identifies factors that impact the risk of developing cardiovascular disease (D)</p> Signup and view all the answers

Flashcards

Fatty streaks

Initial lesions in arterial walls made of lipids that lead to atherosclerosis.

Macrophages in atherosclerosis

Immune cells that infiltrate the artery wall during inflammation, promoting plaque progression.

Ruptured plaque

When an atherosclerotic plaque breaks apart, potentially causing a blood clot.

Thrombus formation

The process of a blood clot forming in a blood vessel, often after plaque rupture.

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Myocardial Infarction (MI)

Heart attack caused by the blockage of blood flow to the heart muscle.

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Ejection Fraction (EF)

Percentage of blood the heart pumps out with each contraction.

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Heart Failure (HF)

Condition where the heart cannot pump enough blood to meet the body's needs.

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Preload

The degree of stretch of the heart muscle before contraction, influenced by blood volume.

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Afterload

The resistance the heart must overcome to eject blood during contraction.

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Cardiogenic Shock

A life-threatening condition where the heart cannot pump enough blood to the body, leading to organ failure.

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Peripheral Arterial Disease (PAD)

A condition where arteries are narrowed, reducing blood flow to limbs.

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Symptoms of PAD

Signs include sores that won’t heal, tired legs, and coldness in feet.

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Risk factors for PAD

Includes diabetes, hypertension, and lifestyle factors like smoking.

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Indigenous populations and PAD

Higher incidence of PAD risk factors among First Nations, Inuit, and Metis peoples.

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Diabetes and PAD

People with diabetes, especially Indigenous, have a greater risk of developing PAD.

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Symptoms of neuropathy

Burning, numbness, or tingling in thighs or calves seen in PAD.

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Importance of assessment

A full head-to-toe assessment includes checking for signs of chronic conditions like PAD.

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Impact of lifestyle on PAD

Factors like smoking and diet significantly affect the risk and progression of PAD.

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Primary Hypertension

High blood pressure without a known secondary cause, often linked to lifestyle and genetic factors.

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Cardiac Output (CO)

The volume of blood the heart pumps per minute, influenced by heart rate and stroke volume.

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Risk Factors for Hypertension

Factors that increase the likelihood of developing high blood pressure, including family history, obesity, and age.

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Secondary Hypertension

High blood pressure resulting from another condition or medication, such as renal or endocrine disorders.

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Complicated Hypertension

Progression of primary hypertension that leads to organ damage over time.

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Malignant Hypertension

A severe and aggressive form of hypertension causing organ damage, often requiring urgent treatment.

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Endocrine Hypertension

High blood pressure caused by hormonal disorders like hyperaldosteronism or pheochromocytoma.

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Hyperaldosteronism

Condition involving excess aldosterone production leading to increased blood pressure.

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Pheochromocytoma

A tumor of the adrenal gland that causes excess norepinephrine, leading to severe hypertension.

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Metabolic Syndrome

Cluster of conditions increasing heart disease and diabetes risk, often with obesity and insulin resistance.

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Insulin Resistance

A condition where cells fail to respond to insulin effectively, often linked to obesity.

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Hypertrophy

The enlargement of the heart muscle due to increased workload, often from hypertension.

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Atherosclerosis

Hardening and narrowing of arteries due to plaque build-up, often leading to cardiovascular diseases.

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Prehypertension

Blood pressure readings that are higher than normal but not yet at the level of hypertension.

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Diastolic Blood Pressure

The pressure in the arteries when the heart rests between beats, important in diagnosing hypertension.

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Restrictive Cardiomyopathy

Myocardial rigidity leading to impaired ventricular filling and increased diastolic pressure.

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Symptoms of Restrictive Cardiomyopathy

Dyspnea, fatigue, palpitations, cardiomegaly, and dysrhythmias are common.

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Ejection Fraction in Restrictive Cardiomyopathy

Typically between 25-50%, indicating impaired heart function.

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Contractility in Restrictive Cardiomyopathy

Generally normal, as the issue lies in filling rather than contraction.

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Heart Failure in Pregnancy

Peripartum Cardiomyopathy (PPCM) occurs with HF symptoms in late pregnancy.

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Symptoms of Peripartum Cardiomyopathy

Includes fatigue, swollen feet, and shortness of breath.

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Ejection Fraction in PPCM

Ejection fraction is often less than 45%, indicating heart failure.

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Lab Tests for PPCM

Tests include electrolytes, CBC, and cardiac markers like BNP.

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Valve Dysfunction Types

Includes aortic and mitral valve dysfunction leading to various symptoms.

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Right Sided Heart Failure Symptoms

Symptoms include systemic venous congestion and peripheral edema.

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Aortic Rupture

A life-threatening condition where the aorta tears, causing severe pain and hypotension.

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Risk Factors for Aortic Rupture

Factors contributing to aortic rupture: genetic predisposition, smoking, hypertension (HTN), and vascular disorders.

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Thoracic Aortic Symptoms

Symptoms include dysphagia, dyspnea, and chest pain radiating to the back, indicating possible thoracic aortic issues.

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Modifiable Risk Factors for PAD

Risk factors for PAD that can be changed include smoking, obesity, diabetes, and high cholesterol diets.

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Non-Modifiable Risk Factors for PAD

Risk factors for PAD that cannot be changed include age and family history.

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Assessment Focus for PAD

Diagnosis often focuses on asymptomatic patients, requiring tests like Ankle Brachial Index and Doppler Blood Flow.

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PAD vs PVD

PAD features slow toenail growth and leg pain while walking; PVD may show swollen legs and spider veins.

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Symptoms of Peripheral Arterial Disease

Common symptoms include leg pain or cramping while walking, leg numbness or weakness.

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Complications of PAD

Patients with PAD are at high risk for cardiovascular death, stroke, myocardial infarction, and limb ischemia.

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Valve Dysfunction

Abnormal functioning of heart valves affecting blood flow.

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Acquired Valve Dysfunction

Valve issues developed due to conditions like rheumatic heart disease or endocarditis.

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Rheumatic Heart Disease (RHD)

Heart damage caused by rheumatic fever, affecting valves.

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Clinical Manifestations of Rheumatic Fever

Symptoms include fever, swollen lymph nodes, and rash.

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Endocarditis

Infection of the inner lining of the heart, causing inflammation.

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Symptoms of Endocarditis

Includes fevers, chills, and petechiae (tiny spots due to bleeding).

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Valve Stenosis

Narrowing of heart valves, restricting blood flow.

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Aortic Stenosis Symptoms

Presenting symptoms are angina, fatigue, and syncope.

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Mitral Stenosis Effects

Increased pressure in pulmonary circulation and risk of atrial dilation.

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Valve Regurgitation

Inability of a valve to close properly, causing backflow of blood.

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Causes of Regurgitation

Includes mitral valve prolapse, RHD, and infective endocarditis.

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Clinical Manifestations of Aortic Regurgitation

Symptoms such as widened pulse pressure and heart failure signs.

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Mitral Valve Prolapse

Condition where mitral valve cusps bulge into the left atrium during systole.

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Mitral Regurgitation Complications

Leads to left atrial dilation and possible heart failure.

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Study Notes

Chronic Cardiovascular Conditions

  • Presented by Sarah Nixon, MN RN
  • Developed by Megan Keszler, BA BN, GradCertEd CNCC(C)
  • Includes adapted slides by Kara Sealock, EdD MEd BN RN, CNCC (C), CCNE & Leah Tellier RN, MN, CCNE, CHSE

Topics and Objectives

  • Age-related cardiovascular changes
  • Hypertension (HTN): including types—complicated HTN, pediatric HTN, endocrine HTN
  • Metabolic syndrome
  • Long-term effects of myocardial infarction (MI)
  • Chronic heart failure
  • Cardiomyopathies
  • Valve dysfunction
  • Acute versus chronic pericarditis
  • Peripheral Arterial Disease (PAD)
  • Collagen, elastin, and calcification increase
  • Wall thickening and arterial stiffening occur
  • Endothelial dysfunction may also promote vasoconstriction, increasing the risk of cardiovascular disease
  • Systolic and pulse blood pressure rise
  • Left ventricular wall thickness increases
  • Early diastolic filling is reduced
  • Cardiac reserve declines
  • Heart rate and rhythm abnormalities
  • Prolonged cardiac action potential
  • Compromised maintenance of extracellular fluid volume and composition
  • Aging increases the risk of hypertension, which is not a normal part of the aging process

Increased Wall Thickening and Arterial Stiffening

  • Endothelial dysfunction is a factor
  • Lead to elevated systolic pressure, reduced cardiac reserve & capacity
  • Affects myocardial relaxation and reduced early diastolic filling

Hypertension (HTN)

  • Sustained systolic pressure above 140 mmHg or diastolic pressure above 90 mmHg
  • Associated with elevated risk of target organ damage (e.g., MI, kidney disease, stroke)

Primary Hypertension

  • CO = HR X SV
  • Increased CO
  • Increased HR
  • Increased SV
  • Increased blood viscosity
  • Increased peripheral vascular resistance
  • Decreased vessel diameter
  • Preload, afterload, contractility

Risk Factors for Hypertension

  • Family history
  • Advancing age
  • Cigarette smoking
  • Obesity
  • Heavy alcohol consumption
  • Gender
  • African or Indigenous decent
  • Increased dietary sodium intake
  • Decreased dietary intake of potassium, magnesium, and calcium
  • Socioeconomic status change related to immigration
  • Glucose intolerance

Hypertension in the Indigenous Population

  • Statistically, First Nations, Inuit, and Métis people have higher rates of:
    • High blood pressure
    • Type 2 diabetes
    • Smoking
    • Childhood obesity
  • Heart disease and stroke rates are significantly higher compared to the general population
  • Poorer health outcomes in Indigenous communities are linked to health inequities

Pathophysiology of Hypertension

  • Sympathetic nervous system (SNS) changes
  • Renin-angiotensin-aldosterone system (RAAS)
  • Pressure natriuresis relationship
  • Inflammation (endothelial injury and tissue ischemia)
  • Obesity
  • Insulin resistance
  • Genetics and environmental factors

Secondary Hypertension

  • Caused by an underlying disease process or medication
  • Caused by renal disorders, endocrine disorders, vascular disorders, pregnancy-induced hypertension (PIH), neurological disorders, acute stress, and drugs.

Complicated Hypertension

  • Primary hypertension develops into complicated hypertension
  • Leads to damage to the aorta, small arteries, the heart, kidneys, retina, and central nervous system (CNS)
  • Leads to various cardiovascular complications

Cardiovascular Complications in Complicated Hypertension

  • Left ventricular hypertrophy
  • Coronary artery disease (CAD)
  • Angina pectoris
  • Myocardial infarction (MI)
  • Congestive heart failure (CHF)
  • Sudden death

Vascular Complications in Complicated Hypertension

  • Formation, dissection, and rupture of aneurysms
  • Intermittent claudication
  • Vessel occlusion resulting in gangrene
  • Deep diffuse chest pain, dysphagia, distended neck veins, edema of the head and arms, and dysrhythmias (irregular heartbeat)

Renal Complications in Complicated Hypertension

  • Parenchymal damage
  • Nephrosclerosis
  • Renal arteriosclerosis
  • Renal insufficiency or failure
  • Microalbuminuria

Retinal Complications in Complicated Hypertension

  • Vascular sclerosis
  • Exudation
  • Hemorrhage

Malignant Hypertension (Hypertension Emergency)

  • Linked to the dysfunction of renin and angiotensin
  • Causes encephalopathy due to high arterial pressure
  • Leads to papilledema, cardiac failure, uremia, retinopathy, and stroke
  • Needs immediate treatment with vasodilators to lower blood pressure

Hypertension in Pediatric and Adolescent Populations

  • Divided into essential (no identifiable cause) and secondary (subsequent to an identifiable cause) types of hypertension
  • Stage I and II hypertension defined by specific thresholds of blood pressure measurements relative to age and gender percentiles

Etiology of Hypertension in Children and Adolescents

  • Occurs secondary to a structural abnormality of underlying pathological processes
  • Often determined by genetic and environmental factors
  • The most common cause of secondary hypertension is renal disease, then cardiovascular, endocrine, and some neurological disorders
  • Younger children, and more severe hypertension, is more likely to be secondary

Clinical Manifestations of Hypertension in Children and Adolescents

  • Routine assessment is crucial for early detection in adolescents and children
  • Family history of hypertension or related conditions should be considered
  • Children with heart disease (CHD), kidney disease, malignancy, or other conditions are also at risk
  • Frequent headaches, irritability, head banging or head rubbing, dizziness, changes in vision and waking up screaming during the night are clinical manifestations in children and adolescents

Endocrine Hypertension: Hyperaldosteronism

  • Primary hyperaldosteronism results from overproduction of aldosterone, most often due to adrenocortical neoplasm, bilateral idiopathic or familial cases.
  • Secondary hyperaldosteronism arises from decreased renal perfusion, often in cases of arterial hypovolemia and edema, or pregnancy.

Endocrine Hypertension: Pheochromocytoma

  • Adrenomedullary hyperfunction due to tumors known as pheochromocytoma
  • Tumors produce excess norepinephrine
  • Characterized by clinical manifestations such as hypermetabolism-related symptoms (diaphoresis), severe pounding headaches, glucose intolerance, heat intolerance, weight loss, and constipation, unexplained abdominal or chest pain lasting from minutes to hours, tachycardia with palpitations.

Metabolic Syndrome

  • Also called insulin resistance syndrome or syndrome X
  • Clustering of clinical traits accelerating cardiovascular disease and type 2 diabetes mellitus
  • Must have 3 of 5 traits: Increased waist circumference, elevated triglycerides, reduced HDL, elevated blood pressure, and elevated fasting glucose levels

Post-Myocardial Infarction

  • Assessment and monitoring of heart rhythms and associated symptoms, as well as medication responses, following myocardial infarction.

Coronary Atherosclerosis (Review)

  • Abnormal accumulation of lipids or fatty substances and fibrous tissue in arterial blood vessel walls
  • Pathophysiology involves fatty streak initiation, lesion progression, inflammatory effects, macrophage infiltration, and plaque rupture leading to thrombosis and potentially myocardial infarction (MI)

Angina (Review)

  • Stable, unstable, and variant angina
  • Associated risk factors
  • Long-term effects on the body post-MI, including dysrhythmias, heart failure, cardiogenic shock, pericarditis, and ventricular aneurysm.

Heart Failure Basics

  • Heart is unable to generate adequate cardiac output due to various conditions like preload, afterload, contractility. Heart failure results in tissue perfusion impairment, increased pulmonary capillary pressures and LV diastolic filling pressures.
  • Risk factors for left and right heart failure.
  • Assessment and diagnosis methods, such as echocardiogram, CT, or cardiac nuclear medicine scan.

Assessment Findings of Left Heart Failure

  • Level of consciousness, dizziness, lightheadedness
  • Poor color, poor pulse strength, tachycardia, presence of S3, S4, delayed capillary refill.
  • Chest sounds: crackles, tachypnea, shortness of breath, persistent wet cough.
  • Gastrointestinal, renal, and musculoskeletal assessments

Right Heart Failure (Cor Pulmonale)

  • Similar symptoms to left-sided heart failure, affecting the right ventricle.
  • Right ventricularheaves, jugular venous distension, right upper quadrant pain (hepatomegaly), anorexia, nausea, abdominal bloating, and ascites.

Cardiac Asthma

  • Medical emergency requiring immediate attention
  • Presents with pulmonary edema, wheezing, coughing, and orthopnea (difficulty breathing while sitting or standing)
  • Diagnosis is facilitated by listening to lower lobes for crackles and upper lobes for wheezing, combined with the evaluation of other heart failure symptoms.

Cardiomyopathy

  • Dilated, hypertrophic, and restrictive types
  • Results from structural abnormalities and/or effects of neurohormonal responses to ischemic heart disease, hypertension, or other conditions.

Valve Dysfunction

  • Aortic, mitral, tricuspid, and pulmonary valves, and their associated dysfunction
  • Regurgitation and stenosis
  • Acquired and congenital
  • Causes and consequences of valve dysfunction

Acute vs Chronic Pericarditis

  • Etiology, including viral or bacterial infections, trauma, surgery, radiation therapy, autoimmune diseases.

Constrictive Pericarditis

  • Chronic inflammation, encasing the heart in a rigid shell, reducing cardiac output, leading to gradually developing symptoms.

Aneurysms

  • Atherosclerosis is the most common cause of arterial aneurysms
  • Aneurysms can result in complications like dissection, rupture, and hemorrhage

Peripheral Arterial Disease (PAD)

  • Atherosclerosis-related narrowing of peripheral arteries
  • Associated with modifiable and non-modifiable risk factors, such as smoking, physical inactivity, diet high in fats and cholesterol, obesity, diabetes mellitus, hyperlipidemia, family history, advanced age, kidney disease, and hypertension
  • Assessment of patients include evaluation for symptoms, such as, leg pain, numbness or weakness, coldness in the foot or legs, open sores that won't, heal changes in leg color or texture, or temperature etc.
  • PAD can lead to serious outcomes such as complications causing cardiovascular death, stroke, myocardial infarction (MI) and limb ischemia or amputation

Indigenous Populations and PAD

  • Higher incidence of PAD in Indigenous peoples associated with diabetes and other complications
  • PAD occurs more frequently in Indigenous populations with diabetes compared to non-Indigenous populations.

Heart Failure in Pregnancy: Peripartum Cardiomyopathy (PPCM)

  • Difficult to diagnose
  • Symptoms, such as fatigue, palpitations, dyspnea, nocturia (frequent urination at night), orthopnea (difficulty breathing while sitting or lying down), swelling (edema) in feet & legs or ankles and shortness of breath
  • Diagnositc tools and tests, like CBC, electrolyte panel, kidney or liver function tests or BNP

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