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Questions and Answers
What is the primary event occurring during diastole?
What is the primary event occurring during diastole?
- Contraction of the atria.
- Ejection of blood into the aorta and pulmonary arteries.
- Relaxation of the ventricles and filling with blood. (correct)
- Closure of the atrioventricular valves.
Cardiac output is determined by what two factors?
Cardiac output is determined by what two factors?
- Preload and afterload.
- Arterial pressure and pulmonary pressure.
- Heart rate and stroke volume. (correct)
- Venous return and systemic pressure.
Which of the following best defines an aneurysm?
Which of the following best defines an aneurysm?
- A temporary blockage of an artery by a traveling clot.
- A hardening of the arterial walls due to plaque buildup.
- A restriction of an artery that can cause hypertension.
- An abnormal, localized dilation of an artery due to a weakened vessel wall. (correct)
What is the primary characteristic of hypertension?
What is the primary characteristic of hypertension?
A patient's resting cardiac output is 5 L/min, and during exercise, it increases to 20 L/min. What is their cardiac reserve?
A patient's resting cardiac output is 5 L/min, and during exercise, it increases to 20 L/min. What is their cardiac reserve?
Which of the following best describes preload?
Which of the following best describes preload?
Which of the following is considered a non-modifiable risk factor for primary hypertension?
Which of the following is considered a non-modifiable risk factor for primary hypertension?
What primarily determines afterload for the left ventricle?
What primarily determines afterload for the left ventricle?
Which of these lifestyle factors is considered a modifiable risk for primary hypertension?
Which of these lifestyle factors is considered a modifiable risk for primary hypertension?
Which of the following is a common cause of secondary hypertension?
Which of the following is a common cause of secondary hypertension?
Ischemia is best defined as:
Ischemia is best defined as:
What is infarction characterized by?
What is infarction characterized by?
What hormone-secreting tumor of the adrenal medulla causes increased blood pressure, headaches, sweating and panic attack symptoms?
What hormone-secreting tumor of the adrenal medulla causes increased blood pressure, headaches, sweating and panic attack symptoms?
Which of the following describes vasculitis?
Which of the following describes vasculitis?
A patient presents with higher blood pressure in their upper extremities compared to their lower extremities, along with delayed femoral pulses. Which condition may be present?
A patient presents with higher blood pressure in their upper extremities compared to their lower extremities, along with delayed femoral pulses. Which condition may be present?
What are metanephrines, which are elevated in patients with pheochromocytoma?
What are metanephrines, which are elevated in patients with pheochromocytoma?
Which chamber of the heart receives deoxygenated blood from the systemic circulation?
Which chamber of the heart receives deoxygenated blood from the systemic circulation?
What is the primary function of the atrioventricular valves?
What is the primary function of the atrioventricular valves?
During which phase of the cardiac cycle do the ventricles contract?
During which phase of the cardiac cycle do the ventricles contract?
Which of the following best explains the role of the left ventricle?
Which of the following best explains the role of the left ventricle?
What is the primary function of the right ventricle during the cardiac cycle?
What is the primary function of the right ventricle during the cardiac cycle?
Which of the following is the correct sequence of blood flow through the heart?
Which of the following is the correct sequence of blood flow through the heart?
If the heart is described as a four-chambered pump, which chambers are responsible for receiving blood?
If the heart is described as a four-chambered pump, which chambers are responsible for receiving blood?
Which process best describes the phase of the cardiac cycle when the ventricles are relaxed and filling with blood?
Which process best describes the phase of the cardiac cycle when the ventricles are relaxed and filling with blood?
Which condition is associated with surges in systolic and diastolic pressure during sleep, contributing to elevated nighttime blood pressure?
Which condition is associated with surges in systolic and diastolic pressure during sleep, contributing to elevated nighttime blood pressure?
What is a common characteristic of primary hypertension, before target-organ damage occurs?
What is a common characteristic of primary hypertension, before target-organ damage occurs?
Which of the following is a direct consequence of increased intravascular pressure on vascular endothelial cells?
Which of the following is a direct consequence of increased intravascular pressure on vascular endothelial cells?
What is the primary mechanism by which hypertension contributes to damage in the kidneys?
What is the primary mechanism by which hypertension contributes to damage in the kidneys?
How does the heart typically respond to the increased workload imposed by elevated blood pressure?
How does the heart typically respond to the increased workload imposed by elevated blood pressure?
What effect does hypertension have on the small penetrating arteries in the subcortical region of the brain?
What effect does hypertension have on the small penetrating arteries in the subcortical region of the brain?
Which of the following is an initial change in the eyes due to hypertension?
Which of the following is an initial change in the eyes due to hypertension?
Which of the following is NOT a typical long-term effect of hypertension?
Which of the following is NOT a typical long-term effect of hypertension?
Which of the following best describes the primary characteristic of diastolic dysfunction?
Which of the following best describes the primary characteristic of diastolic dysfunction?
What is a key consequence of right ventricular failure in terms of systemic circulation?
What is a key consequence of right ventricular failure in terms of systemic circulation?
Hepatic congestion and hepatomegaly in right-sided heart failure is primarily due to:
Hepatic congestion and hepatomegaly in right-sided heart failure is primarily due to:
What is the primary mechanism behind pulmonary edema in left-sided heart failure?
What is the primary mechanism behind pulmonary edema in left-sided heart failure?
If portal circulation is congested due to right-sided heart failure, which of the following conditions might develop?
If portal circulation is congested due to right-sided heart failure, which of the following conditions might develop?
What is a direct result of impaired left heart function?
What is a direct result of impaired left heart function?
How does the sympathetic nervous system respond to decreased cardiac output (CO) in Heart Failure?
How does the sympathetic nervous system respond to decreased cardiac output (CO) in Heart Failure?
Which clinical finding is most indicative of severe right-sided heart failure?
Which clinical finding is most indicative of severe right-sided heart failure?
What is the initial effect of the sympathetic nervous system on maintaining organ perfusion?
What is the initial effect of the sympathetic nervous system on maintaining organ perfusion?
What physiological responses are associated with the stimulation of β-adrenergic receptors by increased sympathetic activity?
What physiological responses are associated with the stimulation of β-adrenergic receptors by increased sympathetic activity?
How does reduced cardiac output in heart failure affect renal function, according to the text?
How does reduced cardiac output in heart failure affect renal function, according to the text?
What is the primary function of aldosterone in the renin-angiotensin-aldosterone mechanism?
What is the primary function of aldosterone in the renin-angiotensin-aldosterone mechanism?
What do Angiotensin II and aldosterone stimulate in addition to fluid retention?
What do Angiotensin II and aldosterone stimulate in addition to fluid retention?
What is the result of fibroblast and collagen deposition in the context of heart failure?
What is the result of fibroblast and collagen deposition in the context of heart failure?
Which of the following describes eccentric hypertrophy?
Which of the following describes eccentric hypertrophy?
When diagnosing heart failure, what is the primary focus of diagnostic methods?
When diagnosing heart failure, what is the primary focus of diagnostic methods?
Flashcards
What is an aneurysm?
What is an aneurysm?
A localized, abnormal widening of an artery caused by a weakened vessel wall.
Define hypertension.
Define hypertension.
Sustained high blood pressure within the arterial system.
What is primary hypertension?
What is primary hypertension?
Hypertension with no identifiable cause.
What is secondary hypertension?
What is secondary hypertension?
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What are nonmodifiable risk factors for primary hypertension?
What are nonmodifiable risk factors for primary hypertension?
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What are modifiable risk factors for primary hypertension?
What are modifiable risk factors for primary hypertension?
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What is a pheochromocytoma?
What is a pheochromocytoma?
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What is coarctation of the aorta?
What is coarctation of the aorta?
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Cardiac Output (CO)
Cardiac Output (CO)
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Cardiac Reserve
Cardiac Reserve
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Preload
Preload
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Afterload
Afterload
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Ischemia
Ischemia
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Infarction
Infarction
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Atherosclerosis
Atherosclerosis
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Vasculitis
Vasculitis
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What is Obstructive Sleep Apnea (OSA)?
What is Obstructive Sleep Apnea (OSA)?
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What are the symptoms of primary hypertension?
What are the symptoms of primary hypertension?
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How does hypertension affect the heart?
How does hypertension affect the heart?
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How does hypertension impact the kidneys?
How does hypertension impact the kidneys?
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Left-sided heart failure
Left-sided heart failure
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Right-sided heart failure
Right-sided heart failure
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How does hypertension affect the brain?
How does hypertension affect the brain?
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What are the effects of hypertension on the eyes?
What are the effects of hypertension on the eyes?
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How does hypertension affect blood vessels?
How does hypertension affect blood vessels?
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Stroke Volume (SV)
Stroke Volume (SV)
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How do oral contraceptives affect blood pressure?
How do oral contraceptives affect blood pressure?
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Sympathetic Nervous System Activity
Sympathetic Nervous System Activity
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End-Diastolic Pressure
End-Diastolic Pressure
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Diastolic dysfunction
Diastolic dysfunction
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Peripheral edema
Peripheral edema
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What is the structure and function of the heart?
What is the structure and function of the heart?
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How does the heart cycle operate?
How does the heart cycle operate?
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What is hypertension?
What is hypertension?
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What is congestive heart failure (CHF)?
What is congestive heart failure (CHF)?
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What is left-sided heart failure?
What is left-sided heart failure?
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What is right-sided heart failure?
What is right-sided heart failure?
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What is the renin-angiotensin-aldosterone system (RAAS) and its role in heart failure?
What is the renin-angiotensin-aldosterone system (RAAS) and its role in heart failure?
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How is heart failure diagnosed and treated?
How is heart failure diagnosed and treated?
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Sympathetic Nervous System's Role in Heart Failure
Sympathetic Nervous System's Role in Heart Failure
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Sympathetic Activity and Heart Failure
Sympathetic Activity and Heart Failure
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Renin-Angiotensin-Aldosterone System (RAAS)
Renin-Angiotensin-Aldosterone System (RAAS)
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Reduced Renal Blood Flow in Heart Failure
Reduced Renal Blood Flow in Heart Failure
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Angiotensin II and Aldosterone
Angiotensin II and Aldosterone
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Effect of Angiotensin II on ADH
Effect of Angiotensin II on ADH
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Angiotensin II and Aldosterone in Heart Remodeling
Angiotensin II and Aldosterone in Heart Remodeling
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Myocardial Hypertrophy and Remodeling
Myocardial Hypertrophy and Remodeling
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Study Notes
Cardiovascular Disorders: Pathophysiology
- The heart is a four-chambered pump with two atria and two ventricles.
- The right atrium receives deoxygenated blood returning from the systemic circulation.
- The left atrium receives oxygenated blood from the lungs.
- The right ventricle pumps blood to the lungs.
- The left ventricle pumps blood into the systemic circulation.
- Heart valves control the direction of blood flow from atria to ventricles.
Cardiac Cycle
- The cardiac cycle describes the rhythmic pumping action of the heart.
- Systole: Ventricular contraction.
- Diastole: Ventricular relaxation and filling with blood.
Regulation of Cardiac Performance
- Cardiac output (CO) is a measure of the heart's efficiency.
- CO = Stroke Volume (SV) × Heart Rate (HR).
- Average resting CO in adults is 4 to 6 L/minute.
- Cardiac reserve is the maximum percentage increase in CO above resting levels.
- Resting CO = 4-6 L/min
- Vigorous Exercise = 21 L/min
- Preload is end-diastolic pressure; venous return influences preload
- Afterload is the work required to move blood into the aorta. Systemic arterial pressure is the main source of afterload on the left heart, and pulmonary arterial pressure is the main source of afterload on the right heart.
- Factors influencing heart rate (HR) include autonomic innervation, hormones, fitness levels, and age.
- Factors influencing stroke volume (SV) include heart size, gender, contractility, duration of contraction, preload, and afterload
Disorders of Systemic Arterial Blood Flow
- Ischemia is the reduction in arterial blood flow insufficient to meet the oxygen demands of the tissues.
- Infarction is an area of ischemic necrosis in an organ caused by occlusion of its arterial blood supply or venous drainage.
- Atherosclerosis is a gradual buildup of fibro-fatty plaques in the intima of large and medium-sized blood vessels
- Vasculitis is the inflammation of blood vessel walls leading to tissue injury and necrosis.
- Aneurysms are abnormal localized dilatations of an artery due to a weakness in the vessel wall.
Hypertension
- Hypertension is a sustained elevation of arterial blood pressure within the arterial circuit.
- It's a major risk factor for cardiovascular disease and a leading cause of morbidity and mortality worldwide.
- Primary hypertension occurs without identifiable causes; secondary hypertension arises due to other conditions like kidney disease.
- Hypertension classifications (American Heart Association): Normal (<120/80 mmHg), Elevated (120-129/<80 mmHg), Stage 1 Hypertension (130-139/80-89 mmHg), Stage 2 Hypertension (≥140/90 mmHg).
- Nonmodifiable risk factors for primary hypertension include age and gender.
- Modifiable risk factors include uncontrolled glucose levels (diabetes), lipid disorders, obesity, hyperuricemia, metabolic syndrome, and unhealthy lifestyle habits (smoking, alcohol, sedentary behavior).
- Secondary hypertension causes include drug use, kidney disease, adrenal gland disorders, and others.
Target-Organ Damage
- Increased perfusion pressure can damage target organs and blood vessels.
- Target-organ damage particularly affects highly vascular organs dependent on adequate blood supply (heart, kidney, brain, eyes).
- Hypertension is a leading cause of: Ischemic heart disease, end-stage renal disease, visual impairment/blindness caused by retinopathy
Heart and Hypertension
- Elevated blood pressure increases the workload on the left ventricle.
- Left ventricular hypertrophy (LVH) is a common response to compensate for increased workload.
- This can increase risk of coronary heart disease, cardiac arrhythmias, sudden death, and congestive heart failure.
Kidney and Hypertension
- Hypertension causes damage to the kidneys through glomerular hypoperfusion, glomerulosclerosis and tubulointerstitial fibrosis.
- Also contributes to endothelial dysfunction and accelerates other kidney diseases (like diabetic nephropathy).
Brain and Hypertension
- Hypertension can contribute to narrowing and sclerosis of small penetrating arteries in the subcortical regions.
- This leads to hypoperfusion, impaired blood-brain barrier, and potential subcortical white matter demyelination.
Eyes and Hypertension
- Increased vasomotor tone, followed by sclerotic changes (media wall hyperplasia, intimal thickening, hyaline degeneration) in the arterioles are effects of prolonged hypertension.
- This can lead to further problems like retinal arteriovenous (AV) nicking and blindness.
- Acute hypertension can also cause hemorrhages, microaneurysms, and hard exudates.
Congestive Heart Failure (CHF)
- A complex syndrome caused by a structural or functional disorder in the heart, impacting its ability to effectively pump and increasing risk of low cardiac output, pulmonary, and systemic congestion.
- Causes include coronary artery disease (CAD), hypertension, dilated cardiomyopathy, and valvular heart disease.
- Important compensations occur with heart failure ( Frank-Starling mechanism.
- Classification of CHF includes stages A (high risk), B (structural heart disease), C (symptoms of heart failure with structural heart disease), and D (advanced heart disease with symptoms at rest with max therapy).
Systolic vs. Diastolic Dysfunction
- Systolic dysfunction is characterized by reduced ejection fraction (typically <40%) and an enlarged left ventricle.
- Diastolic dysfunction involves increased resistance to filling with increased filling pressures but with a normal or slightly enlarged ventricle.
- Right-sided dysfunction causes peripheral edema, and blood backs into the systemic venous system if RV fails.
Compensatory Mechanisms in Heart Failure
- Mechanisms like the Frank-Starling mechanism, sympathetic nervous system activation, and renin-angiotensin-aldosterone system activation initially help maintain the cardiac output and perfusion of vital organs. This initial increase in sympathetic tone may increase the workload on the heart.
Remodeling of the Heart
- The heart responds to chronic stress by remodeling, which comprises myocardial hypertrophy and the accompanying changes in cardiac structure.
Diagnosis and Treatment
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Diagnostic techniques and treatments aim to identify the cause, correct it if possible, restore cardiac function, and control fluid volumes.
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Various medications including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, digoxin, and vasodilators are used to treat heart failure.
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Mechanical support via devices like ventricular assist devices (VADs) may be necessary in severe cases.
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Heart transplantation is the preferred treatment in cases of end-stage heart failure.
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Description
Test your knowledge on key concepts related to cardiology, including diastole, cardiac output, hypertension, and various cardiovascular conditions. This quiz will assess your understanding of vital cardiovascular mechanisms and risk factors. Ideal for students studying cardiology or healthcare professionals looking to reinforce their knowledge.