Cardiovascular System and Hypertension
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Questions and Answers

What is a primary characteristic of unstable angina?

  • It may signal an impending heart attack. (correct)
  • It occurs mainly due to coronary vasospasm.
  • It typically occurs during exercise only.
  • It is often relieved by medication.

When does variant (Prinzmetal's) angina typically occur?

  • Primarily at night or early morning. (correct)
  • Only in stressful situations.
  • After consuming large meals.
  • During exertion or physical activity.

Which of the following is true about microvascular angina?

  • It occurs while actively exercising.
  • It is always relieved by standard angina medications.
  • It lasts shorter than other types of angina.
  • It may signify coronary microvascular disease. (correct)

What initiates the electrical impulses that lead to heartbeats?

<p>The sinoatrial (SA) node. (C)</p> Signup and view all the answers

Which chamber of the heart is located above the right ventricle?

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

What is an effect of a normal heart rhythm in adults?

<p>It beats 60 to 100 times a minute. (D)</p> Signup and view all the answers

Which valve is situated between the left atrium and left ventricle?

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

What is the normal range for blood pressure considered healthy?

<p>120/80 mmHg (D)</p> Signup and view all the answers

What does preload refer to in cardiovascular physiology?

<p>The load on cardiac muscle at the end of diastole (D)</p> Signup and view all the answers

Which condition indicates that blood pressure is considered stage 2 hypertension?

<p>Exceeds 160/100 mmHg (C)</p> Signup and view all the answers

What term describes the volume of blood pumped from the heart per unit time?

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

At what age group is the incidence of hypertension highly associated?

<p>Exceeding 60 years (D)</p> Signup and view all the answers

Which of the following valves permits blood to flow from the left ventricle into the aorta?

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

What is a common cause of heart failure contributing to 62% of cases?

<p>Ischaemic heart disease (A)</p> Signup and view all the answers

What happens to the heart muscle contraction efficiency as heart failure progresses?

<p>It becomes less efficient (C)</p> Signup and view all the answers

What is the effect of sustained untreated hypertension on baroreceptors?

<p>They reset to a higher blood pressure level. (A)</p> Signup and view all the answers

Which option best describes the reason for increased end systolic volume in heart failure?

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

Which of the following best describes the action of angiotensin II?

<p>It causes the kidneys to retain sodium and lose potassium. (A)</p> Signup and view all the answers

What is the cardiac reserve?

<p>The ability of the heart to increase output during exercise (D)</p> Signup and view all the answers

What symptom is most commonly associated with left-sided heart failure?

<p>Shortness of breath on exertion. (B)</p> Signup and view all the answers

What is the primary reason for renin secretion in the kidneys?

<p>Due to decreased intra-renal blood pressure. (C)</p> Signup and view all the answers

How does prolonged heart failure affect exercise tolerance?

<p>It leads to reduced exercise tolerance (C)</p> Signup and view all the answers

What typically occurs to the compliance of the ventricle in heart failure?

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

What is a common consequence of right-sided heart failure?

<p>Swelling in the legs and feet. (B)</p> Signup and view all the answers

In heart failure, what effect does increased sympathetic activity have on heart rate?

<p>It increases the heart rate (A)</p> Signup and view all the answers

Which receptor does angiotensin II bind to in order to exert its effects?

<p>Angiotensin AT1 receptors. (A)</p> Signup and view all the answers

What is the primary effect of the Frank-Starling law on a healthy heart?

<p>Increased contractility with increased ventricular filling (C)</p> Signup and view all the answers

What is a typical renal response to activation of the renin-angiotensin system?

<p>Increased sodium retention. (B)</p> Signup and view all the answers

What is a classic symptom of orthopnea in heart failure patients?

<p>Difficulty breathing while lying flat. (C)</p> Signup and view all the answers

What is the primary effect of sympathetic activity in heart failure?

<p>Increases blood pressure (A)</p> Signup and view all the answers

What is a potential consequence of hypertrophy of the myocardium?

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

What leads to a reduction in stroke volume in heart failure?

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

Which type of angina occurs with exertion and is relieved by rest?

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

How does unstable angina differ from stable angina?

<p>It can occur without physical exertion (B)</p> Signup and view all the answers

What is a common cause of stable angina?

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

What triggers an anginal attack?

<p>Excess oxygen demand (D)</p> Signup and view all the answers

Which systemic mechanism is associated with heart failure due to decreased renal blood flow?

<p>Activation of renin-angiotensin system (A)</p> Signup and view all the answers

What characterizes atrial or supraventricular tachycardia (SVT)?

<p>Electrical signals in the upper chambers fire abnormally. (C)</p> Signup and view all the answers

Which condition is a common trigger for sinus tachycardia?

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

What is the main difference between ventricular tachycardia and atrial fibrillation?

<p>Atrial fibrillation results in uncoordinated electrical signals. (A)</p> Signup and view all the answers

In which situation would ventricular tachycardia be most likely to occur?

<p>In a life-threatening medical emergency. (A)</p> Signup and view all the answers

What is the effect of atrial fibrillation on the heart's pumping action?

<p>The heart quivers without effective pumping. (A)</p> Signup and view all the answers

Which of the following indicates the heart rate in sinus tachycardia?

<p>It is fast and steady. (D)</p> Signup and view all the answers

How does atrial or supraventricular tachycardia affect blood flow?

<p>It compromises blood flow to the body. (D)</p> Signup and view all the answers

What happens to the electrical signals in the heart during atrial fibrillation?

<p>They are disorganized and uncoordinated. (C)</p> Signup and view all the answers

Flashcards

Preload

The load on the cardiac muscle at the end of diastole (heart relaxation).

Afterload

The load on the cardiac muscle at the end of systole (heart contraction).

Cardiac Output

The amount of blood pumped from the heart per unit time (usually measured in liters per minute).

Stroke Volume

The volume of blood ejected from the heart in each beat.

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Heart Rate

The number of heart beats per unit time (usually measured in beats per minute).

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Positive Inotropy

The ability to increase the force of contraction of the heart muscle.

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Positive Chronotropy

The ability to increase the heart rate.

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Positive Dromotropy

The ability to increase the conduction velocity between the atria and ventricles.

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Cardiac reserve

The heart's ability to increase its output in response to increased oxygen demand, especially during exercise.

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Contractility

The force of contraction of the heart muscle.

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End-systolic volume

The amount of blood remaining in the left ventricle after contraction.

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End-diastolic volume

The amount of blood in the left ventricle at the end of relaxation.

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Ascites

Fluid accumulation in the abdominal cavity, causing swelling.

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Hepatomegaly

Enlargement of the liver.

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Heart failure

A condition where the heart is unable to pump blood effectively to meet the body's needs.

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Resetting of baroreceptors in hypertension

Increased blood pressure, often due to a combination of factors, leads to a higher set point for the baroreceptors.

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Renin

Hormone produced by the kidneys that triggers a cascade leading to vasoconstriction and sodium retention, ultimately increasing blood pressure.

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Aldosterone

Hormone released from the adrenal cortex, causing the kidneys to retain sodium and lose potassium.

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Left-sided heart failure

A condition where the left ventricle fails to pump effectively, resulting in congestion of the pulmonary circulation.

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Right-sided heart failure

A condition where the right ventricle fails to pump effectively, leading to congestion of the systemic circulation.

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Orthopnea

Shortness of breath, often worse when lying flat.

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Nocturia

Frequent urination at night.

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Increased sympathetic activity in heart failure

The increased activation of the sympathetic nervous system, a natural response to heart failure, that aims to compensate by increasing heart rate and blood pressure, leading to potential complications.

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Myocardial hypertrophy in heart failure

The enlargement of the heart muscle fibers caused by increased workload in an attempt to compensate for weakened pumping action, contributing to stiffness and reduced relaxation.

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Increased preload in heart failure

The increased load on the heart muscle during its relaxation phase, often seen in heart failure due to the heart's inability to pump effectively.

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Increased afterload in heart failure

The increased load on the heart muscle during its contraction phase, often seen in heart failure due to resistance to blood flow.

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Angina pectoris

Severe chest pain caused by reduced blood flow and oxygen supply to the heart muscle, often due to narrowed coronary arteries.

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Stable angina

A type of angina that occurs predictably with exertion, usually relieved by rest, and is often caused by atherosclerosis.

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Unstable angina

A type of angina that occurs unpredictably, may not be related to exertion, and is less responsive to rest or medications, indicating a more serious situation.

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Variant (Prinzmetal's) Angina

A type of angina that occurs when the coronary arteries spasm, causing a temporary reduction in blood flow to the heart. It often happens at rest, especially at night.

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Microvascular Angina

A type of angina that is caused by narrowing of the small blood vessels (microvessels) that supply blood to the heart muscle. It can be severe and may not be relieved by medication.

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Heart's Electrical Conduction System

The heart's electrical system coordinates its beating. The electrical impulse originates in the sinoatrial node (SA node) and travels through the atria, the atrioventricular (AV) node, and the His-Purkinje system to the ventricles.

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Arrhythmia

A condition in which the rhythm of the heartbeat is irregular or abnormal. This can be caused by a problem with the heart's electrical system.

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Electrocardiography (ECG or EKG)

A painless, non-invasive medical test that records the electrical activity of the heart using electrodes placed on the skin. This helps diagnose arrhythmias and other heart conditions.

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Atrial or Supraventricular Tachycardia (SVT)

A fast heart rate that starts in the upper chambers of the heart. It can cause abnormal electrical signals, leading to rapid heartbeat and compromised blood flow.

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Ventricular Tachycardia

A fast heart rate that starts in the lower chambers of the heart, often occurring in life-threatening situations. It can cause abnormal electrical signals, interfering with the heart's rhythm.

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Sinus Tachycardia

A type of tachycardia where the SA node sends out electrical signals faster than usual, resulting in a fast but steady heart rate.

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Atrial Fibrillation

A condition where the atria quiver instead of pumping. The heart's electrical signals become uncoordinated, leading to irregular and fast atrial contractions, inefficient blood flow.

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Study Notes

Cardiovascular System

  • Heart structure: Four chambers (two atria, two ventricles)
  • Four valves (tricuspid, pulmonary, mitral, aortic)
  • Blood flow: One-way, driven by pressure differences across valves
  • Preload: Cardiac muscle load at diastole end
  • Afterload: Cardiac muscle load at systole end
  • Cardiac output: Blood pumped per unit time
  • Stroke volume: Blood ejected per beat
  • Heart rate: Number of beats per unit time
  • Positive inotropy: Increased contraction force
  • Positive chronotropy: Increased heart rate
  • Positive dromotropy: Increased conduction velocity

Hypertension

  • Elevated blood pressure (≥140/90 mmHg)
  • Systolic pressure > 140 mmHg, diastolic pressure > 90 mmHg
  • Considered a significant cardiovascular disorder
  • Incidence increases with age (60-70% in those over 60)
  • Primary Hypertension: No identifiable cause (accounts for >95%)
  • Secondary Hypertension: Identifiable cause (e.g., renal disease, adrenal dysfunction - accounts for 2-5%)
  • Increased sympathetic activity: Baroreceptors change heart rate and peripheral resistance
  • Renin-angiotensin system: Renin triggers a cascade, increasing blood pressure by causing sodium retention
  • Factors contributing to Hypertension: Increased sympathetic nervous system activity, increased renin-angiotensin system activity
  • Symptoms might include: severe occipital headache, nausea, vomiting, drowsiness, anxiety, mental impairment, stroke, nausea and vomiting

A- Hypertensive Heart Failure

  • Inability to supply sufficient blood flow to meet body's demands.
  • Left-sided failure: Pulmonary congestion, dyspnea (shortness of breath) on exertion, orthopnea (shortness of breath while lying down)
  • Right-sided failure: Systemic congestion, peripheral edema (swelling), ascites (abdomen swelling), hepatomegaly (liver enlargement)
  • Causes: Ischemic heart disease, cigarette smoking, hypertension, obesity, diabetes, valvular heart disease

Angina Pectoris

  • Chest pain due to insufficient oxygen to the heart muscle (ischemia)
  • Types: Stable (effort-related, relieved by rest), Unstable (unpredictable, not relieved by rest), Variant (Prinzmetal's, occurs at rest), Microvascular (difficult to treat)

Arrhythmia

  • Irregular heartbeats caused by abnormal electrical impulses
  • Types: Bradycardia (slow heart rate), Tachycardia (fast heart rate), atrial fibrillation (irregular, quivering atria), atrial flutter (fast, regular rhythm in atria), Ventricular Tachycardia; Complete Heart Block, Torsades de Pointes
  • Causes: Various, including damage to heart tissue or electrical conduction pathways
  • Consequences: Reduced cardiac output, potential for sudden cardiac arrest if severe

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Description

This quiz covers key concepts related to the cardiovascular system, including heart structure, blood flow dynamics, and the physiological aspects of cardiac function. It also addresses hypertension, its classifications, causes, and prevalence among different age groups.

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