Cardiovascular System and Hypertension
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Questions and Answers

What is the primary cause of variant angina?

  • Hypertension
  • Coronary vasospasm (correct)
  • Myocardial ischemia
  • Coronary microvascular disease

Which type of angina may not respond to medication?

  • Variant angina
  • Stable angina
  • Microvascular angina (correct)
  • Unstable angina

What time of day does variant angina typically occur?

  • Evening
  • Midday
  • Afternoon
  • Midnight to early morning (correct)

What is the normal heart rate for an adult at rest?

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

What procedure records the heart's electrical activity to diagnose arrhythmias?

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

Which condition may develop in cases of advanced heart failure?

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

What is the most common cause of heart failure?

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

The Frank-Starling law of the heart states that increased filling of the ventricle results in what?

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

What typically happens to the end diastolic volume in heart failure?

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

In heart failure, what contributes to exercise intolerance?

<p>Reduced spare capacity (C)</p> Signup and view all the answers

What effect does sympathetic stimulation have in heart failure?

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

Which of the following conditions does NOT typically cause heart failure?

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

What is one consequence of reduced contractility in heart failure?

<p>Increased end systolic volume (C)</p> Signup and view all the answers

What does the P-QRS-T pattern in an electrocardiogram represent?

<p>Atrial depolarization followed by ventricular depolarization and then ventricular repolarization (C)</p> Signup and view all the answers

Which phase of the cardiac cycle is characterized by rapid depolarization due to the inflow of Na+?

<p>Phase 0 (C)</p> Signup and view all the answers

What occurs during Phase 3 of the cardiac action potential?

<p>Inward calcium current is decreasing while outward potassium current increases (D)</p> Signup and view all the answers

Which of the following correctly describes an arrhythmia?

<p>Any change from the normal sequence of electrical impulses in the heart (A)</p> Signup and view all the answers

During which phase does the combination of slow inward Ca²⁺ current balance an outward K⁺ current?

<p>Phase 2 (D)</p> Signup and view all the answers

What percentage of systemic hypertension cases is classified as primary (essential) hypertension?

<p>More than 95% (A)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with the neurological findings of elevated untreated hypertension?

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

What is a common ocular finding in patients with untreated hypertension?

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

Which of the following is a characteristic finding of renal complications due to hypertension?

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

What physiological factor can lead to increased blood pressure according to the blood pressure equation?

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

Which type of hypertension is classified as resulting from an identifiable cause?

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

What condition is primarily responsible for renal findings such as arteriolar nephrosclerosis in hypertension?

<p>Elevated serum creatinine (C)</p> Signup and view all the answers

What effect does increased sympathetic nervous system activity have on blood pressure?

<p>Increases peripheral resistance (C)</p> Signup and view all the answers

What distinguishes the atria from the ventricles in the heart?

<p>Atria receive blood while ventricles pump it out. (C)</p> Signup and view all the answers

Which heart valve is located between the left atrium and the left ventricle?

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

What is preload in cardiac physiology?

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

At what blood pressure reading is hypertension typically diagnosed?

<p>Exceeding 140/90 mmHg (B)</p> Signup and view all the answers

Which term refers to the volume of blood pumped from the heart per unit of time?

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

What is the significance of blood flow occurring only when there's a difference in pressure across the valves?

<p>It prevents blood from flowing in multiple directions. (C)</p> Signup and view all the answers

Which population is most likely to have a high incidence of hypertension?

<p>Persons exceeding 60 years of age (B)</p> Signup and view all the answers

What is afterload in the context of the cardiovascular system?

<p>The pressure that must be overcome for the ventricles to eject blood (B)</p> Signup and view all the answers

What is a characteristic feature of atrial flutter compared to atrial fibrillation?

<p>Electrical signals travel in a fast and regular rhythm (D)</p> Signup and view all the answers

What occurs when there is a blockage in one of the bundle branches?

<p>One ventricle contracts slower than the other (D)</p> Signup and view all the answers

What type of arrhythmia is characterized by premature beats that start in the atria?

<p>Premature Atrial Contraction (PAC) (C)</p> Signup and view all the answers

What defines Wolff-Parkinson-White (WPW) syndrome?

<p>An abnormal conduction pathway leading to early ventricular activation (A)</p> Signup and view all the answers

What happens during Sick Sinus Syndrome?

<p>The sinus node malfunctions, causing rate fluctuations. (D)</p> Signup and view all the answers

What is a potential outcome of Premature Ventricular Contractions (PVCs)?

<p>The heart may feel like it skipped a beat due to an extra early beat (A)</p> Signup and view all the answers

In a 3:1 block during atrial flutter, how many atrial beats correspond to one ventricular beat?

<p>3 atrial beats to 1 ventricular beat (A)</p> Signup and view all the answers

What generally happens to the heart rate during Sick Sinus Syndrome?

<p>It often remains slower than normal. (C)</p> Signup and view all the answers

Flashcards

Cardiac Chambers

The heart has four chambers: two atria (upper) and two ventricles (lower).

Heart Valves

The heart has four valves that control blood flow in one direction; tricuspid, pulmonary, mitral, and aortic.

Preload

Cardiac muscle load at the end of diastole (relaxation phase).

Afterload

Cardiac muscle load at the end of systole (contraction phase).

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Cardiac Output

Amount of blood pumped by the heart per unit of time.

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Hypertension

Elevated blood pressure (exceeding 140/90 mmHg) that significantly affects tissue perfusion.

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Normal Blood Pressure

Blood pressure that is not exceeding 120/80 mmHg

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Hypertension Stages

Different levels of high blood pressure; pre-hypertension, stage 1 hypertension, and stage 2 hypertension

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Unstable Angina

A dangerous type of chest pain that signals a potential heart attack, often requiring emergency treatment.

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Cardiac Action Potential Phases

The sequence of electrical changes in a cardiac cell, including depolarization and repolarization.

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Variant Angina

A rare type of angina caused by coronary vasospasm, usually occurring at rest and between midnight and early morning.

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Arrhythmia

A change in the normal sequence of heart's electrical impulses making the heartbeat too fast, too slow or erratic.

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Microvascular Angina

Angina that can be severe and may not respond to medicine, often a symptom of coronary microvascular disease.

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Depolarization

A change in the electrical potential that causes the cell to become more positive.

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Normal Heart Beat (Adult)

A heart rate between 60 and 100 beats per minute, maintained by normal electrical conduction.

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Repolarization

The process of returning the cell's electrical potential to a negative state.

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Arrhythmia

An irregular heartbeat caused by a disruption in the electrical signals that control the heart's rhythm.

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Electrocardiogram (ECG)

A graphical representation of the electrical activity of the heart.

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Ascites

Fluid buildup in the abdominal cavity, causing swelling.

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Hepatomegaly

Enlarged liver.

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Heart Failure Causes (Ischemic)

62% of heart failure is caused by Ischemic heart disease

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Frank-Starling Law

Increased blood filling increases heart contraction force.

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Reduced Contractility

Heart muscle contraction becomes less efficient due to overstretched heart muscle.

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Reduced Cardiac Reserve

Reduced ability of the heart to increase output during higher demand, like exercise.

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Increased Heart Rate (Heart Failure)

Heart beats faster to compensate for reduced efficiency.

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Reduced Stroke Volume

Decreased amount of blood pumped with each heartbeat.

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Hypertension Incidence

Commonly develops between ages 30 and 50.

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Untreated Hypertension Risks

Increases risk of heart attack (MI), stroke, heart failure, eye damage (retina), brain bleeding, headaches, neurological problems, and kidney disease.

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Hypertension Cardiovascular Effects

Causes chest pain (angina), thickened heart muscle (left ventricular hypertrophy), shortness of breath (dyspnea), and swelling in the legs/feet (peripheral edema).

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Hypertension Neurological Effects

Headaches, nausea, vomiting, drowsiness, confusion, and strokes due to weakened blood vessels and blocked blood flow in the brain.

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Hypertension Renal Effects

Increased urination (polyuria, nocturia), protein in urine (proteinuria), blood in urine (red cells), and kidney function decline (increased creatinine).

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Primary Hypertension

Most common type of hypertension (over 95%), with no known specific cause.

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Secondary Hypertension

Less common (2-5%), resulting from an underlying condition like kidney disease or adrenal issues.

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Blood Pressure Equation

Blood pressure equals cardiac output (heart rate times stroke volume) multiplied by peripheral resistance.

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Atrial Flutter

A heart rhythm problem where electrical signals in the atria (upper heart chambers) travel in a fast, regular pattern, unlike the irregular pattern in atrial fibrillation.

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Bundle Branch Block

A heart condition where the electrical signal traveling to one side of the ventricles (lower heart chambers) is delayed, causing one ventricle to contract slightly later than the other.

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Premature Atrial Contraction (PAC)

An extra heartbeat that starts in the atria (upper heart chambers) before the next normal heartbeat.

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Premature Ventricular Contraction (PVC)

An extra heartbeat that starts in the ventricles (lower heart chambers) before the next normal heartbeat.

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Wolff-Parkinson-White Syndrome (WPW)

A heart condition where an abnormal electrical pathway exists between the atria and ventricles, causing the ventricles to receive the signal too early.

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Sick Sinus Syndrome

A heart condition where the sinus node (pacemaker of the heart) doesn't work properly, leading to problems with heart rate, which may fluctuate between slow and fast.

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Atrial Flutter Ratio

The ratio of atrial beats to ventricular beats in atrial flutter. For example, 3:1 means 3 atrial beats for each ventricular beat.

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Irregular Heart Rhythm

A heartbeat that doesn't follow the normal pattern. Extra or missed beats may be present.

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Study Notes

Cardiovascular System

  • The heart has four chambers: two atria (upper) and two ventricles (lower).
  • Four valves control blood flow: tricuspid, pulmonary, mitral, and aortic.
  • Blood flows in one direction due to pressure differences across the valves.
  • Preload: Cardiac muscle load at diastole end.
  • Afterload: Cardiac muscle load at systole end.
  • Cardiac output: The amount of blood pumped by the heart in a given time.
  • Stroke volume: Blood volume ejected from the heart per beat.
  • Heart rate: Number of heart beats per unit time.
  • Positive inotropy: Increased heart contraction force.
  • Positive chronotropy: Increased heart rate.
  • Positive dromotropy: Increased conduction velocity between the atria and ventricles.

Hypertension

  • Hypertension is elevated blood pressure.
  • High when systolic pressure exceeds 140 mmHg and diastolic exceeds 90 mmHg.
  • Normal blood pressure is less than 120/80 mmHg.
  • Pre-hypertension is between normal and high blood pressure.
  • Hypertension increases risk of myocardial infarction, stroke, heart failure, and kidney disease and other complications.
  • Classified into primary (essential) and secondary hypertension.

A-Hypertension

  • Primary hypertension has no identifiable cause, and accounts for ~95% of cases.
  • Secondary hypertension results from another disease (renal or adrenal)
  • Increased sympathetic nervous system activity affects baroreceptors for regulating blood pressure.
  • Blood pressure is affected by cardiac output and peripheral resistance.
  • Increased renin-angiotensin system activity causes the kidneys to retain sodium and lose potassium.

B-Congestive Heart Failure

  • Heart failure is the inability to supply sufficient blood flow to meet the body's needs.
  • Left-sided heart failure causes pulmonary congestion.
  • Right-sided heart failure causes systemic congestion.
  • Associated symptoms like orthopnea, edema, and nocturia.
  • Causes include ischemic heart disease, hypertension, cigarette smoking, obesity, diabetes, and valvular heart disease.
  • Reduced contractility, decreased stroke volume, and reduced spare capacity contribute to the progression of heart failure.

C-Angina Pectoris

  • Angina pectoris (angina) is chest pain due to insufficient blood supply to the heart muscle.
  • Types of angina include stable, unstable, variant, and microvascular.
  • Stable angina occurs with exertion and is relieved with rest.
  • Unstable angina is unpredictable and doesn't follow a pattern, often a symptom of an impending heart attack.
  • Variant or Prinzmetal's angina typically occurs at rest and usually is relieved with medicine.
  • Microvascular angina is severe, may last longer than other types, and may not be relieved with medicine.

D-Arrhythmia

  • Arrhythmia is an irregular heartbeat pattern due to problems with electrical impulses.
  • Types of arrhythmia include bradycardia (slow heart rate) and tachycardia (fast heart rate).
  • Causes of arrhythmia include abnormal impulse formation, abnormal impulse conduction, including re-entry.
  • Arrhythmias can lead to a complete heart block or sick sinus syndrome.

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Description

This quiz covers key concepts of the cardiovascular system, including heart structure, cardiac output, and the factors influencing heart performance. Additionally, it addresses hypertension, its definitions, and implications. Test your knowledge on these important health topics!

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