Cardiovascular System Overview

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Questions and Answers

What is a characteristic sign of unstable angina?

  • It happens mainly at night.
  • It is typically relieved by rest.
  • It usually occurs after a meal.
  • It indicates a potential heart attack. (correct)

When does variant angina typically occur?

  • After eating a heavy meal.
  • Only in the morning hours.
  • During physical activity.
  • While at rest, particularly at night. (correct)

What is microvascular angina associated with?

  • Normal coronary arteries.
  • Coronary vasospasm.
  • Coronary microvascular disease. (correct)
  • Short episodes of pain.

What role does the sinoatrial node (SA node) serve in the heart?

<p>It initiates the heart's electrical impulses. (B)</p> Signup and view all the answers

What is electrocardiography (ECG or EKG) primarily used for?

<p>To record the heart’s electrical activity. (D)</p> Signup and view all the answers

What does the P-QRS-T pattern represent in cardiac activity?

<p>Atrial depolarisation, ventricular depolarisation, and ventricular repolarisation (A)</p> Signup and view all the answers

Which phase of cardiac cell activity features rapid depolarisation due to Na inflow?

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

What is the primary characteristic of Phase 2 in cardiac cells?

<p>Combined inward Ca and outward K currents (D)</p> Signup and view all the answers

During which phase does the outward K current increase, leading to repolarisation?

<p>Phase 3 (A)</p> Signup and view all the answers

What does the term 'arrhythmia' refer to in terms of heart function?

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

What is the age range most commonly associated with the incidence of hypertension?

<p>30 to 50 years (A)</p> Signup and view all the answers

Which of the following is NOT a common consequence of untreated elevated hypertension?

<p>Increased immune response (B)</p> Signup and view all the answers

Primary hypertension constitutes what percentage of all cases of systemic hypertension?

<p>95% or more (C)</p> Signup and view all the answers

What is a neurological finding associated with severe elevation in blood pressure?

<p>Severe occipital headache (C)</p> Signup and view all the answers

What contributes to the development of peripheral edema in patients with hypertension?

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

Which of the following describes secondary hypertension?

<p>Results from renal disease or adrenal dysfunction (B)</p> Signup and view all the answers

Which equation correctly represents blood pressure?

<p>Blood pressure = cardiac output x peripheral resistance (A)</p> Signup and view all the answers

What physiological change can increase blood pressure through the sympathetic nervous system?

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

What are the two upper chambers of the heart called?

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

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

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

What term describes the load on the cardiac muscle at the end of diastole?

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

What is considered high systolic blood pressure?

<p>140 mmHg (D)</p> Signup and view all the answers

Which age group has a higher incidence of hypertension?

<p>Over 60 years (B)</p> Signup and view all the answers

What does cardiac output refer to?

<p>Amount of blood pumped per unit time (C)</p> Signup and view all the answers

What is the normal blood pressure reading for adults?

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

What does positive chronotropy refer to?

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

What is the rhythm characteristic of atrial flutter?

<p>Fast and regular rhythm (C)</p> Signup and view all the answers

What occurs in bundle branch block?

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

What are premature atrial contractions (PACs)?

<p>Extra beats starting in the atria (D)</p> Signup and view all the answers

What is Wolff-Parkinson-White syndrome characterized by?

<p>Abnormal conduction pathways between atria and ventricles (A)</p> Signup and view all the answers

In sick sinus syndrome, how does the heart rate typically behave?

<p>Alternates between slow and fast (C)</p> Signup and view all the answers

What is the main effect of premature ventricular contractions (PVCs)?

<p>They may cause the sensation of skipped beats (B)</p> Signup and view all the answers

What is a typical ratio of atrial beats to ventricular beats in atrial flutter?

<p>3:1 block (A)</p> Signup and view all the answers

What primarily changes in the heart rhythm during sick sinus syndrome?

<p>The sinus node does not fire properly (D)</p> Signup and view all the answers

What typically indicates the location of the electrophysiologic abnormality in arrhythmias?

<p>The first word in the name of the arrhythmia (D)</p> Signup and view all the answers

What is classified as bradycardia in adults?

<p>A heart rate of less than 60 BPM (C)</p> Signup and view all the answers

What condition allows impulses to circulate continuously in the heart, resulting in re-entry arrhythmias?

<p>Unidirectional block in conduction (C)</p> Signup and view all the answers

What is a common cause of ectopic pulses in the heart?

<p>Increased intracellular calcium concentration (C)</p> Signup and view all the answers

Which term describes a heart rate that is slower than normal?

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

What is the result of abnormal impulse conduction in the heart?

<p>Re-entry or conduction block (A)</p> Signup and view all the answers

What type of pulse originates from non-pacemaker cells due to an abnormal action potential?

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

What can lead to damage of nodal or conducting tissue in the heart?

<p>Electrolyte imbalances (C), Structural heart defects (D)</p> Signup and view all the answers

Flashcards

Heart 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

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

Afterload

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

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Cardiac Output

The amount of blood pumped by the heart per unit of time.

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Hypertension

Elevated blood pressure to a level high enough to damage tissues and organs.

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Normal Blood Pressure

Blood pressure that does not exceed 120/80 mmHg.

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Hypertension Stages

Hypertension is classified into stages based on blood pressure readings: Pre-hypertension, Stage 1, Stage 2.

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Primary Hypertension Cause

Primary (essential) hypertension has no identifiable cause; it accounts for over 95% of hypertension cases.

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Secondary Hypertension Cause

Secondary hypertension is caused by an identifiable factor, such as kidney disease or adrenal gland problems. It accounts for a small percentage of hypertension cases.

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Blood Pressure Equation

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

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Hypertension Symptoms (Cardiovascular)

Hypertension can cause angina (chest pain), enlarged heart (left ventricle), shortness of breath, and swelling in the legs and feet.

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Hypertension Symptoms (Neurological)

Hypertension can lead to severe headaches, nausea, vomiting, and even stroke, due to weakened blood vessels in the brain.

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Hypertension Symptoms (Renal)

Hypertension can cause frequent urination, protein in urine, blood in urine, and increased creatinine levels in the blood. This is linked to hardening of kidney blood vessels.

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Hypertension Symptoms (Ocular)

Hypertension can cause bleeding and fluid buildup in the retina due to damaged blood vessels in the eyes.

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Hypertension Incidence Age

High blood pressure commonly occurs between the ages of 30 and 50.

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Unstable Angina

A dangerous type of chest pain that signals an imminent heart attack. It's often caused by factors like hypertension or fever.

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Variant Angina

A rare type of angina caused by spasms in the coronary arteries. It usually occurs at rest, often between midnight and early morning.

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Microvascular Angina

A type of angina affecting smaller blood vessels in the heart. It can be more severe and last longer than other types.

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Sinoatrial Node (SA Node)

The natural pacemaker of the heart, located in the right atrium. It generates electrical impulses that trigger the heartbeat.

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Atrioventricular (AV) Node

A cluster of cells in the heart that acts as a gatekeeper for electrical signals traveling from the atria to the ventricles.

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Atrial Flutter

A type of heart rhythm where the atria beat fast and regularly, but the ventricles beat slower, usually in a 3:1 ratio.

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Bundle Branch Block

A condition where one of the two electrical pathways to the ventricles is blocked, causing one ventricle to contract slightly slower than the other.

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PAC (Premature Atrial Contraction)

An extra heartbeat that originates in the atria, causing a feeling of skipped beats.

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PVC (Premature Ventricular Contraction)

An extra heartbeat that originates in the ventricles, also causing a feeling of skipped beats.

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Wolff-Parkinson-White Syndrome (WPW)

A condition where an abnormal electrical pathway exists between the atria and ventricles, causing the ventricles to contract sooner than normal.

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Sick Sinus Syndrome

A condition where the heart's natural pacemaker (sinus node) doesn't function properly, leading to irregular heart rate that can be slow or fast.

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What is the difference between atrial fibrillation and atrial flutter?

Atrial fibrillation has a fast and irregular rhythm in the atria, while atrial flutter has a fast and regular rhythm.

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Does a stable ratio exist between atrial and ventricular beats?

No, there's no stable ratio between atrial beats and ventricular beats. This is because the ventricles often beat slower than the atria.

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Arrhythmia

An irregular heartbeat that can be either too fast (tachycardia), too slow (bradycardia), or have an abnormal rhythm.

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What causes arrhythmia?

Arrhythmias are caused by either abnormal impulse formation (A) or abnormal impulse conduction (B).

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Abnormal impulse formation

This occurs when there's a problem with the heart's pacemaker cells, which are responsible for generating electrical impulses that regulate heartbeats.

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Abnormal impulse conduction

This occurs when the electrical signals that control the heart rate are blocked or delayed, causing the heart to beat irregularly.

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Re-entry

A common cause of arrhythmia where a faulty circuit forms in the heart tissue causing a continuous loop of electrical signals.

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Bradycardia

A slow heart rate, less than 60 beats per minute (BPM) in adults.

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Tachycardia

A fast heart rate, more than 100 beats per minute (BPM) in adults.

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Fibrillation

A rapid, irregular heartbeat, where the heart chambers are not beating in a coordinated way.

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ECG Pattern

The P-QRS-T wave pattern on an electrocardiogram (ECG) reflects the electrical activity of the heart.

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What does the 'P' wave represent?

The 'P' wave represents atrial depolarization, the electrical signal that triggers the contraction of the atria.

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What does the 'QRS' complex represent?

The 'QRS' complex represents ventricular depolarization, the electrical signal that triggers the contraction of the ventricles.

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What does the 'T' wave represent?

The 'T' wave represents ventricular repolarization, the electrical signal that resets the ventricles for the next heartbeat.

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What is arrhythmia?

Arrhythmia is any abnormality in the heart's electrical rhythm, resulting in irregular, too fast, or too slow heartbeats.

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Study Notes

Cardiovascular System

  • Heart Structure: The heart has four chambers—two atria (upper) and two ventricles (lower).
  • Heart Valves: Four valves regulate blood flow: Tricuspid, Pulmonary, Mitral, and Aortic. These valves permit blood flow in only one direction.
  • Preload: The load on the cardiac muscle at the end of diastole (relaxation).
  • Afterload: The load on the cardiac muscle at the end of systole (contraction).
  • Cardiac Output: The amount of blood pumped from the heart per unit time.
  • Stroke Volume: The volume of blood ejected from the heart in each beat.
  • Heart Rate: The number of heart beats per unit time.
  • Positive Inotropy: Increased heart force of contraction.
  • Positive Chronotropy: Increased heart rate.
  • Positive Dromotropy: Increased conduction velocity between the atria and ventricle.
  • Blood Pressure: Systolic (140 mmHg) and diastolic readings (90 mmHg) are considered high. Readings over 160/100 mmHg are Stage 2 hypertension. Normal is below 120/80 mmHg.

Hypertension

  • Definition: Elevated blood pressure to a degree that perfuses tissues and organs inadequately.
  • Incidence: High incidence (60-70%) in individuals older than 60 years.
  • Associated Diseases: Hypertension can cause complications like myocardial infarction, stroke, heart failure, retinal damage, stroke, headache, neurological symptoms, and kidney disease.

A-Hypertension

  • Elevated Blood Pressure: High blood pressure is typically caused by age, but can be exacerbated by disorders like renal disease or adrenal hyper-function.
  • Classifications: Hypertension is classified into primary (essential), accounting for >95% of Hypertension cases, or secondary, which has an underlying cause.
  • Consequence: Blood pressure is determined by cardiac output and vascular resistance. Increased cardiac output, blood viscosity or reduced vascular resistance all elevate blood pressure.

Heart Failure

  • Definition: Inability of the heart to supply sufficient blood flow to meet the body's needs.
  • Types: Left-sided (pulmonary congestion) or right-sided (systemic congestion).
  • Causes: Ischemic heart disease, cigarette smoking, hypertension, obesity, diabetes, and valvular heart disease.
  • Progression: Reduced contractility, reduced stroke volume, reduced spare capacity, increased heart rate.

Angina Pectoris

  • Definition: Severe chest pain due to reduced blood and oxygen supply to heart muscle.
  • Types: Stable (effort-related), Unstable, Variant (Prinzmetal's), or Microvascular.
  • Symptoms: Stable angina occurs with exertion or physical stress, while unstable is unpredictable.

Arrhythmias

  • Definition: Abnormal heart rhythms from abnormal impulse formation or conduction problems in the heart's electrical system.
  • Types: Bradycardia, Tachycardia (Supraventricular, Sinus, Ventricular), Complete Heart Block, Sick Sinus syndrome, Torsades de Pointes, Wolff-Parkinson-White Syndrome.

Other Cardiovascular Conditions

  • Atrial Fibrillation: Irregular heartbeat in the atria, where many portions of the atria emit uncoordinated electrical signals. May lead to reduced blood output, which can be problematic if untreated.
  • Atrial Flutter: Similar to fibrillation, but the electrical activity in the atria is regular, not irregular.
  • Bundle Branch Block: Electrical impulses are delayed in one or both branches in the heart's conducting system, resulting in a slower contraction in one ventricle as compared to the other.
  • Premature Atrial Contractions (PACs): Extra beats that originate from the atria instead of the sinoatrial (SA) node.
  • Premature Ventricular Contractions (PVCs): Extra beats that originate from the ventricles instead of the sinoatrial (SA) node.

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