Chapter 24: Alterations of Cardiovascular Function

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Questions and Answers

What is the primary cause of varicosities in veins?

Narrowing of arteries

Damaged valves due to trauma or chronic venous distension (correct)

Increased cardiac output

Hypercoagulability of blood

Which of the following statements is true about chronic venous insufficiency (CVI)?

CVI leads to improved metabolic states in cells

CVI causes ischemic changes in tissues (correct)

CVI does not affect the vasculature or skin

CVI is a short-term condition

What complication is most serious in deep venous thrombosis (DVT)?

Stroke

Heart attack

Pulmonary embolism (correct)

Chronic venous insufficiency

What condition is characterized by venous distension in the upper extremities and head?

Superior vena cava syndrome Signup and view all the answers

Which of the following is a risk factor for developing hypertension?

Low dietary potassium intake Signup and view all the answers

What is hypertension primarily a result of?

Increase in systemic arterial blood pressure Signup and view all the answers

Which mechanism is NOT considered an explanation for primary hypertension?

Inadequate hydration levels Signup and view all the answers

What follows the development of chronic venous insufficiency?

Venous stasis ulcers Signup and view all the answers

Primary hypertension can be described as which of the following?

Without a known cause Signup and view all the answers

Which factor does NOT contribute to primary hypertension?

Increased physical exercise Signup and view all the answers

What primarily causes the tissue death in central organs such as the lungs and kidneys?

Emboli occluding blood vessels Signup and view all the answers

What condition describes the improper positioning of the mitral valve leaflets during systole?

Mitral valve prolapse syndrome Signup and view all the answers

Which condition is characterized by a marked vasodilation and blood pooling in muscle vasculature upon standing?

Orthostatic hypotension Signup and view all the answers

What is the most likely initial change that triggers atherosclerosis?

Vascular inflammation Signup and view all the answers

Which of the following is a major consequence of untreated rheumatic fever?

Rheumatic heart disease Signup and view all the answers

What is the primary causes of HF with reduced ejection fraction?

Increased preload and decreased contractility Signup and view all the answers

Which risk factor is considered nontraditional in the onset of coronary artery disease (CAD)?

Elevated C-reactive protein levels Signup and view all the answers

What type of shock is characterized by decreased cardiac output but adequate intravascular volume?

Cardiogenic shock Signup and view all the answers

What distinguishes unstable angina from stable angina?

Unpredictable chest pain Signup and view all the answers

How is myocardial infarction (MI) classified based on electrocardiographic findings?

As non-STEMI or STEMI Signup and view all the answers

Which type of shock results from massive vasodilation and relative hypovolemia?

Neurogenic shock Signup and view all the answers

What is a common result of a rupture in an atherosclerotic plaque?

Formation of a clot Signup and view all the answers

What is a common initial trigger for septic shock?

Uncontrolled septicemia Signup and view all the answers

What condition may develop as a response to both cardiogenic shock and hypovolemic shock?

Multiple organ dysfunction syndrome Signup and view all the answers

What clinical manifestation is NOT typically associated with orthostatic hypotension?

Hypertension Signup and view all the answers

What is primarily responsible for myocardial ischemia in ischemic heart disease?

Decreased myocardial blood supply Signup and view all the answers

Which of the following is a potential effect of anaerobic metabolism during shock?

Activation of inflammatory response Signup and view all the answers

Which of the following is NOT a type of cardiomyopathy?

Ischemic Signup and view all the answers

What contributes to the buildup of lactic acid during shock conditions?

Glycogenolysis and gluconeogenesis Signup and view all the answers

Which neuroendocrine mediators play a role in the pathophysiology of heart failure?

Sympathetic nervous system and RAAS Signup and view all the answers

Study Notes

Diseases of the Veins

Varicosities are enlarged veins, commonly in the saphenous veins, caused by valve damage or chronic venous distension.
Chronic Venous Insufficiency (CVI) is impaired venous return over time, causing tissue damage in the affected area.
Venous Stasis Ulcers appear as a result of CVI due to compromised cell metabolism in the extremities.
Deep Venous Thrombosis (DVT) arises from blood stasis, endothelial damage, or hypercoagulability. Pulmonary embolism is a serious DVT complication.
Superior Vena Cava Syndrome is a progressive blockage of the superior vena cava leading to fluid buildup in the upper body. It is generally associated with cancer and considered an oncological emergency.

Diseases of the Arteries

Hypertension is elevated systemic arterial blood pressure caused by increased cardiac output, total peripheral resistance, or both.
Primary Hypertension has unknown causes, while Secondary Hypertension is linked to underlying diseases.
Risk Factors for Hypertension include family history, age, gender, race, obesity, sodium intake, and lifestyle habits.
Pathophysiology of Primary Hypertension involves potential factors such as overactive SNS, RAAS, kidney dysfunction, and hormonal imbalances.
Clinical Manifestations of Hypertension stem from damage to various organs and tissues, such as retinal changes, heart disease, kidney disease, stroke, and dementia.
Management of Hypertension involves reducing blood volume and peripheral resistance through non-pharmacological and pharmacological interventions.
Orthostatic Hypotension (OH) is a decrease in blood pressure upon standing due to inadequate vasoconstriction and blood pooling in the lower body.
Clinical Manifestations of OH include fainting, cardiovascular symptoms, and potential bowel and bladder dysfunction.
Aneurysm is a localized dilation of a vessel wall, commonly affecting the aorta.
Thrombus is a stationary blood clot attached to a vessel wall. Embolus is a mobile clot or other substance that can obstruct blood flow.
Sources of Embolism include thrombus, air, amniotic fluid, bacteria, fat, and foreign matter.
Common Sources of Arterial Embolism are the heart, often due to valvular disease, fibrillation, or myxomas. Affected areas include the lower extremities, brain, and heart.
Emboli in Central Organs can lead to tissue death in the lungs, kidneys, and mesentery.
Peripheral Vascular Diseases include Buerger's disease and Raynaud phenomenon, affecting arterioles in the extremities.
Atherosclerosis is a type of arteriosclerosis, a leading cause of coronary artery disease (CAD) and cerebrovascular disease.
Atherosclerosis is an inflammatory process starting with endothelial injury.
Atherogenesis Stages include vasoconstriction, macrophage adherence, inflammation, LDL oxidation, foam cell formation, fatty streak development, and fibrous plaque formation.
Plaque Rupture can lead to clot formation, vasoconstriction, and lumen obstruction, compromising tissue oxygenation.
Ischemic Heart Disease commonly results from CAD and reduced myocardial blood supply.
Peripheral Artery Disease develops from atherosclerotic plaques in the arteries supplying the extremities, causing pain and ischemia in the affected limb.
Coronary Artery Disease (CAD) arises from atherosclerotic plaque that narrows or ruptures in the coronary arteries.
Risk Factors for CAD include traditional factors like dyslipidemia, smoking, hypertension, diabetes, obesity, and sedentary lifestyle, as well as non-traditional factors like elevated C-reactive protein, hyperhomocysteinemia, and adipokine changes.
Stable Angina Pectoris is predictable chest pain caused by myocardial ischemia due to increased demand.
Prinzmetal Angina is caused by coronary artery vasospasm.
Silent Ischemia is asymptomatic myocardial ischemia, a risk factor for acute coronary syndromes.
Acute Coronary Syndromes (ACS) are caused by sudden obstruction due to thrombus formation. These syndromes include unstable angina, non-STEMI, and STEMI.
Unstable Angina results in reversible myocardial ischemia.
Myocardial Infarction (MI) is prolonged ischemia leading to myocardial cell death and tissue necrosis.
Complications of MI include dysrhythmias and cardiac failure.
Non-STEMI and STEMI are classified based on ECG findings showing subendocardial or transmural damage.
Plasma Enzyme Levels like CK-MB, troponins, and LDH-1 indicate MI occurrence and severity.
Treatment of MI involves revascularization, antithrombotics, ACE inhibitors, beta-blockers, pain management, and fluid management.

Disorders of the Heart Wall

Pericarditis is inflammation of the pericardium, commonly caused by infection, trauma, surgery, or neoplasm. Although uncomfortable, it is not life-threatening.
Pericardial Effusion is fluid buildup in the pericardial sac, potentially impairing cardiac function if rapid and excessive.
Cardiomyopathies are primary myocardial disorders involving remodelling, neurohumoral responses, and hypertension. Types include dilated, hypertrophic, and restrictive cardiomyopathy.
Cardiac Valve Disorders can be congenital or acquired, leading to stenosis, regurgitation, or both.
Identification of Valve Disorder is aided by heart sounds, murmurs, and symptoms.
Mitral Valve Prolapse Syndrome (MVPS) involves improperly positioning mitral valve leaflets during systole. It can be asymptomatic or lead to unpredictable symptoms.
Rheumatic Fever is an inflammatory response to streptococcal infection, usually resolving without complications if treated.
Rheumatic Heart Disease is a potential complication of untreated or severe rheumatic fever, leading to cardiovascular dysfunction.
Infective Endocarditis is infection and inflammation of the endocardium, particularly the valves.
Consequences of Infective Endocarditis include impaired valve function, bacteremia, and systemic emboli.
HIV and AIDS can lead to cardiac abnormalities like myocarditis, endocarditis, pericarditis, and cardiomyopathy.

Manifestations of Heart Disease

Heart Failure (HF) is broadly classified into reduced ejection fraction (systolic) and preserved ejection fraction (diastolic).
Common Causes of Left Ventricular Failure are MI and hypertension.
HF with Reduced Ejection Fraction (Systolic) arises from increased preload, decreased contractility, or increased afterload. These factors lead to elevated left ventricular end-diastolic volume and pressure, causing pulmonary congestion and edema.
Neuroendocrine Response in HF includes SNS and RAAS activation, exacerbating the condition. Diuretics, beta-blockers, and ACE inhibitors are part of treatment.
HF with Preserved Ejection Fraction (Diastolic HF) is characterized by HF symptoms, preserved ejection fraction, and abnormal diastolic function.
Diastolic Dysfunction causes increased LVEDP even with normal volume and cardiac output.
Right Ventricular Failure can be caused by left ventricular failure or pulmonary disease.
Dysrhythmia (Arrhythmia) is irregular heart rhythm, ranging from occasional missed beats to life-threatening disturbances.
Causes of Dysrhythmias include abnormal impulse generation or conduction.

Shock

Shock is a widespread metabolic impairment leading to MODS through positive feedback loops.
Types of Shock include cardiogenic, hypovolemic, neurogenic, anaphylactic, and septic.
Final Common Pathway in Shock is impaired cellular metabolism, shifting from aerobic to anaerobic metabolism.
Consequences of Anaerobic Metabolism include inflammatory response activation, decreased blood volume, and lowered pH.
Impaired Glucose Utilization in shock leads to glycogenolysis, gluconeogenesis, and lipolysis for energy production.
Gluconeogenesis depletes structural proteins, further impairing cell metabolism while contributing to lactic acid, uric acid, and ammonia buildup.
Cardiogenic Shock involves decreased cardiac output, tissue hypoxia, and adequate intravascular volume.
Hypovolemic Shock is caused by significant blood or fluid loss, leading to reduced tissue perfusion despite compensatory mechanisms.
Neurogenic Shock is caused by massive vasodilation, resulting in relative hypovolemia despite high cardiac output.
Anaphylactic Shock is triggered by an allergic reaction leading to massive vasodilation and fluid shifts, causing relative hypovolemia.
Septic Shock begins with impaired cellular metabolism due to uncontrolled septicemia, triggering inflammation and immune responses, further disrupting tissue and cellular function.
Multiple Organ Dysfunction Syndrome (MODS) is the progressive failure of two or more organs due to severe illness or injury.
MODS Pathophysiology involves stress response, vascular endothelial changes, complement and coagulation protein release, and inflammatory processes.
Consequences of MODS include maldistributed blood flow, hypermetabolism, hypoxic injury, and myocardial depression.
Clinical Manifestations of MODS include inflammation, tissue hypoxia, and hypermetabolism. All organs can be affected.

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Description

This quiz covers various diseases affecting the veins and arteries, including conditions like varicosities, chronic venous insufficiency, deep venous thrombosis, and hypertension. Explore how these diseases impact circulation and overall health. Test your knowledge on symptoms, causes, and complications related to vascular diseases.