Chapter 6: Diseases and Disorders of Cardiovascular System

Low-density lipoprotein

"bad cholesterol"; transports cholesterol from the liver to the body tissues

Heart Valves

*Atrioventricular (AV)* valves (between the atria and the ventricles) → permit one-way blood flow from the atria to the ventricles *Mitral valve* (between left atrium and left ventricle) has two flaps (cusps) that meet when the valve is closed *Tricuspid valve* (between right atrium and right ventricle) has three cusps *Pulmonary semilunar valve*→ permits one-way blood flow from the right ventricle to the pulmonary artery *Aortic semilunar valve*→ controls blood from from the left ventricle to the aorta

endocarditis

*Infection of the endocardium (lining) and heart valves* Risk factors: rheumatic heart disease, heart valve disorders *Vegetations*- (acute formation) nodules of infectious organisms

myocarditis

*Inflammatory disease of the heart muscle* Risks: viral infection; strep or staph infections s&s: flu-like illness, fever, angina, etc. Diagnosis: ECG, CT, MRI, chest x-ray, echocardiogram (ultrasound)

Chronic venous insufficiency

*Poor venous blood return to the heart* Most common cause: *deep vein thrombosis (clot)* s&s: tissue *edema*, necrosis or skin atrophy, and pain in walking

atherosclerosis

*Thickening, narrowing, and hardening of arteries due to plaque buildup* *Fatty streaks* *Fibrous atheromatous plaque* (on arteries) → accumulation of lipids and the formation of scar tissue *thrombosis*- a *clot* within a blood vessel formed from ulceration and a *turbulent blood flow in the region of the plaque* *Carotid arteries blockage*→ reduce blood supply to brain→ *stroke*

arteriosclerosis

*artery walls thicken and harden* (calcium deposition) → inflexible *Hypertension* because blood is forced causes: *fatty material accumulation within walls of the arteries*

Rheumatic Fever

*autoimmune disease*: bacterial antigen and antibodies reaction Risk: A hemolytic *streptococci* *blood clots deposit on cusps of inflamed valves* *cusps adhere to each other* *fibrous tissue develops >> contracts *mitral valve* becomes *stenotic* (narrow)

shock

*blood pressure drops too low to sustain life* *ischemia* *cardiogenic*- arrythmias, heart attack *hypovolemic*- burns, bleeds, surgery, *trauma* *analphylactic* *septic*- bacterial toxins *neurogenic- damage to CNS*

congestive heart failure

*cannot pump enough blood* >>*blood backs up in the veins* leading to the heart, causing an accumulation of fluid in various parts of the body s&s: ankle swelling, shortness of breath with exertion, pulmonary edema Treatment: salt and water restriction prevention: reducing risks for heart disease, diabetes, hypertension

cardiomyopathy

*heart becomes weakened and enlarged or rigid* Three types **Dilated cardiomyopathy*- dilation of the ventricle, contractile dysfunction, and symptoms of congestive heart failure *Hypertrophic cardiomyopathy*- ventricular hypertrophy. *most common cause of sudden cardiac death* among young people *Restrictive cardiomyopathy*- (least common) reduced filling of the heart and endocardial scarring in the ventricle

complications of valve disorders

*hypertrophy* and *weakening of heart muscle* shortness of breath, cyanosis *congestive heart failure*

most common valve disorders

*mitral valve stenosis, mitral valve insufficiency (prolapse), aortic valve stenosis, and aortic valve insufficiency*

Layers of heart

*myocardium*- cardiac muscle *endocardium*-internal smooth lining *pericardium*- double-layered membrane; encloses heart w/in pericardial cavity

stenosis

*narrowing of valve opening and failure to open valve normally* *produce distention (large and internal pressure) of heart chamber- empties blood through diseased valve *impaired filling of chamber receiving blood*

coronary heart disease

*reduced coronary blood flow* Symptoms: *angina pectoris* *palpitations*→ sensation of rapid pound cardiac arrest- *myocardial infarction* Treatment: *Angioplasty*- *procedure used to open a partly occluded artery* -Insert balloon-tipped catheter into the femoral artery -*stent placement* *artery bypass surgery*

varicose veins

*spider veins* Dilated, distorted superficial veins (of the leg) greater saphenous vein Cause: blood pooling within the veins because of decreased, *stagnated blood flow* Treatment: *Compression sclerotherapy*- strong saline solution injected into specific site of the varicose veins

Rhythm disorders

*tachycardia* *bradycardia* *atrial fibrillation*- uncoordinated contraction of atria *ventricular fibrillation*- " " " ventricles *heart block*- atria and ventricles contract independent of each other

venous thrombosis

-*clot in deep or superficial veins of lower extremities* -*emboli*→ clots that travel to vital organs such as the lungs

Doppler ecocariography

-blood flow patterns and changes in velocity of blood flow

most common cause of an aortic aneurysm

atherosclerosis

hyperlipidemia

elevated lipids in the blood

Blood flow through heart

Step 1 Superior and inferior venae cavae Step 2 Right Atrium Step 3 Tricuspid valve Step 4 Right ventricle Step 5 Pulmonary semilunar valve Step 6 Pulmonary trunk Step 7 Left and right pulmonary arteries Step 8 Left and right lungs (capillary beds) Step 9 Four pulmonary veins Step 10 Left atrium Step 11 (Bicuspid) Mitral valve (left atrioventricular valve) Step 12 Left ventricle Step 13 Aortic semilunar valve Step 14 Ascending aorta Step 15 arch of the aorta Step 16 left subclavian artery Step 17 capillary beds of the left upper limb and and anterior thoracic body wall Step 18 Left Subclavian vein Step 19 Left brachiocephalic vein Step 20 Superior vena cava Step 21 right atrium

valvular insufficiency/ regurgitation

a leaky valve; *allows backward flow of blood within heart

Raynaud's disease

a peripheral arterial occlusive disease in which *fingers and toes show pallor or cyanosis, cold, numb, tingly* arteries suddenly contract- *vasospasm*

Aortic Aneurysm

abnormal dilation of the aorta fusiform: uniform shape saccular: out-pouching

cardiac arrhythmia

abnormal heart rhythms *develop from irregularity in impulse generation and conduction* Two Types 1. *supraventricular*- electrical abnormalities in *pacemaker (sinoatrial node), atria*, *AV node*, and junctional tissue 2. *ventricular*- generated in *ventricular conduction system* Cause: *CAD*, heart valve disease, heart attack, *hypertension*, *atherosclerosis* S&S: *syncope- lightheadedness*, edema, shortness of breath Treatment: catheter ablation >> corrects structural problems in heart *electrocardioversion- surgically placed pacemaker* *defibrillator*- implanted under skin resynchronizes heart

heart muscle contraction influenced by...

autonomic nervous system

Congenital heart disease risks

babies born with chromosomal abnormalities (Down's syndrome, Turner's syndrome)

high-density lipoprotein

carries cholesterol out of the blood stream to liver

cardiac catheterization

catheter passed into heart through blood vessels to sample blood in each chamber for oxygen content and pressure

Purkinje fibers

conducts the impulse for contraction to the myocardium of the ventricles

Patent ductus arteriosus

congenital *ductus remains open*>> blood intended for body flows from aorta to lungs, overloading pulmonary artery *higher pressure in aorta; lower bp in PA* *more premature babies* Treatment: *anti-inflammatories to close PDA* and *antibiotics to prevent endocarditis* OR transcatheter, surgery

Transposition of Great Arteries

congenital *aorta and pulmonary artery connect in wrong ventricle* >>aorta- right ventricle; pulmonary artery- left ventricle *blood flow in the lungs and body occur independently* s&s: *cyanosis*, shortness of breath, clubbing of fingers Risk: diabetic mother

coarctation of the aorta

congenital *narrowing of aorta* *increases pressure in left ventricle* s&s: shortness of breath and cold legs Diagnosis: murmur, CT, echocardiography (ultrasound) Treatment: enlargement of aorta lumen

Tetralogy of Fallot

congenital 4 Defects 1. ventricular septal defect (connection between ventricles) 2. pulmonary valve stenosis 3. misplaced aorta (crosses interventricular septum) 4. hypertrophy of right ventricle

septal defects

congential occur between *atria or ventricles* *large atrial septal defects*>> *overload right ventricle>>enlarge and weaken* Diagnosis: *heart mumur*

systole

contracting phase of each chamber

cardiac conduction disorders

disruption of normal contraction and relaxation cycle of atria and ventricles

diastole

filling period

peripheral vascular disease

hardening of arteries in legs

hypertension

high blood pressure over 120/80 mmHg *primary hypertension*: *essential hypertension*: sustained increase in systolic and diastolic pressure; *no other disease* *secondary hypertension*- *caused by another disease*

hypercholesterolemia

high levels of cholesterol in blood; usually familial

Age Related Disease

hypertension systolic pressure and LV mass increase ventricular filling, heart rate, cardiac output: decreases arterial dilation; thickening of arterial intima, vascular stiffness

peripheral arterial disease

produce *ischemia*- *loss of blood and oxygen supply* *intermittent claudication*- pain with walking

__________ __________ is associate with reduced heart-filling pressure nd endocardial scarring

restrictive cardiomyopathy

predominant cause of mitral stenosis

rheumatoid fever

pacemaker of heart

sinoatrial (SA) node