Patho Cardiac Exam #2

amount of blood ejected from the left or right ventricle each minute
to aorta (LV)
to pulmonary trunk (RV)

volume of blood pumped by the ventricle per beat (stroke volume)
number of heart beats per minute

contraction that propels blood out of the ventricles and into the circulation

ventricular relaxation; blood fills the ventricles

stretch on the heart before it contracts; it is based on volume & hydration status
pressure generated in the left ventricle at the end of diastole

strength of contraction at any given preload
degree of mycardial fiber shortening

pressure that must be exceeded before ejection of blood from the ventricle can begin
resistance or impedance to ejection of blood from the left ventricle

volume of blood pumped by the ventricle each heart beat is regulated by three factors
Preload
Contractility
Afterload

amount of blood ejection from ventricle
normal resting heart 60-70%
decrease is hallmark of ventricular failure

resistance to blood flow determined by vascular muscle tone and diameter of blood vessels

the resistance the left ventricle (LV) must overcome to pump blood through the systemic circulation
really involves left ventricle

systemic vascular resistance (SVR)

caused elevation of systemic arterial blood pressure
3rd leading cause of death in the word
called silent killer

increased cardiac output
total peripheral resistance
or both

systolic pressure exceeds 140 mm Hg
diastolic pressure exceeds 90 mm Hg

caused by systemic disease
renal disease, adrenal disorders, vascular disease, drugs
raises peripheral vascular resistance or CO

localized dilation or outpouching of a vessel wall or cardiac chamber
aorta is most susceptible r/t constant stress
3/4th abdomen

atherosclerosis
Syphilis and other infections

True (fusiform; circumferential)
False (saccular)

involves all three layers of vessel

extravascular hematoma
communicates with intravascular space

asymptomatic until rupture
can be painful
dysphagia, dyspnea

clot remains attached to vessel walls
can happen anywhere

detached thrombus
moves around

conditions that promote coagulation or clotting cascade

inflammation of vein

bolus circulating in the bloodstream
travels in bloodstream until it reaches a vessel it cannot fit
life-threatening

air bubble
amniotic fluid
fat
bacteria
cancer cells
foreign substance

ischemia or infarction distal to obstruction
organ -- dysfunction and pain
injury to a large bone (femur)

chronic disease of arterial system

any vascular disease that narrows or occludes the coronary arteries

atherosclerosis

genetics, family history, gender

hyperlipidemia
hypertension
cigarette smoking
diabetes
obesity
sedentary life-style
estrogen deficiency
heavy alcohol consumption

impaired blood flow to myocardium
development within 10 seconds of deprivation

insufficient coronary blood flow to meet metabolic demands of myocardial cells

Hemodynamic factors (decreased blood volume)
Cardiac (tachycardia, valvular incompetence)
Hematologic factors (low hemoglobin concentration)
Systemic disorders (shock)
Increased demand (hypertension, stress, hyperthyroidis, anemia)

atherosclerosis

myocardial ischemia

local, temporary deprivation of the coronary blood supply
some blood supply but not enough

acute inflammation of pericardium

infection
uremia
neoplasm
myocardial infarction
surgery
trauma

sudden onset of severe chest pain
worsening with respiratory movement and lying down
dysphagia
restlessness
irritability
anxiety
weakness
malaise - low energy
low-grade fever
tachycardia

accumulation of fluid in pericardial cavity
can be serous or exudate

tamponade - cardiac compression

pulus paradoxus (indicates tamponade)
muffled or distant heart sounds
dyspnea on exertion
dull chest pain

diverse group of disease affecting myocardium

constricted and narrowed
blood does not flow forward
workload in front of diseased valve is increased

failure of valve to shut completely permitting blood flow to continue when valve should be closed

impairs flow of blood from left atrium to left ventricle

aortic valve doesn't close properly

acute or chronic lesions of rheumatic fever
bacterial endocarditis
syphilis
HTN
connective tissue disorders
atherosclerosis

mitral valve prolapse
rheumatic heart disease
infective endocarditis
CAD
connective tissue disorders
congestive cardiomyopathy

unable to generate adequate cardiac output

ejection fraction less than 40%
inability of the heart to generate adequate cardiac output to perfuse tissues

disruptions decrease cardiac output

dyspnea
orthopnea
cought frothy sputum, fatigue, decreased urine output and edema (starts in lower limbs)

decreased compliance of left ventricle
abnormal diastolic relaxation

dyspnea on exertion, fatigue
pulmonary edema may develop over time

inability of right ventricle to provide adequate blood flow at a normal venous pressure

Cardiovascular system fails to perfuse tissues
cellular functions become impaired
many causes to include multiple organ failure

vary with each type
weakness
cold or hot
nauseated
dizzy, confused
fearful and short of breath