BP

SYSTOLIC= RESISTANCE
-stenosis
If both numbers are high, assume

VOL prob.

Yet, The # with the biggest

CO = SV X HR

Normal CO: 5L/minute

SV: how much blood you pump out with each beat (EDV - ESV)

HR: how many beats in one minute

CO: how much blood pumped out in one minute. equal to blood FLOW
The body tries to keep CO constant, so It will change SV, HR or both in order to do this.

If a patient has tachycardia, give fluids, to ^SV, until the HR is back to normal.

Early exercise: CO is kept by ^HR and ^SV. Late exercise: kept by ^HR only (SV plateus)
^HR leads to ^CO but also to v Diastole.
^^^HR >vvvDiastole(no time for blood to fill heart> vCO
this is why too much tachycardia(^HR) is bad!

BP (also be called MAP (Mean arterial Pressure))

is the average pressure (of syst and diast)
coming out of your left ventricle
BP=CO X TPR
BP= SV x HR x TPR

These are the 3 causes of hypertension(=^BP):

Volume: ^SV Treat with diuretics (Blacks, Hispanics (high sodium diet))
Rate: ^HR Treat with B-blockers (Middle-aged Whites (stressed out))
Resistance: ^TPR (Elderly (less compliance of arterioles))
^SV- by ^ contrxn: thus by ^catecholam, and by ^Ca+in, v Na+out. With ^preload and v
Afterload. **MI leads to death of myocardium(less muscle) and v contrxn, vSV.
HR- by temp; Autonomic NS; SA node, thus also by Na and K levels.
So all these factors if not compensated for, will affect CO and thus will affect BP.
Normal BP= 120/80
HTN= >135/85
-moderate HTN=>155/>100
-severe HTN= >175/>115
BP tells u if its resistance or volume problem!

HYPOVOLEMIA:
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Mean
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blood= v acid protection)

So...
Hypovolemia:
* MAP=
BP= left ventricle p. *MVP= p. outside of Right Atrium= CVP(centra
^NE>
#1MVP
venoconstx
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#3 arterioles dilate (NE stim B2. so ur

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BP
INCREASES
A v TPR due to arteriolar dilation (seen in exercise) will lead to
an equal ^ CO (flow!) with little change in BP (MAP).

Arterioles- have most smooth muscle so constx and dilate most. Have B2(vaso
#1 top auto regulator of BP, keeps it between 60-160 by changing T

MAP-ICP = CPP
MAP= BP ICP= the pressure created by gravity pushing on your brain CPP
pressure is circulating through the brain, keeps the brain perfused.
Pulse pressure
= Systolic - diastolic 120-80=40
= Span of time during which blood is entering aorta, but has not flowed through
80: volume sitting on aortic valve
Need 1 mmHg > diastolic p. to open up the aortic valve (= 81mmHg)
120: resistance in the aorta.
Need 1 mmHg > systolic p. to make blood flow through the aorta (= 12

^ Pulse P = ^resist = hyperthyroid, Aort regurge, Ateriosclerosis, Sleep apnea

v Pulse P= ^vol = aortic stenosis, cardiogenic shock, tamponade, advance he

In order to get sustained contraction, the systolic pressure of the LV must be at

above the resistance in the aorta. This is why the left ventricle is always the firs
in systolic hypertension (htn due to resistance problem).
Pulmonary Capillary Wedge Pressure (PCWP)
Think of it as total volume in the lungs

DIASTOLIC= VOLUME (distention)

-regurgitation or shunting

Systolic heart failure= less contraction prob. Dilated cardiomyopathy. MI

Diastolic heart failure= less volume prob. Hypertrophyc cardiomyopathy

Preload is approximated by EDV (Related to Right Atrial P.) Rubber band.

How much you stretch before contrxn)
Afterload is approx. with BP (p. coming out of left ventr). Resistance in aorta
preventing blood from going in.
Thus: VEnodilators v PrEload and VAsodilators v Afterload
vPreload= vCO BUT! In CHF venodilators cause vPreload which ^CO (heart

Systolic heart failure has v EF (and thus v SV) because heart is not pumping well.
Diastolic heart fail has normal EF. (vEDVbut^contractility>vESV)

Chronic HTN(^BP) which implies a ^afterload, will cause LV hypertrophy to ov

Can HTN cause dilated heart?? From like ^^CO?

Pulsus Alternans: seen with dilated cardiomyopathy, MI

Alternating strong and weak beats (contxns). MCC is left vent systolic failure.
v L.vent contxn > ^EDV> ^muscle distention (preload)> ^L.vent contxn
Pulsus Paradoxus: tamponade, pericarditis

ORTHOSTATIC HTN:
When you stand ^gravity causes ^venous blood pooling and vCO and vSV.
Baroreceptors normally compensate for this. B-block and a-block screw com
vCO causes vArterial BP, if Cerebral blood flow v enough, u get orthostatic hy

EF= fraction of blood ejected in systole. = SV/EDV

EF is an index of Ventricular contractility,

systolic BP 10mmHg during inspiration

MCC is v Left vent capacity
Kussmaul sign: seen in Konstrictive pericard, restrict cardiomy, Right heart tumor
^ JVD on inspiration (instead of only in expiration). MCC is v R. ventricle capacity
blood backs up in Venae Cavae> JVD
* can also be seen in tamponade*

SA node: = sinus rhythm and controls HR

HR: normal: 60-100
*Max possible sinus Heart rate? 220- age (Anything above this is an ARRHYT
*HR increases 10 points for every temp. degree above 100F. So this must be s
ACTUAL HR. (Ex. HR= 90 and 104F. subtract 40 from 90 = 50 HR. Heart bloc

Arterial CLOTS: HTN> high velocity in artery > endothelial damage> platelets
aggregation> Arterial clots
Tx. ASPIRIN! DOC (block PlATELETS!)
Venous CLOTS: stasis> v skeletal movem.> ^blood accum> clotting factors build up and
form Venous clots
Tx. HEPARIN! DOC (stop clotting factors)
CAPILLARIES:

AORTA: Has special armor (SQUAMOUS cells, strong collagen BM, Vasa vasorum

FF= Hydrostatic v + Oncotic v (v=vessel)

Blood passes at ~200 m/h. This speed cleans up possible placks.

BM has HEPARAN SULFATE

Has FENESTRATIONS:
EDEMA

(- charge)

Dilated Cardiomyopathy > veloc blood less cleaning t4 more atheroscler

With age armor weakensexposed muscle(media) weakens t4 risk of aneury

Collagen dzs, BM dzs, syphilis, takyasu ALL cause weak armor t4 risk of ane