QUESTIONS ON CARDIOVASCULAR SYSTEM

I DEFINE
- The electrocardiogram (ECG) - Stress Testing - Thrombus -Embolus -Aneurysm - Valvular Stenosis -Valve Incompetence -Cardiac Shunts -Hypertension - primary or essential hypertension - Secondary Hypertension -Myocardial infarction (MI)

II- MENTION - Enzymes released with cardiac cell death - sources of emboli
Causes of varicose veins

-Causes of systolic murmurs - Causes of diastolic murmurs

III- FILL - ---------------- is the measurement of the electrical currents of the heart
- There are three currents produced in the normal ECG, the P wave corresponds to -------------. The QRS complex (beginning of Q wave to end of S wave) corresponds to depolarization of the ----------------. The T wave corresponds to ------------------of the ventricles. - A ------------------- is a blood clot that can develop anywhere in the vascular system, so blood flow is reduced or totally blocked.). - An ---------------is a substance that travels in the bloodstream from a primary site to a secondary site. - An ----------------- is a dilation of the arterial wall caused by a congenital or commonly, from atherosclerosis.

- --------------- of any valve is narrowing usually occurs as a result of a congenital defect or an inflammatory process (e.g., after rheumatic fever). A -------------------shunt lead to hypertrophy of pulmonary vasculature and right heart failure may develop -------------------- is characterized by accumulation of fatty deposits, platelets, neutrophils, monocytes and macrophages throughout the tunica intima (endothelial cell layer) and eventually into the tunica media (smooth muscle layer). - Arteries most often affected by atherosclerosis include the-----------------------------is an aching, cramping feeling in the lower extremities due to muscle ischemia. ---------------- is temporary spasm of the small arteries and arterioles, usually in the fingers or, less frequently, the toes. -----------------------are tortuous (twisted) distended veins occurring where blood has pooled, often in the legs. ---------------------- is severe pain due to an inadequate oxygen supply to the myocardial cells.

- -------------------- is a combination of classic and variant angina, and is seen in an individual - ---------------------is a serious inflammatory disease that may occur in an individual 1 to 4 weeks following an untreated throat infection by the group A betahemolytic Streptococcus bacteria. ------------------is a narrowing in the opening of the valve between the left atrium and the left ventricle. --------------------is a narrowing in the opening of the valve between the left ventricle and the aorta. --------------- is a narrowing of the opening between the right ventricle and the pulmonary valve. ----------------------is an abnormal opening between the left and right atria. ---------------------Is an abnormal opening between the left and right ventricles. -If the connection between the pulmonary artery and the aorta, remains open after birth,the condition is called-----------------. -----------------------is a congenital defect that results in the narrowing of the aorta as it leaves the left ventricle. The narrowing can be proximal or distal to the ductus arteriosus. ---------------- is the collapse of systemic arterial blood pressure. with worsening coronary artery disease. ---------------- is the death of myocardial cells that occurs following prolonged oxygen deprivation.

- -----------------------shock can occur following collapse of the cardiac output, which often results from a myocardial infarct, fibrillation, or congestive heart failure. - ------------------ shock can occur if there is a loss of circulating blood volume, causing a severe drop in cardiac output and blood pressure. - ---------------------shock can occur following a widespread allergic response - -----------------shock can occur following a massive systemic infection - ---------------------shock occurs following sudden loss of vascular tone from an injury to the cardiovascular center of the brain, a spinal cord injury, or deep general anesthesia. This type of occurrence may explain sudden fainting during a severe emotional disturbance. - Hemorrhage and dehydration can cause hypovolemic shock. -

IV- TRUE OR FALSE

- Echocardiography is highly sensitive and non-invasive and provides a visual image of the
beating heart. - In cardiac catheterization a flexible tube (catheter) is inserted through a peripheral vein (femoral or brachial) into the right side of the heart, or through a peripheral artery (femoral or brachial) into the left side of the heart. - Through the catheter, the chambers of the heart can be visualized and chamber pressures and oxygen content measured. - A radiolabeled dye may be injected through the catheter, and the ability of the dye to move through the heart chambers and vessels may be monitored using x-ray techniques. - Valve movement can be observed. - Because cardiac catheterization is invasive, complications are possible, including tearing of the vessel wall. - After cardiac catheterization , patients must lie still for 4 to 6 hours until leg vessels seal. - Most emboli are :blood clots (thromboemboli) usually from deep leg veins. - After birth, any shunting is abnormal. - A right-to-left shunt is called a cyanotic shunt - Left-to-Right Shunt is acyanotic - A cardiac shunt is a connection between the pulmonary and the systemic circulations. - Lactic acid decreases myocardial pH and causes the pain associated with angina pectoris -The pain of stable angina typically goes away when the individual stops the activity - Prinzmetal's(variant) angina occurs during rest or sleep. - In stable and unstable angina, pain is typically relieved by rest. - In Prinzmetal's angina,pain is unrelieved by rest but usually disappears in about 5 minutes. -Some individuals do not show any obvious signs of an MI (a silent heart attack)

- VSD is the most common cardiac congenital defect. - Tetralogy of Fallot is a cyanotic defect.

V- MCQ
*Clinical Manifestations of atherosclerosis include a- Intermittent claudication, an aching, cramping feeling in the lower extremities due to muscle ischemia b- Cold sensitivity occurs with inadequate blood flow to the extremities. c- The area becomes pale. d- Reduced arterial pulses e- all * Complications of atherosclerosis includes a - Hypertension b- Stroke c- MI

d- Development of an aneurysm. e- all * Causes of Hypertension a- Increase in heart rate c- increase in plasma volume e- all * Complications of hypertentions a- Stroke c- Renal failure b - A myocardial infarct (MI) d - Encephalopathy (brain damage) e-all b-increased peripheral resistance d- increased sympathetic nervous system activity.

* Causes of Myocardial Infarct a- long-standing coronary artery disease (CAD). b- large thrombus that totally obstruct blood flow. c- hypertrophied chambers with relative oxygen deficiency d- all *Complications of MI a-Thromboemboli zation b - Congestive heart failure .

c- Cardiogenic shock (collapse of blood pressure).

d- Myocardial rupture may occur after a large infarct. e - Pericarditis. *Forward Effects of Left Heart Failure a- Decreased systemic blood pressure c- Increased heart rate *Backward Effects of Left Heart Failure a- Increased pulmonary congestion, especially when lying down b- Dyspnea (difficult breathing) c- Right heart failure if the condition worsens *Forward Effects of Right Heart Failure a- Decreased pulmonary blood flow b- Decreased blood oxygenation Fatigue d - Decreased systemic blood pressure *Backward Effects of Right Heart Failure a- Increased venous pooling of blood, edema of the ankles and feet b- Jugular venous distension c- Hepatomegaly and splenomegaly d- all cd- all b- Fatigue d - Decreased urine output

*Tetralogy of Fallot is a congenital heart defect characterized by a- ventricular septal defect. B- pulmonary artery stenosis, c-right ventricular hypertrophy d- a shifting of the position of the aorta so that it opens into the right ventricle (an overriding aorta).