Cardiology:

Medical mnemonic for the order in which the heart valves close:
My — Mitral
Teeth — Tricuspid
Are — Aortic
Pretty — Pulmonary

Systole: pumping out Commented [1]:

Diastole - Filling chambers Commented [2]:

• left atrium (collects blood returning from the lungs)

• left ventricle (the main pumping chamber for the body)
• right atrium (collects blood returning from the body's sup+inf vena cava)
• right ventricle (pumps bloods to the lungs)

coronary heart disease – disease of the blood vessels supplying the heart muscle; Commented [3]:

cerebrovascular disease – disease of the blood vessels supplying the brain; Commented [4]:
Commented [5]:
peripheral arterial disease – disease of blood vessels supplying the arms and legs;
Commented [6]:
rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever,
caused by streptococcal bacteria; Commented [7]:
Commented [8]:
Commented [9]:
congenital heart disease – malformations of heart structure existing at birth;
Commented [10]:
deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge
and move to the heart and lungs. Commented [11]:
Commented [12]:
There are many types of congenital heart disease and they sometimes occur in combination. Some Commented [13]:
of the more common defects include:
Commented [14]:
• septal defects – where there's a hole between two of the heart's chambers (commonly
referred to as a "hole in the heart") Commented [15]:
• coarctation of the aorta – aorta, is narrower than normal Commented [16]:
Commented [17]:
• pulmonary valve stenosis – where the pulmonary valve, which controls the flow of blood
Commented [18]:
out of the lower right ventricle of the heart to the lungs, is narrower than normal
Commented [19]:
• transposition of the great arteries – where the pulmonary and aortic valves and the arteries Commented [20]:
they're connected to have swapped positions Commented [21]:

• Aneurysm - occurs when an artery’s wall weakens and causes an abnormally large bulge. This Commented [22]:
bulge can rupture and cause internal bleeding. Commented [23]:

• Arteriosclerosis -blood vessels that carry oxygen and nutrients from your heart to the rest of your Commented [24]:
body (arteries) become thick and stiff — sometimes restricting blood flow to your organs Commented [25]:
and tissues. Commented [26]:

• Arthersclerosis -These plaques cause the arteries to harden and narrow, restricting the blood flow Commented [27]:
and oxygen supply to vital organs, and increasing the risk of blood clots that could Commented [28]:
 potentially block the flow of blood to the heart or brain Commented [29]:

• Cardiomyopathy - Cardiomyopathy refers to diseases of the heart muscle. These diseases have Commented [30]:
many causes, signs and symptoms, and treatments.
In cardiomyopathy, the heart muscle becomes enlarged, thick, or rigid. In rare cases, the muscle Commented [31]:
tissue in the heart is replaced with scar tissue. Commented [32]:
1. Hypertrophic cardiomyopathy
2. Dilated cardiomyopathy
3. Restrictive cardiomyopathy
4. Arrhythmogenic right ventricular dysplasia
5. Unclassified cardiomyopathy

• Embolism - An embolism is the lodging of an embolus, a blockage-causing piece of material,

inside a blood vessel. The embolus may be a blood clot (thrombus), a fat globule (fat
embolism), a bubble of air or other gas (gas embolism), or foreign material usually travels
through the vena cava to heart and lungs.

• Syncope - is a temporary loss of consciousness usually related to insufficient blood flow to the
brain aka fainting. Due to Drop off blood pressure to brain. (If severe its a Transient
ischemic attack (TIA/Mini-Stroke) which leads ultimately to cerebral necrosis or death)

• Thrombosis - Arterial thrombosis is a blood clot in an artery

The following can increase your risk of developing atherosclerosis:
• getting older
• smoking
• an unhealthy diet
• lack of exercise
• being overweight or obese
• regularly drinking excessive amounts of alcohol
• other conditions, including high blood pressure, high cholesterol and diabetes
• a family history of atherosclerosis
• being of south Asian, African or African-Caribbean descent
 • Venous Varicosity - enlarged
and tortuous vein, artery, or
lymphatic vessel. Specifically, a
varicose vein.

1) blood enters the heart from the body (into atria)

2)by way of the superior & inferior vena cava for right atrial
3) right atrioventicular valve opens (right atrium contracts)
4) right ventricle fills with blood (right ventrical contracts)
5) pulmonary semilunar valve opens (blood passes through)
6)pulmonary arteries fills with blood
8) blood is oxygenated by lungs & returned with blood from hepatic portal vein which comes from
liver and GI.
9)left atrioventricular valve opens
(blood is passed to the bicuspid
valve to left ventricle)
10) left ventricle fills with blood
11) aortic semilunar opens (blood
goes into aorta)
12)aorta sends blood out to rest of
body

•The heart is made up of cardiomyocytes and pacemaker cells

•The principal differences between MSK myocytes and cardiomyocytes is
1.Cardiomyocytes have a much higher density of mitochondria
2.Cardiomyocytes terminate in intercalated discs that a porous to Ca+, K+ and Na+ ions
The heart has a massive amount of mitochondria to produce ATP which is used by cells to do work
(fuel chemical reactions).

Adrenaline is sometimes injected the

heart when someone is having a
myocardial infarction to

get the heart pumping.

The top number is your systolic blood pressure. (The highest pressure when
your heart beats and pushes the blood round your body.) The bottom one is
your diastolic blood pressure. (The lowest pressure when your heart relaxes
between beats.)The diastolic reading, or the bottom number, is the pressure in
the arteries when the heart rests between beats. This is the time when the
heart fills with blood and gets oxygen.

Ischemic stroke
 Most strokes are caused by a blockage cutting off the blood
supply to the brain. This is called an ischaemia stroke.
Because of: athersclerosis, small vessel disease, arteriole
dissection.

Haemorrhage :
A haemorrhage stroke can happen when an artery inside
your brain bursts causing bleeding within your brain. This is
known as an intracerebral haemorrhage.

It can also happen because of bleeding on the surface of

your brain. Your brain sits inside a cushion of membranes
that protect it from your skull. Between the layers of
membrane is a space, which is filled with fluid. If blood
vessels near the surface of the brain burst, blood can leak
into this space. This known as a subarachnoid haemorrhage. Caused by high blood pressure/
aneurysm / anti-coagulants / illegal drugs.

Stralings hypothesis : fluid movement due to filtration across a capillary

is dependant on balance between hydrostatic pressure gradient and the
osmotic pressure gradient across the capillary.

Rate of blood flow back to the heart. Normally limits cardiac output
(they are interdependent but can but independently regulated). Otherwise
blood would unevenly accumulate in systemic/pulmonary circulations.
Injury to Endothelial cells can come in the form
of :
-hypertension
-smoking
-High Blood Glucose
-infection
Effectors include : muscle contraction,
decreased venous compliance
(pressure) , Respiratory activity,
vena cava compression, gravity.

Cardiac muscles: myogenic

uninucleate, exhibit electrical
conduction between cells.
Longer contractions with a
short refractory period. Can
only respire aerobically. Can
use lactic acid to generate ATP.
Smooth muscle(unstriated and
unstriated) can shorten and
stretch to a greater extent. Non-
myelinated nerve fibres in
schwann cells.

Tissue response:
-microphages take up oxidised lipoproteins, becoming
foam cells.
-plaque forms/ foam cells die (apop) / lipid released as a
lipid core.
-tissue repairs laying down more smooth muscle,
collagen, elastin.
- Plaque enlarges.

Lymphatics and oedema - is a collection of fluid in spaces between cells of the body. When fluid
leaks out of a damaged cell.
Types: idiopathic (cause unknown) Localised (in particular part due to injury/allergy) Generalised
(affects the whole body) cerebral (fluid in brain) Pulmonary (lungs) Lymphedema (lymph fluid
build up) .

Shock - Circulatory due to low blood profusion to tissues which results in cellular injury. Some of
the signs are: Low blood pressure, rapid heart rate, signs of confusion, low urine output, weak
pulse. Progresses by a positive feedback mechanism. The poor blood supply which damages the
 cells leads to an
inflammatory
response which
increases B.flow
to the area
Left sided heart
failure:
-Causes :
ischemia
(myocardial
infarction),
hypertension,
valvular disease,
myocardial
disease.
-presentation:
dyspnoea and Commented [33]:
orthopnea caused Difficult / laboured breathing
by pulmonary
congestion and Commented [34]:
oedema. Pleural SOB

effusion/eodema, Commented [35]:

reduction in renal Excessive watery fluid collection
perfusion. Commented [36]:
Anoxia/hypoxia. Fluid buildup in pleural space
Right sided Heart failure:
-tricuspid/pulmonary valve disease
-myopathy/ischemic heart disease.
Presentation: distention of neck veins
(jugulars) , palpable liver and spleen,
renal hypoxia. Pitting
oedema. Plueral effusion. Ascites.

Myocardial Infarction: the

irreversible death (necrosis) of heart
muscle secondary to prolonged lack
of oxygen supply (ischemia). Some of
the
Symptoms/signs include:
Fatigue/chest discomfort/malaise.
Intense for 30/60 mins. Radiates up
neck/shoulder/jaw and left arm.
Increased heart rate, irregular pulse.
-coagulative necrosis of heart :
accidental cell death caused by
ischemia or infarction. Usually due to
lack of blood supply. (Blocked by
plaque,cholesterol.
-Angina pectoralis: chest pain due too
coronary heart disease. (One or more
of the hearts arteries is
narrowed/blocked) similar symptoms
to infarction. But usually when exercising. Relieved by rest or medicine.
Triggers: emotional stress, exposure to temp, smoking.
 Rate of Blood Flow in vessels is effected by:
Radius of vessel
Length of Vessel
Pressure Differential
Viscosity of Blood

Atrial Fibrillation - abnormal heart rhythm (can cause stroke) due to abnormal pulses.
Symptoms: palpitation, SOB, dizziness.
Caused by: H.B pressure, valve disease, excess
alcohol consumption.
changes in B pressure: Treated with beta blockers, anti-arrhythmic drugs,
warfarin.
Short Term: baroreceptor reflex, ANS vaso’s, cardiac
output, drugs.

Long term: changes in volume/ kidneys/ ADH. Hypertension Risk Factors:

Genetics/age/gender/obesity/salt/diabetic/stress/ANS
dysfunction/alcohol

Hypertension secondary factors: drugs (oral contraceptives, liquorice, steroids) aortic coarctation
cushings syndrome, kidney disease.

Anti-hypertensive drugs can work on:

Beta blockers (brain, heart and Kidneys). Diuretics in the kidneys. Alpha1 (B.vessels)
Alpha2(Brain)