Term
| Cardiovascular changes in old people? |
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Definition
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Arterioles
BP
Heart Muscle
Incr AL
Reduced compliance
Stiff valves
Aortic comps |
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Term
| 3 major stimuli for dyspnea |
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Definition
– Pulmonary parenchymal receptors
– Hypoxemia
– Increased pulmonary venous pressure |
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Term
| What diseases can combine with phys affects of aging to cause air hunger? |
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Definition
Pneumonia
Fever and anemia
Atrial Fib |
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Term
| Pneumonia cause air hunger b/c? |
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Definition
Pneumonia itself + V/Q mismatch of aging
--> O2 desaturation --> dyspnea |
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Term
| Fever and anemia cause air hunger by? |
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Definition
| Incr need for CO but aging induced blunted sympathetic response actually causes HF |
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Term
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Definition
wall-increased thickness
calcium deposition
disorganization of elastin and collagen
smooth muscle hypertrophy |
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Term
| Clinical implications of Arterioles changes |
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Definition
| increased systolic and pulse pressure |
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Term
| Changes in blood pressure with aging? Clinical imps? |
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Definition
Measurements are more variable
systolic HTN is as important a cardiovascular risk factor as diastolic HTN; most important modifiable risk factor for stroke; also associated with orthostatic hypotension; more variability means more readings needed, home monitoring helpful.
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Term
| Heart muscle changes and clinical imps? |
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Definition
prolonged contraction and relaxation time
Clinical implications: myocardial ischemia during rapid heart rates
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Term
| Effects of incr after load? Clinical? |
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Definition
Increased after load leads to a thickened heart muscle (LVH)
Clinical implications: diastolic dysfunction (predisposed to HF with otherwise “normal” cardiac output)
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Term
| Reduced LV compliance causes: |
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Definition
atrial systole contributes 45% of stroke volume
Clinical implications: older people are much more sensitive to effects from loss of atrial kick (more likely to get AF)
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Term
| LV stiffening results in? |
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Definition
Mitral clinical implications: passive diastolic filling is reduced, more blood left in left atrium when contraction begins
Aortic clinical implications: aortic stenosis in persons with three leaflets is a disease of old age
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Term
| Cardio response to symp stim in elderly patient? |
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Definition
Reduced ionotropic response (reduced contractility)
Reduced chronotropic response (decreased max heart rate)
Reduced dilation of blood vessels
Cardiac output- no change under normal activity. Less increase under high levels of exercise or stress at older ages compared to young
Clinical implications: reduced response to sympathetic stimulation, increased likelihood for HF during fever, aggressive fluid therapy, surgery
Clinical implications: monitor and match intake and output; after surgery play catch up to remove volume as fluid is mobilized
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