MEDRADSC 1B03 Lecture Notes - Lecture 31: Peripheral Artery Disease, Atheroma, Arteriosclerosis

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Cardiovascular, system
Define&and&briefly&describe&the&following&selected&pathologies:
Arteriosclerosis
Pathophysiology
A&term&for&all&types&of&arterial&changes
Best&applied&to&degenerative&changes&in&arteries&and&arterioles&in&people&over&
50&and&with&diabetes
Elasticity&is&lost&and&walls&become&thick&and&hard,&lumen&narrows&and&may&
become&obstructed
Leads&to&diffuse&ischemia&and&necrosis
Atherosclerosis
Pathophysiology
Caused&by&lipids&circulating&in&blood&which&build&up&sites&of&of&arterial& injury&
along&with&fibrous&tissue,&prostaglandins&are&released&and&more&inflammation&
and&cells&come&to&the&site&causing&arterial& flow&to&become&turbulent
Plaque&may&ulcerate&and&break&open
Blood&flow&decreases&due&to&blockage
Atheroma&damages&arterial&wall,&weakening&the&structure&and&decreasing&its&
elasticity,&it&eventually&calcifies
Can&cause&angina,&myocardial&infarction,&stroke&,&renal&damage&and&peripheral&
vascular&disease
Etiology
Nonmodifiable&factors
Age
Gender&(women&have&more&HDL&until&menopause&when&estrogen&levels&
decrease)
Genetics
Modifiable
Obesity&(high&LDL&cholesterol&diets)
Smoking
Exercise
Diabetes
Poorly&controlled&hypertension
Oral&contraceptives
High&blood&cholesterol&and&high&BP
Diagnostic&Tests
Checking&HDL&and&LDL&levels
CRP&indicates&inflammation&-low&CRP&means&lower&risk&of&cardiovascular&
disease
Treatment
Losing&weight
Healthier&diet
Lowering&serum&cholesterol&and&LDL&levels
Control&diabetes
Angina,Pectoris
Pathophysiology
Chest&pain&when&there&is&a&deficit&of&oxygen&to&the&heart&muscle
Can&occur&when&heart&is&working&harder&than&it&needs&to&be&and&is&in&demand&for&
oxygen&(exercising)
Classic/exertional&angina&
Variant&angina&in&which&vasospasm&occurs&at&rest
Unstable&angina
More&serious&form
Prolonged&pain&at&rest&and&of&recent&onset
Could&be&caused&by&breakage&of&atheroma
Could&cause&myocardial&infarction
Etiology
May&be&caused&by&a&blockage&due&to&atherosclerosis
Insufficient&myocardial&blood&and&oxygen&supply
Severe&anemias&and&respiratory&disease&can&also&cause&oxygen&deficiency&
Tachycardia&associated&with&hyperthyroidism&can&cause&it
Exposure&to&weather&extremes&or&pollution&or&eating&a&large&meal
Signs&and&Symptoms
Occurs&as&brief,&recurrent&episodes&of&chest&pain&usually&triggered&by&a&physical&
or&emotional&stress&which&increases&demand&on&the&heart&for&oxygen
Tightness,&pressure&in&chest&may&radiate&to&neck&or&left&arm
Excessive&sweating
Nausea
Can&last&a&few&seconds&or&minutes
Treatment
Nitroglycerin&(vasodilators)
Stress&reduction&techniques
Myocardial,Infarction
Pathophysiology
When&coronary&artery&is&totally&obstructed,&leading&to&prolonged&ischemia&and&
cell& death&of&the&heart&wall
Thrombus&may&build&to&obstruct&artery
Vasospasm&may&occur&due&to&atheroma,&leading&to&total&obstruction
Thrombus&may&break&off&and&flow&to&smaller&portion&of&vessel&and&block&blood&
flow
Heart&tissue&becomes&necrotic&with&ischemia&developing&around&area
If&blood&supply&is&restored&within&20-30&minutes,&irreversible&damage&may&be&
prevented
Etiology
Atherosclerosis
Signs&and&Symptoms
Feeling&pressure,&heaviness&or&burning&in&chest&or&radiating&pain&to&left&arm,&jaw&
or&neck
Sudden&shortness&of&breath,&sweating,&weakness&or&fatigue
Nausea,&indigestion
Anxiety&or&fear
Diagnostic&Tests
ECG
Serum&enzymes&can&be&found&in&blood&from&necrotic&tissue
Treatment
Analgesics
Oxygen&therapy
Anticoagulants&(heparin,&warfarin)
Pace&maker
Cardiac&rehabilitation&programs
Congestive,Heart,Failure
Pathophysiology
When&heart&is&unable&to&pump&sufficient&blood&to&meet&metabolic&needs&of&the&
body
Usually&chronic&condition
Can&occur&due&to&another&condition&(infarction,&valve&defect)
Usually,&one&side&of&the&heart&fails&first
Mechanisms&in&the&body&which&are&meant&to&help&actually&aggravate&the&
condition
Reduced&blood&flow&causes&vasoconstrictor&hormones&to&be&released&
causing&increased&blood&volume&to&the&heart,&adding&to&the&heart's&
workload
SNS&increases&heart&rate,&decreasing&effectiveness&of&filling&chambers&and&
increasing&work&for&the&heart
Chambers&of&the&heart&dilate&and&cardiac&muscle&hypertrophies&which&
demands&increased&blood&supply,&myocardial&cells&replaced&with&fibrous&
tissue
Two&effects&when&heart&cannot&maintain&pumping&ability
Cardiac&output&or&stroke&volume&decreases
Backup&congestion&develops&in&circulation&behind&affected&ventricle
Etiology
Infarction&that&impairs&pumping&ability&or&efficiency&of&the&conducting&system,&
valvular&changes,&or&congenital&heart&defects&may&cause&failure&of&the&affected&
side
Coronary&artery&disease&is&the&leading&cause
Right&CHF&can&be&caused&by&pulmonary&disease
Signs&and&Symptoms
Failure&of&either&side
Decreased&blood&supply&to&tissues&and&general&hypoxia
Fatigue&and&weakness
Dyspnea&(breathlessness)
Dizziness
Hot&or&cold&intolerance
Compensation&mechanisms
Indicated&by&tachycardia
Pallor
Daytime&oliguria
Backup&effects&of&left&sided&CHF&due&to&pulmonary&congestion
Dyspnea
Difficulty&breathing&when&lying&down
Cough
Paroxysmal&nocturnal&dyspnea&indicates&the&presence&of&acute&pulmonary&
edema
Signs&of&right&sided&CHF&and&systemic&backup
Edema&in&feet&or&legs
Hepatomegaly&and&splenomegaly
Ascites
Acute&right-sided&failure
Hypertension
Pathophysiology
Chronic&elevation&of&systemic&blood&pressure&that&in&the&long&term&causes&end-
organ&damage&which&results&in&increased&morbidity&and&mortality
Etiology
Primary&hypertension
No&identifiable&cause
Secondary&hypertension&(caused&by&underlying&condition)
Obstructive&sleep&apnea
Kidney&problems
Adrenal&gland&tumours
Thyroid&problems
Defects&in&blood&vessels&you're&born&with&
Medications
Alcohol/drugs
Signs&and&Symptoms
No&signs&and&symptoms
May&have&headache,&shortness&of&breath&or&nose&bleeds&if&BP&reaches&life&
threatening&stage
Aortic,Aneurysms
Pathophysiology
Localized&dilation&and&weakening&of&arterial& wall&in&abdominal&or&thoracic&aorta
May&be&a&saccular&shape&(bulging&wall&on&one&side)&or&fusiform&shape&
(circumferential&dilation&along&artery)
Dissecting&aneurysms&develop&when&there&is&a&tear&in&the&intima,&allowing&blood&
to&flow&along&length&of&vessel&in&between&layers&of&arterial&wall
Develops&from&defect&in&medial&layer,&dilation&enlarges,&hypertension&develops&
and&a&thrombus&forms&in&the&area,&obstructing&arteries&
Many&eventually&rupture&causing&a&hemorrhage
Etiology
Atherosclerosis
Trauma&(car&accidents)
Syphilis
Congenital&defects
Hypertension
Signs&and&Symptoms
Asymptomatic&for&a&long&period&of&time&until&they&become&very&large&or&rupture
Abdominal&aneurysms&&are&detected&as&pulsating&masses&with&abnormal&sounds
Rupture&leads&severe&hemorrhage&and&death
Severe&pain&and&shock
Shock
Pathophysiology
Also&known&as&hypotension&results&from&decreased&circulating&blood&volume,&
leading&to&decreased&tissue&perfusion&and&general&hypoxia
Type Mechanism Specific,Causes
Hypovolemic Loss&of&blood&or&plasma Hemorrhage,&burns,&
dehydration,&peritonitis,&
pancreatitis
Cardiogenic Decreased&pumping&
capability&of&the&heart
Myocardial&infarction&of&left&
ventricle,&cardiac&arrhythmia,&
pulmonary&embolus,&cardiac&
tamponade
Vasogenic&
(neurogenic&or&
disruptive)
Vasodilation&owing&to&loss&
of&sympathetic&and&
vasomotor&tone
Pain,&fear,&spinal&cord&injury,&
hypoglycemia&(insulin&shock)
Anaphylactic Systemic&vasodilation&and&
increased&permeability&
owing&to&severe&allergic&
reaction
Insect&stings,&nuts,&shellfish,&
drugs
Septic&
(endotoxic)
Vasodilation&caused&by&
infection&due&to&gram-
negative&bacteria
Virulent&microorganisms&(gram-
negative&bacteria)&or&multiple&
infections
Signs&and&Symptoms
Thirst&
Agitation/restlessness
Cool,&moist,&pale&skin
Tachycardia
Dizziness
Self%Study%Unit
Tuesday,& February&20,&2018
5:45&PM
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Cardiovascular, system
Define&and&briefly&describe&the&following&selected&pathologies:
Arteriosclerosis
Pathophysiology
A&term&for&all&types&of&arterial&changes
Best&applied&to&degenerative&changes&in&arteries&and&arterioles&in&people&over&
50&and&with&diabetes
Elasticity&is&lost&and&walls&become&thick&and&hard,&lumen&narrows&and&may&
become&obstructed
Leads&to&diffuse&ischemia&and&necrosis
Atherosclerosis
Pathophysiology
Presence&of&atheromas&-plaques&consisting&of&lipids,&cells,&fibrin&and&cell&debris,&
often&with&attached&thrombi&which&form&inside&the&walls&of&arteries
Affected&artery&is&rough,&elevated&and&has&loose&pieces&of&plaque&and&thrombus
Caused&by&lipids&circulating&in&blood&which&build&up&sites&of&of&arterial& injury&
along&with&fibrous&tissue,&prostaglandins&are&released&and&more&inflammation&
and&cells&come&to&the&site&causing&arterial& flow&to&become&turbulent
Plaque&may&ulcerate&and&break&open
Blood&flow&decreases&due&to&blockage
Atheroma&damages&arterial&wall,&weakening&the&structure&and&decreasing&its&
elasticity,&it&eventually&calcifies
Can&cause&angina,&myocardial&infarction,&stroke&,&renal&damage&and&peripheral&
vascular&disease
Etiology
Nonmodifiable&factors
Age
Gender&(women&have&more&HDL&until&menopause&when&estrogen&levels&
decrease)
Genetics
Modifiable
Obesity&(high&LDL&cholesterol&diets)
Smoking
Exercise
Diabetes
Poorly&controlled&hypertension
Oral&contraceptives
High&blood&cholesterol&and&high&BP
Diagnostic&Tests
Checking&HDL&and&LDL&levels
CRP&indicates&inflammation&-low&CRP&means&lower&risk&of&cardiovascular&
disease
Treatment
Losing&weight
Healthier&diet
Lowering&serum&cholesterol&and&LDL&levels
Control&diabetes
Angina,Pectoris
Pathophysiology
Chest&pain&when&there&is&a&deficit&of&oxygen&to&the&heart&muscle
Can&occur&when&heart&is&working&harder&than&it&needs&to&be&and&is&in&demand&for&
oxygen&(exercising)
Classic/exertional&angina&
Variant&angina&in&which&vasospasm&occurs&at&rest
Unstable&angina
More&serious&form
Prolonged&pain&at&rest&and&of&recent&onset
Could&be&caused&by&breakage&of&atheroma
Could&cause&myocardial&infarction
Etiology
May&be&caused&by&a&blockage&due&to&atherosclerosis
Insufficient&myocardial&blood&and&oxygen&supply
Severe&anemias&and&respiratory&disease&can&also&cause&oxygen&deficiency&
Tachycardia&associated&with&hyperthyroidism&can&cause&it
Exposure&to&weather&extremes&or&pollution&or&eating&a&large&meal
Signs&and&Symptoms
Occurs&as&brief,&recurrent&episodes&of&chest&pain&usually&triggered&by&a&physical&
or&emotional&stress&which&increases&demand&on&the&heart&for&oxygen
Tightness,&pressure&in&chest&may&radiate&to&neck&or&left&arm
Excessive&sweating
Nausea
Can&last&a&few&seconds&or&minutes
Treatment
Nitroglycerin&(vasodilators)
Stress&reduction&techniques
Myocardial,Infarction
Pathophysiology
When&coronary&artery&is&totally&obstructed,&leading&to&prolonged&ischemia&and&
cell& death&of&the&heart&wall
Thrombus&may&build&to&obstruct&artery
Vasospasm&may&occur&due&to&atheroma,&leading&to&total&obstruction
Thrombus&may&break&off&and&flow&to&smaller&portion&of&vessel&and&block&blood&
flow
Heart&tissue&becomes&necrotic&with&ischemia&developing&around&area
If&blood&supply&is&restored&within&20-30&minutes,&irreversible&damage&may&be&
prevented
Etiology
Atherosclerosis
Signs&and&Symptoms
Feeling&pressure,&heaviness&or&burning&in&chest&or&radiating&pain&to&left&arm,&jaw&
or&neck
Sudden&shortness&of&breath,&sweating,&weakness&or&fatigue
Nausea,&indigestion
Anxiety&or&fear
Diagnostic&Tests
ECG
Serum&enzymes&can&be&found&in&blood&from&necrotic&tissue
Treatment
Analgesics
Oxygen&therapy
Anticoagulants&(heparin,&warfarin)
Pace&maker
Cardiac&rehabilitation&programs
Congestive,Heart,Failure
Pathophysiology
When&heart&is&unable&to&pump&sufficient&blood&to&meet&metabolic&needs&of&the&
body
Usually&chronic&condition
Can&occur&due&to&another&condition&(infarction,&valve&defect)
Usually,&one&side&of&the&heart&fails&first
Mechanisms&in&the&body&which&are&meant&to&help&actually&aggravate&the&
condition
Reduced&blood&flow&causes&vasoconstrictor&hormones&to&be&released&
causing&increased&blood&volume&to&the&heart,&adding&to&the&heart's&
workload
SNS&increases&heart&rate,&decreasing&effectiveness&of&filling&chambers&and&
increasing&work&for&the&heart
Chambers&of&the&heart&dilate&and&cardiac&muscle&hypertrophies&which&
demands&increased&blood&supply,&myocardial&cells&replaced&with&fibrous&
tissue
Two&effects&when&heart&cannot&maintain&pumping&ability
Cardiac&output&or&stroke&volume&decreases
Backup&congestion&develops&in&circulation&behind&affected&ventricle
Etiology
Infarction&that&impairs&pumping&ability&or&efficiency&of&the&conducting&system,&
valvular&changes,&or&congenital&heart&defects&may&cause&failure&of&the&affected&
side
Coronary&artery&disease&is&the&leading&cause
Right&CHF&can&be&caused&by&pulmonary&disease
Signs&and&Symptoms
Failure&of&either&side
Decreased&blood&supply&to&tissues&and&general&hypoxia
Fatigue&and&weakness
Dyspnea&(breathlessness)
Dizziness
Hot&or&cold&intolerance
Compensation&mechanisms
Indicated&by&tachycardia
Pallor
Daytime&oliguria
Backup&effects&of&left&sided&CHF&due&to&pulmonary&congestion
Dyspnea
Difficulty&breathing&when&lying&down
Cough
Paroxysmal&nocturnal&dyspnea&indicates&the&presence&of&acute&pulmonary&
edema
Signs&of&right&sided&CHF&and&systemic&backup
Edema&in&feet&or&legs
Hepatomegaly&and&splenomegaly
Ascites
Acute&right-sided&failure
Hypertension
Pathophysiology
Chronic&elevation&of&systemic&blood&pressure&that&in&the&long&term&causes&end-
organ&damage&which&results&in&increased&morbidity&and&mortality
Etiology
Primary&hypertension
No&identifiable&cause
Secondary&hypertension&(caused&by&underlying&condition)
Obstructive&sleep&apnea
Kidney&problems
Adrenal&gland&tumours
Thyroid&problems
Defects&in&blood&vessels&you're&born&with&
Medications
Alcohol/drugs
Signs&and&Symptoms
No&signs&and&symptoms
May&have&headache,&shortness&of&breath&or&nose&bleeds&if&BP&reaches&life&
threatening&stage
Aortic,Aneurysms
Pathophysiology
Localized&dilation&and&weakening&of&arterial& wall&in&abdominal&or&thoracic&aorta
May&be&a&saccular&shape&(bulging&wall&on&one&side)&or&fusiform&shape&
(circumferential&dilation&along&artery)
Dissecting&aneurysms&develop&when&there&is&a&tear&in&the&intima,&allowing&blood&
to&flow&along&length&of&vessel&in&between&layers&of&arterial&wall
Develops&from&defect&in&medial&layer,&dilation&enlarges,&hypertension&develops&
and&a&thrombus&forms&in&the&area,&obstructing&arteries&
Many&eventually&rupture&causing&a&hemorrhage
Etiology
Atherosclerosis
Trauma&(car&accidents)
Syphilis
Congenital&defects
Hypertension
Signs&and&Symptoms
Asymptomatic&for&a&long&period&of&time&until&they&become&very&large&or&rupture
Abdominal&aneurysms&&are&detected&as&pulsating&masses&with&abnormal&sounds
Rupture&leads&severe&hemorrhage&and&death
Severe&pain&and&shock
Shock
Pathophysiology
Also&known&as&hypotension&results&from&decreased&circulating&blood&volume,&
leading&to&decreased&tissue&perfusion&and&general&hypoxia
Type Mechanism Specific,Causes
Hypovolemic Loss&of&blood&or&plasma Hemorrhage,&burns,&
dehydration,&peritonitis,&
pancreatitis
Cardiogenic Decreased&pumping&
capability&of&the&heart
Myocardial&infarction&of&left&
ventricle,&cardiac&arrhythmia,&
pulmonary&embolus,&cardiac&
tamponade
Vasogenic&
(neurogenic&or&
disruptive)
Vasodilation&owing&to&loss&
of&sympathetic&and&
vasomotor&tone
Pain,&fear,&spinal&cord&injury,&
hypoglycemia&(insulin&shock)
Anaphylactic Systemic&vasodilation&and&
increased&permeability&
owing&to&severe&allergic&
reaction
Insect&stings,&nuts,&shellfish,&
drugs
Septic&
(endotoxic)
Vasodilation&caused&by&
infection&due&to&gram-
negative&bacteria
Virulent&microorganisms&(gram-
negative&bacteria)&or&multiple&
infections
Signs&and&Symptoms
Thirst&
Agitation/restlessness
Cool,&moist,&pale&skin
Tachycardia
Dizziness
Self%Study%Unit
Tuesday,& February&20,&2018 5:45&PM
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Cardiovascular, system
Define&and&briefly&describe&the&following&selected&pathologies:
Arteriosclerosis
Pathophysiology
A&term&for&all&types&of&arterial&changes
Best&applied&to&degenerative&changes&in&arteries&and&arterioles&in&people&over&
50&and&with&diabetes
Elasticity&is&lost&and&walls&become&thick&and&hard,&lumen&narrows&and&may&
become&obstructed
Leads&to&diffuse&ischemia&and&necrosis
Atherosclerosis
Pathophysiology
Presence&of&atheromas&-plaques&consisting&of&lipids,&cells,&fibrin&and&cell&debris,&
often&with&attached&thrombi&which&form&inside&the&walls&of&arteries
Affected&artery&is&rough,&elevated&and&has&loose&pieces&of&plaque&and&thrombus
Caused&by&lipids&circulating&in&blood&which&build&up&sites&of&of&arterial& injury&
along&with&fibrous&tissue,&prostaglandins&are&released&and&more&inflammation&
and&cells&come&to&the&site&causing&arterial& flow&to&become&turbulent
Plaque&may&ulcerate&and&break&open
Blood&flow&decreases&due&to&blockage
Atheroma&damages&arterial&wall,&weakening&the&structure&and&decreasing&its&
elasticity,&it&eventually&calcifies
Can&cause&angina,&myocardial&infarction,&stroke&,&renal&damage&and&peripheral&
vascular&disease
Etiology
Nonmodifiable&factors
Age
Gender&(women&have&more&HDL&until&menopause&when&estrogen&levels&
decrease)
Genetics
Modifiable
Obesity&(high&LDL&cholesterol&diets)
Smoking
Exercise
Diabetes
Poorly&controlled&hypertension
Oral&contraceptives
High&blood&cholesterol&and&high&BP
Diagnostic&Tests
Checking&HDL&and&LDL&levels
CRP&indicates&inflammation&-low&CRP&means&lower&risk&of&cardiovascular&
disease
Treatment
Losing&weight
Healthier&diet
Lowering&serum&cholesterol&and&LDL&levels
Control&diabetes
Angina,Pectoris
Pathophysiology
Chest&pain&when&there&is&a&deficit&of&oxygen&to&the&heart&muscle
Can&occur&when&heart&is&working&harder&than&it&needs&to&be&and&is&in&demand&for&
oxygen&(exercising)
Classic/exertional&angina&
Variant&angina&in&which&vasospasm&occurs&at&rest
Unstable&angina
More&serious&form
Prolonged&pain&at&rest&and&of&recent&onset
Could&be&caused&by&breakage&of&atheroma
Could&cause&myocardial&infarction
Etiology
May&be&caused&by&a&blockage&due&to&atherosclerosis
Insufficient&myocardial&blood&and&oxygen&supply
Severe&anemias&and&respiratory&disease&can&also&cause&oxygen&deficiency&
Tachycardia&associated&with&hyperthyroidism&can&cause&it
Exposure&to&weather&extremes&or&pollution&or&eating&a&large&meal
Signs&and&Symptoms
Occurs&as&brief,&recurrent&episodes&of&chest&pain&usually&triggered&by&a&physical&
or&emotional&stress&which&increases&demand&on&the&heart&for&oxygen
Tightness,&pressure&in&chest&may&radiate&to&neck&or&left&arm
Excessive&sweating
Nausea
Can&last&a&few&seconds&or&minutes
Treatment
Nitroglycerin&(vasodilators)
Stress&reduction&techniques
Myocardial,Infarction
Pathophysiology
When&coronary&artery&is&totally&obstructed,&leading&to&prolonged&ischemia&and&
cell& death&of&the&heart&wall
Thrombus&may&build&to&obstruct&artery
Vasospasm&may&occur&due&to&atheroma,&leading&to&total&obstruction
Thrombus&may&break&off&and&flow&to&smaller&portion&of&vessel&and&block&blood&
flow
Heart&tissue&becomes&necrotic&with&ischemia&developing&around&area
If&blood&supply&is&restored&within&20-30&minutes,&irreversible&damage&may&be&
prevented
Etiology
Atherosclerosis
Signs&and&Symptoms
Feeling&pressure,&heaviness&or&burning&in&chest&or&radiating&pain&to&left&arm,&jaw&
or&neck
Sudden&shortness&of&breath,&sweating,&weakness&or&fatigue
Nausea,&indigestion
Anxiety&or&fear
Diagnostic&Tests
ECG
Serum&enzymes&can&be&found&in&blood&from&necrotic&tissue
Treatment
Analgesics
Oxygen&therapy
Anticoagulants&(heparin,&warfarin)
Pace&maker
Cardiac&rehabilitation&programs
Congestive,Heart,Failure
Pathophysiology
When&heart&is&unable&to&pump&sufficient&blood&to&meet&metabolic&needs&of&the&
body
Usually&chronic&condition
Can&occur&due&to&another&condition&(infarction,&valve&defect)
Usually,&one&side&of&the&heart&fails&first
Mechanisms&in&the&body&which&are&meant&to&help&actually&aggravate&the&
condition
Reduced&blood&flow&causes&vasoconstrictor&hormones&to&be&released&
causing&increased&blood&volume&to&the&heart,&adding&to&the&heart's&
workload
SNS&increases&heart&rate,&decreasing&effectiveness&of&filling&chambers&and&
increasing&work&for&the&heart
Chambers&of&the&heart&dilate&and&cardiac&muscle&hypertrophies&which&
demands&increased&blood&supply,&myocardial&cells&replaced&with&fibrous&
tissue
Two&effects&when&heart&cannot&maintain&pumping&ability
Cardiac&output&or&stroke&volume&decreases
Backup&congestion&develops&in&circulation&behind&affected&ventricle
Etiology
Infarction&that&impairs&pumping&ability&or&efficiency&of&the&conducting&system,&
valvular&changes,&or&congenital&heart&defects&may&cause&failure&of&the&affected&
side
Coronary&artery&disease&is&the&leading&cause
Right&CHF&can&be&caused&by&pulmonary&disease
Signs&and&Symptoms
Failure&of&either&side
Decreased&blood&supply&to&tissues&and&general&hypoxia
Fatigue&and&weakness
Dyspnea&(breathlessness)
Dizziness
Hot&or&cold&intolerance
Compensation&mechanisms
Indicated&by&tachycardia
Pallor
Daytime&oliguria
Backup&effects&of&left&sided&CHF&due&to&pulmonary&congestion
Dyspnea
Difficulty&breathing&when&lying&down
Cough
Paroxysmal&nocturnal&dyspnea&indicates&the&presence&of&acute&pulmonary&
edema
Signs&of&right&sided&CHF&and&systemic&backup
Edema&in&feet&or&legs
Hepatomegaly&and&splenomegaly
Ascites
Acute&right-sided&failure
Hypertension
Pathophysiology
Chronic&elevation&of&systemic&blood&pressure&that&in&the&long&term&causes&end-
organ&damage&which&results&in&increased&morbidity&and&mortality
Etiology
Primary&hypertension
No&identifiable&cause
Secondary&hypertension&(caused&by&underlying&condition)
Obstructive&sleep&apnea
Kidney&problems
Adrenal&gland&tumours
Thyroid&problems
Defects&in&blood&vessels&you're&born&with&
Medications
Alcohol/drugs
Signs&and&Symptoms
No&signs&and&symptoms
May&have&headache,&shortness&of&breath&or&nose&bleeds&if&BP&reaches&life&
threatening&stage
Aortic,Aneurysms
Pathophysiology
Localized&dilation&and&weakening&of&arterial& wall&in&abdominal&or&thoracic&aorta
May&be&a&saccular&shape&(bulging&wall&on&one&side)&or&fusiform&shape&
(circumferential&dilation&along&artery)
Dissecting&aneurysms&develop&when&there&is&a&tear&in&the&intima,&allowing&blood&
to&flow&along&length&of&vessel&in&between&layers&of&arterial&wall
Develops&from&defect&in&medial&layer,&dilation&enlarges,&hypertension&develops&
and&a&thrombus&forms&in&the&area,&obstructing&arteries&
Many&eventually&rupture&causing&a&hemorrhage
Etiology
Atherosclerosis
Trauma&(car&accidents)
Syphilis
Congenital&defects
Hypertension
Signs&and&Symptoms
Asymptomatic&for&a&long&period&of&time&until&they&become&very&large&or&rupture
Abdominal&aneurysms&&are&detected&as&pulsating&masses&with&abnormal&sounds
Rupture&leads&severe&hemorrhage&and&death
Severe&pain&and&shock
Shock
Pathophysiology
Also&known&as&hypotension&results&from&decreased&circulating&blood&volume,&
leading&to&decreased&tissue&perfusion&and&general&hypoxia
Type Mechanism Specific,Causes
Hypovolemic Loss&of&blood&or&plasma Hemorrhage,&burns,&
dehydration,&peritonitis,&
pancreatitis
Cardiogenic Decreased&pumping&
capability&of&the&heart
Myocardial&infarction&of&left&
ventricle,&cardiac&arrhythmia,&
pulmonary&embolus,&cardiac&
tamponade
Vasogenic&
(neurogenic&or&
disruptive)
Vasodilation&owing&to&loss&
of&sympathetic&and&
vasomotor&tone
Pain,&fear,&spinal&cord&injury,&
hypoglycemia&(insulin&shock)
Anaphylactic Systemic&vasodilation&and&
increased&permeability&
owing&to&severe&allergic&
reaction
Insect&stings,&nuts,&shellfish,&
drugs
Septic&
(endotoxic)
Vasodilation&caused&by&
infection&due&to&gram-
negative&bacteria
Virulent&microorganisms&(gram-
negative&bacteria)&or&multiple&
infections
Signs&and&Symptoms
Thirst&
Agitation/restlessness
Cool,&moist,&pale&skin
Tachycardia
Dizziness
Self%Study%Unit
Tuesday,& February&20,&2018 5:45&PM
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Document Summary

Define and briefly describe the following selected pathologies: Pathophysiology: a term for all types of arterial changes, best applied to degenerative changes in arteries and arterioles in people over. 50 and with diabetes: elasticity is lost and walls become thick and hard, lumen narrows and may become obstructed, leads to diffuse ischemia and necrosis. Gender (women have more hdl until menopause when estrogen levels decrease) Diagnostic tests: checking hdl and ldl levels, crp indicates inflammation - low crp means lower risk of cardiovascular disease. Treatment: losing weight, healthier diet, lowering serum cholesterol and ldl levels, control diabetes. Pathophysiology: chest pain when there is a deficit of oxygen to the heart muscle, can occur when heart is working harder than it needs to be and is in demand for oxygen (exercising, classic/exertional angina. Variant angina in which vasospasm occurs at rest: unstable angina. Prolonged pain at rest and of recent onset. Could be caused by breakage of atheroma.

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