PAD, PVD, Cardiac Output and Hypertension

• Peripheral Artery Disease (PAD) involves arteries not functioning correctly, leading to insufficient blood flow resulting in cold, blue feet and weak pulses.
• Peripheral Venous Disease (PVD) involves veins not functioning, causing blood to pool in the feet resulting in warm, reddened feet with possible swelling.

Cardiac Output

• Cardiac Output (CO) is the volume of blood the heart pumps per minute.
• Increased CO can be caused by exercise, stress, or fever.
• Decreased CO can be caused by heart failure, arrhythmias, or hypovolemia.

Hypertension

• Hypertension (HTN) is elevated blood pressure.
• Signs and symptoms are often asymptomatic but may include headaches, dizziness, or nosebleeds.
• Risk factors include age, obesity, smoking, genetics, and stress.
• Treatment includes lifestyle changes and antihypertensive medications like ACE inhibitors, diuretics, and beta-blockers.
• Hypertension can damage blood vessels in the kidneys, impairing their ability to filter blood, potentially leading to kidney disease.

Ischemic Cardiomyopathy

• Ischemic Cardiomyopathy is heart muscle dysfunction due to reduced blood flow, typically from coronary artery disease.

Acute Coronary Syndrome

• Signs and symptoms include chest pain, shortness of breath, sweating, nausea, dizziness, and pain radiating to the left arm or jaw.

Syncopal Episode

• A syncopal episode involves a sudden loss of consciousness due to insufficient blood flow to the brain, typically caused by a drop in blood pressure.

Jugular Venous Distention

• JVD is distention of the jugular veins, often a sign of right-sided heart failure where blood backs up into the body.

Vasodilation and Vasoconstriction

• Vasodilation is when blood vessels widen, causing blood pressure to decrease.
• Vasoconstriction is when blood vessels narrow, causing blood pressure to increase.

Potassium

• Potassium is essential for regulating electrical impulses in the heart.
• High potassium (hyperkalemia) can cause arrhythmias or cardiac arrest.
• Low potassium (hypokalemia) can cause arrhythmias and muscle weakness.

Myocardial Infarction

• Tests to diagnose a myocardial infarction (MI) include ECG and cardiac enzyme blood tests (Troponin, CK-MB).
• Medications for treatment include antiplatelets (Aspirin), anticoagulants (Heparin), pain relief (Morphine), and nitrates.

RAAS System

• The Renin-Angiotensin-Aldosterone System (RAAS) is a hormone system that helps regulate blood pressure by increasing sodium retention and vasoconstriction.

Heart Failure

• Left-sided heart failure causes blood to back up into the lungs, causing shortness of breath, crackles, and pulmonary edema.
• Right-sided heart failure causes blood to back up into the body, causing edema in the legs, hands, and abdomen.
• Acute heart failure is of sudden onset, requiring immediate medical intervention.
• Chronic heart failure develops slowly over time, with gradual worsening of symptoms.

Homan's Sign

• Homan’s sign is pain in the calf upon dorsiflexion of the foot, indicating a possible deep vein thrombosis (DVT).

Deep Vein Thrombosis

• D-dimer test, followed by an ultrasound, is used to rule out a DVT.
• Medications for treatment include anticoagulants (Heparin, Warfarin).

Thrombocytopenia

• Thrombocytopenia is a low platelet count, increasing the risk of bleeding.
• Platelets are formed in the bone marrow, live for 7-10 days, and function in clotting.

Clotting Pathways

• The intrinsic pathway is activated by damage to blood vessels.
• The extrinsic pathway is activated by external trauma to tissues.

Heart Failure

• Left heart failure affects the lungs, causing shortness of breath, crackles, and pulmonary edema.
• Right heart failure affects the body, causing edema in legs, hands, and abdomen.

Elderly Hypertension

• Risk factors include age-related stiffening of blood vessels, kidney dysfunction, and reduced ability to regulate blood pressure.

Collateral Circulation

• Collateral circulation involves the development of new blood vessels that bypass a blockage, especially in cases of coronary artery disease.

Greenfield Filter

• A Greenfield filter is a device placed in the inferior vena cava to prevent pulmonary embolism (PE) by catching blood clots.

Blood Pressure

• Arteries have high blood pressure due to the heart pumping.
• Veins have low blood pressure as blood is returning to the heart.
• Potassium regulates heart rhythm and electrical activity.
• Hyperkalemia can cause arrhythmias or arrest.
• Hypokalemia can lead to arrhythmias and muscle weakness.

Nitrates

• Nitrates cause vasodilation to reduce the heart’s oxygen demand, relieving chest pain in MI patients.

Heart Failure

• Left heart failure affects the lungs causing shortness of breath and crackles.
• Right heart failure affects the body causing edema and JVD.

Hypertension

• Primary hypertension is more common, with no clear cause.
• Secondary hypertension is caused by an underlying condition like kidney disease or a hormonal disorder.
• Early symptoms are often none.
• Advanced stages may include headaches, dizziness, and blurred vision.
• RAAS can contribute to hypertension by causing sodium retention and vasoconstriction, increasing blood pressure.

Nitroglycerin

• Nitroglycerin is used to relieve chest pain by causing vasodilation, improving blood flow to the heart.