Cardiovascular Disease LO2 2020 PDF

Disorders of Cardiovascular system Dr. Riaz Akseer  Nucleus Medical Media (2020). Cardiovascular system [Digital image]. Retrieved from https://ebsco-smartimagebase-com.ezproxy.hct.ac.ae/cardiovascular-system/view-item?Item ID=68971 2  Objectives By the end of this presentation...

Disorders of Cardiovascular system Dr. Riaz Akseer  Nucleus Medical Media (2020). Cardiovascular system [Digital image]. Retrieved from https://ebsco-smartimagebase-com.ezproxy.hct.ac.ae/cardiovascular-system/view-item?Item ID=68971 2  Objectives By the end of this presentation you will learn: Common cardiovascular pathology Ischemic Heart Disease Atherosclerosis Angina Pectoris Coronary Artery Disease Myocardial Infarction Congestive Heart Failure Rheumatoid Heart Disease Hypertension Aneurysm 3  http://www.anatomy.tv.ezproxy.hct.ac.ae/anatomytv/html5uihap_2018/#/product/ cardiovascular/type/Topics/displayType/showAnimation/id/5 4 5 6  BEAR IN MIND-1 CVD- HIGH INCIDENCE atherosclerosis, hypertension, clotting disturbances MALFORMATION OF HEART DEPENDENCE ON NUTRIENTS & OXYGEN infarction, ischemia, angina pectoris BP heart action, elasticity, hormones biogenic amines [ catecholamines, renin, angiotensins, aldosterone ] 7  BEAR IN MIND-2 INFECTION bacteremia [septicemia], bacterial endocarditis, septic emboli, infectious arteritis, thrombophlebitis INFLAMMATION immunoglobulins vasculitis, endocarditis, polyarteritis nodosa, rheumatic fever SYSTEMIC METABOLIC DISEASE microangiopathy MALIGNANT TUMORS-LOW INCIDENCE HEMANGIOMAS- BENIGN TUMORS OF LITTLE CLINICAL SIGNIFICANCE 8  Ischemic Heart Disease Occurs as a result of inadequate blood supply to a heart muscle Is a general term used to reflect many conditions that affect the heart due to inadequate blood supply. 9  Ischemic Heart Disease May be caused by: 10  Ministry of Health and Prevention CVD is a leading cause of mortality in the UAE. Of CVD deaths: 22% because of acute myocardial infarction (AMI) 16% to cerebrovascular disease 6% to ischemic heart disease and 5% to hypertension Ministry of Health and Prevention. United Arab Emirates; 2015 Report 11  Atherosclerosis Generalized, large, small arteries, arterioles. Lipids deposit on the intima of the arteries, Calcification, thrombosis and fibrosis Plaque or atheroma Affected vessels hypertrophy Loss of elasticity 12 Organs damage  Nucleus Medical Media (2020). Atherosclerosis [Digital image]. Retrieved from https://ebsco-smartimagebase-com.ezproxy.hct.ac.ae/atherosclerosis/view-item?ItemID=4519 13  Activity Let’s review– Angina and answer these questions: What are the symptoms of angina? What are 3 main differences between angina and a heart attack? What is used to determine if a patient has angina? What 2 tests are done to measure the structure & function of the heart? What medication is commonly used We’ll discuss yourtoanswers treat angina? in our next class! 14  Ischemic Heart Disease May lead to: Angina pectoris Myocardial infarction 15  Angina Symptoms: Determining if a patient has angina: Tests measuring structure & function of heart: –1 –2 –3 –4 Medication to treat angina: 16  Coronary Artery Disease Coronary artery disease or coronary atherosclerosis can lead to: Heart attack or myocardial infarction 17  Myocardial Infarction (MI) Heart Attack The coronary artery is totally obstructed, leading to prolonged ischemia (over 20 minutes), cell death, or infarction of the myocardium. 18  Compare Angina & MI Angina Myocardial Infarction Decreased blood flow Absence of blood flow Coronary artery narrowed by plaque or Coronary artery completely obstructed spasm Ischemia for a short time Prolonged ischemia greater than 20 minutes Decreased blood supply, but tissue recovers No blood supply - myocardial tissue dies (necrosis) = infarction Pain is relieved with rest or nitroglycerin Pain more severe, not relieved with rest or medicines 19  Diagnostic & Surgical Treatment There are many diagnostic and surgical treatment procedures used to assist physicians Coronary angiography To name a few... Echocardiogram Let’s have a look 20  Treatment Nucleus Medical Media (2020). Coronary artery: stent procedure [Digital image]. Retrieved from https://ebsco-smartimagebase-com.ezproxy.hct.ac.ae/coronary-artery-stent-procedure/view-item?ItemID=8774 21  Complications of MI Dysrhythmias – change in rate or rhythm of heart because of damage to conduction system Week hart beat Congestive Heart Failure Death 22  Congestive Heart Failure Left-sided failure results in pulmonary edema Symptoms: Dyspnea Orthopnea Productive cough Frothy sputum Crackles Pallor 23  Congestive Heart Failure Right-sided failure results in: JVD (Jugular Vein Distention) Edema of feet/legs Ascites (accumulation of fluid in the peritoneal cavity, causing abdominal swelling) Hepatomegaly Fatigue 24  Rheumatic Heart Disease Rheumatic fever is caused by haemolytic strep – usually occurring as a throat infection Clinical problems related to rheumatic fever are carditis and valvulitis These can lead to heart valve deformities such as stenosis, incompetence and insufficiency The mitral valve is the valve most often affected in rheumatic heart disease Pathogenesis - Following infection (“strep throat”), an immune response to streptococci acts on the heart and other organs like the joints, skin, and central nervous system. In the heart it causes endocarditis, myocarditis, and pericarditis. 25  Damjanov Figure 7-23 26  Congenital Heart Disease Any defect of the heart and/or the large arteries and veins that is present at birth Examples: Septal Defects Valvular defects Tetrology of Fallot Pulmonary valve stenosis Ventricular septal defect Dextroposition of the aorta (to the right over the VSD) Right ventricular hypertrophy 27  Tetrology of Fallot 28  Congenital Heart Disease Signs & Symptoms: – Dyspnea on exertion – Tachycardia – Diaphoresis (sweating) – Clubbed finger nails (wide fingertips) – Cyanosis (Blue Baby) 29  Congenital Heart Disease Diagnostic Tests: Severe defects are diagnosed at birth CXR will show cardiomegaly Cardiac catheterization Echocardiogram ECG Treatment: usually surgical repair 30  Hypertension Hypertension is a condition in which there is excessive tension exerted by blood on arterial walls, which results in intermittent or sustained elevation in blood pressure. 31  Hypertension Types: – Primary (Essential) Hypertension – most common etiology (cause) unknown – Secondary Hypertension Caused by disorders of kidneys or endocrine glands – Malignant Hypertension Uncontrollable Severe Rapidly progressive Many complications 32  Activity Review Hypertension What are suggested to be the causes of hypertension? What is recommended in “Controlling Hypertension”? 33  Risk Factors for Hypertension Smoking Obesity High fat / high salt diet Excessive alcohol drinking Physical inactivity Hypercholesterolemia Heart / kidney disease History of stroke Family history African American descent 34  Pathophysiology of Hypertension 35  Hypertension Complications Hypertension is an important factor in... Formation of aneurysms (weak & dilated arteries) Cardiovascular disease (MI, heart failure) Cerebrovascular disease (stroke) Renal disease (kidney failure) Eye disease (impaired vision, blindness) 36  Hypertension – Symptoms & Diagnosis Symptoms: None Headache Extreme fatigue Diagnosis: Measured blood pressure is elevated on several occasions 37  Controlling Hypertension No cure! Change eating habits: Lose weight Eat less table salt (Na++) & less fat Change life style habits: Exercise Stop smoking, decrease alcohol intake Control stress Medications Regular follow up with doctor 38  Aneurysms Abnormal localized dilation of a blood vessel wall - may occur in any vessel Types – 39  Aneurysms–Etiology & Treatment Etiology – Trauma – Congenital defects – Atherosclerosis & hypertension Treatment – Surgery – Before surgery: very important to keep normal blood pressure and prevent sudden elevations in BP (avoid exertion, stress, coughing, constipation) 40  Summary Ischemic Heart Disease Atherosclerosis Angina Pectoris Coronary Artery Disease Myocardial Infarction Congestive Heart Failure Rheumatoid Heart Disease Hypertension Aneurysm 41  References (12/2014). Essential Pathophysiology for Nursing and Healthcare Students, 1st Edition. Damjanov, I (2011) Pathology for the Health Professions 4th edition Lippincott Williams & Wilkins. (2009). Professional guide to diseases (9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Martini, F., & Nath, J. L. (2015). Fundamentals of anatomy & physiology. San Francisco: Pearson/Benjamin Cummings. Richards, A. (12/2014). Essential Pathophysiology for Nursing and Healthcare Students, 1st Edition 42