Cardiovascular System PDF

Week 8 Cardiovascular System Hypertension 5 liters of blood per min Silent killer first time that they find out will be with a stroke Secondary hypertension ○ renal disease holding fluids elevation in blood pressure ○ pre-eclampsia of pregnancy...

Week 8 Cardiovascular System Hypertension 5 liters of blood per min Silent killer first time that they find out will be with a stroke Secondary hypertension ○ renal disease holding fluids elevation in blood pressure ○ pre-eclampsia of pregnancy Teenage mothers and over age of 35 years old weight gain of >5 lbs a week swelling of extremities headache BP elevated protein in urine nephropathy ○ reduced renal function ○ normal small amount of protein but not large amounts ○ Pheochromocytoma benign tumor on adrenal gland norepinephrine catecholamine epinephrine catecholamine  palpitations sweating headache occur at any age but occurs 20-50 years old Adrenalectomy surgical removal of adrenal gland Increase or decrease in stroke volume LISTEN TO THIS AGAIN!!! SVR resistance that aorta overcomes to eject blood to circulatory system ○ the smaller diameter the higher vascular resistance ○ heart works harder to pump blood when vessel is constricted ○ consumes more oxygen this leads to left ventricular hypertrophy this is not a problem for someone that is an athlete this is a problem for someone to have on the daily we don’t want constant strain on heart ○ This is the reason why people have CHF ○ widen blood vessel reduction in blood pressure; decrease in vascular resistance Chronic High Blood Pressure (hypertension) Left untreated can lead to: ○ blood vessel damage arteriosclerosis ○ heart attack or heart failure ○ kidney failure Physiological control of BP in Hypotension ? Antihypertensive Therapy Beta Blockers ○ end in olol ○ two different non selective block beta 1 (heart) and Beta 2 (lungs) receptors cardio selective block beta 1 only ○ not recommended for male patients cause impotence experience rebound hypertension if they stop taking which can cause hemorrhagic stroke ○ suppress glycogenolysis People that experience hypoglycemia LISTEN TO THIS!!! ACE inhibitors ○ ends with “pril” ○ blocks conversion of angiotensin I to angiotensin II ○ prevents release of aldosterone for CHF less water and sodium on being retained ○ dry cough accumulation of prostaglandins and bradykinins calcium channel blockers ○ decrease in vascular resistance ○ slows the movement of calcium in the cell membrane decreases muscle contraction  ○ increases arterial diameter vasodilation and a reduction in blood pressure ○ slows electrical conduction decreases heart rate ○ blood vessel dilation reduction in heart muscle contraction slow heart rate reduction in the amount of oxygen required by the heart Centrally Acting Adrenergic Inhibitors these particular drugs cross blood brain barrier to exert the effect ○ decrease in HR ○ decrease in BP clonidine methyldopa ○ fluid and sodium retention if underlying kidney issues we will not give this medication ○ more effective with a diuretic to withdraw sodium and water Vasodilators Decrease BP ○ minoxidil severe hypertension ○ refractory hypertension is HTN that is not controlled by 5 or more drugs including diuretic  We will see a lot of people that take these amounts but we do this to prevent leakage of cerebral artery and to prevent a hemorrhagic stroke ○ Nitroprusside intravenous medication This is given slowly to avoid cerebral ?? doctor will give you parameters to follow to increase and decrease the dosage to regulate blood pressure potent and direct vasodilator 200/120 SBR is elevated and heart is using more oxygen Arteriosclerosis/Atherosclerosis Hardening of arteries most common type leads to myocardial ischemia ○ lack of oxygenation to cardiac muscle ○ chest pain most men ○ women will experience additional symptoms pain down the left arm tunica intima men post menopausal women ○ because of loss of estrogen unmodifiable risk factors ○ age ○ gender ○ genetics modifiable risk factors  ○ high blood pressure ○ smoking ○ stress ○ hyperlipidemia ○ sedentary lifestyle visceral fat is more concerning ○ obesity ○ diabetes mellitus increase risk of hypertension and hyperlipidemia ? hypoglycemia promotes platelet aggregation Angina Pectoris not enough blood or oxygen lactic acid build up and this produces pain stable angina ○ relieved by rest ○ experience chest discomfort ○ relieved by nitroglycerin unstable angina ○ not relieved by rest ○ more serious ○ new signs and symptoms ○ not relieved by nitroglycerin Treatment for Angina Pectoris Morphine-opiate analgesic oxygen-improves oxygen supply nitroglycerin-sublingual  ○ vasodilates veins and arteries ○ side effects headache ○ under tongue has a rich blood supply aspirin ○ decreases platelet aggregation ○ decreases of clot formation if patient does not get to the hospital on time patient will suffer Myocardial Infarction Myocardial Infarction Occurs on the left side of heart most common is the left anterior descending (LAD) ○ massive heart attack the LAD is occluded major pump Diagnosis and Screening 12 lead ECG ○ ST elevation- injury; looking to see if heart is injured ○ ST depression-ischemia ○ deep and wide Q waves are pathological infarction- this indicated you are having an infarction or had an infarction ○ myocardial infarctions lead to necrosis and death of cardiac tissue- IRREVERSIBLE Laboratory Tests CPK-MB >3% Troponin I