The Cardiovascular System..pdf

The Cardiovascular System Ischemic Heart Disease and Conduction Disorders Pericarditis Pathophysiology: Inflammation of the pericardium, which can lead to fluid accumulation in the pericardial space, causing a pericardial effusion. Signs and Sympt...

The Cardiovascular System Ischemic Heart Disease and Conduction Disorders Pericarditis Pathophysiology: Inflammation of the pericardium, which can lead to fluid accumulation in the pericardial space, causing a pericardial effusion. Signs and Symptoms: Sharp, stabbing chest pain, difficulty breathing while lying down, fever, fatigue, and a pericardial friction rub heard on auscultation Cardiac Tamponade Pathophysiology: Accumulation of fluid in the pericardial space exceeding 200 mL, leading to compression of the heart chambers, preventing them from filling properly. Signs and Symptoms: Hypotension, jugular vein distention, muffled heart sounds, and pulsus paradoxus (a drop in systolic blood pressure of more than 10 mm Hg during inspiration) Endocarditis Pathophysiology: Inflammation of the endocardium and heart valves, typically caused by bacterial infection leading to vegetation formation on valve leaflets. Signs and Symptoms: Fever, chills, anorexia, weight loss, myalgias, arthralgias, heart murmur, and signs of ischemia or infarction in various organs due to septic emboli Myocarditis Pathophysiology: Inflammation of the myocardium, often due to viral infections, leading to degeneration and necrosis of cardiac myocytes and conduction disruptions. Signs and Symptoms: Rapid and irregular heartbeat, fatigue, slight chest pain, joint pain, and breathlessness Myocardial Infarction (MI) Pathophysiology: Prolonged ischemia leading to irreversible damage and necrosis of myocardial cells, typically caused by a blocked coronary artery. Signs and Symptoms: Diaphoresis, dyspnea, extreme anxiety, Levine’s sign (fist to chest), pallor, and crushing chest pain radiating to the shoulder, arm, jaw, or back Myocardial Ischemia Pathophysiology: Reduced blood flow to the myocardium, usually due to partial obstruction of a coronary artery. Signs and Symptoms: Angina pectoris (chest pain), tightness, and crushing sensation in the chest, especially during physical activity Angina Pectoris: Stable vs Unstable Pathophysiology: Stable angina is chronic and predictable chest pain due to myocardial ischemia; unstable angina is a new or worsening chest pain indicating increased ischemia. Signs and Symptoms: Stable angina presents with predictable chest pain during exertion; unstable angina presents with sudden, severe, and unpredictable chest pain, often indicating a higher risk of MI Dressler’s Syndrome Pathophysiology: A type of pericarditis developing 2-3 weeks post-MI, due to an autoimmune response against cardiac antigens. Signs and Symptoms: Chest pain, fever, and pericardial effusion Acute Coronary Syndrome (ACS) Pathophysiology: A group of conditions caused by sudden, reduced blood flow to the heart, including STEMI, NSTEMI, and unstable angina. Signs and Symptoms: Chest pain or discomfort, shortness of breath, nausea, and diaphoresis. Specific symptoms vary with the type of ACS (STEMI, NSTEMI, or unstable angina Heart Failure Left-Sided Heart Failure: Pathophysiology: - Left-sided heart failure occurs when the left side of the heart is unable to pump blood sufficiently to meet the body's needs. This condition leads to volume overload and venous congestion in the lungs, causing pulmonary symptoms. - Causes include cardiomyopathy, coronary artery disease, hypertension, and substance abuse (e.g., alcohol or cocaine). It can result from either systolic dysfunction (reduced ejection fraction) or diastolic dysfunction (preserved ejection fraction but impaired relaxation). Signs and Symptoms: - Decreased blood pressure - Paroxysmal nocturnal dyspnea (sudden shortness of breath at night) - Cough and orthopnea (difficulty breathing while lying flat) - Rales (crackling sounds in the lungs) - Heart murmurs or gallops - Pulmonary edema - Fatigue - Decreased urine output  - Exercise intolerance Right-Sided Heart Failure: Pathophysiology: - Right-sided heart failure occurs when the right side of the heart is unable to pump blood to meet the body's needs. It is often a consequence of left-sided heart failure due to increased work required by the right ventricle to overcome pulmonary venous congestion. - Causes include left-sided heart failure, pulmonary embolus, sickle cell crisis, stenosis of pulmonary or mitral valve, pulmonary hypertension, and ischemia or myocardial infarction. Signs and Symptoms: - Sodium and water retention - Cool extremities and poor distal pulses - Fatigue and exercise intolerance - Syncope (fainting) - Nausea, vomiting, early satiety, and abdominal pain - Elevated jugular venous pressure and distended neck veins - Peripheral edema - Ascites (fluid in the abdomen) - Hepatomegaly (enlarged liver) Arterial Disorders Thrombophlebitis Pathophysiology: Inflammation of a vein associated with blood clot formation. Often occurs in the veins of the lower extremities. Signs and Symptoms: Pain, tenderness, swelling, and redness at the affected area Cerebral Vascular Accident (CVA) Pathophysiology: Interruption of blood flow to the brain, leading to brain cell death. Can be ischemic (blockage) or hemorrhagic (bleeding).  Signs and Symptoms: Sudden numbness or weakness, especially on one side of the body; confusion; trouble speaking; visual disturbances; dizziness; loss of balance; severe headache Varicose Veins Pathophysiology: Dilated and twisted veins, often in the lower extremities, due to venous valve damage and increased venous pressure. Signs and Symptoms: Leg pain and discomfort, enlarged, dark-looking veins Transient Ischemic Attacks (TIAs) Pathophysiology: Brief episodes of impaired cerebral circulation causing temporary neurological dysfunction. Signs and Symptoms: Unilateral blindness, contralateral body paralysis, slurred speech Berry Aneurysm Pathophysiology: Small saccular aneurysms typically found in the circle of Willis in the brain. They can burst and cause subarachnoid hemorrhage. Signs and Symptoms: Sudden severe headache, nausea, vomiting, stiff neck, sensitivity to light, loss of consciousness. Dissecting Aneurysm Pathophysiology: A longitudinal tear in the wall of an artery, usually the aorta, causing blood to split the layers of the artery wall. Signs and Symptoms: Severe chest pain and pressure, symptoms of cardiac tamponade, and potential sudden death Arteriosclerosis Pathophysiology: Hardening and thickening of arterial walls, often due to aging and hypertension. Signs and Symptoms: Reduced blood flow can lead to ischemic symptoms in affected tissues, but specific symptoms depend on the arteries involved. Hypertension Pathophysiology: Consistently high blood pressure, often due to increased peripheral resistance or other factors. Signs and Symptoms: Headaches, dizziness, fatigue, muscle cramping, excessive sweating, irregular heartbeats. Hyperlipidemia (HLD) Pathophysiology: Elevated levels of lipids (cholesterol and triglycerides) in the blood, leading to plaque formation in arteries. Signs and Symptoms: Often asymptomatic; can lead to atherosclerosis and associated complications. Peripheral Arterial Disease (PAD) Pathophysiology: Atherosclerosis of peripheral arteries, leading to reduced blood flow to the extremities. Signs and Symptoms: Pain (intermittent claudication), pulselessness, palpable coolness, paresthesias, and paresis. Atherosclerosis Pathophysiology: Plaque buildup in the arterial walls due to lipid deposits and inflammation. Signs and Symptoms: Can lead to symptoms of ischemia in affected organs (e.g., chest pain in coronary arteries, intermittent claudication in peripheral arteries. Peripheral Vascular Disease (PVD) Pathophysiology: Disorders of blood vessels outside the heart and brain, commonly due to atherosclerosis. Signs and Symptoms: Similar to PAD, with symptoms including pain, pulselessness, coolness, and skin changes in the affected limbs. Cardiac Structural Disorders Rheumatic Fever Pathophysiology: Rheumatic fever is an inflammatory disease that can develop after a Group A beta-hemolytic streptococcal infection, such as strep throat. It can cause damage to connective tissues, particularly in the heart, joints, skin, and brain. The heart valve damage may lead to rheumatic heart disease. Signs and Symptoms: Fever, painful and swollen joints, fatigue, chest pain, heart murmur, and shortness of breath. Diastolic vs. Systolic Murmurs  Pathophysiology: Murmurs are sounds created by turbulent blood flow through the heart. Systolic murmurs occur during heart muscle contraction (systole), while diastolic murmurs occur during heart muscle relaxation (diastole). Diastolic Murmurs: 1. Aortic regurgitation 2. Mitral stenosis 3. Pulmonary regurgitation 4. Tricuspid stenosis Systolic Murmurs: 1. Aortic stenosis 2. Mitral regurgitation 3. Pulmonary stenosis 4. Tricuspid regurgitation Signs and Symptoms: - Diastolic Murmurs: Often due to mitral stenosis or aortic regurgitation. Symptoms may include fatigue, shortness of breath, and heart palpitations. - Systolic Murmurs: Often due to aortic stenosis or mitral regurgitation. Symptoms may include fatigue, chest pain, syncope, and shortness of breath. Tetralogy of Fallot Pathophysiology: A congenital heart defect consisting of four abnormalities: ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. This causes oxygen-poor blood to flow out of the heart and into the rest of the body. Signs and Symptoms: Cyanosis (bluish skin), shortness of breath, rapid breathing, fainting, clubbing of fingers and toes, poor weight gain, irritability, heart murmur, and fatigue during feeding or exercise. Patent Ductus Arteriosus (PDA) Pathophysiology: A condition wherein the ductus arteriosus, a blood vessel in the fetal heart, fails to close after birth. This results in abnormal blood flow between the aorta and pulmonary artery. Signs and Symptoms: Fast breathing, poor feeding and weight gain, fatigue, sweating while feeding, heart murmur, and frequent respiratory infections. Coarctation of the Aorta  Pathophysiology: A narrowing of the aorta, which forces the heart to pump harder to push blood through the narrowed part of the aorta. This can lead to high blood pressure and heart damage. Signs and Symptoms: High blood pressure, especially in the arms, headache, muscle weakness, leg cramps or cold feet, nosebleeds, and heart murmur. Ventral & Atrial Septal Defect (VSD & ASD) Pathophysiology: - Ventral Septal Defect (VSD): A hole in the septum between the heart's ventricles, causing oxygen-rich blood to mix with oxygen-poor blood. Small VSDs might close on their own, while larger VSDs can cause significant shunting of blood. - Atrial Septal Defect (ASD): A hole in the septum between the atria, allowing oxygenated blood to flow from the left atrium to the right atrium, which can lead to increased pulmonary blood flow and volume overload. Signs and Symptoms: - VSD: Shortness of breath, rapid breathing, frequent respiratory infections, fatigue, poor growth, and heart murmur. - ASD: Shortness of breath, especially during exertion, fatigue, palpitations, frequent respiratory infections, and heart murmur.