1. Cardiovascular System Diseases and Disorders
Chapter 8
Cardiovascular System Diseases and Disorders 1

2. Anatomy and Physiology
Cardiovascular system
Heart, arteries, and veins with blood
Heart
Size of man’s fist
Located slightly left of the middle of the chest
Composed of cardiac muscle, 4 chambers, 4 valves 2

3. The Heart 3

4. Anatomy and Physiology
Heart:
Wall of heart has three layers
Epicardium
Myocardium
Endocardium 4

5. Common Signs and Symptoms
Chest pain
Shortness of breath
Tachycardia
Cardiac palpitations 5

6. Diagnostic Tests Noninvasive procedures: Auscultation Doppler
Arterial blood pressure
Electrocardiogram
Echocardiography
PET scan 6

7.
DESCRIPTION
Cardiac positron emission tomography (PET) scanning is used in 2 key clinical situations: 1) myocardial perfusion scanning as a technique of identifying perfusion defects, which in turn reflect coronary artery disease (CAD); and 2) assessment of myocardial viability in patients with left ventricular (LV) dysfunction as a technique to determine candidacy for a revascularization procedure. A third potential clinical use related to CAD is being evaluated, use of cardiac PET in the measurement of myocardial blood flow and blood flow reserve. Cardiac PET is also being studied in the evaluation of coronary artery inflammation.

8. Diagnostic Tests Cardiac catheterization X-rays
Invasive procedure to determine oxygen content and blood pressure
X-rays
To determine normal function of heart and vessels 8

9. The following is a video of a cardiac catherization

10. Diagnostic Tests Common X-rays: Blood tests Angiocardiography
Angiography
Venogram
Blood tests
Enzymes
Creatine phosphokinase (CPK) muscle damage ( CKMB) specific for heart muscle damage
Troponin 1
Lactate dehydrogenase (LDH) 10

11. Diseases of the Cardiovascular System
Cardiovascular disease
CVD (coronary artery disease)
Leading cause of death in the United States
High blood pressure is common cause(= to or > than 140/90) 11

12. Diseases of Arteries Hypertension
Indicator of development of cerebrovascular, cardiovascular, and kidney disease
Chronic disease
Leading cause of stroke and heart failure 12

13. Diseases of Arteries Hypertension Normal blood pressure
119/79 or less
Top number (systolic)
Measures highest pressure in artery when ventricles contract
Bottom number (diastolic)
Measures pressure in artery when ventricles relax
High blood pressure
Equal to or Greater than 140/90 13

14. Diseases of Arteries Hypertension Primary Risk factors:
Idiopathic with gradual onset
Also known as essential hypertension
Risk factors:
Heredity
Diet
Age
Obesity
Smoking
Stress 14

15. Diseases of Arteries Hypertension Treatment:
Antihypertensive medications—second or third
Lifestyle changes—first
Low-salt diet—also first
Stress-reducing exercise—also first
Smoking cessation—also first
Diuretics--second 15

16. Diseases of Arteries Arteriosclerosis and atherosclerosis
Loss of elasticity and thickening of artery wall
Also known as hardening of arteries
Plaque
Deposits of fatty or lipid material in wall of artery 16

17. Diseases of Arteries Atherosclerosis Major areas affected:
Coronary arteries
Cerebral arteries
Aorta
Peripheral arteries 17

18. Diseases of Arteries Atherosclerosis Risk factors:
Noncontrollable factors
Heredity
Age
Sex
Diabetes 18

19. Diseases of Arteries Atherosclerosis Risk factors:
Controllable factors
Diet
Sedentary lifestyle
Cigarette smoking
Stress
Hypertension—even if medication is necessary 19

20. Diseases of Arteries Atherosclerosis
Diagnosis by blood pressure, arteriograms, X-rays, and Doppler
Symptomatic treatment:
Bypass surgery of occluded arteries and plaque removal 20

21. Diseases of Arteries Peripheral vascular disease (PVD)
Caused by atherosclerotic plaque in arteries supplying blood to legs
Intermittent claudication
Muscle cramps relieved with rest and increased with activity 21

22. Diseases of Arteries Peripheral vascular disease (PVD) Treatment:
Endarterectomy
If necrosis occurs, amputation or resection may be necessary 22

24. Physicians use endarterectomy to treat many arteries; however, the most common use is for treating blockages in the carotid arteries. Your carotid arteries are in your neck and deliver blood to your brain. Your physician may recommend endarterectomy to treat one or more of the following:
Carotid artery disease
Peripheral arterial disease, such as leg or arm artery disease
Renal (kidney) artery disease
Aortic arch conditions
Aortoiliac occlusive disease
Visceral (intestines, spleen, and liver) artery disease

25. Diseases of Arteries Aneurysm
Weakening in wall of artery leading to bulge or rupture
Usually asymptomatic and discovered accidentally
Aorta
Most common location
Treatment:
Repairing aneurysm before rupture through resection and grafting 25

26. Types of Aneurysms 26

29. Diseases of Arteries Coronary artery disease
Narrowing of arteries that supply blood to myocardium
Single leading cause of death in United States
Commonly due to atherosclerosis 29

30. Diseases of Arteries Coronary artery disease
Progressive narrowing of vessels may lead to ischemia of heart muscle and symptoms
Scar tissue replaces muscle
Occlusion may progress slowly or suddenly as result of thrombus or embolus 30

32. Diseases of Arteries Coronary artery disease Myocardial infarction
Death of heart muscle caused by ischemia
Diagnosis by history, electrocardiogram (ECG), and angiograms
Treatment:
Aimed at increasing blood flow or decreasing oxygen needs 32

33. Grossly, a remote myocardial infarction is evidenced by white collagenous scar.

34. Diseases of Arteries Coronary artery disease Treatment:
Angina treated with vasodilators—most common is Nitroglycerine
Angioplasty—ballooning of occlusion
Coronary artery bypass graft (CABG)
Reduction of atherosclerotic risk factors
Diet
Exercise
Smoking 34

35. CABG 35

36. saphenous vein is harvested from the leg

37. Diseases of the Heart Angina pectoris Chest pain
Lack of oxygen to heart--ischemia
Sign of impending myocardial infarction
Treatment:
Decrease workload of heart
Use nitroglycerin 37

38. Diseases of the Heart Myocardial infarction Heart attack
Occurs when heart does not get enough oxygen--ischemia
Symptoms:
Severe chest pain with diaphoresis and nausea
Referred pain to neck, arm, and jaw with discomfort similar to bad or unrelieved indigestion 38

39. Diseases of the Heart Myocardial infarction Treatment:
Give immediate attention to prevent shock
Relieve respiratory distress
Decrease workload
If cardiac arrest, cardiopulmonary resuscitation (CPR) must be performed 39

40. Diseases of the Heart Myocardial infarction Treatment:
Oxygen and pain medication—nitroglycerine for chest pain and opening up arteries—morphine for pain
Medications to treat arrhythmias—beta blockers, calcium channel blockers
Clot-busting medications---to open vessels
To keep blood from clotting--aspirin-----heparin---plavix
Education on prevention by lifestyle changes
Smoking cessation
Diet
Exercise 40

41. Diseases of the Heart Hypertensive heart disease
Result of long-term hypertension
Causes:
Disease or disorder causing chronic elevation in blood pressure
Treatment:
Treat cause of hypertension
Can only be controlled
No cure 41

42. Diseases of the Heart Rheumatic heart disease
Autoimmune disorder caused by streptococcal throat infection
All layers of heart and valves can be affected
Treatment:
Prevention/treatment of streptococcal infections
Rest during acute stage
Valve replacement to correct deformity 42

43. Diseases of the Heart Congestive heart failure (CHF)
Heart fails to pump adequate blood supply
Develops slowly and increases workload of heart
Symptoms:
Gradual increase in dyspnea
Tachycardia
Tachypnea 43

44. Diseases of the Heart CHF Symptoms: Neck vein distention—right side
Edema in ankles and lower legs—right side
Right-sided leads to congestion of liver and spleen
Left-sided leads to congestion of lungs 44

45. Diseases of the Heart CHF
Diagnosis by history and physical, chest X-ray, and ECG
Treatment:
Decrease workload
Diuretics
Salt and fluid restrictions
Medications to strengthen and slow heart
E.g., digitalis 45

46. Diseases of the Heart Cardiomyopathy Disease of heart muscle
Characterized by dilated, enlarged, thin, flabby heart muscle
No cure
Leads to CHF, myocardial infarction, and death 46

47. Cardiomyopathy
Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium.

48. normal heart (left) and a patient with hypertrophic cardiomyopathy (right). There is a marked increase in the thickness of the walls of the heart in the patient with hypertrophic cardiomyopathy.

49. Diseases of the Heart Carditis Inflammation of heart
E.g., pericarditis, myocarditis, endocarditis
Often secondary to respiratory, urinary tract, or skin infection
Treatment:
Rest
Antibiotics
Analgesics
Antipyretics 49

50. Diseases of the Heart Valvular heart disease
Malfunction of heart valves
Murmurs or abnormal heart sound
Causes:
Congenital abnormalities or malformations
Rheumatic fever
Endocarditis 50

51. Surgical Repair Of Mitral Valve Stenosis Due to Rheumatic Fever

52. Diseases of the Heart Arrhythmias Abnormal heart rhythm
Sinus rhythm is normal heart rhythm
60 to 100 beats per minute
Flutter
Unusually fast heart rate
Fibrillation
Wild and uncoordinated
Heart block
Interruption in conduction system 52

53. From top to bottom: normal sinus rhythm, atrial flutter, atrial fibrillation, complete heart block

54. Diseases of the Heart Arrhythmias
---atrial fibrillation, atrial flutter, atrial tack, and pacs
-- Junctional—escape, accelerated junctional, junctional tack and pjcs
Blocks are Divided into first-, second degree (mobitz 1 or Mobitz 2), or third-degree(complete heart block)
---mature or early contractions may affect atria (PACs) or ventricles (PVCs)
---Ventricular Rhythms—PVCs, ventricular tack, torsodes, idioventricular, ventricular fibrillation
Treatment:
Ranging from unnecessary if asymptomatic to meds to defibrillation 54

55. From top to bottom: PVC, Ventricular tack, ventricular fibrillation, accelerated idioventricular

56. Diseases of the Veins Phlebitis Inflammation of superficial veins
Symptoms:
Pain
Swelling
Red, cord-like hardening along vein toward heart 56

58. Diseases of the Veins Phlebitis Treatment: Analgesics Warm compresses
Elevation of area above heart level
Elastic stockings
Exercise 58

59. Diseases of the Veins Thrombophlebitis
Clotting in vessels of legs, thighs, and pelvis
Asymptomatic until embolization occurs
Risk factors:
Immobility
Dehydration
Varicose veins
Leg/pelvic surgery, obesity, pregnancy 59

60. Phlebitis and Thrombus60

61. Diseases of the Veins Deep vein thrombosis (DVT) Treatment:
Reduce clot
Prevent embolization
Use anticoagulants 61

62. Diseases of the Veins Varicose veins
Dilated, tortuous, and elongated veins in legs
Causes:
Prolonged sitting or standing
Pregnancy
Obesity 62

63. Diseases of the Veins Varicose veins Symptoms: Treatment:
Leg fatigue and cramps
Thickening veins
Edema
Fluid
Treatment:
Elevate legs
Walk
Use support or elastic hose
Strip vein 63

66. What is ligation and stripping for venous disease?
Ligation means the surgical tying of veins through a small incision in the skin to prevent pooling of blood. Ligation may be used in conjunction with vein stripping, or removal of the vein. In many instances, the vein is removed using a minimally invasive surgical procedure called venous ablation.

67. Trauma Hemorrhage Abnormal loss of blood May be acute or chronic
Exsanguination
Loss of circulating blood
Internal bleeding can lead to anemia or shock due to blood loss 67

68. Trauma
Hemorrhage
Low-pressure vessels lead to petechiae or ecchymosis of purpura
High-pressure vessels lead to squirting of bright red blood 68

69. Trauma
Shock
Extremely low blood pressure that leads to decreased tissue perfusion
Types:
Cardiogenic
Septic
Hypovolemic
Neurogenic
Anaphylactic 69

70. Trauma Shock Symptoms: Facial pallor Cool and clammy skin Cyanosis
Tachycardia
Tachypnea
Altered mental status
Syncope
Unconsciousness
Oliguria or anuria
hypotension 70

71. Trauma Shock Treatment: Rest in supine position
Move to warm, quiet environment
Elevate feet and legs above heart 71

72. Rare Diseases Malignant hypertension Cor pulmonale Raynaud’s disease
Buerger’s disease
Polyarteritis nodosa 72

73. DOWNLOAD ALL SIZES USE THIS FILE ON THE WEB USE THIS FILE ON A WIKI A LINK TO THIS FILE INFORMATION ABOUT REUSING
Cor pulmonale is a condition that most commonly arises out of complications from pulmonary hypertension (high blood pressure). It is also known as right-sided heart failure because it occurs within the right ventricle of your heart. Cor pulmonale causes the right ventricle to enlarge and pump blood less effectively than it should. Subsequently, the ventricle is then pushed to its limit and ultimately fails

74. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in the hands and feet and may eventually affect larger areas of your arms and legs.

75. Polyarteritis nodosa is a serious blood vessel disease.
The small and medium-sized arteries become swollen and damaged.
Symptoms include:
Abdominal pain
Decreased appetite
Fatigue
Fever
Joint aches
Muscle aches
Unintentional weight loss
Weakness

76. Effects of Aging Decreased contractility of heart muscle
Decreased elasticity of vessels
Thickening of valves
Becoming sclerotic 76