Cardiovascular Diseases and Abnormal Conditions

Anemia a. Inadequate number of erythrocytes, hemoglobin, or both b. Symptoms: pallor or paleness, fatigue, dyspnea, rapid heart rate c. Acute blood loss anemia (1) Caused by hemorrhage or rapid blood loss (2) Corrected by transfusions of blood Hemorrhage

a. Iron deficiency anemia: (1) Caused by inadequate amount of iron to form hemoglobin in erythrocytes (2) Treatment: iron supplements and increased iron intake from green leafy vegetables and other foods

b. Aplastic Anemia: (1) Result of injury or destruction of bone marrow (2) Poor or no formation of erythrocytes (3) Common causes: chemotherapy, radiation, toxic chemicals, and viruses (4) Treatment: eliminate the cause, blood transfusions, and bone marrow transplant (5) Fatal unless damage can be reversed

c. Pernicious Anemia: (1) Caused by lack of intrinsic factor, which results in poor absorption of vitamin B (2) Results in formation of inadequate and abnormally large erythrocytes (3) Treatment: replacing intrinsic factor and administering B injections

d. Sickle Cell Anemia: (1) Chronic inherited anemia (2) Results in production of abnormal crescent-shaped erythrocytes that carry less oxygen, break easily, and block blood vessels (3) Occurs almost exclusively among blacks (4) Treatment: transfusions of packed cells and supportive therapy during a crisis (5) Genetic counseling can lead to prevention if carriers make informed decisions about conception of children

Aneurysm a. Ballooning out or saclike formation on wall of artery b. Causes: disease, congenital defects, injuries leading to a weakening of structure of wall of artery c. Symptoms: some cause pain and pressure, some have no symptoms d. Common sites are cerebral, aortal, and abdominal e. If aneurysm ruptures hemorrhage occurs, which can cause death f. Treatment: surgical removal of damaged area and replacement with a plastic graft or another blood vessel

Aneurysms continued… Abdominal aneurysm

Arteriosclerosis a. Hardening or thickening of walls of arteries b. Causes loss of elasticity and contractility c. Commonly occurs as result of aging d. Causes hypertension and can lead to aneurysm or cerebral hemorrhage

Atherosclerosis a. Fatty plaques, frequently cholesterol, deposited on walls of arteries b. Causes narrowing of opening, which reduces or eliminates the flow of blood c. If plaques break loose, they can circulate through the blood stream as emboli

Atherosclerosis continued… d. Treatment: low-cholesterol diet, medications to lower cholesterol blood levels, and exercise e. Surgeries to open clogged arteries (1) Balloon angioplasty (2) Coronary atherectomy (3) Coronary stent (4) Bypass surgery when arteries are completely blocked Stents Balloon angioplasty

Congestive Heart Failure (CHF) a. Heart muscles do not beat adequately to supply blood needs of the body b. May involve either right or left side of heart c. Symptoms: edema, dyspnea, pallor or cyanosis, distention of neck veins, weak and rapid pulse, cough with pink frothy sputum d. Treatment (1) Cardiac drugs and diuretics to remove fluid (2) Elastic support hose to improve circulation (3) Oxygen therapy and bedrest (4) Low sodium diet

Embolus a. Foreign substance circulating in blood stream b. Can be air, blood clot, bacterial clumps, fat globule c. Blockage of vessel occurs when embolus enters an artery or capillary too small for passage

Hemophilia a. Inherited disease b. Occurs almost exclusively in males but carried by females c. Blood not able to clot due to lack of plasma protein (1) Minor cut can lead to prolonged bleeding (2) Minor bump can cause internal bleeding d. Treatment (1) Transfusions of whole blood or plasma (2) Administration of missing protein factor

Hypertension a. High blood pressure (1) Systolic pressure above 140 to 150 mm of mercury (2) Diastolic pressure above 90 mm of mercury b. Risk factors that increase incidence (1) Family history (2) Race: higher in African Americans (3) Obesity (4) Stress (5) Smoking (6) Aging: higher in postmenopausal women (7) Diet high in saturated fat

Hypertension continued… c. Treatment but no cure (1) Antihypertensive drugs (2) Diuretics to remove retained body fluids (3) Decreased stress and avoiding use of tobacco (4) Low sodium or low-fat diet d. If not treated, can cause permanent damage to the heart, blood vessels, and kidneys

Leukemia a. Malignant disease of bone marrow or lymph tissue b. Results in large number of immature white blood cells c. Different types of leukemia: some acute, some chronic d. Symptoms: fever, pallor, swelling of lymphoid tissues, fatigue, anemia, bleeding gums, excessive bruising, joint pain e. Treatment (1) Varies with type of leukemia (2) Can include chemotherapy, radiation, bone marrow transplants Microscopic view of leukemia Bleeding gums Chemo patient

Myocardial Infarction or heart attack a. Blockage in coronary arteries cuts off supply of blood to the heart b. Affected heart tissue dies and is known as an infarct c. Death can occur immediately if large area affected d. Symptoms (1) Angina pectoris: severe crushing pain that radiates to arm, neck, jaw (2) Pressure in the chest (3) Perspiration and cold, clammy skin (4) Dyspnea (5) Change in blood pressure

MI continued… e. Treatment (1) Cardiopulmonary resuscitation if heart stops (2) Immediate treatment aa. Thrombolytic or “clot-busting” drug such as streptokinase or TPA, or tissue plasminogen activator bb. Restores blood flow to heart cc. Must be used within first several hours dd. Use is prohibited if bleeding is present CPR Thrombolytic drugs

MI continued… (3) Additional treatment aa. Complete bed rest bb. Pain medications and anticoagulants cc. Oxygen therapy dd. Treatment of arrhythmias (4) Long-term care aa. Control of blood pressure bb. Diet low in cholesterol and saturated fats cc. Avoidance of tobacco and stress dd. Regular exercise and weight control

Phlebitis a. Inflammation of vein, frequently in leg b. Thrombophlebitis if thrombus or clot forms c. Symptoms: pain, edema, redness, discoloration at site d. Treatment (1) Anticoagulants and pain medication (2) Elevation of affected area (3) Antiembolism or support hose (4) Surgery at times to remove clot Arm & leg phlebitis Thermal imaging of leg phlebitis

Varicose Veins a. Dilated, swollen veins that have lost elasticity and cause a stasis or decreased blood flow b. Occur frequently in legs c. Result from pregnancy, prolonged sitting or standing, and hereditary factors d. Treatment (1) Exercise and avoiding prolonged sitting or standing (2) Antiembolism or support hose (3) Eliminating tight-fitting or restrictive clothing