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. 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 7

8. Diagnostic Tests Common X-rays: Blood tests Angiocardiography
Angiography
Venogram
Blood tests
Enzymes
Creatine phosphokinase (CPK)
Lactate dehydrogenase (LDH) 8

9. Diseases of the Cardiovascular System
Cardiovascular disease
CVD
Leading cause of death in the United States
High blood pressure is common cause 9

10. Diseases of Arteries Hypertension
Indicator of development of cerebrovascular, cardiovascular, and kidney disease
Chronic disease
Leading cause of stroke and heart failure 10

11. Diseases of Arteries Hypertension Normal blood pressure
120/80
Top number (systolic)
Measures highest pressure in artery when ventricles contract
Bottom number (diastolic)
Measures pressure in artery when ventricles relax
High blood pressure
Greater than 140/90 11

12. Diseases of Arteries Hypertension Primary Risk factors:
Idiopathic with gradual onset
Also known as essential hypertension
Risk factors:
Heredity
Diet
Age
Obesity
Smoking
Stress 12

13. Diseases of Arteries Hypertension Treatment:
Antihypertensive medications
Lifestyle changes
Low-salt diet
Stress-reducing exercise
Smoking cessation
Diuretics 13

14. 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 14

15. Diseases of Arteries Atherosclerosis Major areas affected:
Coronary arteries
Cerebral arteries
Aorta
Peripheral arteries 15

16. Diseases of Arteries Atherosclerosis Risk factors:
Noncontrollable factors
Heredity
Age
Sex
Diabetes 16

17. Diseases of Arteries Atherosclerosis Risk factors:
Controllable factors
Diet
Sedentary lifestyle
Cigarette smoking
Stress
Hypertension 17

18. Diseases of Arteries Atherosclerosis
Diagnosis by blood pressure, arteriograms, X-rays, and Doppler
Symptomatic treatment:
Bypass surgery of occluded arteries and plaque removal 18

19. 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 19

20. Diseases of Arteries Peripheral vascular disease (PVD) Treatment:
Endarterectomy
If necrosis occurs, amputation or resection may be necessary 20

21. 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 21

22. Types of Aneurysms 22

23. 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 23

24. 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 24

25. Diseases of Arteries Coronary artery disease Myocardial infarction
Death of heart muscle
Diagnosis by history, electrocardiogram (ECG), and angiograms
Treatment:
Aimed at increasing blood flow or decreasing oxygen needs 25

26. Diseases of Arteries Coronary artery disease Treatment:
Angina treated with vasodilators
Angioplasty
Coronary artery bypass graft (CABG)
Reduction of atherosclerotic risk factors
Diet
Exercise
Smoking 26

27. CABG 27

28. Diseases of the Heart Angina pectoris Chest pain
Lack of oxygen to heart
Sign of impending myocardial infarction
Treatment:
Decrease workload of heart
Use nitroglycerin 28

29. Diseases of the Heart Myocardial infarction Heart attack
Occurs when heart does not get enough oxygen
Symptoms:
Severe chest pain with diaphoresis and nausea
Referred pain to neck, arm, and jaw with discomfort similar to bad or unrelieved indigestion 29

30. 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 30

31. Diseases of the Heart Myocardial infarction Treatment:
Oxygen and pain medication
Medications to treat arrhythmias
Clot-busting medications
Education on prevention by lifestyle changes
Smoking cessation
Diet
Exercise 31

32. 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 32

33. 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 33

34. 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 34

35. Diseases of the Heart CHF Symptoms: Neck vein distention
Edema in ankles and lower legs
Right-sided leads to congestion of liver and spleen
Left-sided leads to congestion of lungs 35

36. 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 36

37. 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 37

38. 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 38

39. Diseases of the Heart Valvular heart disease
Malfunction of heart valves
Murmurs or abnormal heart sound
Causes:
Congenital abnormalities or malformations
Rheumatic fever
Endocarditis 39

40. 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 40

41. Diseases of the Heart Arrhythmias
Divided into first-, second-, or third-degree
Premature or early contractions (PVCs) may affect atria or ventricles
Treatment:
Unnecessary if asymptomatic 41

42. Diseases of the Veins Phlebitis Inflammation of superficial veins
Symptoms:
Pain
Swelling
Red, cord-like hardening along vein toward heart 42

43. Diseases of the Veins Phlebitis Treatment: Analgesics Warm compresses
Elevation of area above heart level
Elastic stockings
Exercise 43

44. 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 44

45. Phlebitis and Thrombus45

46. Diseases of the Veins Deep vein thrombosis (DVT) Treatment:
Reduce clot
Prevent embolization
Use anticoagulants 46

47. Diseases of the Veins Varicose veins
Dilated, tortuous, and elongated veins in legs
Causes:
Prolonged sitting or standing
Pregnancy
Obesity 47

48. 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 48

49. 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 49

50. Trauma
Hemorrhage
Low-pressure vessels lead to petechiae or ecchymosis of purpura
High-pressure vessels lead to squirting of bright red blood 50

51. Trauma
Shock
Extremely low blood pressure that leads to decreased tissue perfusion
Types:
Cardiogenic
Septic
Hypovolemic
Neurogenic
Anaphylactic 51

52. Trauma Shock Symptoms: Facial pallor Cool and clammy skin Cyanosis
Tachycardia
Tachypnea
Altered mental status
Syncope
Unconsciousness
Oliguria or anuria 52

53. Trauma Shock Treatment: Rest in supine position
Move to warm, quiet environment
Elevate feet and legs above heart 53

54. Rare Diseases Malignant hypertension Cor pulmonale Raynaud’s disease
Buerger’s disease
Polyarteritis nodosa 54

55. Effects of Aging Decreased contractility of heart muscle
Decreased elasticity of vessels
Thickening of valves
Becoming sclerotic 55