Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Chapter 8 Cardiovascular System Diseases and Disorders Copyright Copyright © 2010 © 2010 Delmar, Delmar, Cengage Cengage Learning. Learning. ALLALL RIGHTS RIGHTS RESERVED. RESERVED. Anatomy and Physiology • Cardiovascular system – Heart, arteries, and veins with blood • Heart – Size of man’s fist – Four-chambered – Muscular Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Heart Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology • Heart: – Three layers • Epicardium • Myocardium • Endocardium Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play the Heart Animation Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests • Non-invasive procedures: – – – – – Auscultation Doppler Electrocardiogram Echocardiography Ultrasound arteriography Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests • Cardiac catheterization – Invasive procedure to determine oxygen content and blood pressure • X-rays – To determine normal function of heart and vessels Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests • Common x-rays: – Angiocardiography – Angiography – Venogram • Blood tests – Enzymes • Creatine phosphokinase (CPK) • Lactate dehydrogenase (LDH) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Hypertension – Indicator of development of cerebrovascular, cardiovascular, and kidney disease – Chronic disease – Leading cause of stroke and heart failure Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Hypertension – Normal blood pressure • 120/80 – High blood pressure • Greater than 140/90 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Hypertension – Top number • Systolic • Measures highest pressure in artery when ventricles contract – Bottom number • Diastolic • Measures pressure in artery when ventricles relax Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Hypertension – Primary • Idiopathic with gradual onset • Also known as essential hypertension Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Hypertension – Risk factors: • • • • • • Heredity Diet Age Obesity Smoking Stress and type A personality Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Hypertension – Treatment: • • • • • • Anti-hypertensive medications Lifestyle changes Low-salt diet Stress-reducing exercise Smoking cessation Diuretics Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Atherosclerosis – Major areas affected: • • • • Coronary arteries Cerebral arteries Aorta Peripheral arteries Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Atherosclerosis – Risk factors: • Non-controllable factors – – – – Heredity Age Sex Diabetes Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Atherosclerosis – Risk factors: • Controllable factors – – – – – Diet Sedentary lifestyle Stress Cigarette smoking Hypertension Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Atherosclerosis – Diagnosis by blood pressure, arteriograms, x-rays, and doppler – Symptomatic treatment: • Bypass surgery of occluded arteries and plaque removal Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Peripheral vascular disease (PVD) – Treatment: • Endarterectomy – If necrosis occurs, amputation or resection may be necessary Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Types of Aneurysms Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of Arteries • Coronary artery disease – Myocardial infarction • Death of heart muscle – Diagnosis by history, electrocardiogram (EKG), and angiograms – Treatment: • Aimed at increasing blood flow or decreasing oxygen needs Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. CABG Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Rheumatic heart disease – Autoimmune disorder caused by streptococcal throat infection – All layers of heart and valves can be affected Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Rheumatic heart disease – Treatment: • Prevention/treatment of streptococcal infections • Rest during acute stage • Valve replacement to correct deformity Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • CHF – Diagnosis by history and physical, chest x-ray, and EKG – Treatment: • • • • Decrease workload Diuretics Salt and fluid restrictions Medications to strengthen and slow heart – E.g., digitalis Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Congestive Heart Failure Animation Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Carditis – Inflammation of heart • E.g., pericarditis, myocarditis, endocarditis – Often secondary to respiratory, urinary tract, or skin infection Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Carditis – Treatment: • • • • Rest Antibiotics Analgesics Antipyretics Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Valvular heart disease – Malfunction of heart valves – Murmurs or abnormal heart sound – Causes: • Congenital abnormalities or malformations • Rheumatic fever • Endocarditis Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Arrhythmias – Abnormal heart rhythm – Sinus rhythm is normal heart rhythm • 60 to 120 beats per minute – Fibrillation • Wild and uncoordinated Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Heart • Arrhythmias – Flutter • Unusually fast heart rate – Up to 350 beats per minute – Heart block • Interruption in conduction system Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Phlebitis – Inflammation of superficial veins – Symptoms: • Pain • Swelling • Red, cord-like hardening along vein toward heart Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Phlebitis – Treatment: • • • • • Analgesics Warm compresses Elevation of area above heart level Elastic stockings Exercise Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Thrombophlebitis – Clotting in vessels of legs, thighs, and pelvis – Asymptomatic until embolization occurs – Risk factors: • Immobility • Dehydration • Varicose veins Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Phlebitis and Thrombus Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Deep vein thrombophlebitis (DVT) – Treatment: • Reduce clot • Prevent embolization • Use anticoagulants Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Varicose veins – Dilated, tortuous, and elongated veins in legs – Causes: • Prolonged sitting or standing • Pregnancy • Obesity Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Varicose veins – Symptoms: • • • • Leg fatigue and cramps Thickening veins Edema Fluid Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Veins • Varicose veins – Treatment: • • • • Elevate legs Walk Use support or elastic hose Strip vein Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Hemorrhage – Low-pressure vessels lead to petechiae or ecchymosis of purpura – High-pressure vessels lead to squirting of bright red blood Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Shock – Extremely low blood pressure that leads to decreased tissue perfusion Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Shock – Types: • • • • • Cardiogenic Septic Hypovolemic Neurogenic Anaphylactic Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Shock – Symptoms: • • • • • Facial pallor Cool and clammy skin Cyanosis Tachycardia Tachypnea Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Shock – Symptoms: • • • • • Altered mental status Syncope Unconsciousness Oliguria Anuria Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Shock – Treatment: • Rest in supine position • Move to warm, quiet environment • Elevate feet and legs above heart Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rare Diseases • • • • • Malignant hypertension Cor pulmonale Raynaud’s disease Buerger’s disease Polyarteritis nodosa Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Effects of Aging • Decreased contractility of heart muscle • Decreased elasticity of vessels • Thickening of valves – Becoming sclerotic Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Ventricular Fibrillation Animation Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.