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Pathology of the Heart and Vessels Chosen Problems The human heart ☺efficient, durable and reliable pump ☺over 6000 liters of blood daily ☺> 40 mililion beats a year HEART DISEASE IS THE PREDOMINANT CAUSE OF DISABILITY AND DEATH IN INDUSTRIALIZED NATIONS. Cardiovascular dysfunction – principal mechanisms Failure of the pump An obstruction to flow Regurgitant flow Disorders of cardiac conduction Disruption of the continuity of the circulatory system HEART FAILURE ? Heart failure Heart failure - causes Hypertrophy Left ventricular hypertrophy is an independent risk factor for sudden death! BUT Physiologic hypertrophy (induced by regular strenuous exercise) has minimal or no deleterious effect. Left-sided and right-sided cardiac failure can occur independently. BUT Failure of one side (particulary the left side) often produces excessive strain on the other, leading to the global heart failure. Left–sided heart failure Causes: Left-sided failure – effects Heart Lungs Brain Right – sided heart failure The most common reason of right-sided failure is prolonged left-sided failure Right-sided heart failure - effects Liver Spleen Bowels Kidneys Brain Ischemic Heart Disease (IHD) The clinical manifestation of IHD: 1. 2. 3. 4. IHD in its various forms is the leading cause of death in industrialized nations. Ischemic heart disease - causes Angina pectoris Stable angina Prinzmetal angina Unstable angina Myocardial infarction („heart attack”) Risk factors Myocardial necrosis The location and size of MI depend on: Evolution of gross changes in MI Evolution of microscopic changes in MI Consequences and complications of MI Chronic ischemic heart disease Sudden cardiac death Nonatherosclerotic causes of SCD