Chapter 08 Cardiovascular

6/26/2009
Chapter 8
Cardiovascular System
Diseases and Disorders
Anatomy and Physiology Anatomy and Physiology
• Cardiovascular system - heart, arteries, • Three layers of the heart

and veins with blood – Epicardium
• Heart is the size of a man’s
man s fist – Myocardium
• Heart is four chambered and muscular – Endocardium
Copyright © 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3 Copyright © 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4
Diagnostic Tests Diagnostic Tests
• Non-invasive procedures • Cardiac Catheterization

– Auscultation – Invasive procedure to determine oxygen
– Doppler content and blood p
pressure
– Electrocardiogram • X-rays
– Echocardiography – To determine normal function of heart and
– Ultrasound arteriography vessels
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Common Diseases of the

Diagnostic Tests Cardiovascular System
• Common X-rays • Diseases of arteries
– Angiocardiography – Hypertension
– Angiography • Indicator of development
p of cerebrovascular,,
cardiovascular, and kidney disease
– Venogram
• Chronic disease
• Blood Tests • Leading cause of stroke and heart failure
• Enzymes including CPK, LDH
Common Diseases of the Common Diseases of the

Cardiovascular System Cardiovascular System
• Diseases of arteries • Diseases of arteries
– Hypertension – Hypertension
• Normal blood ppressure is 120/80 • Bottom number is diastolic blood p
pressure that
• Top number is systolic blood pressure measures pressure in artery when ventricles
measuring highest pressure in artery when relax
ventricles contract

• Diseases of arteries • Risk factors
– Hypertension – Heredity
• High
g blood ppressure is g
greater than 140/90 – Diet
• Primary Hypertension - idiopathic with gradual – Age
onset
• Primary hypertension is also called essential
– Obesity
hypertension – Smoking
– Stress and type A personality
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• Hypertension Treatment • Arteriosclerosis and atherosclerosis

– Anti-hypertensive medications – Loss of elasticity and thickening of artery
– Lifestyle changes wall
– Low salt diet – “Hardening of arteries” is a lay term
– Stress-reducing exercise – Deposits of fatty or lipid material in wall of
– Smoking cessation artery is called plaque
– Diuretics

• Arteriosclerosis and atherosclerosis • Risk factors of atherosclerosis
• Major areas affected by atherosclerosis – Non-controllable factors
– Coronary arteries • Heredityy
• Age
– Cerebral arteries
• Sex
– Aorta • Diabetes
– Peripheral arteries

• Risk factors of atherosclerosis • Diagnosis of atherosclerosis - blood

– Controllable factors pressure, arteriograms, X-rays, doppler
• Diet • Treatment administered for symptoms
• Sedentary lifestyle
• Stress
• Bypass surgery of occluded arteries and
• Cigarette smoking plaque removal
• Hypertension
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• Peripheral Vascular Disease (PVD) • Peripheral Vascular Disease (PVD)
– Caused by atherosclerotic plaque in – Treatment includes an endarterectomy
arteries supplying
pp y g blood to legs
g – If necrosis occurs, amputation or resection
– Intermittent claudication - muscle cramps may be necessary
that are relieved with rest and increase
with activity

• Aneurysm • Aneurysm
– Weakening in wall of artery creating a – Aorta is most common place
bulge
g or rupture
p – Treatment includes repairing aneurysm
– Usually asymptomatic and discovered before rupture through resection and
accidentally grafting

• Coronary Artery Disease • Coronary Artery Disease
– Narrowing of arteries that supply blood to – Progressive narrowing of vessels may lead
the myocardium
y to ischemia of the heart muscle and
– Single leading cause of death in United symptoms
States – Scar tissue replaces muscle
– Commonly due to atherosclerosis – Occlusion may progress slowly or suddenly
as result of a thrombus or embolus
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• Coronary Artery Disease • Coronary Artery Disease
– Death of heart muscle is called a – Angina is treated with vasodilators
myocardial
y infarction – Angioplasty
– Diagnosis is based on history, EKG, – Coronary artery bypass graft (CABG)
angiograms – Reduce atherosclerotic risk factors - diet,
– Treatment is aimed at increasing blood exercise, and no smoking
flow or decreasing oxygen needs
Diseases of the Heart Diseases of the Heart
• Angina Pectoris • Myocardial Infarction

– Chest pain – Heart attack
– Lack of oxygen to heart – Occurs when heart does not get enough
– Sign of impending myocardial infarction oxygen
– Treatment: decrease workload of heart and
nitroglycerin
• Myocardial Infarction • Myocardial Infarction

– Classic symptoms – Treatment
• Severe chest ppain with diaphoresis
p and nausea • Immediate attention to pprevent shock
• Referred pain to neck, arm, and jaw with • Relieve respiratory distress
discomfort similar to bad or unrelieved • Decrease workload
indigestion • If cardiac arrest, CPR must be performed
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Diseases of the Heart

Diseases of the Heart
• Myocardial Infarction • Hypertensive Heart Disease

– Treatment – Result of long-term hypertension
• Oxygen
yg and p pain medication – Causes are disease or disorder causing
• Medications to treat arrhythmias chronic elevation in blood pressure
• “Clot busting” medications – Treatment: treating cause of hypertension
• Education needed on prevention by lifestyle
changes: smoking cessation, diet, exercise
– Can only be controlled, not cured
• Rheumatic Heart Disease • Rheumatic Heart Disease

– Autoimmune disorder – Treatment: prevention and treatment of
– Caused by streptococcal throat infection streptococcal
p infections
– All layers of heart and valves can be – Rest during acute stage
affected – Valve replacement to correct deformity
• Congestive Heart Failure • Congestive Heart Failure

– Heart fails to pump adequate blood supply – Symptoms
– Develops slowly and increases the workload • Tachycardia
y
of heart • Tachypnea
– Symptoms • Neck vein distention
• Gradual increase in dyspnea
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• Congestive Heart Failure • Congestive Heart Failure

– Symptoms – Diagnosis: history and physical, chest
• Edema in ankles and lower legsg –XX-ray,
ray, EKG
• Right sided leads to congestion of liver and – Treatment
spleen
• Decrease workload
• Left sided leads to congestion of lungs
• Diuretics
• Congestive Heart Failure • Cardiomyopathy

– Treatment – Disease of heart muscle
• Salt and fluid restrictions – Characterized by dilated, enlarged, thin,
• Medications to strengthen and slow the heart flabby heart muscle
such as digitalis
– Incurable leading to congestive heart
failure, myocardial infarction and death
• Carditis • Valvular Heart Disease

– Inflammation of the heart such as – Malfunction of heart valves
pericarditis, myocarditis,
p y endocarditis – Murmurs or abnormal heart sound
– Often secondary to respiratory, urinary – Causes
tract, or skin infection • Congenital abnormalities or malformations
– Treatment: rest, antibiotics, analgesics, • Rheumatic fever
and antipyretics • Endocarditis
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• Arrhythmias • Arrhythmias
– Abnormal heart rhythm – Heart block: interruption in conduction system
– Sinus rhythm is normal heart rhythm (60 to – Divided into first-,
first , second
second-,, or third
third-degree
degree
120 beats per minute) – Premature or early contractions (PVCs) may
– Fibrillation - wild and uncoordinated affect atria or ventricals
– Flutter - unusually fast heart rate (up to 350 – Treatment: unnecessary provided person is
beats per minute) asymptomatic
Diseases of the Vein Diseases of the Vein
• Phlebitis • Phlebitis
– Inflammation of superficial veins – Treatment
– Symptoms: pain, swelling, red-cord-like
red cord like • Analgesics
g
hardening along vein from injury toward • Warm compresses
heart • Elevation of area above heart level
• Elastic stockings and exercise
Diseases of the Vein Diseases of the Vein
• Deep Vein Thrombophlebitis • Deep Vein Thrombophlebitis

– Clotting in vessels of legs, thighs, and pelvis – Treatment
– Asymptomatic until embolization occurs • Reduce clot and p
prevent embolization
– Risk factors: immobility, dehydration, – Anticoagulants
varicose veins
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Diseases of the Veins Diseases of the Veins
• Varicose Veins • Varicose Veins

– Dilated, tortuous, and elongated veins in – Symptoms: leg fatigue and cramps,
legs
g thickeningg veins, edema, and fluid
– Causes: prolonged sitting, standing, – Treatment: elevate legs, walking, and use
pregnancy, and obesity of support or elastic hose
– Vein stripping
Trauma Trauma
• Hemorrhage • Hemorrhage
– Abnormal loss of blood – Low-pressure vessels lead to petechiae or
– Acute or chronic ecchymosis
y of p
purpura
p
– Exsanguination: loss of circulating blood – High-pressure vessels leads to squirting of
– Internal bleeding can lead to anemia or bright red blood
shock due to blood loss
Trauma Trauma
• Shock • Shock
– Extremely low blood pressure that leads to – Types of shock
decreased tissue p
perfusion • Cardiogenic
g
• Septic
• Hypovolemic
• Neurogenic
• Anaphylactic
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Trauma Trauma
• Shock • Shock
– Symptoms – Symptoms
• Facial p
pallor • Altered mental status
• Cool and clammy skin • Syncope
• Cyanosis • Unconsciousness
• Tachycardia • Oliguria
• Tachypnea • Anuria
Trauma Rare Diseases
• Shock • Malignant Hypertension

– Treatment • Cor Pulmonale
• Rest in supine
p p
position
• Raynaud’s
Raynaud s Disease
• Warm and quiet
• Elevate feet and legs above heart • Buerger’s Disease
• Polyarteritis Nodosa
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Chapter 08 Cardiovascular

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6/26/2009

Anatomy and Physiology Anatomy and Physiology

• Cardiovascular system - heart, arteries, • Three layers of the heart

Diagnostic Tests Diagnostic Tests

• Non-invasive procedures • Cardiac Catheterization

Common Diseases of the

Common Diseases of the Common Diseases of the

Common Diseases of the Common Diseases of the

Common Diseases of the Common Diseases of the

• Hypertension Treatment • Arteriosclerosis and atherosclerosis

Common Diseases of the Common Diseases of the

Common Diseases of the Common Diseases of the

• Risk factors of atherosclerosis • Diagnosis of atherosclerosis - blood

Common Diseases of the Common Diseases of the

Common Diseases of the Common Diseases of the

Common Diseases of the Common Diseases of the

Common Diseases of the Common Diseases of the

Diseases of the Heart Diseases of the Heart

• Angina Pectoris • Myocardial Infarction

Diseases of the Heart Diseases of the Heart

• Myocardial Infarction • Myocardial Infarction

Diseases of the Heart

• Myocardial Infarction • Hypertensive Heart Disease

Diseases of the Heart Diseases of the Heart

• Rheumatic Heart Disease • Rheumatic Heart Disease

Diseases of the Heart Diseases of the Heart

• Congestive Heart Failure • Congestive Heart Failure

Diseases of the Heart Diseases of the Heart

• Congestive Heart Failure • Congestive Heart Failure

Diseases of the Heart Diseases of the Heart

• Congestive Heart Failure • Cardiomyopathy

Diseases of the Heart Diseases of the Heart

• Carditis • Valvular Heart Disease

Diseases of the Heart Diseases of the Heart

Diseases of the Vein Diseases of the Vein

Diseases of the Vein Diseases of the Vein

• Deep Vein Thrombophlebitis • Deep Vein Thrombophlebitis

Diseases of the Veins Diseases of the Veins

• Varicose Veins • Varicose Veins

Trauma Rare Diseases

• Shock • Malignant Hypertension

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