Alterations of Cardiovascular Functions

Alterations of Cardiovascular Functions

1. Venous Diseases

   • Venous Thromboembolism
     • Pulmonary Embolism
     • Deep Venous Thrombosis (DVT)
       • Post- thrombotic Syndrome - ulceration and infection
   • Thrombus
     • Virchow's Triad
   • Embolism
   • Chronic Venous Insufficiency
   • Superior Vena Cava Syndrome (SVCS)

2. Diseases of the Arteries

   • Aneurysm
     • True
       • Fusiform- circumferential
       • Saccular- sac
     • False
     • Dissecting
   • Peripheral vascular diseases
     • Thromboangitis obliterans aka Buerger Disease
       • inflammation --> necrotizing
     • Raynaud Phenomenon and Disease
       • vasospasm of the hands
   • Peripheral Artery Disease (PAD)
   • Atherosclerosis
     • Pathophysiology: Inflammatory mechanisms in the setting up of dyslipidemia--> atherosclerosis 1. Endothelial injury & dysfunction; 2. Fatty Streak; 3. Fibrotic Plaque; 4. Complicated lesion/ plaque
   • Coronary Artery Disease (CAD)
     • CAN LEAD TO.....
       • Reversible myocardial ischemia
         • Stable Angina
       • Acute Coronary Syndrome (ACS)
         • Unstable Angina
         • MYOCARDIAL INFARCTION
           • STEMI
             • Thrombus lodges permanently; Infarction extends through myocardial wall; ST segment elevation; Highest risk for serious complications
           • Non- STEMI
             • Thomrbus may have broken up before significant distal necrosis occurred; subendocardial; usually ST depression and T wave inversion; recurrent thrombus formation on plaque likely to occur w/o intervention

3. Congesitve Heart Failure

   • GENERAL: Increased diastolic (filllling) pressures or inc. diastolic volume. Not enough getting out. Risk factors: CAD, HTN (high afterload, vasoconstricted)
     • Left sided heart failure
       • SYSTOLIC
         • decreased ejection fraction- (normal ejection is 50-75%) this is because there is dec. contractility - causes inc. preload and inc. afterload i- which causes dec. contractility - viscious cycle
       • DIASTOLIC
         • dec. filling of the LV - Why would this happen? Ventricle is stiff - dec. compliance, doesn't stretch well (due to HTN, remodeling, cardiomyopathy), so it doesn't fill well. leads to dec. preload. this may be OK at rest but when you exercise your heart won't be able to handle it
       • SEQUELAE _ blood backs up, causes blood to back up into the lungs - Pulmonary Edema; stasis of bllodd in left chamber because it's not pumping well; inadequate perfusion of tissues
     • Right sided heart failure
       • LEFT SIDED FAILURE
       • COR PULMOARE
       • SEQUELAE - fluid backup in the body

4. Dysrhythmias

   • ATRIAL
   • SINUS
   • VENTRICULAR
   • AV BLOCK

5. Disorders of the Heart Wall

   • Pericardum
     • Acute pericarditis
       • Idiopathic
     • Pericardial effusion
       • Accumulation of pressure in right heart
     • Constrictive pericarditis
       • TB, cancer radiation, cardiac surgery - calcification and scarring
   • Myocardium: Cardiomyopathies
     • Dilated
     • Hypertrophic
     • Restrictive
   • Endocaridum
     • Vallvular Dysfunction
       • Stenosis or Flapping in the Wind; both stenosis and regurgitation lead to inc. workload
     • Rheumatic Disease
     • Infective Endocarditis