Aisha's not feeling well

Aisha's not feeling well

1. chest pain

   • dyspnea
     • Pulmonary edema
       • Sarcoidosis
         • Pleurisy
     • Pulmonary hypertension
       • Tuberculosis
     • Cardiomyopathy
     • Heart arrhythmias
     • Heart failure
       • compensation mechanisms
         • Compensation Mechanisms
       • pathophysiology
         • intrinsic decrease in muscle contractility
           • Preload or left atrial filling pressure is increased pulmonary congestion and dyspnea.
             • Although systemic blood pressure is often reduced, there is an increase in systemic vascular resistance (afterload) reduce cardiac output
               • Heart rate is generally increased as part of a compensatory mechanism
                 • inadequate to meet the peripheral demands of the body
         • left sided leads to
           • Backward effect
             • Pulmonary congestion: Blood is not drained from the pulmonary circulation blood vessels become engorged
               • Transudate (no inflammation) accumulates in the alveolar sacs
                 • RBCs engulfed by macrophages hemosiderin-laden macrophages
               • Pulmonary Edema: Crackles
           • Forward effect
             • Reduced CO + less EF because the heart is unable to pump blood
               • Hypo-perfusion of organs occur
           • right sided leads to
             • Jugular venous distension
               • Painful hepatosplenomegaly with “nutmeg” liver
                 • Pitting edema (peripheral) due to increased hydrostatic pressure
                   • signs and symptoms
                     • Rapid or irregular heartbeat
                     • Fatigue and weakness
                     • Lack of appetite and nausea
                     • how to check for them & confirm diagnosis
                       • Investigations
                         • chest X-ray
                           • cardiothoracic ratio
                         • ECG
                         • blood tests
                           • cardiac enzymes
                             • renal function
                             • glucose concentrations
                         • catheterization
                         • echocardiography
                         • treatment
                           • non-pharmacological
                             • life-style modifications
                           • pharmacological
                             • Angiotensin-converting enzyme inhibitors (ACEIs)
                             • Angiotensin receptor blockers (ARBs)
                             • Aldosterone antagonists
                             • β-Blockers
                             • Vasodilators (long-acting nitrates and hydralazine)
                             • Diuretics
                             • Digoxin
                           • • complications
                               • Kidney damage or failure
                               • Heart valve problems
                               • Heart rhythm problems
                               • Liver damage
                             • prognosis
                               • People with heart failure may have severe symptoms, and some may require heart transplantation or support with a ventricular assist device
                               • The probability of someone with a diagnosis of heart failure dying within five years was 62% and 75% in men and 38% and 42% in women, respectively
                     • crackles on ascultation
       • causes
         • myocardial infarction
           • congenital heart disease
             • Coronary artery disease
           • arrhythmias
         • Abnormal heart valves
         • High blood pressure
     • Pericarditis
     • Anemia
       • Broken ribs
         • Myasthenia gravis
     • an intense tightening in the chest, air hunger or a feeling of suffocation
     • types
       • orthopnea
         • sensation of breathlessness in the recumbent position, relieved by sitting or standing.
       • Paroxysmal nocturnal Dyspnea
         • sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep.
   • edema
     • result of the activation of a series of humoral and neurohumoral mechanisms that promote sodium and water reabsorption by the kidneys and expansion of the extracellular fluid.

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