Heart disorders Flashcards
Risk factors
High blood cholesterol level high blood pressure cigarette smoking obesity diabetes mellitus genetic predisposition gendder
Hearth falilure
disorder of coronary arteries high blood pressure cardiomyopathy abnormal heart rhythm heart valve disorder
Hypertension
systolic BP > 140 mmHg
diastolic BP > 90 mmHg
90-95% no identifiable cause
can lead to heart failure, kidney disease, CVA
severe damage occurs to heart, brain & kidneys before noticeable symptoms occur
Treatment
lifestyle modification
wieghtloss reduce alcohol intake exercise low salt diet stress management smoking cessation `
treatment drug therapy
diuretics
beta blockers
calcium channel blockers
ACE inhibitors
left ventricular failure
hypertension leads to LV pressure overload
aortic valve stenosis causes pressure overload
mitral valve disease leads to L atrial failure
Muscles in left ventricle have to work harder to exceed blood pressure of aorta and then muscle hypertrophy occurs less volume and damage to aortic valve resulting in a volume overload as blood return to atrium from ventricle to aortic valve
Acute heart failure
Cardiac output fails as ther eis lesscontractile mass to eject blood from the left ventricle
the sympathetic nervous system is activated increasing HR and inducing vasoconstriction in attempt to maintain normal blood pressure and perfusion of vital organs
pressure in the left ventricle increases as it is unable to empty efficiently
this pressure is conducted back to the lungs where it pushesflu idinto the alveoli causing acute SOB and pulmonary odema coughing up sputum
Atherosclerosis
Most common vascular disease Underlying disease process in most CAD causing MI Larger arteries are affected -Abdominal aorta -Common iliacs -Coronary arteries
Coronary artery disease
narrowed arteries with reduced blood flow to myocardium
Leads to damage of myocardium CHD / IHD
Symptoms range from angina pectoris to major myocardial infarction
The symptoms appear when a coronary arteryu is 70 - 75% occluded
CAD
Myocardial ischaemia Imbalance between supply and demand of blood to myocardium Angina MI Arrhythmias
Coronary arteries consequences
left ventricles has highest demand and is most common site of ischaemia
50-70%
Angina
Result of transient ischaemia Pain experienced on exertion or stress causing increased HR / BP Emotion cold large meal Lasts minutes relieved by rest or nitroglycerine (GTN)
Acute Myocardial Infarction
arterial obstruction Death of tissue distal to obstruction acute myocardial ischaemia and death of cardiac muscle muscle is replaced by scar tissue doesn’t regenerate less muscle therefore~weaker pump effects depend on site of infarction Conduction may be disrupted Arrythmias Sudden death
Clinical presentation
sweating SOB nausea chest pain upper abdomen, back neck, jaw and left shoulder pain
Diagnosis
cardiac enzymes
ECG
acute MI consequences
Arrythmias -Ventricular Fibriliation -Cardiogenic shock -low CO -Inadequate perfusion Thrombus formation -Risk of emboli Rupture Healing -fibrosus scar tissur loss of contractility -bulge on ventricular contraction permanent pump reduction LVF
Treatment of CAD
Depends on severity of symptoms drugs: beta-blockers and vasodilators Cardiac Catheterisation/angiography PTCA, Stenting, laser, drilling Conaary artery bypass graft- Physiotherapy involvement in cardiac rehabilitation and peri-operative care
Physiotherapy
MI Cardiac rehabilitation
outpatient/ in patient
CABG
itu-discharge
post discharge rehabilitation
biomedical approach
psycho social base
Left vntricule pulmonary odema
muscle hypertrophy occurs resulting in smaller capacity volume of blood in the ventricle and the left ventricle fails unable to pump all the blood from the left atrium causing a back pressure in pulmonary veins. When Pulmonary BP exceeds osmotic (oncotic) pressure of blood fluid moves from capillaries into alveoli = pulmonary oedema.
LVF causes
- disorder of coronary arteries
- high blood pressure
- cardiomyopathy
- abnormal heart rhythm
- heart valve disorder
- fluifdoverload
- myocardial infraction
- subsequent to right heart failure
effects of MI to heart
- acute myocardial ischaemia and death of cardiac muscle
- muscle is replaced by scar tissue ~weaker pump
- effects depend on site of infarction
- Conduction may be disrupted
- Arrythmias
- Pulmonary odema
Pulmonary oedma symptoms
Frothy Sputum production, tinged with blood (write or pink) due to failure of left ventricle
Increased WOB due to flow restriction
Decreased exercise capacity due to less efficient gaseous exchange as increase diffusion distance and decrease surface area.
Sob, fluid reduces oxygen airflow through the lungs
Wheezing due to the narrowing of airways
