Pathologies 2 Flashcards
What is Raynaud’s Syndrome
intermittent ischeamia in extremeties (peripheral BVs)
Raynaud’s Syndrome most commonly affects who
women 30-40
causes/triggers Raynaud’s Syndrome
extreme temperature
emotional stimuli
signs/symptoms Raynaud’s sydrome
VASO-SPASMING causes
PAINFUL PALE COLD extremeties
Treatment Raynaud’s Syndrome
No stress exercise regularly keep warm stop smoking homeopathy herbs - ginger, gingko, capiscum
What is oedema
Excess tissue fluid build-up causing swelling
water retention
pathophysiology oedema
increased venous hydrostatic pressure
veins not building, water builds up, transfers out to surrounding tissue
triggers oedema
heart failure kidney disease external pressure on limb impaired lymphatic drainage increased small vessel permeability (leaky) pregnancy injury some medications
signs/symptoms oedema
skin discolouration hold imprint (pitting oedema) aching tender limbs stiff joints raised BP & pulse
Complementary treatment oedema
Treat cause! Exercise/lose weight raise legs, lymphatic drainage massage herbs - nettle, dandelion
What is ascites
accumulation fluid in peritoneum, abdominal cavity
causes ascites
cirrhosis heart failure constrictive pericarditis cancer tuberculosis
What is constrictive pericarditis
thickened fibrotic pericardium - restricts heart expansion
signs/symptoms ascites
may be asymptomatic
abdominal pain/bloating
shortness breath
complementary treatment ascites
CAUSE!
no alcohol/salt
diuretics herbs homeopathy
What is classed as hypertension at the Docs and what number is definitely a problem!
135/85mmHg or higher
over 200 defo problem!
2 types hypertension
primary - over 90%
secondary - result kidney damage/hormone problems (adrenal, thyroid)
why would damaged kidneys lead to hypertension
damaged kidneys release vasoconstrictors
causes hypertension
inherited
obesity/lack exercise
alcohol/smoking
signs/symptoms hypertension
none - silent killer
complementary treatment hypertension
diet, ex, lifestyle, lose wight avoid salt*, caffeine, stress magnesium, vit C, B6,9 & 12 massage, acupuncture herbs - hawthorn, dandelion
complications hypertension
cardiovascular events chronic kidney disease (CKD) cognitive decline premature death retinal bleeding cerebral oedema renal disease aneurysm heart failure stroke
two types heart failure blood pooling
left ventricle failure - blood pools in lungs as nowhere to go back to
right ventricle failure - blood pools in tissues/body as nowhere to go back to
(acute/chronic)
hypotension is what
low BP - under 90/60mmHg
leads to inadequate blood supply to the brain
what is postural hypotension syncope
fainting after standing too quickly
due to delayed response of the baroreceptors to the change in BP on standing
causes hypotension
shock
adrenal fatigue
genetics
signs/symptoms
unsteadiness/dizziness
light-headedness/fainting
complementary treatment hypotension
if required - hydration, salt
smaller meals more often, dry skin brushing
treat adrenal fatigue
why take (good) salts for hypotension
to increase blood volume,
ensures water stays in, not weed out
what is heart failure
heart fails to pump sufficient blood around body at the right pressure - fails to circulate sufficient blood to meet the needs of the body.
two types heart failure
acute - SUDDEN decrease in output of blood from heart
chronic - GRADUAL- heart muscle becomes to weak/stiff to work properly (common in old age)
L or R
general causes acute heart failure
MI life threatening cardiac arrhythmia ischaemic damage from atheroma/thrombosis/pulmonary embolism rupture heart chamber or valve acute myocarditis
what is myocarditis
acute inflammation response in heart muscle
general causes chronic heart failure
degenerative changes with advancing age chronic hypertension, valve disease lung disease smoking obesity anaemia
general signs/symptoms acute heart failure
chest pain radiating to jaw/neck/arms/back shortness of breath weakness lightheaded feeling impending doom MEDICAL EMERGENCY
general signs symptoms chronic heart failure
may be asymptomatic enlarged cardiac muscle water & salt retention* vasoconstriction* * to increase blood volume
cause RIGHT sided heart failure
L heart failure increased vascular resistance back pressure from L side (valve probe) previous heart attack cannot push blood through lungs
symptoms RIGHT sided heart failure
cannot push blood through lungs - affects liver, spleen, kidneys, systemic oedema ascites portal hypertension oesophageal varices
cause left sided heart failure
hypertension
myocardial weakness
valve problems
symptoms left sided heart failure
pulmonary oedema
congestion bronchitis
cardiac asthma - coughing
often most severe at night
allopathic treatment acute heart failure
EMERGENCY no drinking ]sit nitro-glycerine sub-lingually CPR 100mg aspirin periodic forceful coughs by patient
what does CPR stand for
caedio pulmonary resuscitation
allopathic treatment chronic heart failure
depends on cause lifestyle changes drugs devices surgery
alternative support chronic heart failure
diet, ex, lifestyle, lose weight
reduce salt*
hydrate
EFAs, vit E, C, turmeric, gingko, garlic
What is STENOSIS
narrowing of heart valve opening - usually mitral
causes HEART MURMUR
causes REGURGITATION into previous chamber
causes stenosis
hereditary
infection causing endocartitis/scarring of valve (rheumatic fever/diptheria)
all treatment stenosis
TREAT CAUSE
valve repair
treat infection
heart attack also known as
MYOCARDIAL INFARCTION (MI)
pathophysiology MI
occlusion/blockage blood supply to heart
results in HYPOXIA then NECROSIS
Hypoxia definition
oxygen deficiency
causes Myocardial infarction
Atherosclerosis/embolism or both
signs/symptoms myocardial infarction
severe chest pain longer than 20 mins des not improve on rest dyspnoea syncope fatigue pale clammy skin
What else could a Myocardial Infarction be
Andina Pectoris
What is term for any disorder of heart rate/rhythm
arrhythmias
5 types arrhythmia
bradycardia - rate below 60 tachycardia - rate over 100 fibrillation - irregular rhythm/force short blood supply heart block cardiac arrest
2 reasons for bradycardia
physiological - atheletes
pathological - after infarction (myocardial or cerebral) or with intracranial pressure
infarction definition
obstruction of blood supply to tissue or organ, typically from embolus/thrombus causing localised death of tissue
what happens in a heart block
electrical impulses to heart disrupted - beats slower
SAN gets diseased/damaged AVN takes over
in relation to a heart block, what is the stroke rate of the AVN
40-60 per minute
below 35-40bpm = deprives blood flow to organs
Can the AVN increase the heart rate in response to exercise, drugs, fever?
Not v well
What is the most common cardiac arrhythmia
atrial fibrillation
what is atrial fibrillation
quivering/uncoordinated, rapid, small
local ATRIAL contractions
complications with atrial fibrillation
palitations/fainting/chest pain
may lead to congestive heart failure
why does atrial fibrillation significantly increase the risk of stroke
because blood may pool & form clots in poorly contracting atria
what is a cardiac arrest
conduction arrest
occurs when heart develops an arrhythmia causing it to stop
is cardiac arrest a heart attack
no but may cause one
Treatment Cardiac arrest
CPR for circulatory support until defibrillation
what is defibrillation
application of electrical current to reset electrical impulses running through auto-rythmic cells
What is endocarditis
inflammation of inner layer of heart & valves
when does endocarditis mostly occur
in those with heart defects
causes endocarditis
infection
signs/symptoms endocartidis
fever/chills paleness heart murmur fatigue aching muscles/joints night sweats dyspnoea persistent cough swelling in feet/legs/abdomen wight loss blood in urine tenderness in spleen microbes in blood stream oslers nodes petechiae
what are osler’s nodes
red tender spots under skin on finhers
what are petechiae
tiny purple/red spots on skin/in mouth/whites of eyes
treatment endocarditis
intravenous antibiotics
alternaive support endocartitis
herbs & nutrition
antimicrobials, immune support
complications endocarditis
septic embolus causing stroke/damage to other organs
fatal if untreated
damage to heart valves/lining could lead to heart failure
what is pericarditis
inflammation of pericardium
when does pericarditis mostly occur
in those with heart defects
causes pericarditis
secondary to - infection tuberculosis cancer heart attack lupus, R arthritis trauma
signs/symptoms pericarditis
chest pain - better sitting up, worse lying down/breathing deeply dyspnoea when reclining fever weakness fatigue nausea dry cough oedema
allopathic treatment pericarditis
rest
NSAIDs
antibiotics if infection
surgical draining if nec
complementary support pericarditis
cause herbs/nutrition antimicrobials immune anti-inflammatory acupuncture
complications pericarditis
constrictive pericarditis - permanent thickening/scarring
cardiac tamponade/pericardial effusion - fluid collects in pericardium, puts pressure on heart, stops from properly filling
what is shock
reduction in circulating blood volume, BP/cardiac output = hypoxia of tissues
5 types of shock
hypovolaemic cardiogenic septic neurogenic anaphylactic shock
what is hypovolaemic shock
blood volume reduced by 15-25% blood/liquid loss from haemorrhage severe burn vomiting diarrhoea organ perforation (bleeding into cavity)
what is cardiogenic shock
heart muscle can’t maintain cardiac output - acute heart disease (MI)
what is septic shock
infection = immune/inflammatory response + vasodilation/pooling of blood
what is neurogenic shock
loss of sympathetic control on BVs & increased parasympathetic stimulation of the heart
= dilation of BVs/brachycardia
= reduced cardiac output, blood pooling, faiting
what is anaphylactic shock
severe allergic response = vasodilation bronchorestriction reduced venous return reduced cardiac output tissue hypoxia
signs/symptoms shock
hypoxia - cold, clammy, sweating, cyanosis
faint, weak, drowsy, confusion, anxiety
tachycardia, weak pulse, shallow breathing
hypotension
physiological changes shock
body attempts to counteract by - vasoconstriction increased heart rate water retention if inefficient = anaerobic respiration lactic acid build up acidosis cellular damage/death
Treatment shock
Medical emergency lay flat, raise legs, helps restore BP stop bleeding - pressure on wound/tourniquet anaphylaxis treatment if nec no food/drink keep warm with blankets losen tight clothing
what is cyanosis
pale, blue skin & lips
7 differential diagnoses chest pain
heart disease (angina MI) pericarditis pulmonary embolism oesophageal disease pneumonia pneumothorax pleurisy
clinical examination for chest pain
vital signs temperature pulse BP respiratory rate cyanosis clubbing of nails heart rhythm
3 cardiac output-related causes of hypertension
Hypervolemia
Stress (sympathetic activation)
pheochromocytoma - rare adrenal gland tumour increases BP
what is hypervolemia
too much fluid in blood
renal disease
pregnancy preeclampsia
etc
7 systemic vascular-resistance - related causes of hypertension
stress atherosclerosis renal artery disease pheochromocytoma thyroid disfunction diabetes cerebral ischeamia
narrowing of valve opening known as -
stenosis
