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Pathophysiology Flashcards

1
Q

What is pneumonia?

A

An inflammatory condition of the lung leading to abnormal alveolar filling with consolidation & exudation

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2
Q

Who does pneumonia affect?

A

Affects youngest and oldest most

Single largest infectious cause for death in children

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3
Q

What is the pathology of pneumonia?

A

An infection, chemical or aspiration irritant
During pulmonary infection, acute inflammation results in the migration of neutrophils out of capillaries into airspaces (alveoli), these cells phagocytose & release antimicrobial enzymes & inhibitors -> more inflammation and oedema

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4
Q

What are the 4 stages of pneumonia?

A

Congestion
Red hepatisation
Grey hepatisation
Resolution

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5
Q

What is the congestion stage of pneumonia?

A

The first 24 hours
Characterised by vascular engorgement, intra-alveolar fluid & numerous bacteria
The lung is heavy, boggy and red

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6
Q

What is the red hepatisation stage of pneumonia?

A

2-3 days
Massive exudation develops, with red blood cells, leukocytes & fibrin filling the alveolar spaces
The affected area appears red, firm & airless, with a liver like consistency

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7
Q

What is the grey hepatisation stage of pneumonia?

A

4-6 days

Progressive disintegration of red blood cells and the persistence of a fibrin exudate

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8
Q

What is the resolution stage of pneumonia?

A

> 6 days
The consolidated exudate within the alveolar spaces undergoes progressive digestion to produce debris that is later reabsorbed, ingested by macrophages or coughed up

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9
Q

What are the causes of pneumonia?

A 
Bacteria 
Fungi 
Virus 
Parasites 
Chemical 
Aspiration 
Inhalation
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10
Q

What are the classifications of pneumonia?

A

Community Acquired Pneumonia (CAP)
Health Care Associated Pneumonia (HCAP)
Hospital Acquired Pneumonia (HAP)
Ventilator Associated Pneumonia (VAP)

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11
Q

What are the causes of CAP?

A 
Strep pneumonia/staphylococcus aureus 25% 
Virus 10%
Mycoplasma 6%
H influenza 5%
Legionella 3%
Unknown cause 37%
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12
Q

What are the causes of HAP

A 
MRSA 15%
Pseudomonas Aeruginosa 14%
MSSA 9%
Kiebsiella pneumonia 3%
Other gram negative rods 9%
Unknown cause 37%
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13
Q

Common symptoms of pneumonia

A 
Fever 
Malaise 
Muscle ache/fatigue 
Coughing (productive & non-productive)
Tactile fremitus on palpation 
Dyspnoea 
Pleuritic or chest pain 
Loss of appetite 
Rapid heartbeat
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14
Q

Less common symptoms of pneumonia

A 
Coughing up blood 
Fatigue 
Nausea/vomiting 
Diarrhoea 
Wheezing 
Confusion
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15
Q

What are the complications of pneumonia?

A

Lung abscess
Pleural effusions
Empyema (infection/puss inbetween pleural cavity)
Septic shock

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16
Q

What is the medical diagnosis for pneumonia?

A 
Temperature> 37.8 degrees 
HR > 100bpm
Crackles 
Decreased breath sounds or bronchial breath sounds 
Absence of asthma
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17
Q

What is the clinical prediction rate of pneumonia?

A 
5 findings = 84-91%
4 findings = 58-85%
3 findings = 35-51%
2 findings = 14-24%
1 finding = 5-9%
0 findings = 2-3%
With a chest x ray
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18
Q

What are the other diagnostic tests for pneumonia?

A 
CXR
CT scan 
Blood test 
Sputum culture 
Pleural fluid culture 
Bronchoscopy
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19
Q

What is the general management for pneumonia?

A 
Antibiotics/Anti-fungal medication 
Oxygen support 
Hydration - IV fluids 
Rest 
Analgesics 
Cough-suppressant medication 
Fever-reducing medication 
Prevention through vaccination programmes
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20
Q

What is the physiotherapist treatment for pneumonia?

A

Care needed as may increase oxygen consumption and demand or cause a bronchospasm
Treat the clinical signs and symptoms
Non-productive - positioning V/Q, mobilising or no intervention
Productive - sputum clearance techniques including positioning, breathing exercises, adjuncts etc

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21
Q

What is bronchiectasis?

A

Permanent abnormal dilation in one or more of the lungs Bronchi
Extra mucus is secreted and pools in the areas of the airways that are dilated making the person more prone to infection
It has similar symptoms to COPD but doesn’t always show as airflow obstruction

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22
Q

What is the epidemiology of bronchiectasis?

A

Precise incidence is uncertain
Female > male
Average age of 66

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23
Q

What is the pathology of bronchiectasis?

A

Impaired mucociliary clearance leads to accumulation of secretions
Accumulation of secretions leads to infection by bacteria
Infection by bacteria leads to increased mucus production, increased impaired ciliary performance, increased inflammatory response
Excessive inflammatory response causes tissue damage
Tissue damage eventually produces dilated bronchi including loss of cilliated epithelium and impaired mucocillary clearance
VISCOUS CYCLE

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24
Q

What are the causes of bronchiectasis?

A 
Idiopathic 
Infection (usually in childhood) 
Cystic fibrosis 
Immunodeficiency 
Cillary dysfunction 
Allergic brochopulmonary aspergillosis (ABPA)
Inflammatory conditions 
Aspiration/obstruction
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25
Q

What are the clinical features of bronchiectasis?

A

Virtually all patients have cough & sputum production
75% dyspnoea & wheeze
50% chest pain
1/3 have signs of chronic sinusitis & nasal polyps
Recurrent exacerbations are common
Approx. 50% patients experience experience haemoptysis (very rarely life threatening)

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26
Q

What is the diagnosis of bronchiectasis?

A

Chest X-ray
High resolution computed tomography (HRCT)
Bloods & sputum microbiology
Pulmonary function tests

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27
Q

What are the types of bronchiectasis?

A

Saccular - occurs in large bronchi that become large and balloon like
Cylindrical - involves medium sized bronchi which usually are symmetrically dilated
Varicose - constrictions and dilations deform the bronchi
They can be localised or widespread

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28
Q

What are the symptoms of acute exacerbation?

A 
Change in sputum production 
Increased dyspnoea 
Increased cough 
Temperature > 38 degrees 
Increased wheezing 
Malaise, fatigue, lethargy or decreased exercise tolerance 
Reduced pulmonary function 
X-ray changes consistent with a new pulmonary process 
Changes in chest sounds
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29
Q

What is the treatment and management for bronchiectasis?

A 
Physiotherapy 
IV/oral/rebulised antibiotics 
Bronchodilators 
Steroids 
Nasal sprays 
All & pneumococcal vaccinations 
Surgery
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30
Q

What is the prognosis of bronchiectasis?

A

Prognosis for hospital treated patients is better than COPD but poorer than asthma
Associated disease has an effect on prognosis

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31
Q

What is COPD?

A

Characterised by airflow obstruction

  • progressive in severity
  • not fully reversible
  • doesn’t change markedly over several months
  • umbrella term for chronic bronchitis, emphysema and chronic asthma
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32
Q

What are the three diseases under COPD?

A

Emphysema
Chronic bronchitis
Asthma

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33
Q

What is normal airway clearance?

A

Airways are lined with cells which produce mucus and tiny hairs (cilia) which continually beat
Mucus traps dust particles and bacteria
The cilia move the mucus along until it reaches the throat and we swallow it or cough
Defence mechanism

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34
Q

What can go wrong in airway clearance in COPD?

A 
Excess mucus is produced 
Mucus is thicker and stickier 
The cilia are unable to beat 
Smoking paralyses the cilia 
This means:
- dust and bacteria stay trapped in the airways 
- mucus build up & provides warm, moist environment for bacteria to grow 
- infections can develop
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35
Q

What is bronchitis?

A

Chronic disease of the lungs where bronchi become inflamed

The inflammation causes more mucus to be produced which narrows the airways & makes breathing more difficult

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36
Q

What does bronchitis cause?

A

Increased sputum production - over production of mucus in airways which becomes difficult to clear
Wheezing is very common (especially after coughing) due to inflamed airways narrowing for short periods of time which reduces the amount of air entering the lungs
Inflamed airways
Airways narrower with less space for sputum to get through
May feel tired, unwell and unable to cough

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37
Q

What’s emphysema?

A

A condition where the alveoli of the lungs become inflamed and lose their natural elasticity
The alveoli over expand and lose their ability to fill up and contract properly
As air fills up in these sacs some rupture and become one sac reducing surface area for gas exchange
When breathe out the trapped air cannot be released and breathing becomes more and more difficult

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38
Q

What’s asthma?

A

An episodic increase in airway obstruction caused by various stimuli resulting in increased airway resisted
Common disease in UK - approx 5 million people suffer with it
Often reversible airway disease but it can become chronic with some fixed airway damage and therefore comes under COPD umbrella
Inflammation & Bronchoconstriction

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39
Q

What are the symptoms of asthma?

A

Breathlessness
Wheeze
Tightness in chest

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40
Q

Why are the airways sensitive in asthma?

A

Become irritated, inflamed and narrow

Reduced airflow through the airways

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41
Q

What are the causes of COPD?

A

Cigarette smoking (90%) significant smoking history - 20 pack years or more
Occupational exposure - coal miners
Alpha-1 Antitrypsin deficiency
Social deprivation

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42
Q

What the diagnosis for COPD?

A 
Detailed patient history 
Clinical signs 
- breathlessness on exertion 
- cough 
- increased sputum 
- risk factors 
- rule our other causes 
Spirometry 
- diagnosis 
- categorise severity 
- monitor progression 
Chest x-ray
43
Q

What’s the classification for COPD?

A

Early disease
Moderate disease
Severe disease

44
Q

What is the early disease classification for COPD?

A

Often few symptoms
- morning cough (smokers cough)
- chest infections in winter
- breathlessness when exercising vigorously
Clinical examination may be normal although spirometry may be reduced

45
Q

What is the moderate disease classification of COPD?

A 
Range of respiratory symptoms
- cough 
- wheeze 
- SOB with moderate exertion 
Clinical examination may reveal wheeze, barrel chest, flattened diaphragm on CXR
46
Q

What is the severe disease classification of COPD?

A

Severe symptoms

  • cyanosis
  • weight loss
  • raised JVP (jugular venous pressure)
  • peripheral oedema
47
Q

What is the treatment for COPD?

A

Smoking cessation

  • 4x more likely to quit with help, advice & nicotine replacement
  • stop smoking services are widely available in the community
  • stopping smoking will help to slow the progression of the disease
  • we can refer as physios any time
48
Q

What’s the medication for COPD?

A

Inhalers
Steroids & antibiotics
Mucolytics
Flu & pneumonia vaccines

49
Q

Pulmonary rehabilitation for COPD ?

A 
Exercise 
Education 
Self management 
Diet 
Lifestyle modification
Will help reduce admissions & aid recovery time post exacerbation
50
Q

What is pulmonary fibrosis?

A

Restrictive disease caused by inflammation and scarring of the lungs
Progressive condition where the scarring and inflammation build up (build up called fibrosis)
Can be known as ctyptogenic fibrosing alveolitis or usual interstitial pneumonia
Results in reduced gas exchange

51
Q

What are the causes of pulmonary fibrosis?

A

Men, older people more likely
Causes unknown (idiopathic)
?smoking
?occupational exposure - dust from wood, metal, textile or stone
?infection & some viruses such as herpes & Hep C
Some link to people with GORD (gastro-oesophageal reflux disease) which causes heart burn
In a few cases can be a genetic link

52
Q

What are the symptoms of pulmonary fibrosis?

A

Main symptom - breathlessness, severe in most
In some symptoms gradually worsen and in others progress quickly
No cure - almost 1/2 don’t live for more than 3 years after diagnosis
Constant cough
Feeling tired all the time
Clubbing of fingers and toes
It’s not infectious

53
Q

What’s the diagnosis of pulmonary fibrosis?

A 
Detailed patient history 
Clinical signs 
- breathlessness at rest & exertion 
- persistent cough 
- clubbing 
Spirometry 
Bronchoscopy - look at lung tissue 
Chest x-ray - followed by a CT
54
Q

What’s the treatment for pulmonary fibrosis?

A

Not generally treated with inhalers
Oxygen therapy
Pulmonary rehab to manage breathlessness, maintain & improve exercise tolerance
Medications such as sedatives & morphine for help with breathlessness
Treatment for heartburn & blocked nose that may be making the symptoms worse
Lung transplant - very rare

55
Q

What are the medications for pulmonary fibrosis?

A

Pirfenidone (Esbriet)
- mild to moderate IPF
- capsule that is thought to slow down the inflammation and build up of scar
Nintedanib
- originally used in lung cancer patients
- reduces the rate at which the lungs become scarred & helps reduce ‘flare ups’

56
Q

What is the pulmonary rehab for pulmonary fibrosis?

A 
Exercise 
Education 
Self management 
Diet 
Lifestyle modifications 
Help with management of breathlessness & exercise tolerance
57
Q

How can pulmonary fibrosis patients help themselves?

A

Stop smoking
Have early flu jab
Have pneumococcal vaccination
Avoid people with chest infections and colds
Stay as fit and active as you can
Eat a healthy balanced diet
Get in touch with the British lung foundation for further support and guidance

58
Q

What is cystic fibrosis?

A

An inherited autosomal recessive disease that’s the result of a gene mutation (single gene defect on chromosome 7)
Chromosome 7 is responsible for encoding the cystic fibrosis membrane conductance regulator - a transmembrane protein involved in ion transport called the CF Transmembrane Regulating (CTFR) protein
This defect leads to a compromise in ion transport - it impairs transport of chloride ions and also affects levels of sodium and water in the cell
It affects several organs causing ducts to become obstructed with mucus -> inflammation & replacement of damaged cells with connective tissue (scarring)

59
Q

What does the CFTR protein do?

A

It’s a channel protein that controls the flow of water & chloride ions between membranes
When the structure is changed the passage of molecules & ions is blocked
The most common pathology of CF
There are over 1500 mutations of the CTFR gene that produce different variations of the CTFR protein

60
Q

What does a defect in the CFTR result in?

A

Respiratory disease - abnormally conc. fluid in lungs leads to viscous secretions in airways, mucus isn’t cleared predisposing pts to infection
High sodium sweat - chloride ions not absorbed prevents sodium absorption
Pancreatic insufficiency - abnormal ion transport leads to dehydration of pancreatic secretions - leads to stagnation in pancreatic duct
Biliary disease - reduced water mvt in lumen, concentrated bile damages wall
Infertility - males due to absence of vas deferens prevents transport of sperm
Cirrhosis of liver - abnormality in ion transport
Gastrointestinal disease - intraluminal water deficiency problem w bowel mvt

61
Q

What is the diagnosis for CF?

A

Genetic testing - simple mouthwash or blood test
Heal prick test
Sweat test - collecting small amount of sweat from arm or leg

62
Q

What are the symptoms of CF at birth?

A

Roughly 10% babies born with a serious bowel obstruction (meconium ileus) - thick black substance that is normally passed out within a day or 2
In babies with CF it’s too thick to be passed through so causes a blockage in the bowels and surgery is normally needed to clear
Some babies will show signs of jaundice which are yellowing of the skin, eyes & mucus membrane

63
Q

What are common symptoms of CF in the lungs?

A 
Persistent cough 
Coughing fits 
Inflammation in the lungs - wheezing, SOB, difficulties breathing 
Recurring chest & lung infections 
Cross infection
Impaired diaphragm from enlarged liver
64
Q

What are the common symptoms of CF in the digestive system?

A

Large, smelly stools

Malnutrition, poor weight gain, stunted growth

65
Q

What are other symptoms of CF?

A

Diabetes
Sinusitis
Nasal polyps (fleshy swellings that grow from the lining of nose or sinuses)
Arthritis
Osteoporosis
Infertility
Liver failure (tiny bile ducts get blocked by mucus)
Urinalysis incontinence
Delayed puberty
Msk system
- inspiratory muscle atrophy
- weakness/atrophy in anti-gravity muscles such as gastrocnemius
- kyphosis of the spine resulting in neck & back pain

66
Q

What treatments are there for CF?

A 
Medication 
Physiotherapy 
Dietary advice 
Education 
Exercise 
Lung transplant psychological support
67
Q

What medications are there for CF?

A 
Bronchodilators 
Hypertonic saline nebs
Antibiotics 
Mucolytic (DNAse)
Steroids
Routine vaccinations 
Digestive enzymes (creon)
68
Q

What physiotherapy is used for CF?

A 
Postural drainage?
Percussion, vibs/shakes
Active cycle of breathing technique 
Autogenic drainage 
Adjuncts 
Mobilisation/exercise 
Suction (ITU)
69
Q

What’s the prognosis of CF?

A

No cure or prevention
Currently about 1/2 of people with CF will live past the age of 40 (some to 47)
Lung complications are normally the cause of death in CF patients
Specific quality of life depends of specific protein mutation (1500 types) and environmental & developmental factors

70
Q

What is cardiovascular disease?

A

General term for conditions affecting the heart and blood vessels
It is also associated with damage to the arteries of the brain, kidneys and eyes

71
Q

What are the types of CVD?

A

Coronary heart disease (CHD)
Cerebral vascular accidents (CVA)& Transient ischaemic attacks (TIA)
Peripheral vascular disease (PVD)
Aortic disease

72
Q

What is coronary heart disease?

A

Sometimes called Ischaemic heart disease or coronary artery disease
A disease where the coronary arteries are blocked or narrowed
Includes:
Angina
Myocardial infarction
Heart failure

73
Q

What are the risk factors of CHD?

A 
Age 
Gender 
Social deprivation 
Smoking 
Diet 
Exercise 
Alcohol 
Psychosocial well being 
Blood pressure 
Cholesterol 
Obesity 
Diabetes 
Ethnicity 
Family history
74
Q

What are the symptoms of CHD?

A
  • Only appear when a coronary artery is 70-75% occluded
    Pain, discomfort, pressure, tightness, numbness or burning sensation in chest, arms, shoulders, back, upper abdomen or jaw
    Dizziness
    SOB
    fatigue or weakness
    Nausea or vomiting
    Indigestion or heartburn
    Sweating or clammy skin
    Rapid heart rate
    Palpations
    Swollen ankles or legs feeling of something being wrong
75
Q

What is angina?

A

Chest pain due to inadequate supply of oxygen to the heart muscle
Tends to be transient

76
Q

What are the types of angina?

A

Stable - happens at predictable times e.g. stress or exercise
Unstable - happens when no particular demand is being placed on the heart
Variant - when a coronary artery goes into spasm
Microvascular - affects the very smallest of the vessels

77
Q

What is treatment for angina?

A

Medications - nitrates, anticoagulants
Lifestyle changes
Surgery - angioplasty, CABG

78
Q

What is a myocardial infarction?

A

When the blood supplying the oxygen to the heart is severely reduced or cut off
The result is ischaemia of the heart muscle and scar formation

79
Q

What is the diagnosis of MI?

A 
Cardiac enzymes 
- troponin
- appears after 3-6 hours 
- peaks 24-48 hours 
- lasts 7-10 days 
- creating kinase 
ECG 
- ST elevation 
- inversion of T wave 
- enlarged Q wave
80
Q

What are the symptoms of MI?

A

Sweating or cold, clammy skin
Feeling out of breath
Feeling dizzy or like you’re going to pass out
Pain, tingling or discomfort in other parts of the upper body, including the arms, back, neck, jaw or stomach
Pain, pressure or discomfort in chest
Nausea, vomiting, burping or heartburn
A fast or uneven heartbeat

81
Q

What is the prognosis for MI?

A 
Depends on site of infarction and degree of damage 
Sudden death 
Arrhythmias
Heart failure 
Cardiogenic shock 
Thrombus formation 
Rupture
82
Q

What is the treatment for MI?

A

Depends on severity of symptoms
Drugs - beta-blockers & vasodilators
Cardiac catheterisation/angiography, PTCA, stents, laser, drilling
CABG
Physiotherapy involvement in cardiac rehab and preoperative care

83
Q

What is the physiotherapy for MI?

A 
MI rehab 
- in patient 
- outpatient 
CABG surgery
- range from critical care -> discharge 
- post discharge rehab
84
Q

What is heart failure?

A

The heart is unable to adequately pump the blood around the body usually because the heart has become too stiff or weak

85
Q

What are the causes of heart failure?

A 
Common cause is MI
Other causes:
HTN (particularly pulmonary) 
Cardiomyopathy 
Damaged valves 
Arrhythmias 
Congenital conditions 
Viral infections 
Chemotherapy 
Excessive alcohol 
Anaemia 
Thyroid disease
86
Q

What are the symptoms of heart failure?

A

SOB on exertion +/- at rest
Swollen feet, ankles, stomach & lower back
Fatigue or feeling weak

87
Q

What are the treatments of heart failure?

A

No cure or treatments so aim to control symptoms
Diuretics
Some patients benefit from a pacemaker or an implantable cardioverter defibrillator (ICD) to help improve the pumping action of the heart

88
Q

What are the causes of heart valve disease?

A 
Congenital HD 
Rheumatic fever 
Cardiomyopathy 
MI
Endocarditis 
Aging
89
Q

What are the symptoms of heart valve disease?

A

SOB
Ankle/feet swelling
Fatigue

90
Q

How does a diseased/damaged valve affect the flow of blood?

A

If the valve doesn’t open fully -> obstruct or restrict flow of blood = stenosis or narrowing
If the valve doesn’t close properly -> blood leaking backwards = valve incompetence or regurgitation or leaky valve

91
Q

What are other common cardiac problems?

A

Congenital heart disease
Rhythm issues - AF, Atrial flutter, Arrythmia, AV heart blocks, bundle branch blocks
Sudden death - Brugada syndrome, sudden arrhythmic death syndrome (SADS)
Aortic disease - aneurysm, dissection, stenosis
Out of hospital cardiac arrest (OHCA)

92
Q

What are the different cardiac operations?

A 
CABG
valve repair/replacement 
heart transplant 
heart lung transplant 
repair of congenital heart defects 
- neonatal, paediatric, adolescents & adults
93
Q

What’s a coronary artery bypass graft (CABG)?

A

Surgical procedure used to treat coronary heart disease
Involves bypassing a blocked portion of a coronary artery using another piece of blood vessel
Can be single or multiple arteries

94
Q

What are the common graft sites for a CABG?

A

Saphenous vein
Radial artery
Left internal thoracic (mammary) artery - LITA
Right internal thoracic (mammary) artery - RITA
Right gastroepiploic artery
Inferior epigastric artery

95
Q

What are the complications of a CABG?

A 
Perioperative MI
Bleeding 2-5% require reopening 
Low cardiac output 
Atrial fibrillation - 40%
Lower lobe collapse (L)
Restrictive lung deficit
Chest infection/pneumonia 
Other infection 
Late graft stenosis
Non union of sternum 
Keloid scarring (overgrown scar surrounded by collagen 
Vasoplegic syndrome 
Pericardial tamponade 
Pulmonary oedema/pleural effusion 
Pneumothorax/haemothorax 
Renal impairment/failure 
Wound infection 
Neurological - CVA 1-5% psychosis 
Grafts only last 8-15 years 
Chronic pain at incision sites
96
Q

What is the physiotherapy management for CABG?

A 
Uncomplicated cardiac surgery 
Techniques such as 
- secretion clearance 
- decrease WOB
- increase lung volume 
Advice regarding early mobilisation 
Stair climbing day 3/4 post op 
Discharge home 4/5 days post op 
Rehab programme 2 weeks post op 
Advice re ADL & progressive exercise 
Should be walking approx 3 miles in 4/52
97
Q

What are the special considerations of CABG?

A

Complications may lead to prolonged ITU stay
May require ‘high tech’ support which can limit physio treatments
Do not tolerate head down positions
Teach how to support sternum
- if problem w/ sternum may hear & feel clicking
May need postural correction/shoulder exercises
Mood change/depression common in post op recovery period

98
Q

What are the causes of heart valve disease?

A 
Congenital heart disease 
Rheumatic fever 
Cardiomyopathy 
MI
Endocarditis 
Aging
99
Q

What are the types of valve replacement?

A 
Mechanical 
-long lasting 15-25 years 
- require long term anticoagulants 
- made of pyrolytic carbon 
Tissue 
- sometimes called bioprosthetic
- created from animal donors valves or other animal tissue 
- lasts 10-20 years 
Donor 
- least common 
- lasts 10-20 years 
Ross procedure 
- the aortic valve is replaced with the pulmonary valve which is subsequently replaced as well 
TAVI/TAVR
- transcatheter aortic valve implantation or replacement
100
Q

What are the complications of a valve replacement?

A 
Stroke 
Clotting 
Arrhythmia 
Valve becomes damaged/worn out 
Chest infection/pneumonia 
Other infection 
Pulmonary oedema/pleural effusion 
Pneumothorax/haemothorax 
Renal impairment/failure 
Wound infection 
Chronic pain at incision sites 
Keloid scarring 
Pericardial tamponade non union of sternum
101
Q

What is a heart transplantation?

A 
Has to be from a heart beating donor 
Needed:
- in severe CHD 
- cardiomyopathy 
- congenital heart disease
102
Q

What are the complications of transplantation?

A

Immune system recognising transplanted heart as foreign and attacking it (rejection)
Donated heart failing to work properly (graft failure)
Narrowing of the arteries supplying the heart (cardiac allograft vasculopathy)
Side effects from the immunosuppressant medications such as an increased vulnerability to infections, weight gain & kidney problems
Plus the complications on CABG & valve surgery

103
Q

What’s the life expectancy after a transplantation?

A

80-90 in every 100 will live at least a year
70-75 at least 5 years
50 at least 10 years
Some people have survived more than 25 years after

104
Q

What’s the life after transplantation?

A 
Regular follow-up appointments 
Immunosuppressants for life 
Exercise 
Diet 
Pregnancy

Cardiorespiratory (2 decks)

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