Disease of Blood Vessels and Heart

Question Answer
Polycythemia : Too many RBC’s, low plasma volume causes causes blood to become more concentrated, Most often found in obese, stressed, hypertensive people.
Leukopenia: Due to decreased granulocytes, failing bone marrow, associated with immunodeficiency diseases.
Anemia and hemolytic anemia Anemia: Lack of hemoglobin,
Hemolytic Anemia: Destruction of RBC’s
Anemia and Hemolytic anemia Symptoms Hemolytic anemia: increased ldh, low blood hepatoglobin, increased blood bilirubin,
Congenital heart defects – shunts Left to Right Most common, atrial septa defect, ventricular septa defect, patent ductus arteriousus
Congenital Heart Defects- Shunts Right to Left Tetralogy of fallot, transposition of great vessels
Congenital Heart Defects Shunts Symptoms DA and PDA:
Normal during fetal development, DA connects pulmonary artery to aortic arch, blood from RV bypasses compressed lung of fetus, at birth lungs open and pulmonary resistance decrease, DA closes
Tetraology: 1.) aortic valve is misplaced downward, opens very close to septa defect.
2.) Ventricluar septal defect
3.) Pulmonary stenosis
4.) Right ventricular hypertrophy
Aortic regurgitation Incompetent aortic valve causing regurgitation of blood flow from aorta to LV during ventricular diastole
Aortic Regurgitation Causes: Rheumatic heart disease, connective tissue disorder, iatrogenic, during valvotomy, traumatic impact to chest.
Aortic Regurgitation Symptoms: Fatigue, weakness, short of breath, chest pain discomfort with exertion, fainting, irregular rapid pulse, heart palpitations, swollen feet or ankles.
Aortic stenosis Narrowing of the aortic valve causing obstruction of blood flow from LV to aorta during ventricular systole.
Aortic Stenosis Causes Rheumatic heart disease, congenital, most common age related calcification.
Aortic Stenosis Complications Pulmonary edema, left-sided heart failure.
Aortic Stenosis Symptoms: Angina, chest tightness, light-headed, short of breath, fatigue, heart palpitations, heart murmur

Low volume, weak pulse, left ventricular hypertrophy, syncope,

Aortic Stenosis Treatment: Valve replacemnet, treat underlying symptoms.
Mitral Regurgitation: Incompetence of the mitral valve causing regurgitation to blood flow from LV and LA during ventricular systole.
Mitral Regurgitation Causes: Rheumatic heart disease, congenital mitral valve prolapse, connective tissue disorder, acute mitral regurgitation, myocardial infarction, ineffective endocarditis
Mitral Regurgitation Complications: Left sided heart failure, from vlo overload, ineffective endocarditis
Mitral Regurgitation Symptoms: Dyspnea on exertion, paroxysmal nocturnal dyspnea, heart palpitations
Mitral Regurgitation Treatment Mitral valve replacement, treat underlying symptoms.
Mitral stenosis Narrowing of mitral valve causing obstruction to blood flow from LA to LV during ventricular diastole
Mitral stenosis causes Rheumatic heart disease, congenital
Mitral stenosis complications Atrial Fibrilation, thromboembolism, heart failure
Mitral stenosis symptoms Fatigue, short of breath, swollen feet or ankles, heart palpitations, frequent respiratory infections, heavy cough, blood tinged sputum, chest discomfort and pain.
Mitral stenosis treatment and tests Diagnostic test
2-D echocardiogram
Treat the underlying medical conditions, amoxicillin, mitral valvotomy, valvuloplasty, valve replacement
Congestive heart failure cause pathology Most common cardiac muscle damage, less common valve defect, Heart compensates before it fails, heart hypertrophy, ventricles stretch, Heart becomes hard.
Congestive heart failure left sided symptoms Left: Dyspnea, prominent pulmonary veins, enlarged cardiac silhouette, wet lung sounds, increased HR, mitral regurgitation, artial fibrillation
Congestive heart failure right sided symptoms Right: Distended neck veins, foot and genital edema, hepatomegaly, splenomegaly, peritoneal and pleural effusion
Congestive heart failure risk factors compensated and uncompensated Uncompensated heart failure: ventricles are stretched out, less forceful contraction

Compensated Failure: Ventricles dilate, more forceful contraction

Rheumatic fever Acute: 1 wk to 10 days after strep, more common in children 5-15, usually self limiting
Chronic: Autoimmune attacks occur, subclinical, Valvulitis is the first sign. Patients rarely have a history of acute rheumatic fever.
Rheumatic Fever how is strep involved? Autoimmune disease that occurs following a strep infection.
Rheumatic fever complications Fibrosis and calcification of valves, leading to stenosis, and regurgitation
Rheumatic fever risk factors Strep, children, 5-15, low soc status, developing countries, damp moist environments, lack of med treatment
rheumatic fever public health Decreased incidence rate fell 39%
Myocardical Infarction Symptoms Angina, retrosternal pain, radiating pain entire chest, back, jaws, and both arms and left hand. Sweating, restlessness, vomiting, bradychardia, hypotension, fever, ECG changes
Myocardial Infarction Treatment Bypass, angioplasty
Hypertension High: 140/90
Prehypertension: 120/80 to 139/89
Normal: 119/79
Hypertension Pathological Consequence Cardiomegaly (enlarged heart; typically left ventricular hypertrophy) Concentric hyperplasia
Renal Ischemia, Hypertensive encephalopathy (stroke), papilloedema (optic disc swelling.
Hypertension Risk Factors Obesity, being male, or post-menopausal woman, elevated LDL and tryglycerides, decreased HDL
Hypertension Treatment Behavioral modification, dash diet, increased PA, stress reduction, weight loss and medication, surgery.
Hypertension Public Health Males are more affected and females post-menopausal. 25 % are on hypertension meds. Blacks are more affected.
Atherosclerosis Deposit of fatty substance, cholesterol, Ca, fibrin, build up in inner lining.
Vessels narrow and harden, flow is impeded and reduced.
Can cause ischemia
Artherosclerosis Symptoms Vary by site of artherosclerosis-describe
Exaggerated inflammation to injury.
Artherosclerosis Risk Factors Modifiable:
Smoking, hypertension, diabetes, obesity,
Inactivity, stress, high carb diet

Non-modifiable: Age, gender, family history

Artheroslerosis tests Calcium scoring + others
Artherosclerosis Public Health Women are more affected after 80yrs.

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