Pathophysiology Notes - Cardiovascular System

DeltaPg.:(gCHF (CONGESTIVE HEART FAILURE) :In Heast failure, the heart loss the ability to pumpin a blood to the tissues which lead tolow blood supply to the organs and tissuesresulting in deficient supply of oxygen andnutrients to function properly. In congestiveIrability of heart to suppyenough blood /laeeBlood supply 11tissue and organ DeathTirednesstcauses Pelmonary edema (swelling)arrythemiasyHeart failure has two types1. Left Sided heart failure2. Right Sided heart failureLeft ventricle e abnormalities (m case of Left-3sided heart fBlood supply inhibitPoShortness of breath and coughingfluid store in lungsIf Pulmonary edema thenBlood comes in coughing DOPDeltaIn case of Right sidedheart failure)Right ventricles abnosmalitiesBlood supply to lungs get decreaseBlood get collect to Right indelegsedema feet andcauses of CHF :- Corinary heartsycleseaseSilent heart attackcardiomyopathyHypertensionHeart Value diseaseCongental heart disease -Alcolism and smokingDrug abusesymptoms of CHFShortners of BreathcFrequent coughing specially when lying dron.cswollen feet ankles and legsAbdominal swelling and vomitingfatigueitDiginess faintingsudden deathfailsPathophysiology: Divided into two partssystolic Dysfunction Diastolic Dysfunction. Dt.:Pg.:elta#systolic DisfunctionIfVentricles contraction ability ItIt isdue tostroke volume - systemic bloodneedStressf+heart work load 11heart failureDiastolic Disfunction100Ventricle compliance I &+CVenous pressure 11 to maintainventricular filling+work work load 19 of heartCHF.allISCHEMIC HEART DISEASE :fo2.It is imbalance between myocardial oxygen supply3.and demand whichhypoxia (lack of 02) and accumulation of wasteresulting in myocardial4.metabolites. Ischemia is an insufficient supply 5.blood to an organ dueto a blooked artiry. causes duto!Pg:DLelta6IIDIHDSilentSymptomaticusChest painargina pectorisClassification of Ischemia Heart FailureIHFInfarct effectNon-infuct effect1.Chronic ischamic heatmycardial infractiondisease.2. sudden cardiac death3. Angina pictoriesCStableUnstable Angina in TranscentCanginaanginaBraintechnic CAttackTIA)lauses of IHF:ABlockage of an Arteryal3. silent Ischemia is caused by Finational or mental2. formation of Blood clotsstress or exertion without any symptoms.of5. (TIA) is caused by Blood clot due to the Blockage4. Heavy Exerciseof cerebral artery DeltaDt.:Pg.:Factors which effect.1. Hereditary2. Sex (Male or Female)3. Age.4. smoking5. High cholesterol6. High BP.7. Lack of physical acturityS. Diabetes Mallitus9. obesity10. stress and anger.ANGINA PECTORIS :It is an operasive heavy crushing pain or aconstrictive feeling in the centre of the clustHbehind the sternum or on a left side ofthe chest The pain may radiate to oneor both arms generally more to the left armynIt can be experienced in the throat jawthe shoulderand a stomach and more rarely betweenAnginaClassical AnginaVarient orConstablityarthersclossisPrigmetal'splatelet aggregationanginaanginaArtery sparmsparm-magnesium Overloadconc. It,calcium conc 11 ForPg.:eltacmorecauses : Physical Exercise(Ny) Psycological stress extremeccosinary erythroscolossiscold heavy meal Anaemia specially at night time67the corinary astery,secure aosticAnaemia marrioring ofHyperthyredismstenosis hypertropy6Hypogycemia : blood glucose level Itenergy provideGGenergyt(+O2demandAnginaHypecthyrodism: in CVS ( cardio vascular system)thyroid cut gyckonPalpitationexcessive intoleranceedemaO2 demand MTOfHeart work load to pump bloodHeart muscle weak4tAngina andany disease5heart For Pg.: Dt.:ettaT3catabolic effectProtein used as source of energyprolonged timethe Nitrogen BalanceTissue waste100O2 demandfor Body growthAnginaPathophysiology :Narrowing of artiriesBlood flow LL+6O2demandAnaerobic metabolism++Lactels. absorution forLactic acid depositionMycasdialney nerve fibrePain radiationArigina"L ettaMYOCARDIAL INTRACTION (MI) :Myocardial Infection also known as Heart attack TheMyocardial Infection focus on the heart and theThe word infraction means the clopping of arterychanges is nacrosis (cell death) of myocardial tissue.blood supply inhibit in 1 past of heart02 11cell or heart tissuedamage or death#no blood flow or little blood flowcardiac activity does not complete9+chances of InfractionSubendo cardial infraction : Sub type of M.I.Blood flow Ld in subendo cardiac infractionInfractionPathophysiology:#Stagnant bloodorearing+Muscle fibre DeltaDt.:Pg.:Hb bluesh colourheart infracted areacolour changes-Blood vessels weakBlood goes to adjoining tissueedema Cause.Symptoms:Chest painYorkSensation, tightness. pressure or squeezingBPain radiates to left armPain also radiates to the lower jaw neckRight arm, back and epigastreumHeart Burnshortness of BreadthPulmonary edemanausea , , vomiting and pappitationSudden deathLoss of conscious nessARTHEROSCHEPOSIS : ATHEROSCLEROArtherosclerosis is a specific type of asteriosclosoris8It is a disease in whichatinside the arteries Plague is made up of fatBlague builts upLchlores cholesksol, calcuin andothersubstancesinblord DeltaPg.:The flow Plaque hardens the narrow arteries This limitStheolygen rich blood to the organs and otherpasts of the body. Although Artheraclerosisisconsidered a heart problem but itcan affect arteries anywhere in the body.Types:SymptomaticArteries in the areaheart arteriesArteriestheheart attacksupplying theand bybrainObstruction €poChest painobstruction inof blood in thethe carolidarteries eu anusckartery.and legs6stroke-leg painEsudden numbnessweaknessParalysisduring WaltiyadiginessCauses:1. Damage or injury to the inner layer of an artery2. High Blood pressure053. High Cholesterol40 smokingsis5. some disease like diabetes.PathophysiologyOx-LDL Non-enzymaticoly DL (low Density lipids )oxididedreleasebioactive phospholipidsAf DeliaDL:Pg.:endothelial cells7+Proinflammatoryother initiation+on step ofpro coagulantArtheroscetosisleekocytes formation2.3adhere to intima edemaARTERIOSCBLROSIS- :It is the defect occuring in the artery walls. Itrefers values to hardening of the normally flexibledue to theasterial structureOn loss of elasticity of theare to young stage f the artereeknown as elastin as age increase there esflexible due the presence of proteinVthe arterial values.a loss. of elastin which cause thicking ofCa+2 + Plague depositF+arteries wall thicktooelastin proteinWall become brettle and hard. : DelraHeart work lord 11MICause and Symptomssame as ArtheroscherosisPathophysiology1.Andothelial Disfunction2.Adhesion of cellsblood3.Immigration of Adhered WBC.1 Andothdial Disfunctioninner layermaintainLI(11)leNitric Date PGI2AngiotensinVancontrictorFG3oxideET-1ieesphosidital dor(Prostacydic)(Endothelin-1)nasconstrictorisHigh BP, Diabeties, Milletus, smokingendothelial dysfunctionof00Ans-IINO PG I, ET-1Improper heart work ZetiaDt.:Pg.:2. Adhesion of blood cells.In Endothdial dyfactionNo LL(+ET-1NormalarteryP-selection Q E-selection releaseCertogy of cell adhesion molecules (glycoporation!VCAM releaseICAM- - I releaseVascular cell Adhesion(Intracellulared cell adhesismofewule)molecule)& Thromocytes & fibsin releaseBlood clot3.Immigration of adhesed WBC.In case of macrophageIt-8 (Interleukin)cellular necrosis + fibroblast + cellular codhesion, reChemokineeltaIL-8 + Mcp- (CCL-L, > Maerophage chemoattract Protein-P.Diapederia