Atheroma

definition

Atheroma

causes

Atheroma

effects

• partial or complete blockage of arteries
• narrowing -> ischaemic pain
  • angina pectoris
  • intermittent claudication
• TIA

Atheroma

tests

angiogram

doppler

stress test

Atheroma

complications

• myocardial infarction
• cerebral infarction
• thrombosis
• haemorrhage (artery walls become brittle from calcium deposits)
• aneurysm

Arteriosclerosis

definition

loss of elasticity (especially in medium & large arteries) because of fibrous tissue and calcium buildup

increases w/ systolic blood pressure

Arteriosclerosis

symptoms & complications

ischaemia in the limbs -> gangrene

especially in smokers & diabetes

senile arteriosclerosis leads to cerebral ischaemia and loss of mental function

symptoms: hard, red & painful area above superficial vein

tr: cooling, elevation, gentle exercise, heparin cream, enzymes

predisposing factors (see book)

complication: pulmonary embolism

tr: complete rest, hospital - blood thinners

varicose veins

definition & symptoms

incompetent valves, chronically dilated veins

aching and fatigue of veins

varicose veins

treatments

compression, hydrotherapy, horse chestnut, exercise, elevation, speed up digestion

operation

varicose veins

complications

angina pectoris

symptoms

severe ischaemic pain in the chest, can radiate into the arm

sudden crushing pain that lasts less than a minute

intially pt. is fearful, anxious

angina pectoris

contributing factors

physical strain

cold weather

strong emotions

heavy metal

angina pectoris

treatments

angina pectoris

differential diagnosis

angina pectoris

complications

Myocardial infarction

definition

occlusion of a coronary artery -> infarct

permanent death of an area of tissue

Myocardial infarction

symptoms

• pressure or devastating pain in the center of chest, lasting more than a few minutes or going away and coming back
• pain spreading to shoulders, neck or arms
• chest discomfort combined w/ light-headedness, fainting, sweating, nausea or shortness of breath

Myocardial infarction

differential diagnosis

doesn't respond to nitroglycerin

different from angina: pain will persist w/ rest, last more than 5 minutes

high cholesterol

smoking

hypertension

diabetes mellitus

obesity

stres

men: 50-60

women: 60-70

stenosis

incompetence

• thickening and narrowing of the valve, obstructing the flow of blood out of the chamber
• results in murmur
• diagnosed w/ echocardiogram

rheumatic fever

diphtheria

congenital

autoimmune after streptococcus infection

generally starts with throat infection, then in a few weeks will present with joint pains, fever, breathlessness, chest pain

on exam will find heart murmur

antibodies created to fight infection will start attacking body

endocarditis

definition

endocarditis

causes

altered blood flow around the valves as bacteria adhere

bacteremia can be caused by dental procedures, surgery

endocarditis

symptoms

• fever of unknown origin
• continuous presence of microorganisms in blood stream determined by serial collection of blood cultures
• new or changing heart murmur
• septic emboli (causing problems such as stroke, gangrene, conjunctival hemorrhage)
• glomerulonephritis
• painful subcutaneous lesions in distal fingers
• positive rh factor

endocarditis

complications

endocarditis

treatment

hospitalization

iv antibiotics

bed rest

cardiac failure

definition

cardiac failure

symptoms

enlargement of the heart muscle (cardiomyopathy

develops in 4 stages

cardiac failure

causes

• chronic hypertension
• valve disease
• lung disease
• previous heart attack
• degenerative changes
  
• smoking
• obesity
  

F orgotten medication

A rrythmia/anaemia

I schaemia/infarct/infection

L ifestyle

U pregulation

R enal failure

E mbolus

• increased vascular resistance in the lungs (lung disease)
• back pressure from the left side of the heart
• previous heart attack

• congestion thruout the venous system
• first affected organs: liver, spleen, kidneys
• oedema of the limbs

• high blood pressure
• valve probs
• myocardial weakness

• congestion before the left heart
• congestion bronchitis, cardiac asthma (often worse at night)
• lung oedema

• diuretics
• anti-hypertensives
• lower salt

pressure exerted by the blood on the vessel walls

the elasticity of the arterial walls ensures steady blood flow

• decreased blood volume due to injury, haemorrhage, menstruation, dehydration
• complications of other conditions like shock
• warm weather, esp while standing

normal: <140 / <90

borderline: 140-160 / 90-95

high: >160 / >95

essential - runs in families, unknown cause

secondary - kidneys, hormones (adrenal, thyroid)

heredity

obesity

excessive alcohol intake

smoking

lack of exercise

LEFT ventricle failure - lung congestion

RIGHT ventricle failure - oedema

Stroke

• hypovolemic (blood vol down by 15-25%)
• cardiogenic shock (acute heart disease)
• septic
• neurogenic
• anaphylactic

• fast, weak pulse
• low bp
• feeling faint, dizzy or nauseous
• dizziness
• cold, clammy skin
• rapid, shallow breathing
• blue lips
  

low haemoglobin

may be due to low RBC count

will interfere w/ oxygen levels in blood

iron deficiency anaemia

(hypochromic)

severe anaemia when hemoglobin less than 9g/dl

(normal: F 12-18, M 13-18)

deficient intake

malabsorption

chronic blood loss

chronic peptic ulcers

heavy menstruation

intestinal ulceration

haemorrhoids

carcinoma

depends on cause

i.e. iron supplements

iron rich foods

deficient intake (vegans)

lack of intrinsic factor due to pernicious anaemia, gastrectomy, chronic gastritis, etc.

pernicious anaemia causes

(pernicious = harmful)

vit B12 injections

folic acid supplements

general symptoms plus:

glossitis - tongue swelling & redness

digestive discomfort, nausea, diarrhoea, tingling sensations

nerve degeneration

tongue ulceration

congential - sickle cell anaemia

drugs/chemicals

autoimmune

wrong blood transfusion

blood incompatibility between mother & child

haemolysis due to plasmodium parasite in malaria

increased venous hydrostatic pressure

• right heart failure
• kidney disease - left heart failure, hypertension
• external pressure on the limb caused by blocked lymph drainage
  

• decreased plasma osmotic pressure
• impaired lymph drainage
• increased small vessel permeability