Cardiovascular disorders 2

• inability to effectively pump the amount of blood delivered to the heart
• causes: 1) MI; 2) chronic ischemic heart disease, 3) valvular disease, 4) cardiomyopathy (heart muscle inadequate force, genetic)

• systolic dysfunction:
• a) char by low ejection fraction;
• b) associated with poor contractility
• c) associated with MI often
• diastolic dysfunction:
• a) char by near normal ejection franction
• b) associated with slow or poor relaxation (stiff)
• c) often associated with aging

• systolic: LV does not pump enough blood to body
• diastolic: LV does not accept enough blood from lungs
• lungs fills with fluid - pulmonary congestion
• body lacks blood - weakness; low CO

• systolic: RV does not pump enough blood to lungs
• diastolic: RV does not accept enough blood from body
• boody fills with blood - systemic venous congestion
• lungs do not oxygenate enough blood - low CO

• 1) infectious (rheumatic heart disease)
• i) endocarditis
• ii) myocarditis
• iii) pericarditis
• 2) cardiomypathies
• 3) valvular disorders

• i) endocarditis
• ii) myocarditis: inflam w/ WBC/inflam mediators
• iii) pericarditis: inflammation of the pericardium
• causes pain and exudate, ECG changes
• catheters may intro microbes leading to pericarditis
• may restrict the heart movemnt due to:
• a) serous exudate filling the pericardial cavity (pericardial effusion) ; cardiac tamponade: rapid accumulation of exudate compresses the heart, decr. diastolic volume
• b) fibrous scar tissue making the pericardium stick to the heart (constrictive pericaditis)
• fibrin = sticky (may make membranes stick together)

• pericarditis: inflammation of the pericardium
• causes pain and exudate, ECG changes
• catheters may intro microbes leading to pericarditis

• may restrict the heart movemnt due to:
• a) serous exudate filling the pericardial cavity (pericardial effusion) ; and
• cardiac tamponade: rapid accumulation of exudate compresses the heart, decr. diastolic volume

b) fibrous scar tissue making the pericardium stick to the heart (constrictive pericaditis)fibrin = sticky (may make membranes stick together)

• ventricular muscle becomes too week
• malfunctioning heart muscle can cause HF if
• i) ventricles are unusually thick so there is not a normal amount of room for blood inside them
• ii) ventricles are too stiff to stretch
• ventricles are too weak to pump out the blood that is in them (-> systolic)

• 1) dilated cardiomyopathies: resistance of the heart wall decr. (too elastic) = overfill = heart not pumping out all the blood
• 2) hypertrophic cardiomyopathies:
• 3) restrictive cardiomyopathies: heart muscle is too stiff; cavity not dilated; EDV low

1) dilated cardiomyopathies: resistance of the heart wall decr. (too elastic) = overfill = heart not pumping out all the blood

heart muscle is too stiff; cavity not dilated; EDV low

• - defects in their contrctile proteins, make cells tpo weak
• they hypertrophy to do the same amount of work as normal cells
• - need more oxygen and perform less efficintly so the person is prone to HF and may suffer sudden death during exertion
• - has low activity tolerance
• - (incr. in muscle to get more protein for the same effect BUT results in incr. muscle mass)

the endocardial sturctures lining the herat can cause heart failure

• valve will not open all teh way
• it is harder to force bloo dthrough it
• may result from inlam, atheosclerosis, Ca2+ deposit
• murmur of blood shotting through the narrow opening when the valve is open
• whstling sound
• more freq affects SL valves

• valve will not close all the way
• it leaks when it should be closed
• may allow back flow
• murmur of blood leaking back thru when the vlave should be closed
• low pitched sound, gurgling soung as bloo dflows back and forth

• LA to LV (norm) but alot of LV to LA
• blood flows back in LA
• LA larger, incr. pressur eis built as well
• can lead to pulmoary congestion
• decr. CO

• blood LA<-> LV
• decr. CO
• incr. EDV in LV
• decr. SV
• heart overdilated
• failure of LV to expel

• LV to body
• difficult pushing blood thru
• LV muscle workds harder
• hypertrophy
• problem having enough O2 for enlarged LV
• fixed by incr. contraction of LV or maintained/compensated but overtime decr. CO + Ca2+ deposit hardens

• LA to LV
• pulmoary congestion is possible
• decr. EDV b/c decr. blood to LV
• decr. CO

• cardiogenic: heart
• hypovolemic: volume
• distributive: vasomotor tone
• septic: infection

• heart fails to pump blood adequately
• a) decr. CO lowers BP
• b) SNS responds causes vasoconstric; incr. after load
• c) vasocontriction incr. resistance to blood flow
• d) incr. workload on herat worsesn heart failure

• hemorrage > decr. BV > decr. CO > decr. BP
• may suffer irrev organ damage  if not treat right away
• restore by blood transfusion

• i) blood vessels dilate
• ii) there's not enough blood to fill circulatory system
• iii) blood flow decr.
• iv) less blood is returned to teh heart
• v) less blood is circulated to the body
• causes:
• xcess vasodilator
• anesthesia (smooth muscle relaxants)
• allergies
• a) decr. SNS activity - brain or spine injury; anesthetics; insulin
• b) vasodilator substances in blood - type I hypersensitivity (anaphylatic shock); inflammatory response to infection (sepsis)
• c) vessel damage from severe hypovolemia

• also caled systemic inflammatory response syndrome (SIRS)
• inflam mediators also incr. the metabolic rate of tissues, so they need more O2
• 40% mortality

• acute renal failure
• acute respi distress syndrome