Objectives

• Identify anatomy and physiology of the cardiovascular system

• Recognize common symptoms of the cardiovascular system

• Recognize common laboratory and diagnostic tests for diseases of the cardiovascular system

• Differentiate various diseases of the cardiovascular systemMyocardial InfarctionCongestive Heart FailureThrombophlebitisReye’s SyndromeRheumatic Fever

Identify anatomy and physiology of the cardiovascular system

Recognize common symptoms of the cardiovascular system• Fatigue• Dyspnea• Fever• Weakness• Tachycardia and

palpitations• Pallor• Chest pain (angina)

• Unusual sweating, especially at night

• Edema• Nausea, vomiting or

anorexia• Anxiety• Headache• Clubbing

Common laboratory and diagnostic tests • Blood tests (serum

enzymes, ESR)• Angiography/

arteriography• Electrocardiography• Chest x-ray• Cardiac

catheterization• Blood pressure• Echocardiography

Cardiac catheterization

Echocardiography Angiography

Atherosclerosis

controllable risk factors for atherosclerosis:

• High blood cholesterol (especially LDL or "bad" cholesterol over 100 mg/dL)

• Cigarette smoking and exposure to tobacco smoke

• High blood pressure • Diabetes mellitus • Obesity • Physical inactivity

Myocardial Infarction

• Life-threatening; occlusion of one or more coronary arteries

• Predisposing factorsheredity, obesity, aging, hypertension, cholesterol, smoking, diabetes, lifestyle

• Unrelieved crushing chest pain• ECG, cardiac enzyme levels

angiography,• CPR, hospitalization, bedrest• Prognosis is guarded

Heart attacks can have gender-specific symptoms

Congestive Heart Failure

• Impaired ability of the heart to pump blood

• Inadequate pumping of either left or right ventricles

• Signs/symptoms determined by which ventricles are affected

• ECG, chest x-ray, elevated venous pressure; echocardiography, angiography

• Tx includes diuretics, bedrest, vasodilators, digitalis, low-sodium diet

Thrombophlebitis

• Inflammation of vein with formation of a clot

• Caused by trauma, reduced blood flow, infection, prolonged immobility

• Dull ache and tightness at site; induration, redness, tenderness

• Dx’d by phlebography, US

• Tx depends if superficial or DVT

Reye’s Syndrome• Disruption of urea cycle;

accumulation of ammonia in blood, hypoglycemia, severe brain edema

• Affects children under 15; follows URI; use of ASA

• Signs/symptoms follow stages• Dx’d by lab tests: increase

ammonia in blood, liver function studies, spinal fluid analysis

• Tx to restore blood sugar levels, control cerebral edema, correct acid-base imbalances

• Prognosis dependent on which stage dx’d; fatal

Rheumatic Fever

• Systemic inflammatory disease• Likely complication of strep A

infection• Signs/symptoms: polyarthritis,

carditis, fever, chorea, subQ nodules over body surfaces, erythemia

• Dx’d by ASO (test for antibodies) increased WBC, elevated ESR, cardiac enzymes

• Tx of strep infection• Can cause scarring and

deformities of the valves

BLOOD THINNING WITH WARFARIN (COUMADIN)

• Drug used to “thin” blood

• Warfarin still used as rat poison

• Pro Time test essential