Cardiovascular System (Ch 5)

Diagnostics, Pathology, & Treatments

Cardiovascular Specialists• Cardiologist• Hematologist-specialist who treats

diseases and disorders of the blood

DIAGNOSTIC PROCEDURES

Diagnostic procedures• Angiography – radiographic study of the

blood vessels after the injection of a contrast medium

• Angiocardiography – uses a contrast medium and chest x-rays to visualize the dimensions of the heart and large blood vessels

Diagnostic Procedures• History & Physical

– Checking for symptoms of disease• Chest pain, shortness of breath, awareness of

heartbeat (palpitation), fatigue, dizziness or loss of consciousness, edema, pain in the legs while walking (claudication)

Diagnostic Procedures• Cardiac catheterization – a procedure in

which a catheter is passed into a vein or artery and is guided into the heart– X-rays taken during the procedure– Dye is also injected

Diagnostic procedures• Electrocardiography-tracing electricity

– Electrocardiogram – ECG – EKG– Holter monitor – portable EKG that is worn by

an ambulatory patient to continuously monitor the heart rates and rhythms over a 24-hour period.

– Stress tests– Thallium stress test – uses a

radiopharmaceutical to test heart function

Diagnostic procedures• Ultrasonic diagnostic procedures• Ultra sound

– Echocardiography – the use of sound waves to evaluate the structures and motion of the heart

• Pulse ox

PATHOLOGY

Blood Vessel Pathology

• Angiitis• Angionecrosis-tissue death of the

walls of blood vessels• Angiostenosis

– Abnormal narrowing of a blood vessel– Angiospasm– Angina pectoris – severe episodes of

spasmodic, choking chest pain

Pathology • Arteries

– Aneurysm – a localized weak spot or balloon-like enlargement of the wall of an artery that can rupture

– Arteritis– Polyarteritis– Arteriosclerosis-hardening of the arteries– Raynaud’s phenomenon – intermittent attacks

of pallor, cyanosis, and redness of the fingers and toes due to arterial contraction.

Pathology• Atherosclerosis

– Hardening and narrowing of the arteries due to fatty deposits on the walls of the arteries

– Causes• Increased blood lipids• High blood presssure• Smoking• Obesity• Physical inactivity• Tension• http://www.nlm.nih.gov/medlineplus/ency/anatomyvid

eos/000006.htm

Atherosclerosis can lead to;• Angina pectoris-coronary arteries are

temporarily blocked-reduced blood supply to the heart – chest pain

• ischemia – oxygen deprived heart muscle, injured muscle

• Myocardial Infarction, heart attack– necrosis of the heart muscle due to severe, prolonged ischemia,

Pathology • Coronary artery disease (CAD) • Congestive Heart Failure (CHF)

– Pumping action is diminished– Fluid accumulates and is retained in the

tissues• Carditis

Congenital Heart Disease• Defects in the heart that occurred during

fetal development• Involves defective communication

between the chambers, malformation of the valves, and malformation of the septa

• Cyanotic – inability of the individual to get adequate oxygen so they turn blue

Pathology • Arrhythmias-abnomality in

rate, rhythm, or conduction of the heart beat– Fibrillation-rapid, irregular,

ineffective contractions, quivering

• Atrial fibrillation-irregular quivering action of the atria. Results in very rapid ventricular heartbeat

• V fib – fatal unless reversed– Flutter – Bradycardia-abnormally slow

heartbeat– Tachycardia

Pathology • Veins

– Phlebitis – inflammation of a vein– Varicose veins-enlarged veins which can be inflammed

• Hemorrhoids – varicose veins of the rectal & anal area– Valvulitis-inflammation of a heart valve – Phlebostenosis – narrowing of the lumen of a vein from any cause

• Thrombus-blood clot circulating in the blood stream• Thrombosis-abnormal condition of clot formation• Embolisms – any foreign object circulating in the blood

stream; clot, air, fat particle, plastic from IV catheters, etc.• Blood disorders

– Dyscrasia – any abnormal or pathologic condition of the blood– Hemochromatosis– Septicemia – also known as blood poisoning, is the presence of

pathogenic microorganisms or their toxins in the blood.

Pathology • Blood cells

– Erythrocytosis – abnormal increase in the number of circulating red blood cells

– Thrombocytopenia – also known as thrombopenia, is an abnormal decrease in the number of platelets

– Leukopenia – an abnormal decrease in the number of white blood cells. May affect one or all types.

– Leukemia

Pathology • Anemias – a disorder characterized by lower

than normal levels of red blood cells in the blood– Aplastic – an absence of all formed blood elements– Hemolytic – red blood cells are destroyed faster

than the bone marrow can replace them– Iron deficient– Megaloblastic – large abnormal red blood cells

(megaloblasts) with a reduced capacity to carry oxygen are produced by the bone marrow

Pathology • Anemias continued

– Sickle cell– Pernicious– Thalassemia – Cooley’s anemia, group of

genetic disorders characterized by short-lived red blood cells that lack the normal ability to produce hemoglobin

Pathology • Hypertension (HTN)

– Essential – primary – idiopathic – consistently elevated blood pressure of unknown origin 90% of cases

– Secondary – caused by a different medical problem such as a kidney disorder or a tumor on the adrenal glands 10% of cases

– Malignant – characterized by the sudden onset of severely elevated blood pressure

TREATMENTS

Treatments • Antihypertensive medications

– ACE inhibitors– Beta-blockers– Calcium channel blockers– Diuretics

Treatments • Additional medications

– Statins– Digoxin– Nitroglycerin– Anticoagulant – thrombolytic– Antiarrhythmic-controls irregularities of

the heartbeat– Tissue plasminogen activator (TPA)-used

to dissolve clots

Treatments • Coronary artery bypass graft – CABG –

bypass surgery• Heart

– Defibrillation – Cardioversion– Pacemaker – CPR

Treatments • Clearing blocked arteries

– Percutaneous transluminal coronary angioplasty – PTCA – balloon angioplasty, opens the blocked artery but doesn’t actually remove the plaque

– http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000096.htm

– Atherectomy – surgical removal of plaque from the interior lining of an artery

Treatments– Endarterectomy – surgical removal of the

lining of an artery that is clogged with plaque

– Carotid endarterectomy – same as above for a carotid artery