高血压英文ppt精品课件alterations of cardiovascular

Alterations of Cardiovascular Function Chapter 30 1 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Arteriosclerosis n Chronic disease of the arterial system o Abnormal thickening and hardening of the vessel walls o Smooth muscle cells and collagen fibers migrate to the tunica intima 2 Mosby items and derived items 2006 by Mosby, Inc. Arteriosclerosis 3 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Atherosclerosis n Form of arteriosclerosis n Thickening and hardening is caused by accumulation of lipid-laden macrophages in the arterial wall n Plaque development 4 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Atherosclerosis n Progression o Inflammation of endothelium o Cellular proliferation o Macrophage migration o LDL oxidation (foam cell formation) o Fatty streak o Fibrous plaque o Complicated plaque 5 Mosby items and derived items 2006 by Mosby, Inc. Atherosclerosis 6 Mosby items and derived items 2006 by Mosby, Inc. Atherosclerosis 7 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Hypertension n Primary hypertension o Essential or idiopathic hypertension o Genetic and environmental factors o Affects 90% to 95% of individuals with hypertension 8 Mosby items and derived items 2006 by Mosby, Inc. Primary Hypertension 9 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Secondary hypertension n Caused by a systemic disease process that raises peripheral vascular resistance or cardiac output o Isolated systolic hypertension n Elevations of systolic pressure are caused by increases in cardiac output, total peripheral vascular resistance, or both o Complicated hypertension o Malignant hypertension 10 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Complicated hypertension n Chronic hypertensive damage to the walls of systemic blood vessels n Smooth muscle cells undergo hypertrophy and hyperplasia with fibrosis of the tunica intima and media o Malignant hypertension n Rapidly progressive hypertension n Diastolic pressure is usually 140 mm Hg 11 Mosby items and derived items 2006 by Mosby, Inc. Treatment for Hypertension 12 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Orthostatic (postural) hypotension n Decrease in both systolic and diastolic blood pressure upon standing n Lack of normal blood pressure compensation in response to gravitational changes on the circulation n Acute orthostatic hypotension n Chronic orthostatic hypotension 13 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Aneurysm n Local dilation or outpouching of a vessel wall or cardiac chamber n True aneurysms o Fusiform aneurysms o Circumferential aneurysms n False aneurysms o Saccular aneurysms 14 Mosby items and derived items 2006 by Mosby, Inc. Aneurysm 15 Mosby items and derived items 2006 by Mosby, Inc. Aneurysm 16 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Thrombus formation n Blood clot that remains attached to the vessel wall n Thromboembolus n Thrombophlebitis n Arterial thrombi n Venous thrombi 17 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Embolism n Bolus of matter that is circulation in the bloodstream o Dislodged thrombus, air bubble, amniotic fluid, aggregate of fat, bacteria, cancer cells, or a foreign substance 18 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Arteries and Veins o Peripheral artery disease n Atherosclerotic disease of the arteries that perfuse the limbs n Intermittent claudication o Obstruction of arterial blood flow in the iliofemoral vessels resulting in pain with ambulation 19 Mosby items and derived items 2006 by Mosby, Inc. Peripheral Artery Disease o Thromboangiitis obliterans (Buerger disease) n Occurs mainly in young men who smoke n Inflammatory disease of peripheral arteries resulting in the formation of nonatherosclerotic lesions o Digital, tibial, plantar, ulnar, and palmar arteries n Obliterates the small and medium-sized arteries 20 Mosby items and derived items 2006 by Mosby, Inc. Peripheral Artery Disease o Thromboangiitis obliterans (Buerger disease) n Causes pain, tenderness, and hair loss in the affected area n Symptoms are caused by slow, sluggish blood flow n Can often lead to gangrenous lesions 21 Mosby items and derived items 2006 by Mosby, Inc. Peripheral Artery Disease o Raynaud phenomenon and Raynaud disease n Episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes n Raynaud phenomenon is secondary to other systemic diseases or conditions o Collagen vascular disease (scleroderma), smoking, pulmonary hypertension, myxedema, and environmental factors (cold and prolonged exposure to vibrating machinery) n Raynaud disease is a primary vasospastic disorder of unknown origin 22 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Veins o Varicose veins n A vein in which blood has pooled n Distended, tortuous, and palpable veins n Caused by trauma or gradual venous distention o Chronic venous insufficiency n Inadequate venous return over a long period due to varicose veins or valvular incompetence n Venous stasis ulcers 23 Mosby items and derived items 2006 by Mosby, Inc. Diseases of the Veins o Deep venous thrombosis n Obstruction of venous flow leading to increased venous pressure n Factors o Venous stasis o Venous endothelial damage o Hypercoagulable states n Post-thrombotic syndrome (PTS) 24 Mosby items and derived items 2006 by Mosby, Inc. Coronary Artery Disease o Any vascular disorder that narrows or occludes the coronary arteries o Atherosclerosis is the most common cause o Risk factors n Dyslipidemia n Hypertension n Cigarette smoking n Diabetes mellitus n Obesity/sedentary lifestyle 25 Mosby items and derived items 2006 by Mosby, Inc. Coronary Artery Disease o Nontraditional risk factors n Markers of inflammation and thrombosis o C-reactive protein, fibrinogen, protein C, and plasminogen activator inhibitor n Hyperhomocysteinemia n Infection 26 Mosby items and derived items 2006 by Mosby, Inc. Coronary Artery Disease o Myocardial ischemia n Local, temporary deprivation of the coronary blood supply n Stabile angina n Prinzmetal angina n Silent ischemia n Angina pectoris 27 Mosby items and derived items 2006 by Mosby, Inc. Myocardial Ischemia 28 Mosby items and derived items 2006 by Mosby, Inc. Myocardial Ischemia 29 Mosby items and derived items 2006 by Mosby, Inc. Coronary Artery Disease o Acute coronary syndromes n Transient ischemia n Unstable angina n Sustained ischemia n Myocardial infarction n Myocardial inflammation and necrosis 30 Mosby items and derived items 2006 by Mosby, Inc. Myocardial Infarction 31 Mosby items and derived items 2006 by Mosby, Inc. Coronary Artery Disease o Myocardial infarction n Sudden and extended obstruction of the myocardial blood supply n Subendocardial infarction n Transmural infarction 32 Mosby items and derived items 2006 by Mosby, Inc. Myocardial Infarction o Cellular injury o Cellular death o Structural and functional changes n Myocardial stunning n Hibernating myocardium n Myocardial remodeling o Repair 33 Mosby items and derived items 2006 by Mosby, Inc. Disorders of the Heart Wall o Disorders of the pericardium n Acute pericarditis n Pericardial effusion o Tamponade n Constrictive pericarditis 34 Mosby items and derived items 2006 by Mosby, Inc. Pericarditis 35 Mosby items and derived items 2006 by Mosby, Inc. Disorders of the Myocardium o Cardiomyopathies n Dilated cardiomyopathy (congestive cardiomyopathy) n Hypertrophic cardiomyopathy o Asymmetrical septal hypertrophy o Hypertensive (valvular hypertrophic) cardiomyopathy n Restrictive cardiomyopathy 36 Mosby items and derived items 2006 by Mosby, Inc. Cardiomyopathy 37 Mosby items and derived items 2006 by Mosby, Inc. Disorders of the Endocardium o Valvular dysfunction n Valvular stenosis o Aortic stenosis o Mitral stenosis n Valvular regurgitation o Aortic regurgitation o Mitral regurgitation o Tricuspid regurgitation n Mitral valve prolapse syndrome 38 Mosby items and derived items 2006 by Mosby, Inc. Valvular Dysfunction 39 Mosby items and derived items 2006 by Mosby, Inc. Valvular Dysfunction 40 Mosby items and derived items 2006 by Mosby, Inc. Acute Rheumatic Fever and Rheumatic Heart Disease o Rheumatic fever n Diffuse, inflammatory disease caused by a delayed immune response to infection by the group A -hemolytic streptococci n Febrile illness o Inflammation of the joints, skin, nervous system, and heart n If left untreated, rheumatic fever causes rheumatic heart disease 41 Mosby items and derived items 2006 by Mosby, Inc. Acute Rheumatic Fever and Rheumatic Heart Disease o Rheumatic fever n Carditis n Polyarthritis n Chorea n Erythema marginatum 42 Mosby items and derived items 2006 by Mosby, Inc. Acute Rheumatic Fever and Rheumatic Heart Disease 43 Mosby items and derived items 2006 by Mosby, Inc. Infective Endocarditis o Inflammation of the endocardium o Agents n Bacteria, viruses, fungi, rickettsiae, and parasites o Pathogenesis n “Prepared” endocardium n Blood-borne microorganism adherence n Proliferation of the microorganism 44 Mosby items and derived items 2006 by Mosby, Inc. Infective Endocarditis 45 Mosby items and derived items 2006 by Mosby, Inc. Cardiac Complications of AIDS o Myocarditis o Endocarditis o Pericarditis o Cardiomyopathy 46 Mosby items and derived items 2006 by Mosby, Inc. Heart Failure o General term used to describe several types of cardiac dysfunction that result in inadequate perfusion of tissues with blood-borne nutrients 47 Mosby items and derived items 2006 by Mosby, Inc. Heart Failure o Congestive heart failure n Systolic heart failure o Inability of the heart to generate adequate cardiac output to perfuse tissues n Diastolic heart failure o Pulmona