WCU Patho Week 3

backward effects of right sided heart failure

Systemic: hepatomegaly, ascites, splenomegaly, anorexia, subcutaneous edema (lower extremities) and jugular vein distension

Pulmonary stenosis

Hypertrophy of the right ventricle

backward effects of left sided heart failure

Lungs: dyspnea, orthopnea, cough, paroxysmal nocturnal dyspnea, cyanosis, and basilar crackles

Forward effect of heart failure (left-sided & right-sided) select all that apply

Impaired memory, mental fatigue, confusion, ^ heart rate ^, anxiety

What is paroxysmal nocturnal dyspnea?

Episodes of sudden dyspnea and orthopnea that awaken the patient from sleep

Stable angina

Triggered chest pain that is relieved by rest and medication

Unstable angina (acute coronary syndrome)

Chest pain not relieved by rest and medication

Complications of Acute coronary syndrome (select all that apply)

Unstable angina, MI (NSTEMI, STEMI), sudden cardiac arrest.

Diagnostic tests and findings to detect myocardial infarction (STEMI)

ST segment elevation

rhuematic heart disease cause

Beta - hemolytic streptococcal infection

Complications of orthostatic (postural) hypotension (select all that apply)

Stroke, cognitive impairment, and death

What is orthostatic hypotension?

A drop in blood pressure due to a sudden change of posture. (Sitting to standing)

symptoms of hypotension

dizziness, confusion, syncope and blurred vision

What is the action of an ACE inhibitor (ACE-I)

It blocks conversion of Angiotensin I to Angiotensin II

Normal blood pressure range

**Prehypertension BP**

120-129/ &

Stage 1 hypertension blood pressure

130-139 or 80-89

hypertensive crisis

higher than 180 and/or higher than 120

Stage 2 hypertension blood pressure

greater than or equal to 140 or greater than or equal to 90

Hypertensive urgency

Similar blood pressure elevation (>180/120) W/OUT end-organ damage

End organ damage of hypertension (select all that apply)

stroke, renal disease, ischemic heart disease

hypertensive emergency

Sudden increase in either both systolic or diastolic BP W/ evidence of end organ damage >180/120

Primary/ ideopathic hypertension

Nonmodifiable risk factors: family history & Age. Modifiable risk factors: dietary factors, sedentary lifestyle, obesity, & metabolic syndrome

secondary hypertension

Hypertension attributed to a specific identifiable pathology or condition. Related to: renal disease, obstructive sleep apnea (OSA), endocrine disorders, pregnancy

Modifiable risk factors are first and most important intervention in managing hypertension

Hypertensive-> lifestyle modification-> BP reduction/still hypertensive -> continue lifestyle modifications/ no medication

cardiac tamponade clinical presentation

Becks triad. Hypotension, distended neck veins (JVD), muffled heart sounds

What is sepsis?

Systemic inflammatory response to infection.

Clinical presentation of septic shock

Fever, hypotension and lactic acidosis

What is cardiogenic shock?

reduced cardiac output

Signs and Symptoms of anaphylactic shock (select all that apply)

Peripheral pooling of blood -> severe hypotension, uticaria (hives)/ angioedema, wheezing

Most common cause of anaphylactic shock

Antibiotic therapy. Massive release histamine -> vasodilation -> hypotension

Obstructive shock (select all that apply)

Pulmonary embolism (PE), cardiac tamponade, tension pneumothorax

cor pulmonale

Due to PRIMARY pulmonary condition -> right ventricular hypertrophy

Pulmonary Condition

Leads to increased pulmonary vascular resistance -> pulmonary hypertension-> right side heart failure

What is the correlation between LDL (bad cholesterol) levels and coronary artery disease

Low-density lipoproteins (LDL) and triglycerides are bad cholesterol; high cholesterol is associated with the highest risk of atherosclerosis; encourage plaque build-up that can cause occlusion in coronary artery. Can leave to MI.

congenital heart defects

Patent ductus arteriosus: baby born with communication between aorta and pulmonary artery (shouldn't exist)

What is the importance of sodium in hypertension management

Sodium intake has to be decreased.

Disruptive (septic, neurogenic, anaphylactic) shock

Hypotension due to peripheral pooling of the blood

What happens in any type of heart failure?

Reduced cardiac output

A patient presents to the emergency department with a diastolic pressure of 132 mmHg, retinopathy, and symptoms and ischemic stroke. This symptomology is likely the result of?

Hypertensive crisis

Lifestyle modifications to prevent and treat hypertension in adults

Weight reduction, decreased sodium intake, exercise plan, moderate alcohol intake