Recording-2025-02-25T14:07:52.869Z

Overview of Cardiac Health Issues

• Cardiac problems remain the top cause of death in the US and globally.

• Risk factors can include genetic predispositions, lifestyle, and underlying health conditions.

Venous System vs. Arterial System

• The venous system has structures (e.g., valves) that are absent in the arterial system due to its lower pressure.

• Valves help maintain unidirectional blood flow back to the heart.

• Proper muscle contraction during movement helps pump blood through the veins.

Risks of Immobilization

• Extended bed rest increases the risk of venous complications such as blood clots (Deep Vein Thrombosis, DVT).

• Lack of movement can lead to varicose veins, chronic swelling, and potential venous ulcers.

Prevention Strategies

• Primary Prevention: No existing issues but screening for potential risks.

• Secondary Prevention: Early identification and intervention to prevent disease progression.

• Tertiary Prevention: Management of existing complications through education, compression stockings, and physical activity to enhance venous return.

DVT Understanding

• A thrombus is a stationary blood clot, while an embolus is a clot that has detached and is traveling through the blood.

• Conditions contributing to thrombosis include venous stasis, endothelial damage, and hypercoagulability.

Pulmonary Embolism (PE)

• Result of a thrombus moving from the venous system to the pulmonary arteries, leading to impaired oxygenation in the lungs.

• Symptoms may include shortness of breath and decreased oxygen levels.

• Diagnosis involves understanding ventilation and perfusion mismatches in the lungs.

Hypertension & Its Effects

• Primary hypertension is caused by intrinsic factors such as genetics, while secondary hypertension results from other conditions.

• Systolic hypertension is a critical factor for target organ damage, particularly in the heart, kidneys, and brain.

• Risk factors include obesity, high sodium intake, diabetes, and family history.

Pathophysiology of Hypertension

• Activation of neurohormonal systems (renin-angiotensin-aldosterone system) leads to vasoconstriction and fluid retention, worsening hypertension.

• Long-term hypertension can result in organ damage, atherosclerosis, and vascular remodeling.

Heart Failure

• Characterized by the heart's inability to pump effectively, leading to systemic issues.

• Can be classified into:

  • Systolic Heart Failure: Poor contractility affecting ejection fraction (EF < 40%).

  • Diastolic Heart Failure: The heart muscles are stiff; EF may be normal.

Compensatory Mechanisms in Heart Failure

• As cardiac output decreases, compensatory mechanisms (e.g., fluid retention, vasoconstriction) are activated but often work against the patient.

• Medications may include diuretics, ACE inhibitors, beta-blockers, and inotropic agents to manage heart failure.

Cardiac Output Optimization

• Cardiac output (CO) is influenced by preload (volume entering the heart) and afterload (resistance against which the heart pumps).

• High preload can increase blood volume and stress the heart, whereas high afterload makes it difficult for the heart to pump effectively.

Dysrhythmias

• Origin from disruptions in the electrical conduction system, which regulate heart rhythm and rate.

• Conditions like atrial fibrillation and ventricular fibrillation significantly impact cardiac output and can lead to impaired perfusion.

Congenital Heart Diseases

• Various heart defects can lead to abnormal blood flow patterns, exerting unique and potentially harmful effects on circulation.

• Conditions like patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot require careful management and may need surgical intervention.