Vascular and Inflammatory Disorders - Perfusion

Aneurysms and Aortic Dissection#### Aortic Aneurysm
  • Disease: Localized dilation and thinning of the arterial wall, resulting in weakness.
  • Interventions:
    • Goal: Prevent rupture.
    • Non-Surgical:
      • Control blood pressure (BP).
      • Monitor size of aneurysm.
  • Signs and Symptoms:
    • Thoracic Aneurysm:
    • Often asymptomatic, generalized symptoms may include cough, shortness of breath, hoarseness, dysphagia, chest/back pain.
    • Abdominal Aneurysm:
    • Pulsatile mass (do not palpate), gnawing abdominal, back, or flank pain.
  • Complications:
    • Rupture: Leads to hypovolemic shock and internal bleeding.
Aortic Dissection
  • Disease: A tear in the intimal layer creating a false lumen, diverting blood flow.
  • Interventions:
    • Goal: Prevent rupture and cardiac tamponade.
    • Non-Surgical:
      • Control heart rate (HR), BP, and pain.
  • Signs and Symptoms:
    • Abrupt onset of severe pain (ripping, sharp, stabbing).
    • Diaphoresis, angina, new high-pitched heart murmur.
    • Neurological symptoms: altered LOC, paraparesis.
  • Complications:
    • Decreased perfusion, leading to reduced urine output, decreased GI motility, diminished peripheral pulses.
Inflammatory Heart Disease#### Pericarditis
  • Disease: Inflammation of the pericardium.
  • Interventions:
    • Goals: Treat underlying cause and reduce symptoms.
  • Signs and Symptoms:
    • Grating, oppressive chest pain, worse on inspiration, pericardial friction rub.
  • Complications:
    • Pericardial Effusion, Cardiac Tamponade
Endocarditis
  • Disease: Infection and lesions on heart valves.
  • Interventions:
    • Antibiotic Therapy: Prophylactic antibiotics before dental procedures.
  • Signs and Symptoms:
    • Petechiae, new systolic murmur, embolization of vegetations.
  • Complications:
    • Potentially fatal if untreated.
Myocarditis
  • Disease: Infection/inflammation of the heart muscle, often viral.
  • Interventions:
    • Limit alcohol consumption, treat heart failure symptoms.
  • Signs and Symptoms:
    • Fatigue, fever, dyspnea on exertion, palpitations.
  • Complications:
    • Severe heart failure.
Cardiomyopathies#### Dilated Cardiomyopathy
  • Disease: Ventricular dilation with normal wall thickness.
  • Interventions:
    • Treat Heart Failure: Use diuretics, vasodilators.
  • Signs and Symptoms:
    • Symptoms may be asymptomatic till sudden heart failure.
  • Complications:
    • Sudden heart failure.
Hypertrophic Cardiomyopathy
  • Disease: Increased heart muscle mass without increased chamber size.
  • Interventions:
    • Negative inotropic agents, heart transplants if needed.
  • Signs and Symptoms:
    • Syncope, atypical chest pain, syncope.
  • Complications:
    • Sudden death risk, ventricular dysrhythmias.