CARDIOVASCULAR SYSTEM
PREPARED BY MR. ABHIJIT DAS
HYPERTENSION
DEFINITION
Hypertension, or high blood pressure, is when the force
of blood against the walls of the arteries is consistently too high.
This can damage blood vessels and increase the risk of heart disease, stroke,
and kidney failure.
ETIOPATHOGENESIS
(CAUSES):
- Genetics: Family history of high blood pressure.
- Lifestyle: Poor diet, high salt intake, alcohol consumption, smoking, and
lack of exercise.
- Age: Higher risk as people get older.
- Obesity: Excess weight can raise blood pressure.
CLINICAL
MANIFESTATIONS (SYMPTOMS):
- Often no symptoms: Most people don’t feel any different.
- Headaches: Especially in the morning.
- Dizziness: Feeling lightheaded, especially when standing up.
- Shortness of breath: During activity or at rest.
- Chest pain: Pressure or tightness in the chest.
- Vision changes: Blurred or double vision.
- Fatigue: Feeling very tired.
- Nausea and vomiting: Rarely.
- Nosebleeds: Rarely.
NON-PHARMACOLOGICAL
MANAGEMENT:
- Healthy diet: Which includes fruits, vegetables, whole grains, lean proteins,
and low-fat dairy while limiting salt, saturated fat, and cholesterol.
- Weight loss: Losing weight can help lower blood pressure.
- Regular exercise: Aim for at least 150
minutes of moderate exercise per week.
- Limit alcohol: No more than one drink per day for women and two for men.
- Quit smoking: Smoking raises blood pressure and heart disease risk.
- Stress reduction: Use techniques like deep
breathing, meditation, or yoga.
- Limit caffeine: Reduce intake of coffee, tea, and
energy drinks.
PHARMACOLOGICAL
MANAGEMENT:
- Diuretics: Reduce fluid buildup, e.g., hydrochlorothiazide, furosemide.
- ACE inhibitors: Relax blood vessels, e.g., lisinopril, enalapril.
- ARBs (Angiotensin II Receptor Blockers):
Block angiotensin action,
e.g., losartan, valsartan.
- Calcium channel blockers: Relax blood vessels, e.g., amlodipine,
nifedipine.
- Beta-blockers: Slow heart rate and reduce its force, e.g., metoprolol,
propranolol.
ANGINA
DEFINITION:
Angina is chest pain or discomfort that happens when the heart doesn't get enough blood and oxygen. This is
often due to narrowed or blocked coronary arteries. It can feel like squeezing,
pressure, heaviness, or tightness in the chest and may be accompanied by
shortness of breath, sweating, nausea, or fatigue.
ETIOPATHOGENESIS
(CAUSES):
- Reduced blood flow: Due to narrowed or
blocked coronary arteries from plaque buildup (atherosclerosis).
- Risk factors: High blood pressure, smoking, diabetes, high cholesterol,
inactivity, stress, and family history of heart disease.
CLINICAL
MANIFESTATIONS (SYMPTOMS):
- Chest pain: Pressure, squeezing, burning, or tightness in the chest, possibly
spreading to arms, neck, jaw, shoulder, or back.
- Shortness of breath: Especially during physical activity or stress.
- Fatigue or weakness
- Sweating
- Nausea or vomiting
- Dizziness or lightheadedness
- Anxiety or fear
- Palpitations: Racing, pounding, or irregular heartbeat.
NON-PHARMACOLOGICAL
MANAGEMENT:
1. Exercise:
Moderate activity for 30 minutes most days.
2. Healthy diet:
Low in unhealthy fats, cholesterol, and sodium; high in fruits, vegetables,
whole grains, and lean proteins.
3. Quit smoking:
Improves blood flow to the heart.
4. Manage stress:
Techniques like deep breathing, meditation, or yoga.
5. Maintain healthy weight: Reduces heart's workload.
6. Surgery (if severe): Procedures like coronary artery bypass surgery (CABG) or percutaneous
coronary intervention (PCI) to improve blood flow.
PHARMACOLOGICAL
MANAGEMENT:
1. Nitrates:
Like nitroglycerin, to relax blood vessels and reduce heart workload.
2. Beta-blockers:
Like metoprolol and atenolol, to slow heart rate and reduce blood pressure.
3. Calcium channel blockers: Like amlodipine and verapamil, to relax blood vessels
and improve blood flow.
4. Ranolazine:
A newer drug to reduce heart workload and oxygen demand.
5. Aspirin:
To reduce the risk of blood clots, heart attack, or stroke.
MYOCARDIAL INFARCTION
DEFINITION:
Myocardial infarction, or
heart attack, occurs when blood flow to a part of the
heart is blocked, usually by a clot, leading to damage or death of heart
muscle if untreated.
ETIOPATHOGENESIS:
- Mainly caused by plaque
buildup (fat deposits) in coronary arteries, leading to
atherosclerosis.
- Contributing factors: high
blood pressure, smoking, diabetes, high cholesterol, inactivity, stress, family
history.
CLINICAL
MANIFESTATIONS:
- Chest pain (pressure, tightness) lasting minutes or intermittent.
- Shortness of breath, sweating, nausea/vomiting, and sudden fatigue.
- Discomfort in arms, neck, jaw, shoulder, or
back may also occur.
NON-PHARMACOLOGICAL
MANAGEMENT:
- Lifestyle changes: diet, exercise, quitting smoking, stress
management.
- Cardiac rehab: structured exercise and education program.
- Oxygen therapy: for increasing blood oxygen.
- Emergency procedures (PCI or CABG) may be necessary.
- Monitoring: Close observation to detect complications.
PHARMACOLOGICAL
MANAGEMENT:
- Aspirin: reduces blood clots.
- Nitroglycerin: relieves chest pain.
- Beta blockers: slow heart rate and reduce heart’s workload.
- ACE inhibitors: lower blood pressure.
- Statins: reduce cholesterol.
- Antiplatelet and thrombolytic agents: prevent clots and restore blood flow.
HYPERLIPIDAEMIA
DEFINITION:
Hyperlipidaemia is a condition
with elevated blood lipid levels, such as
cholesterol and triglycerides, commonly referred to as high cholesterol or high
triglycerides.
ETIOPATHOGENESIS:
1. Genetics:
Inherited factors can increase risk.
2. Diet:
High intake of saturated fat contributes to hyperlipidaemia.
3. Lifestyle:
Lack of exercise, smoking, and excess alcohol intake are risk factors.
4. Medical conditions: Hypothyroidism, diabetes, and kidney disease increase risk.
5. Medications: Some
drugs, like steroids and diuretics, can raise lipid levels.
CLINICAL
MANIFESTATIONS:
Often asymptomatic, but may
lead to:
- Chest pain (angina) and shortness of breath
- Leg pain with exercise (claudication)
- Heart attack, stroke, and peripheral artery disease
- Xanthomas (fatty deposits under skin)
NON-PHARMACOLOGICAL
MANAGEMENT:
1. Dietary changes: Low in saturated fats, more fruits, veggies, whole grains.
2. Exercise:
At least 150 minutes of moderate aerobic activity weekly.
3. Weight loss:
Reduces lipid levels, especially if excess weight is abdominal.
4. Smoking cessation: Reduces risk and helps manage lipid levels.
5. Limit alcohol:
Moderate drinking benefits lipid levels; excessive intake worsens it.
PHARMACOLOGICAL
MANAGEMENT:
1. Statins:
Lower LDL cholesterol and reduce cardiovascular risk.
2. Bile acid sequestrants: Reduce cholesterol absorption.
3. Ezetimibe:
Blocks cholesterol absorption in the intestines.
4. PCSK9 inhibitors: Lower LDL cholesterol when combined with other meds.
5. Fibrates:
Lower triglycerides and raise HDL (good cholesterol).
CONGESTIVE HEART FAILURE
DEFINITION:
CHF is a chronic condition
where the heart cannot pump enough blood,
leading to fluid buildup in the body.
ETIOPATHOGENESIS:
1. Heart muscle damage from heart attacks or high blood pressure reduces heart efficiency.
2. Valve problems
cause blood backflow, straining the heart.
3. Coronary artery disease narrows arteries, reducing blood supply.
4. Abnormal heart rhythms disrupt blood flow.
5. High blood pressure increases heart workload, thickening the heart muscle.
CLINICAL
MANIFESTATIONS:
- Shortness of breath (especially when lying down)
- Fatigue and weakness
- Swelling in feet, legs, or abdomen (edema)
- Rapid/irregular heartbeat
- Reduced exercise tolerance
- Dizziness or lightheadedness
- Sudden weight gain from fluid retention
NON-PHARMACOLOGICAL
MANAGEMENT:
1. Lifestyle changes: Reduce salt, limit alcohol, avoid smoking, maintain a healthy weight.
2. Exercise:
Moderate activity like walking improves endurance.
3. Fluid restriction: Limits fluid overload.
4. Daily weight monitoring: Detects fluid retention early.
5. Cardiac rehab:
Provides structured support and education.
6. Oxygen therapy:
Helps with breathing if needed.
PHARMACOLOGICAL
MANAGEMENT:
1. Diuretics:
Reduce fluid buildup (e.g., furosemide).
2. ACE inhibitors:
Relax blood vessels, lower blood pressure (e.g., enalapril).
3. Beta blockers:
Lower heart rate and workload (e.g., metoprolol).
4. Digoxin:
Strengthens heart contractions.
5. Vasodilators:
Relax blood vessels (e.g., hydralazine).
6. Ivabradine:
Lowers heart rate for symptom relief.