Scribd
Upload
55 views

Cardiovascular Physio Logic Process

This document summarizes cardiovascular disease and its pathophysiology. It describes that cardiovascular disease includes conditions like atherosclerosis, hypertension, and ischemic heart disease. The cardiovascular system consists of the heart and blood vessels that circulate blood throughout the body. Atherosclerosis is a disease of the arteries where plaque builds up in the walls over time due to risk factors like high cholesterol, smoking, and hypertension. This plaque buildup can restrict blood flow and lead to complications like angina, heart attack, and stroke. Treatment involves managing risk factors and using medications like statins to lower cholesterol levels.

Uploaded by

matrixtrinity
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
55 views

Cardiovascular Physio Logic Process

This document summarizes cardiovascular disease and its pathophysiology. It describes that cardiovascular disease includes conditions like atherosclerosis, hypertension, and ischemic heart disease. The cardiovascular system consists of the heart and blood vessels that circulate blood throughout the body. Atherosclerosis is a disease of the arteries where plaque builds up in the walls over time due to risk factors like high cholesterol, smoking, and hypertension. This plaque buildup can restrict blood flow and lead to complications like angina, heart attack, and stroke. Treatment involves managing risk factors and using medications like statins to lower cholesterol levels.

Uploaded by

matrixtrinity
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 35

Pathophysiology of

Cardiovascular Disease
Cardiovascular Physiology and
Pharmacology
Heart Disease
There is no such thing as heart disease

There is cardiovascular disease
Cardiovascular Disease
Atherosclerosis
Hypertension
Ischaemic Heart Disease
Angina
Stable Angina
Unstable Angina
Myocardial Infarction
Heart Failure
Cerebrovascular Accident
Peripheral vascular disease
Cardiovascular System
Heart
Blood Vessels
Arteries
Arterioles
Capillaries
Veins
Venules
Blood components
platelets, leucocytes, fibrinogen, PAI-
1,vitamins

Neurohormonal Components

Sympathetic System
Renin-Angiotensin-Aldosterone System
Endothelin
Natriuretic peptides
Nitric oxide

What is the purpose of the
cardiovascular system?

Supply oxygen and nutrients to the
tissues and organs, and to remove
waste products
To defend the supply of nutrients to
organs by
maintaining cardiac output
sympathetic, RAAS, endothelin, nitric oxide,
fluid retention
maintaining organ perfusion pressure
The Heart
The heart is a muscle which must operate
in all conditions
Operates 24 hours a day
Possesses own blood supply
The right heart pumps deoxygenated
blood to the lungs
The left heart pumps oxygenated blood to
the rest of the body
Anatomy
Four chambers
Right Heart (Low Pressure)
Right Atrium, Right Ventricle
Left Heart (High Pressure)
Left atrium, Left Ventricle
Four Valves
Tricuspid, Pulmonary
Mitral, Aortic
Valves ensure blood flow is in one
direction at the correct time
Blood is pumped in to arteries,
arterioles, capillaries
Blood is returned via veins to the right
heart
Cardiac Innervation
Parasympathetic System
Slow heart rate
Reduce cardiac output
Sympathetic System
Increase heart rate
Increase force of contraction
Increase cardiac output
Coronary Arteries
Heart muscle is supplied with oxygen and
nutrients by
Left coronary artery
Right coronary artery
The Left coronary artery supplies Left
ventricle
These arteries are narrow and highly
susceptible to obstruction
What are the primary
cardiovascular diseases?
Hypertension
Major risk factor for cardiovascular disease
Discuss later in course
Atherosclerosis

Both play a fundamental role in all other
cardiovascular diseases
Atherosclerosis
Disease of the muscular arteries (not
veins)
coronary
cerebral vessels
Progressive deposition of cholesterol
esters
Accounts indirectly for half of annual
mortality
Ischaemic heart disease MI
Cerebrovascular disease Stroke
Lesions start as fatty streaks (aged
20years)
subendothelial accumulation of large foam
cells (derived from macrophages plus SM
cells) filled with lipid
Fibrous Plaque
More advanced and the cause of disease
Develop from fatty streaks
Projects into arterial lumen
Reduced blood flow

Most of the changes are in the intimal
layer
Accumulation of monocytes, lymphocytes,
foam cells, and connective tissue
Most of the foam cells are of smooth
muscle origin
Necrotic core
Fibrous cap

So What?
Calcification pipe like rigidity with loss
of compliance
Rupture or ulceration exposing
thrombo-genic material to circulating
blood
Vessel occlusion, angina, MI
Haemorrhage into plaque
Embolisation from plaque
Weakening of vessel wall with rupture
Risk Factors
Hyperlipidaemia
Increased levels of circulating lipids.
The higher the total or LDL cholesterol the
greater the risk of CHD and CVD
Smoking
Hypertension
Diabetes Mellitus
Homocysteinemia
The higher the levels of homocysteine the
greater the risk
Infectious agents
herpes virus, chlamydia

Pathogenesis of Atherosclerosis
These risk factors cause:
Endothelial Dysfunction
Injury to the endothelium is the primary event
Mechanical, tissue hypoxia,
Impair endothelial protection
decrease in plasminogen activators, heparan
sulphate, prostacyclin
If the endothelium is damaged it no
longer serves as a barrier
LDL cholesterol passes into the intima
and accumulates and modified
(oxidised) by free radicals
Attracts monocytes and is ingested by
macrophages
Key step is attraction of monocytes and T
lymphocytes by TNF and MCP released
by injured endothelium and expression of
VCAM-1, ICAM
Monocytes migrate to subendothelial
space where they become
macrophages Foam Cells
Foam cells secrete PDGF, IL-1, TGF,
TNF which activate SM cells to migrate
and proliferate and deposit connective
tissue
Foam cells also release tissue factor
which is highly thrombogenic
Gives rise to overlying thrombus
formation

The Result
Atheromatous deposits
Sudden death
Peripheral vascular disease
Myocardial Ischaemia
Angina
Unstable angina
MI
Cerebrovascular accidents
Stroke
TIA Transient Ischaemic event

Treatment
Statins
HMG-CoA-reductase inhibitors
Simvastatin, Pravastatin, Atorvastain
Proven benefit in the Primary and Secondary
prevention of cardiovascular disease
Reduce risk by approximately 30%
Expensive

You might also like