Risk Factors: • Hypercholesterolemia • Men (>45 years old) • Women (>55 years old) • Cigarette smoking • Alcoholism • Diabetes

mellitus • Obesity • Physical inability

Genetic predisposit ion cell membrane alteration functional vasoconstri ction

• •

↑ sodium intake* Hereditary*

Predisposing Factors: • Hypertension*


↑ peripher al HPN (↑ BP)
Vasoconstrictio n of blood vessels

Vasoconstricti on of coronary arteries Increase pressure of blood flow Injury of the endothelial vessel layer (coronary Vessel damage Monocytes, platelets,cholesterol and other blood Scarrin g


workloa d

LV contractio

↑ force of

↑ stress on
the left ventricular ↑ cardiac output

Left ventricular Hypertroph Ventricular remodeling LV Hypoxia


CA D ↓ cardiac

tissue blood flow

↓ cardiac
muscle contraction Activation of baroreceptors in the LV, aortic

perfusion: dizziness, light headedness, confusion, anxiety, restlessness . ↓Response to energy demands causing easily

↓ Brain

↓ left ventricular ↑ residual blood of the LV at the time of diastole ↑ LV pressure
blood backflows from LV to


↓ Cardiac

↓ Systemic
blood pressure

Stimulation of vasomotor regulatory centers in Activation of sympathetic nervous system ↑ catecolami nes (epinephrin

↑ residual blood of the LA during diastole ↑ LA pressure
blood returns to pulmonary circulation Accumulation of blood in the pulmonary capillary bed (Lung s) ACE

↓ Perfusion of
tissues of the body



Proteinu ria, ↑ urea (8.0), ↓ crea

Reni formation of Angiotensi Angiotensin

Hypothala ADH Sodium and Water retention ↑osmo tic pressu Pulmonary edema: dyspnea, cough, crackles, 2 pillow orthopnea Pulmonary edema: dyspnea, cough, crackles, 2 pillow orthopnea

↓ urine

↓ urine

↑osmo tic pressu


↑ pulmonary vascular resistance ↑ RV contract ↑ force of RV contractio ↑ RV oxygen demand

↓O2 saturation

RV ↓ force of RV contractio

↑ residual
blood of the RV at the time of ↑ RV blood backflows from RV to ↑ RA ↑ RA

Peripheral edema, liver congestion, ascites, weakness, weight gain due

↑ fluid moves
into the interstitial

↑ venous
pressure JVD (07/24/08)

blood backflows from RA to

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