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HYPERTENSIVE CARDIOVASCULAR DISEASE
SUBMITTED BY: Joseph King D. Macaranas BSN – 2A SUBMITTED TO: Ms. Estrella P. Espiritu, R.N., M.A.N. Hospital, Clinical Instructor
and enlargement of the heart that occur because of high blood pressure. ANATOMY AND PHYSIOLOGY Hypertensive Cardiovascular Disease Hypertensive heart disease refers to coronary artery disease. and outlook of hypertensive heart disease. treatment. This may worsen atherosclerosis (increased cholesterol deposits in the blood vessels). The amount of blood pumped by the heart each minute (cardiac output) goes down. symptoms of congestive heart failure may develop. 2010 Time of Admission: 06:02 AM Admitting Diagnosis: Hyperensive Cardiovascular Disease Chief of Complaint: Hypertension PHYSICAL ASSESSMENT HISTORY OF PRESENT ILLNESS Patient known hypertension more than 5 years. Persistence of elevated blood pressure prompted consult for further evaluation and management. Causes High blood pressure increases the pressure in blood vessels. The heart complications that develop determine the symptoms. This also increases the risk of heart attacks and stroke. Hypertensive heart disease is the leading cause of illness and death from high blood pressure. High blood pressure also contributes to thickening of the blood vessel walls.PATIENTS PROFILE Name: Fe Mercado Beroga Gender: Female Age: 54 Years Old Date of Birth: Novemmber 21. Without treatment. It can cause ischemic heart disease from the increased supply of oxygen needed by the thicker heart muscle. High blood pressure is the most common risk factor for heart disease and stroke. heart failure. diagnosis. Angina Dilated cardiomyopathy Heart failure Hypertrophic cardiomyopathy Possible Complications Angina Arrhythmias . in losartan and aspirin. As the heart pumps against this pressure. it must work harder. Batangas Citizenship: Filipino Religion: Roman Catholic Date of Admission: January 15. 1955 Place of Birth: Lipa City. this causes the heart muscle to thicken and the left ventricle to become enlarged. Over time.
and treatments. Frequent blood pressure measurements taken at home are often recommended for people with difficult-to-control high blood pressure. and other conditions that increase the risk of heart disease. vascular surgeons. making primary prevention efforts necessary from childhood. neurologists. Heart attack Heart failure Stroke Sudden death Prevention Have your blood pressure checked at regular intervals (as recommended by your health care provider) to monitor the condition. and low-fat dairy products Reduce salt intake (may be beneficial) Eat whole grains. Do not stop or change treatment. the underlying cause (atherosclerosis) is usually quite advanced. Causes In his book "The Heart Healthy Program". By the time that heart problems are detected. exercise and avoidance of smoking. and fish Exercise regularly Reduce excessive alcohol consumption Stop smoking -. including: . and it is common for certain procedures to be performed by different types of specialists in different hospitals. In addition to medications. mechanisms. Carefully control diabetes.cigarettes are a major cause of hypertension-related heart disease Lose weight if you are overweight or obese Cardiovascular disease or cardiovascular diseases is the class of diseases that involve the heart or blood vessels (arteries and veins). recommended lifestyle changes include: Diet changes: Avoid trans fats and saturated fats Increase fruits. having progressed for decades. and interventional radiologists. depending on the organ system that is being treated. While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH). heart disease kills more Americans than cancer. Fleming has identified several key dietary factors that can lower the risk of heart disease. Treat your high blood pressure. There is therefore increased emphasis on preventing atherosclerosis by modifying risk factors. vegetables. These conditions have similar causes. the cardiologist Dr Richard M. hyperlipidemia. A large histological study (PDAY) showed vascular injury accumulates from adolescence. Most countries face high and increasing rates of cardiovascular disease. poultry. It is the number one cause of death and disability in the United States and most European countries (data available through 2005). thoracic surgeons. cardiovascular disease is treated by cardiologists. Each year. In practice. except on the advice of your health care provider. such as healthy eating. it is usually used to refer to those related to atherosclerosis (arterial disease). There is considerable overlap in the specialties.
The most primitive animal phyla lack circulatory system. to the lungs. they are not visible in unstained blood smears. The lymphatic system. blood cells. Two types of fluids move through the circulatory system: blood and lymph. Oxygen deprived blood from the vena cava enters the right atrium of the heart and flows through the tricuspid valve into the right ventricle. from which it is pumped through the pulmonary semilunar valve into the pulmonary arteries which go to the lungs. Increased antioxidant activity by higher consumption of fruits and vegetables.7 liters) of blood. and lymph vessels form the lymphatic system. The lymph. The circulatory system includes: the pulmonary circulation. red blood cells. This system may be seen strictly as a blood distribution network. However. Reduction of Homocysteine levels by supplementation with Vitamins B6 and B12. to and from cells in the body to help fight diseases and help stabilize body temperature and pH to maintain homeostasis. lymph nodes. Pulmonary circulation Main article: Pulmonary circulation The Pulmonary circulation is the portion of the cardiovascular system which transports oxygendepleted blood away from the heart. The circulatory system is an organ system that passes nutrients (such as amino acids and electrolytes). The cardiovascular system and the lymphatic system collectively make up the circulatory system. the digestive system works with the circulatory system to provide the nutrients the system needs to keep the heart pumping.7 to 5. some invertebrate groups have an open cardiovascular system. This method of early detection allows to identify people at risk and take appropriate measures. which distributes blood. Diagnosis Platelet and Fibrin complexes can be seen with the technique of dark field microscopy. the blood. where it enters the left atrium before flowing through the mitral valve into the left ventricle. While humans. and the lymphatic system. white blood cells. gases. and folic acid. a "loop" through the lungs where blood is oxygenated. . The main components of the human circulatory system are the heart. which consists of plasma. and on to the rest of the body. Then. is an open system. but some consider the circulatory system as composed of the cardiovascular system. a "loop" through the rest of the body to provide oxygenated blood. These complexes are clearly visible in dark field but not in stained bright field samples because the different staining methods disburse them. and the systemic circulation. on the other hand. as well as other vertebrates. Pulmonary veins return the now oxygen-rich blood to the heart. and returns oxygenated blood back to the heart. heart. poultry and eggs. Lowering of fibrinogen and growth factors by cutting back on foods such as red meat. An average adult contains five to six quarts (roughly 4. and platelets. veins and capillaries). Also. which distributes lymph. have a closed cardiovascular system (meaning that the blood never leaves the network of arteries. oxygen-rich blood from the left ventricle is pumped out via the aorta. Lowering of Triglyceride levels by reducing consumption of sugary and processed foods. hormones. The blood. dairy products. Lowering of LDL cholesterol by reducing saturated fat intake. etc. and the blood vessels. They are much bigger than red blood cells and easily block capillaries. and blood vessels form the cardiovascular system.
Arteries are blood vessels that carry blood away from the heart. All arteries. and returns oxygen-depleted blood back to the heart. Its proper functioning is responsible for the delivery of oxygen and nutrients to all cells. to the rest of the body. distance-wise. Heart View from the front. transporting blood to every part of the body. Systemic circulation is. left ventricle. myocardial infarction and stroke each may directly result from an arterial system that has been . The blood that is returned to the right atrium is deoxygenated (poor in oxygen) and passed into the right ventricle to be pumped through the pulmonary artery to the lungs for re-oxygenation and removal of carbon dioxide. and with both a systemic and a pulmonary circulation there are four chambers in total: left atrium. right atrium and right ventricle. In developed countries. much longer than pulmonary circulation. carry oxygenated blood. the two leading causes of death. The left atrium receives newly oxygenated blood from the lungs as well as the pulmonary vein which is passed into the strong left ventricle to be pumped through the aorta to the different organs of the body. and the mobility of the elements. with the exception of the pulmonary and umbilical arteries. The circulatory system is extremely important for sustaining life. which means the right side of the heart is on the left of the diagram (and vice-versa) Main article: heart The heart pumps oxygenated blood to the body and deoxygenated blood to the lungs. In the human heart there is one atrium and one ventricle for each circulation.Systemic circulation Main article: Systemic circulation Systemic circulation is the portion of the cardiovascular system which transports oxygenated blood away from the heart. maintenance of optimum pH. as well as the removal of carbon dioxide and waste products. proteins and cells of the immune system. The right atrium is the upper chamber of the right side of the heart.
which is the portion of the cardiovascular system which carries deoxygenated blood away from the heart. which is the part of the cardiovascular system which carries oxygenated blood away from the heart. or media. and reflects heart activity. or diastolic pressure between contractions. Inside this layer is the tunica media. at the macroscopic level. Description The arterial system is the higher-pressure portion of the circulatory system. carrying blood from the heart to the whole body. which is in direct contact with the flow of blood is the tunica intima. The hollow internal cavity in which the blood flows is called the lumen. This pressure variation within the artery produces the pulse which is observable in any artery. The larger arteries (>10mm diameter) are . called the systolic pressure.slowly and progressively compromised by years of deterioration. which must be studied with the aid of a microscope. and returns deoxygenated blood back to the heart. Gross anatomy The arterial system or the human body is divided into systemic arteries. and microscopic anatomy. commonly called the intima. Types of arteries Pulmonary arteries The pulmonary arteries carry deoxygenated blood that has just returned from the body to the heart towards the lungs. Anatomy The anatomy of arteries can be separated into gross anatomy. when the heart expands and refills. and the minimum. and returns oxygenated blood back to the heart. (See atherosclerosis). Anatomy of the arterial wall The outermost layer is known as the tunica externa formerly known as "tunica adventitia" and is composed of connective tissue. Arteries also aid the heart in pumping blood.according to the relative compositions of elastic and muscle tissue in their tunica media as well as their size and the makeup of the internal and external elastic lamina. carrying blood from the heart to the lungs. and pulmonary arteries. to the lungs. Arteries carry oxygenated blood away from the heart except for pulmonary arteries. Arterial pressure varies between the peak pressure during heart contraction. which is made up of smooth muscle cells and elastic tissue. This layer is made up of mainly endothelial cells. Systemic arteries Systemic arteries can be subdivided into two types . to the body. Systemic arteries Systemic arteries are the arteries of the systemic circulation.muscular and elastic . The innermost layer. Pulmonary arteries See also: Pulmonary circulation Pulmonary arteries are the arteries of the pulmonary circulation. where carbon dioxide is exchanged for oxygen.
across which the greatest pressure drop occurs. are the principal determinants of arterial blood pressure at any given moment. They differ from arteries in structure and function. oxygen and carbon dioxide and nutrients and wastes are exchanged In the kidneys. sugars and other nutrients to surrounding tissues. help regulate blood pressure by the variable contraction of the smooth muscle of their walls. namely the brachiocephalic artery. These small diameters of the capillaries provide a relatively large surface area for the exchange of gases and nutrients. The combination of heart output (cardiac output) and systemic vascular resistance. which supply blood to the heart muscle itself. It receives blood directly from the left ventricle of the heart via the aortic valve. the left common carotid and the left subclavian arteries. The Aorta The aorta is the root systemic artery. a red blood cell is typically 7 micrometers outside diameter. exceptions are the pulmonary and umbilical veins. they become successively smaller in diameter. veins (from the Latin vena) are blood vessels that carry blood towards the heart. The red blood cells must distort in order to pass through the capillaries.  What capillaries do: In the lungs. The very first branches off of the aorta are the coronary arteries. for example.generally elastic and the smaller ones (0. Systemic arteries deliver blood to the arterioles. and wastes released In the circulatory system. The capillaries are a single cell in diameter to aid fast and easy diffusion of gases. The arterioles supply capillaries which in turn empty into venules.1-10mm) tend to be muscular. the smallest of the true arteries. where nutrients and gasses are exchanged. and these arteries branch in turn. which refers to the collective resistance of all of the body's arterioles. Most veins carry deoxygenated blood from the tissues back to the lungs. As the aorta branches. Arterioles Arterioles.  Functions of capillaries Capillaries have no smooth muscle surrounding them and have a diameter less than that of red blood cells. They are the primary "adjustable nozzles" in the blood system. Anatomy Cross section of a vein showing a valve which prevents backflow . Capillaries The capillaries are where all of the important exchanges happen in the circulatory system. nutrients are picked up. both of which carry oxygenated blood. carbon dioxide is exchanged for oxygen In the tissues. wastes are released to be eliminated from the body In the intestine. Arterioles and blood pressure Arterioles have the greatest collective influence on both local blood flow and on overall blood pressure. capillaries typically 5 micrometers inside diameter. These are followed by the branches off the aortic arch. arteries are more muscular than veins and they carry blood away from the heart. and then to the capillaries. down to the arteriole. and deliver blood to the capillaries.
called tunica adventitia or tunica externa. entering the veins filled with cellular waste and carbon dioxide. The thick outermost layer of a vein is made of connective tissue. which empties into the left ventricle. The arteries are perceived as carrying oxygenated blood to the tissues. Incompetence of this vein is an important cause of varicose veins of lower limbs. by far the larger of the two circuits of blood in the body. Long periods of standing can result in blood pooling in the legs. The return of blood to the heart is assisted by the action of the skeletal-muscle pump which helps maintain the extremely low blood pressure of the venous system. This phenomenon is the opposite of Rayleigh scattering. These are infoldings of the tunica intima. In these cases the smooth muscles surrounding the veins become slack and the veins fill with the majority of the blood in the body. First described by the Persian physician Avicenna. The interior is lined with endothelial cells called tunica intima. keeping blood away from the brain and causing unconsciousness. The de-oxygenated blood is taken by veins to the right atrium of the heart. where it is then pumped through the pulmonary arteries to the lungs. The pulmonary veins carry relatively oxygenated blood from the lungs to the heart. meaning hidden. respectively. Deeper are bands of smooth muscle called tunica media. which are generally thin as veins do not function primarily in a contractile manner. permitting only the highly energetic blue wavelengths to penetrate through to the dark vein and reflect off. In pulmonary circulation the pulmonary veins return oxygenated blood from the lungs to the left atrium. where its nutrients and gases are exchanged at capillaries. which transports oxygen from the heart to the tissues of the . Veins appear blue because the subcutaneous fat absorbs low frequency light. Examples of such systems include the hepatic portal vein and hypophyseal portal system. completing the cycle of blood circulation. In systemic circulation oxygenated blood is pumped by the left ventricle through the arteries to the muscles and organs of the body.Veins generally function to return deoxygenated blood to the heart. A portal venous system is a series of veins or venules that directly connect two capillary beds. which is usually dark red as a result of its low oxygen content. Color Vein color is determined in large part by the color of venous blood. Most veins have one-way flaps called venous valves that prevent blood from flowing back and pooling in the lower extremities due to the effects of gravity. Neurogenic and hypovolaemic shock can also cause fainting. The precise location of veins is much more variable from person to person than that of arteries. with blood pressure too low to return blood to the heart. The superior and inferior venae cavae carry relatively deoxygenated blood from the upper and lower systemic circulations. and are essentially tubes that collapse when their lumens are not filled with blood. which transfers the blood to the right ventricle. Function Veins serve to return blood from organs to the heart. This vein is "hidden" in its own fascial compartment in the thigh and only exits the fascia near the knee. This is true of the systemic circulation. Fainting can be caused by failure of the skeletal-muscular pump. the reason the sky is blue. Saphenous derives its name from Safina. Notable veins and vein systems The greater saphenous vein is the most important superficial vein of the lower limb. while veins carry deoxygenated blood back to the heart.
Classification Veins are classified in a number of ways. the contractions of skeletal muscles). small. which comes into contact with the parenchymal cells of the body. such as dendritic cells. The lymphatic system has three interrelated functions: it is responsible for the removal of interstitial fluid from tissues. The lymph also carries lymphocytes from the efferent . deep. The lymph is then moved along the lymphatic vessel network by either intrinsic contractions of the lymphatic vessels or by extrinsic compression of the lymphatic vessels via external tissue forces (e. and have no corresponding arteries. Lymphoid tissue is found in many organs. and in the lymphoid follicles associated with the digestive system such as the tonsils. it absorbs and transports fatty acids and fats as chyle to the circulatory system. For example. in pulmonary circulation the arteries carry deoxygenated blood from the heart to the lungs and veins return blood from the lungs to the heart. and it transports immune cells to and from the lymph nodes. Superficial veins Superficial veins are those whose course is close to the surface of the body. The difference between veins and arteries is their direction of flow (out of the heart by arteries. The system also includes all the structures dedicated to the circulation and production of lymphocytes. bone marrow and the lymphoid tissue associated with the digestive system. not their oxygen content. but constituents of the blood first exit the microvascular exchange blood vessels to become interstitial fluid. Portal veins carry blood between capillary beds. The lymph transports antigen-presenting cells (APCs). returning to the heart for veins). thymus. Deep veins Deep veins are deeper in the body and have corresponding arteries. including superficial vs. However.g. The blood does not directly come in contact with the parenchymal cells and tissues in the body. pulmonary vs. The lymphatic system in vertebrates is a network of conduits that carry a clear fluid called lymph. there is an exception. The blood is then drained in the gastrointestinal tract and spleen where it is taken up by the hepatic veins and blood is taken back into the heart. which includes the spleen. and large vs. Since this is an important function in mammals. Systemic veins Systemic veins drain the tissues of the body and deliver deoxygenated blood to the heart. Although most veins take blood back to the heart.body. though it is considerably less than that carried by the systemic arteries or pulmonary veins. the hepatic portal vein takes blood from the capillary beds in the digestive tract and transports it to the capillary beds in the liver. Lymph is the fluid that is formed when interstitial fluid enters the initial lymphatic vessels of the lymphatic system. Pulmonary veins The pulmonary veins are a set of veins that deliver oxygenated blood from the lungs to the heart. particularly the lymph nodes. The lymphatic system as we know it today was first described independently by Olaus Rudbeck and Thomas Bartholin. Blood clotting in the hepatic portal vein can cause portal hypertension which results in a decrease of blood fluid to the liver. systemic. to the lymph nodes where an immune response is stimulated. In addition. damage to the hepatic portal vein can be dangerous. It also includes the lymphoid tissue through which the lymph travels. deoxygenated blood that is carried from the tissues back to the heart for reoxygenation in systemic circulation still carries some oxygen.
primary prevention is needed. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 7–9 years. and cancer than cardiovascular disease. Problems with the system can impair the body's ability to fight infections. The process of atherosclerosis evolves over decades. and begins as early as childhood. The intervening lymph nodes can trap the cancer cells. In order to stem the tide of cardiovascular disease. prognosis. PATHOPHYSIOLOGY Population based studies in the youth show that the precursors of heart disease start in adolescence. because of its physical proximity to many tissues of the body.lymphatics exiting the lymph nodes. This is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. However. The lymphatic system. and treatment of cancer. Primary prevention starts with education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken LABORATORY RESULTS NURSING CARE PLAN DRUG STUDY . If they are not successful in destroying the cancer cells the nodes may become sites of secondary tumors. accidents. Diseases and other problems of the lymphatic system can cause swelling and other symptoms. is responsible for carrying cancerous cells between the various parts of the body in a process called metastasis. The study of lymphatic drainage of various organs is important in diagnosis. most adolescents are more concerned about other risks such as HIV.