Cardiovascular

System

Prepared by: Caroline V.

San Diego MAN,RN

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 AGING CHANGES IN
CARDIOVASCULAR STRUCTURE
• Decrease in Myocardial cells
• Decrease in Aortic Distensibility
• Decrease in Vascular tone
• Increase in Heart Weight
• Increase in Myocardial Cell Size
• Increase in Left ventricle wall thickens
• Increase Artery Stiffness
• Increase in Collagen, Elastin
• Increase in Atrium Size 3
 AGING CHANGES IN
CARDIOVASCULAR FUNCTION
• Decrease Diastolic pressure
• Decrease Diastolic Filling
• Decrease to Beta-adrenergic stimulus
• Increase in Systolic Pressure
• Increase Arterial pressure
• Increase in wave velocity
• Increase in left end diastolic pressure
• Elongation of muscle contraction phase
• Elongation of muscle relaxation phase
• Elongation of ventricular relaxation 4
NO CHANGE WITH AGE
•Ejection Fraction
•Stroke Volume
•Overall Systolic function
EXERCISE AND AGING
•Maximum Oxygen consumption decreases to
10% as the person aged.
•Continued Exercise:
•To increase the end diastolic pressure
•Increase the stroke volume
•Increase the vascular resistance
Increase the systolic and diastolic 5
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 Prevalence of Cardiovascular
Disease
➢32% of all deaths in 2008 contributed with
CVD.
➢no. 1 cause of Mortality in the Elderly.

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HYPERTENSION
• A Raise in blood pressure.
• 65-74: 63.6% of men and
73.9% of women were
diagnosed to had HTN in
2004. 75 or older: 69.5% of
Men and 83.8% of women
had HTN.
– Essential Hypertension –
no known cause (95%)
– Secondary Hypertension
– elevation of Blood
pressure from a disease
process.

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 Risk Factors:
Non-Modifiable: Modifiable
• Race • Sedentary
Lifestyle
• Heredity
• High Sodium
• Increase with Intake
Age
• Heavy Alcohol
• Male Gender consumption
• Diabetes and • Obesity
Renal Disease • Pregnancy
• Some Oral
Contraceptives 9
•CORONARY HEART DISEASE
•also known as Coronary Artery Disease (CAD)
or Ischemic Heart Disease.
•82% died with CHD are aged 65 years or over.
•Caused by hardening and narrowing of the blood
vessels of the heart. (Atherosclerosis
)

M.I
Main Cause: CAD
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• Pain- Crushing or substernal
• May radiate to jaw,neck, L arm
Unrelieved by nitroglycerin or rest
Priority Nrsg Dx:

ain
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 MI: ECG

ST elevation- injury
T wave inversion- ischemia
Abn. Q wave -necrosis

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 Complications of AMI

C ardiogenic shock

Arrythmias- most common

Recurrent chest discomfort
 INTERVENTIONS
Morphine - Relieves MI pain
Aspirin
ACE INHIBITOR
Reperfusion treatment

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 Thrombolytic

Dissolve thrombus/ clot in coronary arteries

T-PA (alteplase)
Streptokinase
 INTERVENTIONS

Assess Pain
O2
Semi fowlers , Bedrest
ANGINA
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 S table Angina

R elieved -by rest & drugs

Occurs during exertion

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 UNstable Angina
Not relieved by rest & drug
Occurs on exertion emotion

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 VARIANT /Prinzmetal’s Angina

• Cause: Arterial Spasm

–may occur at rest

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 ANGINA:

Nitroglycerin- DOC of angina

- vasodilator- dilates 1 vein then arteries
st

- Preload , after load, BP SE: flushing, headache

- Store in dark container
- Refill q 6 mos
-
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 Heart Failure: Etiology

MI

Incompetent valves
Cardiomyopathy
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 Medication

Diuretics- pulmonary congestion

VasoDilators preload

Digoxin- improve Cardiac contractility

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