CARDIOVASCULAR

DISORDERS
 LEARNING OBJECTIVES:
At the end of the lecture, the students will be able to:
1. Identify the major organs and structures of cardiovascular
system
2. Discuss the risk factors associated in the development of
cardiovascular disorder
3. Discuss the physical assessment that provide information
about the functioning of the cardiovascular disorder
4. Describe common diagnostic tests and their nursing
responsibilities
5. Discuss the pathophysiology of clients with
cardiovascular disorder
6. Enumerate the different clinical manifestations
associated with each illness of clients with
cardiovascular disorder
7. Identify actual and at-risk nursing diagnosis
8. Discuss medical and surgical interventions
9. Discuss the appropriate nursing interventions with
client/s and family for identified nursing interventions
10.Implement plan of care with clients and family
 CARDIOVASCULAR
SYSTEM

is a closed system consisting of the

heart and blood vessels
FUNCTION
- to supply body cells
and tissues with
oxygen-rich blood and
eliminate carbon
dioxide and cellular
wastes
HEART
- a cone-shaped muscle
with four chambers; a
double pump about the
size of a clenched fist

-pumps blood throughout circulatory system

LAYERS OF THE HEART
 ARTERIES
- blood vessels withthree coats:
tunicaintima, tunica media, and
tunica adventitia.
- carry oxygenated blood away from
left heart and unoxygenated blood
to lungs via pulmonary arteries
 VEINS

VEINS carry unoxygenated blood

back to right heart, except for
pulmonary veins, which carry
oxygenated blood from lungs to left
heart.
CARDIAC OUTPUT
– is the amount of
blood pumped out of
the left ventricle
each minute
 CARDIO
VASCULAR

ASSESSMENT
PAST MEDICAL HISTORY REVIEW
OF ALLERGIES MEDICATION
HISTORY FAMILY HISTORY
PERSONAL AND SOCIAL HISTORY
COMMON MANIFESTATIONS OF
HEART DISEASE

CHEST
PAIN
OTHER MANIFESTATIONS:
• shortness of
breath
• palpitations
• weakness
• fatigue
• dizziness
• syncope
• GI complaints
 PHYSICAL EXAMINATION
GENERAL APPEARANCE
-non-verbal behavior and body position
(anxious, depressed, pain, uncomfortable)

PAIN
-classic sign of
ischemia
 PHYSICAL EXAMINATION
VITAL SIGNS

TEMPERATURE
-note presence of fever

PULSE RATE
-note rate, rhythm and quality

RESPIRATORY RATE
-if patient has labored breathing

BLOOD PRESSURE
-take BP lying, sitting, & standing positions (orthostatic VS)
 CARDIAC RHYTHM
-electrical activity can be
observed continuously
with bedside CARDIAC
MONITOR

-electrodes are attached to the chest &

connected to a machine that displays the
cardiac rhythm
 SKIN
-note changes in skin color (cyanosis,
pallor)
-note if the skin is warm or cold, dry
or clammy
 PERIPHERAL EDEMA
EDEMA occurs when blood is not
pumped efficiently, or plasma
protein levels are inadequate to
maintain osmotic pressure
AREA: feet and ankles
OTHER AREAS: fingers, hands, over the
sacrum
Evaluated on a scale of 1-4
 WEIGHT GAIN
-can indicate edema

JUGULAR VEINS
-distention of this vein usually indicates
increased fluid volume and pressure in the
right side of the heart
 MENTAL STATUS
-if patient is alert and oriented,
confused and disoriented
CONFUSION and
DISORIENTATION can
result from a decrease in the oxygen
supply to the brain (cerebral
ischemia) as a result of poor
circulation
DIAGNOSTIC
TESTS
 Diagnostics
❑ Blood Test (CK-MB),
Troponin Levels, CBC, PT, PTT, Blood
Chemistry

❑ ECG
❑ 24-hour Holter
Monitoring
❑ Stress Test
❑ Chest Xray
❑ CT Scan, MRI,
❑ Ultrasound
TREATMENTS
DRUG THERAPY
ADRENERGICS
ANTIANGINALS
ANTIARRHYTHMICS
ANTIHYPERTENSIVES
ANTILIPEMICS
ANTIPLATELET AGENTS
DIURETICS
INOTROPHIC AGENTS
THROMBOLYTICS
CARDIAC
PACING
CARDIAC PACEMAKER

- is an electronic
device that delivers
direct electrical
stimulation to stimulate
the myocardium to
depolarize, initiating a
mechanical contraction
 INDICATIONS
1. Symptomatic bradydysrhythmias
2. Symptomatic heart block
a. Mobitz II second-degree heart block
b. Complete heart block
3. Prophylaxis
a. After acute MI: dysrhythmia and conduction
defects
b. Before or after cardiac surgery
c. During diagnostic testing
 INDICATIONS

4. Tachydysrhythmias; to break rapid

rhythm disturbances
a. Supraventricular tachycardia
b. Ventricular tachycardia
 TYPES
PERMANENT PACEMAKERS

Used to treat chronic heart conditions;

surgically placed, utilizing a local
anesthetic, the leads are placed
transvenously in the appropriate
chamber of the heart and then anchored
to the endocardium
 TEMPORARY PACEMAKERS

are usually placed during an

emergency, such as when a patient
demonstrates signs of decreased
CO until the temporary condition is
resolved
SURGERY
 CORONARY ARTERY BYPASS
GRAFTING

• CABG circumvents anoccluded

coronary artery with an
autogenous
graft (usually a segment of
saphenous vein or internal mammary
artery, thereby restoring blood flow
 Coronary artery
bypass graft
surgery is done
primarily to
alleviate anginal
symptoms as well
as improve
survival
 CANDIDATES FOR CABG

-
Severe angina from atherosclerosis
-
CAD with high risk of MI
 VASCULAR REPAIR
May treat:
- Vessels damaged by arteriosclerotic or
thromboembolic disorders (such as aortic
aneurysm or arterial occlusive disease), trauma,
infections, or congenital defects
- Vascular obstructions that severely compromise
circulation
- Vascular disease that doesn’t respond to drug
therapy
- Life-threatening dissecting or ruptured aortic
aneurysm
 BALLOON CATHETER
TREATMENTS
⮚ PERCUTANEOUS BALLOON
VALVULOPLASTY

⮚ PERCUTANEOUS
TRANSLUMINAL CORONARY
ANGIOPLASTY (PTCA)
▪ can be performed in the cardiac catheterization
laboratory
▪ seeks to improve valvular function by enlarging the
orifice of a stenotic heart valve caused by
congenital defect, calcification, rheumatic fever, or
aging
▪ offers a nonsurgical alternative to coronary artery
bypass surgery
▪ uses a balloon-tipped catheter to dilate a coronary
artery that has become narrowed because of
atherosclerotic plaque
▪ can open an occluded coronary artery without
opening the chest
DISEASES
OF THE
HEART
 Thrombus
a blood clot that can develop
anywhere in the vascular system
causing the narrowing of a vessel.
blood flow can be occluded
(reduced or totally blocked)
 Embolus
– a substance that travels in the bloodstream from a primary
site to a secondary site
– becomes trapped in the vessels at the secondary site
– causes blood flow obstruction.
– Most emboli are blood clots (thromboemboli)
usually, deep leg veins

- Other sources of emboli

• fat
– released during the break of a long bone
– produced in response to any physical trauma, and amniotic
fluid
» which may enter maternal circulation during the intense
pressure gradients generated by labor contractions.
 CORONARY ARTERY DISEASE
⮚ Focal narrowing of the large and
medium-sized coronary arteries
⮚ Due to deposition of atheromatous
plaque in the vessel wall
⮚ LIPID or FATTY Substance
⮚ FIBROUS TISSUE
 RISK FACTORS
Hereditary, including race
Age & Gender
Cigarette Smoking
- Hypertension
-Elevated Serum Cholesterol Level
- Diabetes Mellitus
- Physical Inactivity
- Obesity
ARTERIOSCLEROSIS – hardening
of the arteries, which results in loss
of elasticity of intimal layer of the
artery

ATHEROSCLEROSIS –accumulated
fatty plaques made of lipids inthe
arteries
 SIGNS AND SYMPTOMS
ANGINA (classic symptom)
▪ occurs as burning, squeezing or
crushing tightness in the substernal
or precordial chest
▪ may radiate to the left arm, neck, jaw
or shoulder blade
 MAJOR FORMS OF ANGINA
STABLE
- pain that’s predictable in frequency and duration and can
be relieved with nitrates and rest.

UNSTABLE
- increased pain that’s easily induced

PRINZMETAL’S or VARIANT
- From Unpredictable coronary artery spasm

MICROVASCULAR
- impairment of vasodilator reserve, which causes angina-
like chest pain in a patient with normal coronary arteries
OTHER SIGNS AND SYMPTOMS
Nausea
Vomiting
Weakness
Diaphoresis
Cool extremities
Diagnostics
✔ ECG
✔ STRESS TEST
✔ CRONARY ANGIOGRAPHY
✔ BLOOD CHEMISTRY
 CORONARY ARTERY DISEASE

NURSING DIAGNOSIS
❑ Acute pain
❑ Decreased Cardiac Output
❑ Anxiety
 CORONARY ARTERY DISEASE

MEDICAL MANAGEMENT
❑ SURGERY

❑ Nitrates
❑ Antiplatelets
❑ Antilipemics
❑ Beta-adrenergic blockers
❑ Calcium channel blockers
 CORONARY ARTERY DISEASE

NURSING MANAGEMENT
❑ Alleviate pain/ Promote pain relief
❑ Maintain Cardiac output at its normal
level
❑ Decrease Anxiety
 CORONARY ARTERY DISEASE

PREVENTION
❑ Cessation of Smoking
❑ Control BP
❑ Diet
❑ Limit alcohol intake
❑ Exercise
❑ Weight control
❑ Control of DM
 MYOCARDIAL INFARCTION
refers to a dynamic process by
which one or more regions of
the heart experience a severe
and prolonged decrease in
oxygen supply because of
insufficient coronary blood
flow; subsequently, necrosis or
death to the myocardial tissue
occurs
 MYOCARDIAL INFARCTION
Obstruction in a coronary
artery resulting in
necrosis

Due to:
Atherosclerotic plaque
Thrombus
Embolism
 MYOCARDIAL INFARCTION
CLINICAL MANIFESTATIONS
o CHEST PAIN
o Typically, persistent and crushing, located
substernal with radiation to the arm, neck, jaw
and unrelieved by rest or nitrates
o Occurs without cause, primarily early morning
o NOT relieved by rest or nitroglycerin lasts 30
minutes or longer
 MYOCARDIAL INFARCTION
CLINICAL MANIFESTATIONS
o Diaphoresis, cool clammy skin, facial pallor
o Hypertension or hypotension
o Bradycardia or tachycardia
o Premature ventricular and/or atrial beats
o Palpitations, severe anxiety, dyspnea
o Disorientation, confusion, restlessness
o Fainting, marked weakness
o Nausea, vomiting, hiccups
o Atypical symptoms: epigastric or abdominal distress, dull
aching or tingling sensations, shortness of breath,
extreme fatigue
 MYOCARDIAL INFARCTION
DIAGNOSTICS
o ST segment is ELEVATED.
o T wave inversion, presence of Q-wave
o Elevated CK-MB, LDH and Troponin levels CBC -
Elevated WBC count
 MYOCARDIAL INFARCTION
NURSING DIAGNOSIS
o Acute Pain
o Anxiety related to chest pain, fear of death, threatening
environment
o Decreased Cardiac Output related to impaired contractility
o Activity Intolerance
o Risk for Injury (bleeding) related to dissolution of
protective clots
 MYOCARDIAL INFARCTION
MEDICAL MANAGEMENT

o Morphine sulfate
o O2 therapy
o Nitrates
o Aspirin
 MYOCARDIAL INFARCTION
NURSING MANAGEMENT

o Administer prescribed medications

o Monitor cardiac enzymes
o Minimize anxiety
o Diet (low sodium, low cholesterol, low fat
diet)
o prepare the client for treatment, such as
percutaneous transluminal coronary
angioplasty and coronary artery bypass
grafting
 HEART FAILURE
is a syndrome of pulmonary or
systemic circulatory congestion
caused by decreased myocardial
contractility, resulting in inadequate
CO to meet oxygen requirements of
tissues.
 HEART FAILURE
CLASSIFICATION:

LEFT-SIDED (or
left ventricular)

RIGHT-SIDED (or
right ventricular)
 HEART FAILURE
CAUSES:

❖ Atherosclerotic heart disease

❖ MI
❖ Hypertension
❖ Rheumatic heart disease
❖ Congenital heart disease
❖ Ischemic heart disease
❖ Arrhythmias
 HEART FAILURE
DIAGNOSTICS:

❖ ECG
❖ Chest Xray
❖ ABG
❖ Ct Scan/ MRI
 HEART FAILURE
CLINICAL MANIFESTATIONS

Left Sided HF
▪ decreased peripheral pulses and capillary refill
▪ Decreased urinary output easy fatigability
▪ Insomnia and restlessness
▪ dyspnea on exertion, paroxysmal nocturnal dyspnea, or
orthopnea
▪ crackles on lung auscultation
▪ frothy blood-tinged sputum
▪ tachycardia with S3 heart sound
▪ pale, cool extremities
▪ peripheral and central cyanosis
 HEART FAILURE
CLINICAL MANIFESTATIONS

Right Sided HF
▪ dyspnea on exertion, paroxysmal nocturnal dyspnea, or
orthopnea
▪ crackles on lung auscultation
▪ frothy blood-tinged sputum
▪ tachycardia with S3 heart sound
▪ pale, cool extremities
▪ peripheral and central cyanosis
 HEART FAILURE

NURSING DIAGNOSIS:

❖ Decreased CO related to an
ineffective ventricular pump
 HEART FAILURE
PHARMACOLOGIC TREATMENT:
❖ Vasodilators
❖ Diuretics
❖ Digoxin
❖ Dobutamine
❖ Beta-adrenergic blocking agents
(metoprolol, carvedilol)
 HEART FAILURE
NURSING MANAGEMENT:
ϑ
Administer medications as ordered
ϑ
Provide ongoing assessment
-Monitor hemodynamic parameters, HR,
rhythm,
-weigh OD
ϑ
Prevent complications of immobility
 HEART FAILURE
NURSING MANAGEMENT:

✔ Provide a low-sodium diet, as

prescribed
✔ Provide client and family teaching
 HYPERTENSION
refers to an intermittent or sustained
elevation in diastolic or systolic blood
pressure
 Guidelines for
Determining
Category Hypertension
Systolic Pressure Diastolic Pressure

Normal <120 mm Hg <80 mm Hg

Prehypertension 120-139 mm Hg 80-89 mm Hg

Stage 1 140-159 mm H g90-99 mm Hg
hypertension
>160 mm Hg >100 mm Hg
Stage 2
hypertension
 HYPERTENSION
RISK FACTORS
❑ Family history of hypertension
❑ Race (more common in blacks)
❑ Gender
❑ Diabetes mellitus
❑ Stress
❑ Obesity
❑ High dietary intake of saturated fats or sodium
❑ Tobacco use
❑ Hormonal contraceptive use
❑ Sedentary lifestyle
❑ aging
 HYPERTENSION
SYMPTOMS:
❖ blood pressure measurements of more
than 140/90mmHg
❖ Throbbing occipital headaches upon
waking
❖ Drowsiness
❖ Confusion
❖ vision problems
❖ nausea
 HYPERTENSION
DIAGNOSTICS:

• BUN - May be elevated

• SERUM CREATININE - determines
if renal dysfunction is present as a
complication of hypertension
• Total cholesterol, Triglycerides
• Electrocardiogram (ECG)
 HYPERTENSION
TREATMENT:
SECONDARY HPN - correcting the
underlying cause and controlling
hypertensive effects
LIFESTYLE MODIFICATIONS:
change in diet, relaxation
techniques, exercise, smoking
cessation,
 HYPERTENSION
TREATMENT:
DRUG THERAPY

THIAZIDE – for uncomplicated HPN

ACE INHIBITOR
BETA-ADRENERGIC BLOCKER
 HYPERTENSION
TREATMENT:
ΕDRUG THERAPY

Angiotensin II receptor
blockers Alpha-receptor
blockers Calcium channel
blockers
 HYPERTENSION
NURSING DIAGNOSIS:
Knowledge deficit related to chronic
disease management

INTERVENTIONS: Health education;

Teaching: Diet, Disease process, Health
behaviors, Medication, Prescribed
activity, Treatment regimen
 INFLAMMATORY
DISORDERS OF THE
PERIPHERAL BLOOD
VESSELS
 VARICOSE VEINS
• Permanently distended
veins that develop from
loss of valvular
competency
• Faulty valves elevate
venous pressure
• Causes distension and
tortuosity
 Predisposing Factors

❑ Pregnancy
❑ Obesity
❑ Heart disease
 Assessment Findings

• Aching, a feeling of
heaviness in the legs
• Itching, moderate swelling
• Superficial inflammation
• Dilated tortuous skin veins
 Diagnostics

❑ Trendelenberg test:
❑ Doppler ultrasound
❑ Decrease or no blood flow heard
after calf or thigh compression
Medical Management
 THROMBOPHLEBITIS
-is an inflammation of a vein
accompanied by clot or thrombus
formation
DEEP VEIN
THROMBOSIS –
veins that are
deep in the lower
extremeties
 THROMBOPHLEBITIS
-when inner lining of a vein is irritated or
injured, platelets clump together, forming
a clot
ι
Clot interferes with blood flow, causing
congestion of venous blood
 THROMBOPHLEBITIS
SIGNS AND SYMPTOMS

-complaints of discomfort in the affected

extremity
-Calf pain (+Homan’s sign)
-heat, redness, swelling on the affected
vein
 THROMBOPHLEBITIS

DIAGNOSTICS

VENOGRAPHY –
indicates a filling
defect in the area
of the clot
 THROMBOPHLEBITIS
MANAGEMENT
Complete rest of the affected part
anticoagulant therapy (heparin)
Continues warm, wet packs – to
improve circulation, ease pain, decrease
inflammation
THROMBECTOMY- surgical removal
of the clot
THROMBOANGITIS OBLITERANS
(BUERGER’S DISEASE)

Inflammatory, nonatheromatous
occlusive condition that causes
segmental lesions and subsequent
thrombus formation

- affects small arteries and veins of

the legs
THROMBOANGITIS OBLITERANS
(BUERGER’S DISEASE)
CAUSE:
-unknown but definite link
to smoking

CLINICAL
MANIFESTATIONS:
-Intermittent Claudication
THROMBOANGITIS OBLITERANS
(BUERGER’S DISEASE)
- No specific treatment exist,
except smoking cessation

- Amputation
maybe necessary
for patients with
gangrene
formation
 INFECTIOUS AND
INFLAMMATORY
DISORDERS OF THE
HEART
 RHEUMATIC FEVER
is a systemic inflammatory disease
that sometimes follows a group A
streptococcal infection of the throat

RHEUMATIC CARDITIS
refers to the inflammatory cardiac
manifestations of Rheumatic Fever in
either the acute or later stage
 RHEUMATIC FEVER

STRUCTURES AFFECTED:

heart valves, praticularly mitral valve

endocardium
myocardium
pericardium
 RHEUMATIC FEVER
SIGNS AND SYMPTOMS:

most commonin children 2-3 weeks

after a streptococcal infection

CARDITIS – inflammation of the layers

of the heart
 RHEUMATIC FEVER
POLYARTHRITIS – inflammation of
more than 1 joint
rash, subcutaneous nodules,
chorea (characterized by involuntary
Grimacing & an inability to use skeletal
muscles in coordinated manner)
 RHEUMATIC FEVER
SIGNS AND SYMPTOMS:
mild fever
Heart rate (rapid, rhythm abnormal)
Red, spotty rash (trunk, disappears
rapidly)
Swollen, warm, red & painful joints
 RHEUMATIC FEVER

DIAGNOSTICS:
no specific laboratory tests
ASO titer
ESR, C-reactive protein –
elevated, ECG,
ECHOCARDIOGRAPHY –
structural changes in the heart
 RHEUMATIC FEVER
MEDICAL MANAGEMENT:
IV ANTIBIOTICS:
PENICILLIN – drug of choice
Others: AZYTHROMYCIN
(ZYTHROMAX),
CLINDAMYCIN, VANCOMYCIN
CEPHALOSPORINS:
Cephalexin, Cefadroxil
 RHEUMATIC FEVER
MEDICAL MANAGEMENT:
ASPIRIN – to control the formation of
blood clots around heart valves
STEROIDS – to suppress the
inflammatory response
BED REST
 RHEUMATIC FEVER
MEDICAL MANAGEMENT:
SURGERY may be required to treat
constrictive pericarditis and damage to
heart valves
 RHEUMATIC FEVER
NURSING MANAGEMENT:
Administer prescribed
drug therapy and monitor
for therapeutic and
adverse effects

Plan diversional activities that require

minimal activity
INFECTIVE ENDOCARDITIS
formerly called BACTERIAL
ENDOCARDITIS
is inflammation of the inner layer of
heart tissue as a result of an
infectious microorganism
MICROORGANISM – bacteria and
fungi BACTERIA: Streptococcus
viridans, Staphylococcus aureus
 INFECTIVE ENDOCARDITIS
SIGNS AND SYMPTOMS:
-can have an acute onset – less than one week
-fever, chills, muscle aches in the lower back and thighs, joint
pain
SPLINTER HEMORRHAGES – black
longitudinal lines can be seen in the nails
-JANEWAY LESIONS – small, painless, red-blue macular lesions
on the palms and soles of the feet
ROTH’S SPOT – white areas in the retina surrounded by areas
of hemorrhage
 INFECTIVE ENDOCARDITIS
SIGNS AND SYMPTOMS:
- HEART MURMUR – may be present from
malfunctioning valves
- PETECHIAE – tiny red-dish hemorrhagic spots
on the skin and mucous membranes
- weakness, anorexia, weight loss
 INFECTIVE ENDOCARDITIS
DIAGNOSTICS:
- BLOOD CULTURE – to determine
microorganism circulating in the blood

- ECG
INFECTIVE ENDOCARDITIS
MEDICAL MANAGEMENT
⮚ High doses of IV Antibiotics
⮚ Antibiotic Therapy extends at least
2- 6 weeks
⮚ Bedrest
⮚ SURGERY – valve replacement if
heart valve is severely damaged
INFECTIVE ENDOCARDITIS
NURSING MANAGEMENT
❑ Remind client to limit activity
❑ Assess for changes in weight and
pulse rate and rhythm
❑ Administer prescribed antibiotics
❑ Inform client that periodic antibiotic
therapy is a lifelong necessity
because they will be vulnerable to the
disease for the rest of their lives
 MYOCARDITIS
is an inflammation of the
myocardium (the muscle layer of
the heart)
CAUSES: Viral, bacterial,
fungal, or parasitic infections
VIRAL AGENTS: coxsackie virus A & B,
influenza A & B, measles, adenovirus,
mumps, rubeola, rubella
 MYOCARDITIS
Inflammatory response causes
the cardiac muscle to swell
ι
Interferes with the myocardium’s ability to
stretch and recoil
ι
Cardiac output is reduced, and blood
circulation is impaired, predisposing the
client to CHF
 MYOCARDITIS
CLINICAL MANIFESTATIONS:

❑ sharp stabbing pain or squeezing chest

discomfort that resembles a MI (pain is relieved
by sitting up)
❑ Low-grade fever, tachycardia, dysrhythmias
❑ Dyspnea, malaise, fatigue, anorexia
❑ Skin is pale and cyanotic
❑ Neck vein distention, ascites,
❑ Peripheral edema,
❑ Crackles
 MYOCARDITIS
DIAGNOSTICS:

❑ WBC = elevated
❑ C-Reactive protein = elevated,
inflammatory conditions
❑ CARDIAC ISOENZYMES = elevated
❑ CHEST XRAY = heart enlargement,
fluid infiltration in the lungs
 MYOCARDITIS
MANAGEMENT
❑ Treat underlying cause and prevent
complications
❑ ANTIBIOTICS if bacterial
❑ Bed Rest
❑ Sodium-restricted diet
❑ Cardiotonic drugs – digitalis to prevent or
treat heart failure
❑ Heart transplant is necessary in severe
cases of cardiomyopathy
 MYOCARDITIS
NURSING MANAGEMENT
❑ Monitor client’s cardiopulmonary status
(daily weights, vital signs, I & O, heart &
lung sounds, edema)
❑ Maintain bed rest
❑ Administer antipyretics if patient has
fever
❑ Elevate head of the bed for maximal
breathing potential
 CARDIOMYOPATHY
is a chronic condition characterized by
structural changes in the heart muscle
TYPES:
DILATED CARDIOMYOPATHY
HYPERTROPHIC CARDIOMYOPATHY
RESTRICTIVE CARDIOMYOPATHY
 CARDIOMYOPATHY
DILATED CARDIOMYOPATHY
-the cavity of the heart is stretched (dilated)

CAUSES: Viral myocarditis, Autoimmune

response, chemicals (chronic alcohol ingestion)

TREATMENT: Drug Therapy to

minimize symptoms & prevent
complications, abstinence from alcohol,
salt restriction, weight loss, possible
 CARDIOMYOPATHY
DILATED CARDIOMYOPATHY
-dyspnea on exertion & when lying
down, fatigue, edema, palpitations,
chestpain
HYPERTROPHIC CARDIOMYOPATHY
-syncope, fatigue, shortness of
breath, chestpain
-some are asymptomatic
 CARDIOMYOPATHY
HYPERTROPHIC CARDIOMYOPATHY
-the muscle of the left ventricle &
septum thickens, causing heart
enlargement)
CAUSES: hereditary, unknown

TREATMENT: Drug Therapy to reduce

heart rate & force of contraction,
antidysrhythmic drugs, artificial pacemaker
 CARDIOMYOPATHY
RESTRICTIVE CARDIOMYOPATHY
-heart muscle stiffens, which interferes with
its ability to stretch & fill with blood
CAUSES: deposits of amyloid, scleroderma,

TREATMENT: no specific treatment, drugs

such as diuretics & antihypertensives used
to control symptoms
 CARDIOMYOPATHY
RESTRICTIVE CARDIOMYOPATHY
-exertional dyspnea, dependent edema in
the legs, ascites, hepatomegaly
 CARDIOMYOPATHY

TREATMENT:
-DIURETICS
-CARDIAC GLYCOSIDES
-ANTIHYPERTENSIVE
 PERICARDITIS
inflammation of the pericardium

PRIMARY – develops
independently of any
other condition

SECONDARY – develops because of

another condition
 PERICARDITIS
Usually secondary to endocarditis,
myocarditis, chest trauma or MI
OTHER CAUSES: tuberculosis,
malignant tumors, uremia
 PERICARDITIS
SIGNS AND SYMPTOMS
Fever and malaise
Dyspnea, or complaints of chest
heaviness
PRECORDIAL PAIN (relieved by upright
or leaning forward)
 PERICARDITIS
DIAGNOSTICS

❑ ECG – ST segment elevation (cardiac

isoenzymes normal)
❑ ECHOCARDIOGRAPHY
❑ WBC & ESR - elevated
 PERICARDITIS
MANAGEMENT
❑ Rest
❑ DRUGS: Analgesics, antipyretics,
NSAIDs, corticosteroids
❑ PERICARDIOCENTESIS -needle
❑ aspiration of fluid from between the
visceral and parietal pericardium