DEFINITION

ETIOLOGY

1. Impaired Filling of Heart Chamber

2. Increase workload on heart

3. Intrinsic pump failure

TYPES OF HEART FAILURE:

• Acute heart failure

• Chronic heart failure
• Left side heart failure
• Right side heart failure
• forward heart failure
• Backward heart failure
• Systolic heart failure
• Diastolic heart failure
• High output heart failure
• Low output heart failure
Pathogenesis Heart

Heart Disease
Impaired filling Intrinsic pump failure
Increased workload

Compensatory action

Fluid and water retention Sympathetic activation

Increase blood volume

Increase force of contraction
Stretching of ventricular fibers Long
Long
term Improve pumping action term
Improved cardiac output

Temporary relief
vasoconstriction
Escape
fluid from
circulation Heart Increase work load
edema failure
SYMPTOMS

First systems: Fatigue, swelling in ankles, feet, and legs, weight gain
Symptoms indicate condition is worsened: irregular heart beat, caught from
congested lungs, shortness of breath
Severe: chest pain, rapid breathing, skin become blue
DIAGNOSIS

• take a careful medical history

• review symptoms and perform a physical examination
• Using a stethoscope, listen lungs for signs of congestion
• Stethoscope also picks up abnormal heart sounds that may
suggest heart failure
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of salt
2. Exercise, weight reduction , limited alcohol intake

PHARMACOLOGICAL :
3. Isotropic drug: group of medicines called vasodilators and uterine
relaxants.  egg cardiac glycoside, dopamine
4. Angiotensine converting enzyme (Angiotensin-converting enzyme (ACE)
inhibitors are medications that help relax the veins and arteries to
lower blood pressure. )
5. Diuretics (Diuretics, sometimes called water pills, help rid your body of
salt (sodium) and water. Most of these medicines help your kidneys
release more sodium into your urine)
Hypertension
DEFINITION

•Hypertension is defined as abnormally high blood pressure ( more than

120/80mm Hg) in the arteries.
•It generally symptomless but increase the risk of various other cardiovascular
diseases like stroke ( Rupture of blood vessel in brain), heart attack, renal damage
etc.
•Clinically blood pressure more than 140/90 mm Hg is considered as hypertension.
ETIOLOGY
• It can happen because of unhealthy lifestyle choices, such as not getting
enough regular physical activity.

•Certain health conditions, such as diabetes and having obesity, can also increase
the risk for developing high blood pressure. Stress.
TYPES OF HYPERTENSION:

1. Primary / Essential Hypertension: It is condition with high blood pressure,

which has no definite cause And treated by general approach.
2. Secondary Hypertension: About 10% people suffer from secondary type of
hypertension which as some general cause such as renal, endocrine ,
cardiovascular, or structural abnormalities are responsible.
3. Isolated systolic Hypertension: In this, systolic pressure is above 140mm Hg
but diastolic remain constant.
4. Malignant Hypertension: It is severe form of hypertension and death may
occur within a few month if not treated.
Pathogenesis
Vascular reactivity is broadly defined as the responsiveness of a blood vessel to a specific
stimulus

 Total peripheral resistance (TPR), is the amount of force exerted on circulating

blood by the vasculature of the body

SYMPTOMS

•Dizziness( Feeling weak, unstable ), Irregular Heart Beat, nausea, vomiting,

fatigue, low or high blood pressure
DIAGNOSIS

• Take a careful medical history

• Review symptoms and perform a physical examination
• Using a stethoscope, listen heart rate
• Using spingnomanometer check Blood pressure.
TREATMENT
NON- PHARMACOLOGICAL:
1. Weight Reduction, Exercise, salt restriction
2. limited alcohol intake, tobacco , cigarette , Relaxation and stress reduction
therapy.

PHARMACOLOGICAL :
3. Diuretics: This agents increase the urine output thus reduce blood volume
eg Furosemide
4. Vasodilators : This agents results in dilation of vascular smooth muscle eg
Minoxidil
5. B- adrenergic blocker: This block the B receptor mediated effect of
sympathetic nervous system and reduce elevated B.P. eg propanolol.
6. A-adrenergic blocker: This agents lower the elevated B.P. by inhibiting
the alpha receptor mediated vasoconstriction eg prazocine
7. Calcium Channel Blocker: This agents block calcium channel thus
prevent vasoconstriction eg Verapamil
DEFINITION

• Is defined as a acute or chronic disability arising from

imbalance between myocardial supply and demand of
oxygenated blood
Causes

1. Increase oxygen demand

2. Reduction in oxygen supply
3. Combination of both
ISD

1. Angina Pectoris
2. Myocardial infarction
3. Atherosclerosis And Arteriosclerosis
DEFINITION

• Angina pectoris is a temporary substernal (below the

sternum) chest pain occurring due to imbalance
between myocardial oxygen supply and demand.
ETIOLOGY

1. Any factor that reduce myocardial oxygen supply

2. Abnormality of aortic valve

TYPES:

• Stable angina/ classical angina; Stable angina doesn't typically

change in frequency and it doesn't worsen over time.
• Unstable angina/ variant angina: Unstable angina is chest pain
that occurs at rest or with exertion or stress.
SYMPTOMS

Pain or pressure in chest

Numbness (loss of sensation), anxiety (feeling of fear), dizziness
(feeling weak) , sweating, shortness of breath,
pale skin, irregular heart beat, nausea
DIAGNOSIS

• Physical examination
• ECG examination
• Coronary angiography: A coronary angiography is a test to find out if
you have a blockage in a coronary artery,  X-ray imaging to see your heart's blood
vessels.

• Radionuclide imaging
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake
2. Exercise, weight reduction , limited alcohol intake, tobacco , cigarette

PHARMACOLOGICAL :
3. Nitrates: egg Nitroglycerines
4. Anti-platelet drug Eg Aspirin
5. Calcium channel blocker eg, verapamil

SURGICAL TREATMENT :
6. Angiography
7. Bypass Surgery
DEFINITION

• Myocardial Infraction is a condition resulting from

decreased blood and oxygen supply to heart causing
death of myocardium( death of heart muscle)
irreversible .
ETIOLOGY

 Reduction in blood supply to heart

 nearer the front
further back in position;
 towards, or from the side 
lower

Anterolateral situated or occurring in front and to the side.

Posterolateral situated or occurring in back and to the side
Pathogenesis
Severe vasospasm
Severe arterial occlusion atheroma

Reduced blood flow

Myocardium infraction

Deficient pumping
Occlusion is a complete or
partial blockage of a blood
vessel
Congestive shock
cardiac
failure
death
An atheroma,, is an abnormal and reversible
accumulation of material in the inner layer of
an arterial wall.
SYMPTOMS

Fatigue, chest discomfort, chest pain, anxiety, cough, nausea,

shortness of breath, rapid irregular heart rate
DIAGNOSIS

• Physical examination
• ECG examination
• Blood enzyme
• Radionuclide imaging
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake
2. Exercise, weight reduction , limited alcohol intake, tobacco , cigarette

PHARMACOLOGICAL :
3. Immediately given a aspirin tablet to chew
4. B- blocker
5. Thrombolytic therapy to dissolve clot eg, streptokinase
6. Anticoagulant eg heparine
7. Morphine ( analgesic)
8. Continue oxygen supply
Arteriosclerosis andAtherosclerosis
Atherosclerosis
DEFINITION
• Arteriosclerosis is occurs when arteries grow thick , stiff and restrict blood
flow to organs and tissue in the body.
• This is also called as hardening of arteries, weakness mostly in heart.
• Arteriosclerosis develops into a Atherosclerosis.
• Arteriosclerosis is the stiffening or hardening of the artery walls. 
• Atherosclerosis is the narrowing of the artery because of buildup of fats,
cholesterol and other substances in and on your artery walls.
• This buildup is called plaque. The plaque can cause your arteries to narrow,
blocking blood flow. The plaque can also burst, leading to a blood clot.  
ETIOLOGY

1. High cholesterol, high BP, insulin resistance diabetics

2. Obesity, smoking, alcoholism
3. Family history
4. buildup of plaque in the inner lining of an artery. Risk factors
may include high cholesterol and triglyceride levels, high blood
pressure, smoking, diabetes, obesity, physical activity, and
eating saturated fats.
Pathogenesis
Lesions of arteriosclerosis begins as the innermost layer of arterial wall start to
fill up with the deposition of cellular waste

As these start to mature , they can take different form of arteriosclerosis

All linked with common features such as the stiffening of arterial vessels, thickening of
arterial wall

Arteriosclerosis
and develop
into
Atherosclerosis

Lesion is any damage or abnormal change in the tissue of an organism, usually caused
by disease or trauma.
SYMPTOMS

• Pain or pressure in chest or angina

• shortness of breath,
• Fatigue
• Pain in leg arm, anywhere where artery blocked,
• Muscle weakness, confusion
DIAGNOSIS

• Physical examination and medical history

• Blood test
• CT scan
• Electrocardiogram
• Radionuclide imaging
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake, healthy diet, exercise, tobacco , cigarette,
medication

PHARMACOLOGICAL :
2. aspirin
3. B- blocker
4. Anticoagulant eg heparine
5. Calcium channel blocker eg Verapamil