Anemia
reduction in total _____ in circulating blood
OR
reduction in ___ or quantity of ____
number of RBC
quality, Hb
fundamental problem in congestive heart failure
heart is unable to pump sufficient blood to supply the body's needs
T/F stroke and pseudohypertrophy are clinical manifestations
myocardial infarction and stroke
bottom line of anemia
demands of heart are unmet
treatment of atherosclerosis
pharmaceuticals to reduce LDL, CHOL; and control HTN, diabetes
exercise
diet
3 clinical manifestations of anemia
imparied aerobic capacity
dizziness
SOB
fatigue
pale skin
impaired healing
contributing factors to left sided heart failure
*LV cant maintain normal CO
ischemic heart disease (less blood supply to heart)
HTN
myocardial diseases (prevent heart from pumping blood thru)
aortic and mitral valvular diseases
causes of endothelial damage
HTN
hyperlipidemia
toxins/viruses
hemodynamic factors (viscosity/constituents of blood)
hyperhomocysteinemia (high homocysteine proteins)
definitions/effects of:
SV
BPG
SV stroke volume: volume of blood pumped by LV per beat
compensate for lack of O2 --> hyperdynamic circulation --> cardiac murmurs and cardiac failure
BPG protein in blood: competitively bind to Hb which pulls Hb from other tissues
release of O2 from Hb
T/F right sided heart failure causes peripheral, GI tract, and liver congestion
true
"4" pathophysiological mechanisms
impaired RBC production
blood loss
increased RBC destruction
combination of 1-3
pathophysiology of left sided heart failure
L. HF --> pulmonary congestion --> impaired gas exchange --> cyanosis and signs of hypoxia
pulmonary congestion --> pulmonary edema --> fluid can migrate to other portions of body (swelling of hands and feet), orthopnea (SOB), productive cough, paroxysmal nocturnal dyspnea
L. HF --> decreased cardiac output --> activity intolerance and signs of decreased tissue perfusion
fatty streak
lipid formation w/in vessel
platelets attach to endothelium (to prevent clotting and heal area)
foam cells/macrophages (ingest lipids and die = become foam cells)
fibroblast being laid down (bc healing and inflammatory process)
migration of smooth muscle into intima of area (to help repair process)
Which of the following immune cells commonly become dysregulated with aplastic anemia?
lymphocytes
right sided heart failure due to
due to LV failure or pulmonary hypertension
____ leads to tissue hypoxia (definition)
tissue hypoxia leads to ____ and ____
hypoxemia (decreased O2 carrying capacity/in blood)
tissue hypoxia (decreased O2 in body tissue)
ischemia (decreased O2 in blood supply)
fatty liver changes (heart and kidneys also)
mechanical issues with left sided heart failure pathophysiology
1. LV weakens and cant empty (LV atrophy and stretched out)
2. decrease cardiac output to system
3. decreased renal blood flow --> stimulates RAAS --> modifies blood pressure and fluid balance
4. backup of blood into pulmonary vein
5. high pressure in pulmonary capillaries leads to pulmonary congestion or edema
metabolic syndrome
measured by _ outcomes
what are the outcomes
predisposes an individual to heart disease and diabetes (syndrome not a diagnostic)
5
low HDL: <40mg/dL (men) <50mg/dL (women)
high glucose: >/= 100mg/dL or medication
high BP: >/= 130/85 or medication
waist circumference: >40in (men) >35in (women)
high triglycerides: >/= 150mg/dL or medication
T/F Aplastic anemia occurs when there are low counts of RBC, WBC, and platelets. The immune system becomes dysregulated and attacks stem cells that have been created by bone marrow.
True
Aplastic anemia is a type of bone marrow failure that causes a deficiency of red blood cells, white blood cells, and platelets.
cardiac output
CO = HR x SV
volume of blood being pumped by heart per min over time (either LV or RV)
indicate heart performance
"4" compensatory mechanisms due to tissue hypoxia
cardiovascular => increased SV (and HR, and capillary dilation)
increased BPG in cells => release of O2 from Hb in tissues
renal/kidneys => RAAS system and extracellular fluid
increased O2 demands for work of heart => increase erythropoietin (RBC production)
cardiac output is ___ leading to ___ and ___ (describe why)
decreased
activity intolerance: bc not enough heart function to deliver O2 to have productive movement that is unexertional
decreased tissue perfusion = less O2 getting to body = fatigue, anxiety, nausea
"5" stages of atherosclerosis
1) damage to endothelium
2) response to injury (immune system)
3) fatty streak
4) fibrous plaque
5) complicated lesion
Mrs. Roberts, 68, presents with increasing dyspnea on exertion, orthopnea, and bilateral ankle edema. She has a history of hypertension and had a myocardial infarction two years ago. Her symptoms have been gradually worsening over the past six months.
diagnosis?
Left-sided heart failure
pt presents with complaints of increasing fatigue, shortness of breath with mild exertion, and dizziness over the past month. She appears pale, and her nail beds are lighter than usual. She follows a strict vegan diet and has heavy menstrual periods.
diagnosis? evaluation? treatment?
anemia
blood tests to check for RBC, Hb, iron, other vitamin deficiencies
supplementation to offset cause (iron)