Cardiovascular System – Heart and Blood VesselsTopics in Human Pathophysiology Fall 2011Gilead Drug Safety and Public Health

Outline Blood continued

Hemopoiesis Erythrocytes cont. Platelets and Clotting

Heart Structure Cardiac cycle Conduction System and ECGs Coronary Circulation Cardiovascular Disease – diagnosis and treatment

Blood Cell Genesis - Hemopoiesis

Blood Types

Disorders of Erythrocytes Anemias

Blood Type mismatching – Acute Hemolytic Reaction

Hemolytic Reaction of the Newborn

Blood Doping - polycythemia

Agglutination in Blood Typing test

Hemolytic Disease of the Newborn

Platelets

Stages of Hemostasis

Disorders of Clotting Thrombi and Emboli

Hemophilia

Thrombocytopenia

Impaired Liver Function

White Blood Cells - Leukocytes

Protect against pathogens by:

causing inflammation and fever

phagocytosing pathogens

creating antibodies to tag pathogens for destruction

killing pathogens in other ways

Creating a cadre of cells to fight reinfection by specific pathogens (immune memory)

Heart Structure

The cardiac cycle Systole – ventricles contract, semilunar

valves open to allow blood to large arteries; AV valves close to prevent backflow to the atria

Diastole – ventricles relax, semilunar valves close to prevent backflow into the ventricles, AV valves open to allow ventricles to fill

Cardiac Cycle video

The heart electrical system SA node is primary pacemaker AV node is secondary pacemaker AV bundle carries signal to ventricles Electrical signal stimulates muscle

contraction For the conduction system to work

properly adequate blood supply is required.

Figure 8.14

ECG Tracings

Figure 8.11

Ischemic Heart Disease Coronary artery disease Myocardial ischemia Myocardial hypoxia Myocardial infarct Myocardial necrosis

From wikipedia

Risk Factors for Cardiovascular Disease

Age

Male sex

Heredity

Smoking

Diabetes mellitus

Hypertension

High cholesterol

Obesity

Lack of exercise

Diagnosis and Treatment of Ischemic Heart Disease

Diagnosis BP monitoring Symptoms ECG Angiogram Stress Test Nuclear myocardial

perfusion tests

Coronary Angiogram

Lexiscan (regadenoson)

For myocardial perfusion imaging (MPI) A2A adenosine receptor agonist Vasodilates coronary arteries as if

exercising Injected into blood stream prior to gamma

camera scan Can give a good indication of myocardial

perfusion

Treatment of Ischemic Heart Disease

• Treatment– Coronary bypass surgery– Angioplasty– Stents– Cholesterol lowering

agents– Anticoagulents– Antianginal medications

Ranexa

For angina Thought to inhibit a sodium ion channel in

the cardiac muscle cells Contraction of those cells might normally

cause compression of cardiac blood vessels during diastole.

Can be taken with other anti-anginal meds Very effective

Congestive Heart Failure

Congestive Heart Failure

Heart becomes weak

Blood backs up in veins and capillaries

Fluid excess in tissues

Symptoms include shortness of breath, edema, difficulty breathing (especially when lying down,) difficulty exercising

Congestive Heart Failure

Causes: cardiomyopathy hypertension lung disease coronary artery disease previous MI valve disease