Cardiovascular System – Heart and Blood Vessels

1. Cardiovascular System – Heart and Blood Vessels Topics in Human Pathophysiology Fall 2011 Gilead Drug Safety and Public Health

2. Outline • Blood continued • Hemopoiesis • Erythrocytes cont. • Platelets and Clotting • Heart • Structure • Cardiac cycle • Conduction System and ECGs • Coronary Circulation • Cardiovascular Disease – diagnosis and treatment

3. Blood Cell Genesis - Hemopoiesis

5. Blood Types

6. Disorders of Erythrocytes • Anemias • Blood Type mismatching – Acute Hemolytic Reaction • Hemolytic Reaction of the Newborn • Blood Doping - polycythemia

7. Agglutination in Blood Typing test

8. Hemolytic Disease of the Newborn

9. Platelets

10. Stages of Hemostasis

11. Disorders of Clotting • Thrombi and Emboli • Hemophilia • Thrombocytopenia • Impaired Liver Function

12. 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)

13. Heart Structure

14. 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

15. 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.

16. Figure 8.14

17. ECG Tracings

18. Figure 8.11

19. Ischemic Heart Disease • Coronary artery disease • Myocardial ischemia • Myocardial hypoxia • Myocardial infarct • Myocardial necrosis

20. From wikipedia

21. Risk Factors for Cardiovascular Disease

22. Diagnosis and Treatment of Ischemic Heart Disease • Diagnosis • BP monitoring • Symptoms • ECG • Angiogram • Stress Test • Nuclear myocardial perfusion tests

23. Coronary Angiogram

24. 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

25. Treatment of Ischemic Heart Disease • Treatment • Coronary bypass surgery • Angioplasty • Stents • Cholesterol lowering agents • Anticoagulents • Antianginal medications

26. 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

27. Congestive Heart Failure

28. 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

29. Congestive Heart Failure • Causes: • cardiomyopathy • hypertension • lung disease • coronary artery disease • previous MI • valve disease