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Myocardial Infarction, increased BP in L ventricle causes R ventricle to…

- - - - fibrous plaques cause impingement on lumen
        
        plaque calcification or hemorrhaging if vessel was necrosed d/t lack of blood flow
    - - space for blood flow is decreased
        
        decreased blood flow to organs, can lead to anoxia/hypoxia
- - - - Signs and Symptoms
        
        Orthopnea (SOB that happens when lying down)
        
        Fatigue/Weakness (d/t lack of blood and O2 being efficiently pumped to the rest of the body)
        
        Progressive dyspnea (d/t fluid build up in the lungs and lack of O2 being delivered to the rest of the body)
        
        S3 heart Sound (d/t a sudden deceleration of blood flow into the ventricle that makes that extra sound after the S2 heart sound)
        
        Paroxysmal nocturnal dyspnea (this is the patient being woken up during their sleep with SOB; d/t the fluid settling in their lungs while they sleep)
        
        Cerebral Hypoxia (lack of O2 rich blood getting to the brain)
        
        Crackles at lung bases (d/t fluid that is backed up into the lungs/pulmonary circulation)
        
        Pulmonary Edema
        
        S/S of Pulmonary Edema
        
        Diaphoresis (d/t the overworking of their heart and extra fluid in their body which makes it difficult to control their body temperature)
        
        Tachypnea (increased workload of the heart)
        
        Cyanosis (d/t lack of enough O2 rich blood being circulated)
        
        Anxiety (d/t difficulty breathing)
        
        Pallor (d/t lack of O2 rich blood to the rest of the body)
        
        Agitation (d/t difficulty breathing)
        
        Marked dyspnea (d/t fluid taking up space in the lungs and not getting enough O2)
        
        Enlarged heart (d/t the heart over-working)
      - Usually happens first and results in pulmonary S/S due to back up of blood into the pulmonary circulation
        
        The L ventricle is gradually weakened and the heart becomes unable to pump oxygen-rich blood (from the lungs) to the heart's L atrium, into the L ventricle, and then to the rest of the body.
        
        Diastolic Heart Failure
        
        When the L ventricle grows stiff/thick, and is unable to fill the lower left chamber of the heart properly (aka HF with Preserved Ejection Fraction)
        
        This reduces the the amount of blood pumped out to the body
        
        This causes blood to build up inside the L atrium, and then in the lungs, leading to fluid congestion and symptoms of HF
        
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        HF with Preserved Ejection Fraction = Impaired ventricular relaxation; reduced preload at the end of diastole in the L ventricle
        
        Systolic Heart Failure
        
        When the L ventricle cannot contract forcefully enough to keep blood circulating normally throughout the body (aka HF with Reduced Ejection Fraction; EF of 40% of less)
        
        This deprives the body of a normal, oxygen-rich blood supply
        
        As the L ventricle is working harder to compensate, it grows weaker, and then leads to backwards blood flow into the organs, causing fluid build up in the lungs and swelling in other parts of the body
        
        1 more item...
        
        HF with Reduced Ejection Fraction = Impaired ventricular contraction; reduced force of contraction in the L ventricle
    - - Most common pathology is left ventricle does not pump efficiently
        
        Blood backs up behind left ventricle into left atrium
        
        blood backs up into right ventricle
        
        Allows blood to back up in the peripheral circulation; affecting extremities, liver and other organs
        
        Systemic signs and symptoms
        
        fatigue, anorexia, nausea, bloating, weight gain, cyanosis
        
        Hepatomegaly: HF leading to back-up of blood in hepatic veins; causing the liver to become congested and grow larger
        
        Dependent edema: build-up of extra fluid in systemic system due to HF
        
        Ascites: Results from transudation from hepatic and peritoneal veins.
        
        Abnormal S3: Altered physical properties of ventricle or increased in the rate and volume of blood flow in the rapid filling phase during ventricle diastole
        
        S4 heart sound: forceful contraction of the atria in an effort to overcome an abnormally stiff or hypertrophic ventricle
        
        Jugular venous distension: Increased blood volume due to HF increases central venous pressure and amount of JVD.
        
        Reduced urine output: Elevated systemic venous pressure can further reduce renal blood flow as the gradient between mean renal arterial pressure and systemic venous pressure declines.
      - Alterations to pre-load, afterload, contractility, heart rate
      - Impaired ventricular contraction or impaired ventricular relaxation
        
        impaired ventricular contraction leads to reduced ejection fraction
        
        in impaired ventricular relaxation the ejection fraction is preserved
      - Other causes include: Chronic lung disease, CAD, pulmonic stenosis, tricuspid stenosis, tricuspid regurgitation, pericardial constriction, left-to-right shunt
    - - Most common cause is MI
        
        Leads to left or right sided hear heart failure and depending on which phase of contraction, systolic or diastolic heart failure
        
        Systolic heart failure: Inadequate ejection of blood out of the ventricle
        
        Diastolic heart failure: increased resistance to filling
- - - - vasoconstriction to increase SV & BP
        
        excessive afterload (caused by underlying HTN) leads to reduced EF (<55%)