PATHOPHYSIOLOGY OF CARDIOPULMONARY DISEASE Three components of cardiac diseases 1- diseases affecting heart muscles 2- diseases affecting heart valves 3- defects of the cardiac nervous system Disease affecting cardiac muscle Coronary artery disease Myocardial infarct Pericarditis Congestive heart failure Aneurysm

2. Lecture objectives:
 Components of cardiac diseases .
 Sign And Symptoms Of Cardiovascular
Diseases.
 Coronary Artery Disease.
 Ishemic Cardiac Condition

3.  PATHOPHYSIOLOGY OF CARDIOPULMONARY
DISEASE
 Three components of cardiac diseases
1- diseases affecting heart muscles
2- diseases affecting heart valves
3- defects of the cardiac nervous system
Disease affecting cardiac muscle
Coronary artery disease
Myocardial infarct
Pericarditis
Congestive heart failure

4.  Disease affecting Heart valves
1-Rheumatic fever Endocarditis
2-Mitral valve prolapse
3- Congenital deformities .
 Frequently, these conditions occur
sequentially.
 For example, an underlying obstruction such
as pulmonary embolus, leads to
congestion, and subsequent dilation of the
vessels blocked by the embolus.

5. Disease affecting cardiac nervous system
 Arrhythmias
 Tachycardia
 Bradycardia
 There may be underlying cardiovascular impairment
such as
 1. Obstruction or restriction
 2. Inflammation
 3. Dilation or distention.
Any combination of these can cause chest, neck, back,
and/or shoulder pain.

6. DEGENERATIVE HEART DISEASE
Degenerative heart disease refers to the changes
in the heart and blood supply to the heart and
major blood vessels that occur with aging.
Examples:
 atherosclerotic cardiovascular disease,
 Arteriosclerotic cardiovascular disease,
 coronary heart disease (CHD)
 coronary artery disease (CAD).

7. SIGN AND SYMPTOMS OF
CARDIVASCULAR DISEASES
 chest pain
 palpatation
 Dyspnea
 Fatigue
 Cardiac syncope
 Cough
 cynosis
 Edema
 Claudication

8. CORONARY ARTERY DISEASE
 The heart muscle must have an adequate
blood
supply to contract properly
 The coronary arteries carry oxygen and
blood to the myocardium.
 When a coronary artery becomes
narrowed
or blocked, the area of the heart muscle
supplied
by that artery becomes ischemic and injured
and causes infarction

9.  The major disorders caused by insufficient
blood
supply to the myocardium are angina pectoris and
myocardial infarction
 These disorders are collectively
known as coronary artery disease (CAD),
also called coronary heart disease or ischemic
heart disease.
 CAD includes atherosclerosis (fatty buildup)
 thrombus (blood clot)
Spasm (intermittent constriction)

10.  CAD results from a person's complex genetic
makeup and interactions with the environment,
including nutrition, activity levels, and history of
smoking.
Susceptibility to CVD may be explained by genetic
factors, and it is likely that an "atherosclerosis
gene" or "heart attack gene" will be identified
ATHEROSCLEROSIS
Atherosclerosis is the disease process often called
arteriosclerosis or hardening of the arteries.
 It is a progressive process that begins in child
 It can occur in any artery in the body

11.  it is most common in medium-sized arteries, such
as those of the heart, brain, kidneys, and legs.
 Starting in childhood, the arteries begin to fill with a
fatty substance, or lipids such as triglycerides and
cholesterol, which then calcify or harden
 This filler, called plaque, is made up of fats,
 calcium, and fibrous scar tissue, and lines the
usually supply arterial walls, progressively narrowing
the arteries.
 These arteries carry blood rich in oxygen to the
myocardium

12.  The atherosclerotic process leads to
ischemia and to
necrosis of the heart muscle
Necrotic tissue gradually forms a scar, but
before scar formation, the weakened area is
susceptible to aneurysm development.
 When fully developed, plaque can cause
bleeding,
clot formation, and distortion or rupture of a
blood vessel

17. ISHEMIC CARDIAC CONDITION
 Myocardial infarct (MI), also known as a
 Heart attack,
 Coronary occlusion
 Development of ischemia and necrosis of
myocardial tissue
 It results from a sudden decrease in
coronary perfusion or an increase in
myocardial oxygen demand without
adequate blood supply.

18. If the requirements for blood are not eased (e.g.,
by
decreased activity), the heart attempts to continue
meeting the increased demands for oxygen with
an inadequate blood supply, which leads to
an MI
 Myocardial tissue death is usually preceded by
a
sudden occlusion of one or more of the major
coronary Arteries
 Occlusion of one or more of these blood vessels
 (coronary occlusion) is one of the major causes
of
MI.
 The occlusion may result from the formation of
a clot that develops suddenly when plaque
ruptures

19. through the sublayers of a blood vessel, or when
the narrow, roughened inner lining of a
sclerosed artery leads to complete Thrombosis
 Although coronary thrombosis is the most
common cause of infarction Other factors
including
 coronary artery spasm
 platelet aggregation
 embolism
 thrombus
 secondary to rheumatic heart disease

20.  endocarditis,
 aortic stenosis
 , a thrombus on a prosthetic mitral or aortic
valve, or
 a dislodged calcium
 plaque from a calcified aortic or mitral valve.
 Coronary blood flow is affected by the
tonus(tone) of the coronary arteries.
 Arteries "clogged“ by plaque formation
become rigid, and resultant spasm may be
provoked by cold and by exercise