Cardiovascular System Pathology, Slides of Anatomy

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Cardiovascular

Pathology

Why?

• (^) Leading cause of death worldwide
  • (^) Very common
• (^) Small structural changes affect whole-body function - (^) Highlights structure-function relationships
• (^) Studying pathology and disease shows how normal physiology becomes disrupted/dysfunctional/dysregulated
• (^) How the body responds to these disruptions/dysfunctions/dysregulation=pathophy siology

Atherosclerosis

• (^) Fatty plaque buildup in arterial walls
• (^) Occurs in large and medium arteries
• (^) Narrows and stiffens vessels

Atherosclerosis:

• Pathophysiology

Endothelial damage

• Via chronic hypertension, chronic inflammation from poor diet, uncontrolled blood sugars, etc

Low-density lipoprotein (LDL; AKA “bad”

cholesterol) enters vessel wall

• triggers inflammatory response
• -Macrophages engulf lipids foam cells

Foam cells evolve to form plaques

Plaques decrease diameter available for blood

flow

• (^) Leads to poor O 2 + nutrient delivery
• Increases BP - Why?

Coronary Artery Disease

(CAD)

• (^) Atherosclerosis of coronary arteries
• (^) Reduced oxygen to myocardium
• Causes angina

Angina vs Heart Attack

• (^) Angina: temporary ischemia, no permanent damage - (^) Usually exertional and will improve with rest - (^) Normal EKG
• (^) Heart Attack: prolonged ischemia, muscle death - (^) Labs will show evidence of cardiac muscle death - (^) I.e.-elevated troponin levels - (^) Pathological changes on EKG

Heart Failure

• (^) Heart cannot meet body's demands
• (^) Can be acute or chronic
• (^) Decreased cardiac output
  • (^) Other organs and tissues are insufficiently oxygenated as blood becomes backed up

eft-Sided Heart Failure

• (^) Blood backs up into lungs
  • (^) Pulmonary edema
  • (^) Leads severe SoB
• (^) More common than right-sided HF
• (^) Also most common cause of right-sided HF
• (^) Can be either systolic or diastolic

ystolic vs Diastolic HF

• Diastolic Heart Failure - (^) compromised relaxation/filling of left ventricle - (^) AKA: HF with preserved EF (HFpEF) - (^) LV pumps % of blood it should but is starting with less blood = Low EDV

ght-Sided Heart Failure

• (^) Blood backs up into body (systemic venous blood)
• (^) Peripheral edema
• (^) Enlarged liver
• (^) Often caused by LSHF

16 Erythrocyte Disorders

• (^) Two types:
  • (^) anemias
  • (^) polycythemias
• (^) Anemia: characterized by

abnormally low oxygen

carrying capacity

• (^) Sx include fatigue, paleness, SoB, and feeling cold
• (^) Anemias further divided

based on source of

defect/problem:

• (^) Insufficient number of RBCs
• (^) Decreased levels of hemoglobin
• (^) Abnormal hemoglobin

17

Insufficient RBCs

• (^) Hemorrhagic: blood loss
  • (^) Trauma/accidents
• (^) Hemolytic: erythrocytes rupture/lyse prematurely
  • (^) Mutations of spectrin protein/transfusions of mismatched blood
    • (^) Spectrin protein-gives flexibility to RBCs
• (^) Aplastic: destruction/inhibition of red marrow
  • (^) bacterial toxins, drugs, radiation

19

Genetically Abnormal Hemoglobin

• (^) Thalassemia: one of the globin chains is absent or faulty - (^) Seen in people of Mediterranean descent - (^) Leads to low # of functional RBCs, but no treatment is required - (^) WHY? - (^) Individuals become acclimated!
• (^) Sickle Cell Anemia: mutations lead to altered shape of hemoglobin protein - (^) The mutated hemoglobin, hemoglobin S (HbS), causes the RBCs to take on a sharp/spiky appearance - (^) can cause blockages in small blood vessels - (^) Can lead to rupture/destruction of RBCs - (^) This leads to/becomes:

20

Sickle Cell Anemia (SCA)

• (^) Most common in African Americans
  • (^) A.A. populations make up roughly 95% of all SCA cases
  • (^) Why?
• (^) Sickle-cell gene provides increased resistance to malaria
  • (^) Is therefore an advantageous trait in malaria-endemic regions
• (^) Tx includes medication, transfusion, gene therapy