Cardiovascular Disorders Instructor – Cindy Quisenberry

Anemia Inadequate number of erythrocytes or hemoglobin Symptoms Pallor, paleness Fatigue Dyspnea Tachycardia Chest pain

Types of Anemia Iron Deficiency – Caused by not enough iron in the body Pernicious – lack of absorption of Vitamin B12 Aplastic – the body’s bone marrow does not make enough new blood cells Sickle Cell – RBC’s are shaped like a crescent (inherited – have inherited 2 genes from their parents)

Normal RBC’s

CBC RBC’s Male: 4.7-6.1 million cells/mcL Female: 4.2-5.4 million cells/mcL WBC’s 5,000-10,000 million cells/mcL Hematocrit (Hct) Male: 40.7-50.3% Female: 36.1-44.3% Hemoglobin (Hgb) Male: 13.8-17.2 gm/dL Female: 12.1-15.1 gm/dL

Pernicious Anemia The body cannot make enough healthy red blood cells because it doesn’t have enough vitamin B12. B12 is a nutrient found in some foods. People who have pernicious anemia can’t absorb enough B12 from food, because they lack intrinsic factor, a protein made in the stomach.

Pernicious Anemia Other conditions and factors that can also cause vitamin B12 deficiency include: Infections Surgery Medicines Diet

Foods High in B12 1) Beef liver 2) Mackerel 3) Beef 4) Tuna 5) Swiss cheese 6) Cottage cheese 7) Lamb 8) Milk 9) Yogurt 10) Oysters 11) Sardines 12) Clams

Pernicious Anemia Teardrop (dacrocytes) cells are found in pernicious anemia, thalassemia, and some hemolytic anemias.

Sickle Cell Anemia Target cells are also known as codocytes. They resemble a bull’s eye. These cells are indicative of an anemia state.

Sickle Cell Anemia

Sickle Cell Anemia

Aneurysm Ballooning out or saclike formation on the wall of an artery Causes Disease Congenital defects Injuries Weakening in the structure of the wall of the artery

Aneurysm Symptoms Pain Pressure Common Sites Cerebral Aorta Abdominal Rupture Hemorrhage Death

Aneurysm

Aneurysm Treatment Surgical removal of damaged area Replacement with plastic graft or another blood vessel

Aneurysm

Ascending Aorta Aneurysm Repair

Arteriosclerosis Hardening or thickening of the walls of the arteries Loss of elasticity Commonly occurs as a result of aging Causes Hypertension May lead to aneurysm or cerebral hemorrhage

Arteriosclerosis

PAD/PVD Peripheral Artery Disease/ Peripheral Vascular Disease A condition of the blood vessels that leads to narrowing and hardening of the arteries that supplies the legs and feet. The narrowing of the blood vessels leads to decrease blood flow, which can injure nerves and other tissues.

CAD Coronary Artery Disease Also known as, ASHD- Atherosclerotic Heart Disease A result of the accumulation of plaques on the walls of the coronary arteries (fat, cholesterol, calcium, etc) Blocks or reduces the flow of blood to the heart muscle (myocardium) Can cause a heart attack (myocardial infarction)

Myocardial Infarction Occurs when blood flow is blocked to the heart muscle causing ischemia (lack of O2) and cell death or damage; death can occur Symptoms can include: Pressure Pain (Angina) – severe crushing Radiates to the left arm, jaw, or neck Diaphoresis (cold, clammy skin) Nausea Change in BP Dyspnea

Myocardial Infarction CPR EARLY TREATMENT Complete bedrest Pain meds and anticoagulants Thrombolytics (given as early as possible, within 12 hours of onset with ST-elevation) O2 Therapy Treatment of arrhythmias

Embolus Foreign substance circulating in the bloodstream Blood clot Air Fat globule

Ejection Fraction (EF) The amount of blood pumped (ejected) by your heart with each beat Measured with an echocardiogram Normal EF is 50% or greater, which means at least one-half of the blood in the heart is ejected with each beat A low ejection fraction increases the risk for heart failure or sudden cardiac arrest

Congestive Heart Failure Heart muscles do not beat adequately to supply blood needs of the body May involve either right or left side of the heart (or both)

Congestive Heart Failure Treatment Cardiac drugs and diuretics Elastic support hose to improve venous return (circulation) Oxygen therapy and bedrest Low sodium diet

Healthy Blood Pressure AHA recommendation Systolic is < 120 Diastolic is < 80 Prehypertensive - systolic is 120-139 or diastolic is 80-89

Blood Pressures Systolic Pressure - 120-139 mmHg Prehypertension Systolic Pressure - 120-139 mmHg Diastolic Pressure - 80-89 mmHg HTN Stage 1 Systolic Pressure - 140-159 mmHg Diastolic Pressure - 90-99 mmHg HTN Stage 2 Systolic Pressure > 160 Diastolic Pressure > 100

Hypertension Treatment Antihypertensive drugs Diuretics to remove retained body fluids Decreased stress and avoiding use of tobacco Low sodium diet

Hypotension Low blood pressure Systolic pressure is < 100 mmHg and Diastolic is < 60 mmHg Causes: Heart failure Hemorrhage Dehydration Depression Severe Burns Shock Drugs Lack of rest or sleep

Orthostatic Hypotension Postural Hypotension – occurs when there is a sudden drop in both systolic and diastolic pressure This occurs when the individual moves from a lying to a sitting or standing position Caused by an inability of the blood vessels to compensate quickly to the change in position

Thrombophlebitis Thrombophlebitis – occurs when a blood clot blocks one or more of your veins, typically in your legs. Rarely, thrombophlebitis (sometimes called phlebitis) can affect veins in your arms or neck. The affected vein may be near the surface of your skin, causing superficial thrombophlebitis, or deep within a muscle, causing deep vein thrombosis (DVT).

Thrombophlebitis Caused by: Trauma (injury to the vein) Surgery or prolonged inactivity Inherited blood disorder Superficial thrombophlebitis may occur in people with varicose veins.

Thrombophlebitis Risk Factors: Immobility (ie: prolonged hospitalization, fractures, stroke, sitting in an airplane or car, etc.) Pacemaker Pregnancy, BCP’s Family history Disorders (ie: atrial fibrillation)

Thrombophlebitis Superficial thrombophlebitis symptoms include: Warmth Tenderness Pain in the affected area Redness and swelling .

Thrombophlebitis Deep vein thrombophlebitis symptoms include: Pain Swelling Leg swelling and pain along with shortness of breath or chest pain that hurts when the patient takes a deep breath, usually indicates a clot has moved to the lung (PE)

Thrombophlebitis A clot in a deep vein increases the patient’s risk of serious health problems, including the possibility of a dislodged clot (embolus) traveling to the lungs and blocking an artery in the lungs (pulmonary embolism). Deep vein thrombosis is usually treated with blood-thinning medications. Superficial thrombophlebitis is sometimes treated with blood-thinning medications.

Thrombophlebitis Treatment Deep vein thrombosis is usually treated with blood-thinning medications. Pain meds Elevation TEDS Surgery

Thrombophlebitis Prevention Avoid for sitting for long periods of time Exercise – early ambulation for surgical patients; ambulation for hospitalized patients as approved by physician TEDS, compression devices Elimination of tight fitting/restrictive clothing Surgery to remove or kill a vein

Hemophilia Inherited diseased More common in males Blood not able to clot due to lack of clotting factor (ie: Factor VIII)

Hemophilia Treatment Transfusions of whole blood or plasma Administration of missing Factor

Leukemia Malignant disease of bone marrow lymph tissue Results in large number of immature white blood cells Different types of leukemia Acute or Chronic

Leukemia Varies with type of leukemia Chemotherapy Radiation Bone Marrow transplants

Leukemia