Pathophys.docx

SCHEMATIC DIAGRAM Precipitating Factor:

Predisposing Factor:

Hereditary

Hypertension

Age

Hyperlipidemia

Gender

Diabetes Mellitus

race

Smoking Diet Hypertension

Vasoconstriction

Increase afterload, preload and pressure

Increase workload

Increase force on LV Injury of the endothelial vessel layer

Increase stress on the LV

Increase cardiac output

Scarring LV Hypertrophy Atherosclerosis Ventricular remodelation CAD Decrease LV force

LV hypoxia

Decrease cardiac tissue

Decrease cardiac muscle

Activation of baroreceptor in LV

Stimulation of vasomotor regulator

Increase LA pressure Decrease cardiac output Back flows Decrease systemic output

Decreased perfusion tissue of the kidney

Decreased GFR

Activation of sympathetic nervous system

Increased catecolamines

Decreased renal perfusion

Hyponatre mia

Juxtoglomelular cells

Renin

Increased residual volume blood from LA

Blood returns to pulmonary

Increased pulmonary capillary hydrostatic pressure

Hydrostatic pressure exceeds osmotic pressure

Fluids moves to interstitial space

Angiotensinogen RAAS Arteriolar vasoconstrict ion

Angiotensin I

Amount of fluid exceeds lymphatic systems ability to remove it

Angiotensin II Increased peripheral resistance

Adrenal cortex

PULMONARY EDEMA

Increased aldosterone

Dyspnea, cough, crackles, orthopnea, frothy blood sputum

Increased Na reabsorption

Increased H2O reabsorption

Increased plasma volcano (ECF)

Increased BP

Decreased BP, HR

Decreased perfusion of tissue in the body

Decreased O2 supply to tissue

Increased sympathetic activity

Myocardium: increased cardiac workload

Increased peripheral vasoconstriction

Brain: decreased oxygen supply to cerebral tissue

Renal vasoconstriction GI Tract: decreased O2 supply to GI Increased renin

Lack of oxygen supply and nutrients to supply

Liver: dysfunction UA: Hematuria, albumin

Capillary endothelial damage

hypoxia

Altered cerebral metabolism

Aneurysm

Paralysis

ACUTE ISCHEMIC INFARCT

Brain tissue necrosis

Increased BUN

Dilute urine

Dehydration

Decreased GFR

Increased Serum creatinine

Hyperthropy of remaining nephrons

Loss of NA

Inability to concentrate urine

Hyponatremia

Oliguria

Further loss of nephron function

Loss of nonexcretory renal function

Failure to convert forms of calcium Decreased calcium absorption Hypocalcemia

Loss of excretory renal function

Failure to produce erythropoietin

Impaired insulin function

Anemia Decreased hemoglobin

Erratic blood glucose

Increased productio n of lipids

Immune disturbance

Advance artheroscleros is

Delayed wound healing

Infection

Loss of excretory renal function Decreased excretory of nitrogenous waste

Decreased uremia

Increased BUN,Creatinine, uric acid

Decreased NA reabsorption in tubule

Water retention

Decreased K excretion

Decreased phosporus

Hyperkalem ia

hypophosp athemia

Hypertensi on Heart failure Edema

Protenuria

Peripheral nerve changes

CNS changes

CHRONIC KIDNEY DISEASE

Decreased hydrogen excretion

Metabolic acidosis