باذن الله كل ما سنحت لي الفرصه بنزل معلومات عن disorders of cardiac function...
#nursing_intern
#nursing_intern
اولا: coronary artery disease )CAD)
نحتاج أنه نتذكر
1- Anatomy
2- physiology
3- pathologically changes
3.1 endothelial injury due to
*plaque growth and vascular remodeling
*plaque rupture
*spasm
*high pressure
4- consequences
*o2 demand more than o2 supply
نحتاج أنه نتذكر
1- Anatomy
2- physiology
3- pathologically changes
3.1 endothelial injury due to
*plaque growth and vascular remodeling
*plaque rupture
*spasm
*high pressure
4- consequences
*o2 demand more than o2 supply
لما نخلص هذا الدرس كقارى ان شاء الله تكون متمكن من pathological changes
متمكن من the consequences of endothelial injury
1- increase premability to lipoproteins
2- decreased nitric oxide production
3increase leukocyte migration and adhesion
4-vascular growth stimulation
متمكن من the consequences of endothelial injury
1- increase premability to lipoproteins
2- decreased nitric oxide production
3increase leukocyte migration and adhesion
4-vascular growth stimulation
متمكن أنه risk factor for CAD
1- Hyperlipidemia
2- hypertension
3- cigarette smoking
4- diabetes mellitus
5- age
6- gender
7- Family history
1- Hyperlipidemia
2- hypertension
3- cigarette smoking
4- diabetes mellitus
5- age
6- gender
7- Family history
10 year risk of mi estimates based on risk factors
هذا موقع يحسب لك نسبه الخطر لحضور MI بناء ع وجود risk factor
hp2010.nhlbihin.net
هذا موقع يحسب لك نسبه الخطر لحضور MI بناء ع وجود risk factor
hp2010.nhlbihin.net
Cad and aging
هذه الصوره توضح كيف تصير endothelial dysfunction ع مرور السنوات
هذه الصوره توضح كيف تصير endothelial dysfunction ع مرور السنوات
السبب الثاني cad and lipids
الا يصير
وجود نسبه متوزانه من HDL يعمل ع promote the efflux of cholesterol from the cells which then minimize the accumulation of foam cells on the artery wall and then its lead to decrease the risk of developing artherosclerosis
الا يصير
وجود نسبه متوزانه من HDL يعمل ع promote the efflux of cholesterol from the cells which then minimize the accumulation of foam cells on the artery wall and then its lead to decrease the risk of developing artherosclerosis
لكن ف حاله وجود نسبه كبيره من LDL والي يعمل ع promote the influx of cholesterol from the cells and binds to the matrix of cells and then forms foam cells..
التغريده الجايه راح اوضح هالمصطلحات
التغريده الجايه راح اوضح هالمصطلحات
الكوليسترول الجيّد HDL والمعروف علمياً بالبروتينات الدهنيّة مُرتفعة الكثافة ( High-Density Lipoprotein) أحد أنواع البروتينات الدهنيّة التي تحمل الكوليسترول ويُطلق عليه الكوليسترول المفيد لأنّه ينقل الكوليسترول الزائد من أنسجة الجسم إلى الكبد من أجل التخلّص منه بالشكل الصحيح.
البروتين الدهني منخفض الكثافة Low-density lipoprotein LDL) هو نوع من أنواع البروتينات الدهنية الي تنقل الكوليسترول وثلاثي الغليسريد من الكبدإلى الأنسجة المحيطة
وُيطلق عليه "الكوليسترول المرضي" أو "الكوليسترول السئ" على النقيض من البروتينات الدهنية المرتفعة الكثافة HDL
وُيطلق عليه "الكوليسترول المرضي" أو "الكوليسترول السئ" على النقيض من البروتينات الدهنية المرتفعة الكثافة HDL
*Cad and hypertension
HTN يعمل ع damage blood vessels wall which then lead to plaque formation and then increase Cad risk
*cad and smoking
يعمل ع damage blood vessels via vasconstction and also increases Ldl and decreased Hdl then increase cad risk
HTN يعمل ع damage blood vessels wall which then lead to plaque formation and then increase Cad risk
*cad and smoking
يعمل ع damage blood vessels via vasconstction and also increases Ldl and decreased Hdl then increase cad risk
Cad and Dm والذي يعمل ع damage blood vessels via inflammation and then lead to plaque formation and then increase Cad risk
*CAD and renal disease which is worked like present of HTN
CAD AND metabolic syndrome which act like present of DM
*CAD and renal disease which is worked like present of HTN
CAD AND metabolic syndrome which act like present of DM
بتكلم الان بعد ما عرفنا risk factor عن pathophysiology of CAD
1-present of one of risk factors for example high LDL
2- trigger vascular inflammation
3-wall injury
4- ldl moves into the vessel wall
5- monocytes migrate to the vessel wall
6- United with ldl
7- form foam cells
1-present of one of risk factors for example high LDL
2- trigger vascular inflammation
3-wall injury
4- ldl moves into the vessel wall
5- monocytes migrate to the vessel wall
6- United with ldl
7- form foam cells
تابع باثو
8- precoagulant lipid forms
9- connective tissue form a cap coveres the lipd liquid
10- cap rupture
11- lipid forms thrombosis
12- occlude coronary artery
13- acute coronary artery symptoms
8- precoagulant lipid forms
9- connective tissue form a cap coveres the lipd liquid
10- cap rupture
11- lipid forms thrombosis
12- occlude coronary artery
13- acute coronary artery symptoms
اول ما تظهر حاله cad نسميها acute coronary syndrome
اول signs هو angina
Angina
تكون stable
And unstable
راح اطرق لكل وحده..
Stay tuned
#nursing_intern
اول signs هو angina
Angina
تكون stable
And unstable
راح اطرق لكل وحده..
Stay tuned
#nursing_intern
Stable angina pathophysiology
1-spasm or blockage lead to ischemia=inadequate coronary blood flow 30%or less
Then o2 imbalance supply<demand
Then lead to myocardial anaerobic metabolism
And lactic acid production
Which irritates myocardial nerve endings
And pain or pressur
1-spasm or blockage lead to ischemia=inadequate coronary blood flow 30%or less
Then o2 imbalance supply<demand
Then lead to myocardial anaerobic metabolism
And lactic acid production
Which irritates myocardial nerve endings
And pain or pressur
كيف نفرق بين stable and unstable
1-Angina is caused by coronary ischemia
2-Partial (75%) coronary blockage or spasm lead to ischemia and then o2 supply <o2 demand then lead to ischemic pain (usually in chest but may radiate to left side of neck back of left arm
1-Angina is caused by coronary ischemia
2-Partial (75%) coronary blockage or spasm lead to ischemia and then o2 supply <o2 demand then lead to ischemic pain (usually in chest but may radiate to left side of neck back of left arm
3- coronary ischemia on ECG T wave inversion
4- angina pain OLDCART 60% of patients experiencing the following
O: predictable
L:?
D: < 5m when treated with rest and Ntg
C: heaviness, pressure, stabbing, radiating
A:physical activities and stress
R:rest and ntg
T:rest ntg
4- angina pain OLDCART 60% of patients experiencing the following
O: predictable
L:?
D: < 5m when treated with rest and Ntg
C: heaviness, pressure, stabbing, radiating
A:physical activities and stress
R:rest and ntg
T:rest ntg
Acs pain location
بعد ما تكلمنا عن stable angina راح اتكلم عن unstable وكيف نعرفه
* stable angina may progress to unstable
Unstable angina is usually caused by disrupted atherosclerotic plaques and overlaid thrombi
*unstable coronary atherosclerotic plaque lead to ischemic ... o2 supply <o2 dem..
* stable angina may progress to unstable
Unstable angina is usually caused by disrupted atherosclerotic plaques and overlaid thrombi
*unstable coronary atherosclerotic plaque lead to ischemic ... o2 supply <o2 dem..
O2 supply <o2 demand lead to ischemic pain usually in chest but may radiate to left side of neck back and left arm
Unstable angina ecg T wave inversion or st depression
Unstable angina pain OLDCART
O- unpredictable can start during sleep or rest or rest after activities
تابعو..
Unstable angina ecg T wave inversion or st depression
Unstable angina pain OLDCART
O- unpredictable can start during sleep or rest or rest after activities
تابعو..
L- SAME STABLE
D- >5 min
C- intense, heaviness, pressure, stabbings, radiation
A- Unpredictable
R- several doses of Ntg
T: rest, ntg drip and PCI
D- >5 min
C- intense, heaviness, pressure, stabbings, radiation
A- Unpredictable
R- several doses of Ntg
T: rest, ntg drip and PCI
باثو of unstable angina1- unstable plaque
2- plaque rupture
3- thrombus formation
4- incomplete coronary conclusion
5- sever ischemia
6- pain
2- plaque rupture
3- thrombus formation
4- incomplete coronary conclusion
5- sever ischemia
6- pain
بكتفي اليوم وبكره بنكمل باقي الانواع من angina
@Rattibha
تكرما
تكرما
@Rattibha
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