Heart – Clinical Pathologic Correlation
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Notes: Think of CC as what body system could this be applied to/related to. "How many organ systems can cause [CC]"
Copy charts - so they are memorized
Failure: increase in left ventricle and diastolic pressure/volume
>this causes blood/pressure back-up in the pulmonary veins & lungs, leading to pulmonary edema;
>BNP: indication of stretch
> auscultation: S3 & crackles
>CXR will show cardiomegaly (remodeling), consolidations (PE), Kerley B lines in peripheral (Edema)
>Echo: EF less than 35%
In right-sided failure (usually caused by left-sided failure): the blood/pressure has continue to back-up to the RV, RA and systemic veins (JVD, increase in liver activity, pitting edema)
correct BP - neurohormonal regulation
BP = CO x TPR
CO = HR x SV
SV is proportional to preload (blood volume, veins), afterload (BP and TPR) and contractility (Ca2+)
heart: SA node and myocyte via B1 receptors
Beta-blockers: block cardiac effects of the SNS
adrenal medulla: catecholamines, vasoconstriction for TPR, ^BP
kidney: RAAS increased, increased BV and vasoconstriction
Directics (Furosemide): decrease BV
ACEI: decrease Angiotensin II and Aldosterone, decrease BV
Spironolactone: Inhibits aldosterone, decreases BV, vasodilation v. constriction
ARB (when cannot take ACEI): blocks vasoconstriction, and decreases BV via decreased angiotensin and aldosterone
Natriuretic Peptide Inhibitors/ARB: sacubitril/valsartan (Entresto): inhibits aldosterone, decreases BV
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