Cardiovascular System Introduction Heart is muscular pump its

Cardiovascular System

Introduction Heart is muscular pump , its function is to move the blood through vascular system. Circulating blood provided body cells with oxygen , nutrients and other chemical necessary for function of life. Blood also carries away the waste products of cell metabolism.

Introduction The three types associated with the heart : 1 - Cardiac Failure which is due to the failure of pumping action of the heart. 2 - Cardiac Arrhythmias which is due to disturbances in either the generation of impulses or its conduction in the heart 3 - Angina pectoris due to the deficiency in supply of oxygen to heart Hypertension : is situation affected by the cardiac out put

Heart Failure

Définitions Cardiac Failure( CF) : Result from any cardiac disorder that impairs the ability of the ventricle to deliver enough quantities of blood to the metabolizing tissues during normal activity or at rest. Edematous state: commonly produced by the fluid backup resulting in shortness of breath, fatigue, limitation of exercise tolerance, and fluid retention. Fluid retention: may lead to pulmonary and peripheral edema.

Définitions : Diastolic dysfunction : inability for the ventricles to fill with blood during diastole, or ventricular relaxation. Systolic dysfunction: refers to an impaired degree of ventricular contraction resulting in a decrease in cardiac entropy (contractility)

Treatment To treat heart failure we use the following drugs : 1 - Digitalis glycosides ( Digoxin ) 2 - Diuretics (Furosemide (Lasix)) 3 - ACE Inhibitors (Captopril , Benazepril) 4 - Beta Blockers (Carvedilol) Some time we use combined drugs for treatment like : Digitals and Diuretics Digitals and Beta blockes

Treatment 1 - Digitalis glycosides Most important drug ( Digoxin ) It has two affect in the heart Positive inotropic effects: (contraction) increased the force of contraction of the heart Increase the out heart output Negative chronotropic effect : when the heart output increased rate will decrease. the heart

Treatment Digoxin adverse reaction : In high dose or toxic dose it will cause Nausea , vomiting Exerted by the kidney so can not be given to patient with renal failure

Precautions and monitoring effects: when using digoxin Drug Decreased potassium levels increase Digoxin binding to cardiac cells and increase its effect , thus increasing the digitalis toxicity. Conversely, increased potassium levels seem to decrease digoxin binding and decrease its effect. Magnesium levels are inversely related to digoxin activity. As magnesium levels decrease, the predisposition to toxicity increases.

Signs of toxicity in digoxin include: Anorexia, a common and early sign Fatigue, headache Nausea and vomiting Mental confusion and disorientation Alterations in visual perception. Cardiac effects

Treatment of toxicity 1 - Digital is is discontinued immediately. 2 - I f the patient is hypokalemic, potassium supplements are administered and serum levels are monitored. 3 - Arrhythmias are treated with lidocaine. 4 - Cholestyramine, which binds to digitalis may help prevent absorption and reabsorption of digitalis in the 5 - Patients with very high digoxin levels digoxin-specific we give Digibind which is an antibodies (. bile.

Treatment 2 - Diuretics : (Furosemide (Lasix)) It decrease pulmonary and peripheral edema. Increase the vessels capacity and decrease ventricular filling pressure so it help in heart failure. adverse effect : effect to blood pressure mild Increase LDL Load in the kidney

Treatment 3 - ACE Inhibitors ( Angiotensin converting enzymes ) Captopril , benazepril improve cardiac function hypertension. adverse effect : cough , hypotension and hyperkalemia 4 - Beta blockers ( Carvedilol) used for hypertension and improve cardiac out put Adverse effect : Increase LDL/HDL reduce libido