2. The patient suffers from silent myocardial infarction, but there are other ty
ID: 202393 • Letter: 2
Question
2. The patient suffers from silent myocardial infarction, but there are other types of heart diseases. Consider these questions: o Describe the heart valvular disorders and how they can produce cardiac failure. o What is endocarditis, and what are the most common causes? o How many types of shocks are there? Explain them. 3. As a lifetime smoker, the patient is at risk of several respiratory disorders. Consider these questions: o What is COPD? What are the three most common diseases that produce a COPD? What are their causes? o What is asthma? Explain the origin of its symptoms. o What is a pneumothorax? What are its symptoms and signs, and what are its causes?Explanation / Answer
Answer:
2a) Valvular disorders can be either due to narrowing of the heart valves causing stenosis or due to the failure of complete closure of the valves during functioning causing regurgitation.
The valvular diseases that affect the heart are:
Acute Rheumatic fever, Mitral stenosis, Mitral regurgitation, Aortic stenosis, Aortic regurgitation, Tricuspid valve stenosis, and regurgitation, pulmonary valve stenosis and regurgitation and infective endocarditis.
Acute rheumatic fever is an acute valvular heart disease following streptococcal infection(throat infection) and is seen to affect children and young adults.It brings about an inflammation to the heart valves,called valvulitis with nodules forming on the mitral valve leaflets.The cause of cardiac failure may result due to impaired function of the ventricular muscle or from mitral or aortic incompetence. The disease causes development to wide range of manifestations such as arthritis, nodules over bones and tendons, skin lesions such as erythema marginatum, erythema nodosum on front of shins, CNS involvement causing chorea, fever, breathlessness etc.
Chronic valvular diseases differ from acute diseases in the development of fibrosis of the valves due to its chronic long-term nature.
In mitral stenosis, there is a reduction in the size of heart valve orifice causing a rise in left atrial, pulmonary venous and pulmonary capillary pressure, resulting loss of lung compliance and development of exertional dyspnoea.There is reduced ventricular filling.Atrial fibrillation causes a rise in ventricular pressure can cause an onset of atrial fibrillation which leads to pulmonary edema causing a fall in cardiac output.
Regurgitation caisese a rapid rise in left atrial pressure , the combined rise in artial and venous pressure leads to pulmonary edema and precipitate cardiac failure.
b) Endocarditis is a valvular heart disease due to microbial infection of a heart valve, either native or prosthetic or on the lining of a chamber or blood vessel. The causative organism may be bacterial, rickettsial, Coxiella burnetti, chlamydia or fungus.Streptococcal viridans from a dental infection or staphyloccoccus aureus from a skin infection are other causes.
c) Shock is a condition where circulation fails to meet the nutritional demands of the cells and also there is a failure to remove metabolic waste products.
TYpes of shock are:
Hypovolemic shock: Due to loss of intravascular volume. There is low cardiac output, low blood pressue leading to cold clammy fingers.
Traumatic shock: Hypovolemia due to bleeding due to internal or external hemorrhaging which leads to developing the shock.
Neurogenic shock : Due to blockage of sympathetic nervous system resulting in loss of arterial and venous tone resulting in pooling of blood.
Cardiogenic shock: Caused by injury to heart by myocardial infarction, cardiac arrhythmias, or congestive cardiac failure, the heart fails to pump blood.
Septic shock : The circulatory failure that develops due to the enditoxins released into blood due to gram negative septicemia.
Other examples are anaphylactic shock, insulin shock, cardiac compressive shock due to cardiac tamponade.
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