1. Ischemic heart disease
2. Mitral and aortic valvular disease
3. Hypertensive heart disease
4. Primary (non-ischemic) myocardial disease

• reduction in coronary blood flow
• conditions that increase in cardiac energy demand (hypertrophy)
• conditions that lower systemic BP (shock)
• conditions that cause hypoxemia (respiratory problem)
• rapid HR

1. Reduced nutrient supply and inadequate removal of metabolites
2. Reduced O2 supply
3. Reduced ATP production and the subsequent cellular damage

• fissuring
• overt plaque rupture
• local platelet aggregation
• coronary artery thrombosis

1. Myocarditis
2. Cardiomyopathies
3. Systemic disorders
4. Muscular dystrophies
5. Immunologic disease

1. Typical (stable, chronic)
2. Prizmetal's or variant angina
3. Unstable Angina Pectoris (crescendo angina)
4. Infarction angina

• occurs at rest or awakens the pt from sleep.
• associated with coronary artery spasm near atherosclerotic plaque
• Relieved by vasodilators

• Increased frequency of pain
• More intense and longer lasting than stable kind.
• Most serious and potentially irreversible myocardial ischemia
• Referred to as preinfarction angina

• severe crushing substernal chest pain (may radiate into neck, jaw, epigastrium, shoulder, or left arm)
• Pain lasts several hours to days and not relieved by nitroglycerine.
• Irreversible

Sign: soft tissue edema ( first in feet and lower legs than generalized), distended neck veins, enlarged liver

Symptom: tender liver, deep venous thrombi (leading to pulmonary embolism)

1. EKG: changes in Q wave, ST segment abnormalities, T wave inversion, presence of arrhythmias.

2. Laboratory evaluation: CK (will see in first 2 days if MI), lactate dehydrogenase, serum levels of myocardial proteins especially troponins (rise)

• Mitral stenosis
• Aortic stenosis
• Mitral regurgitation
• Aortic regurgitation
• Intrinsic valvular disease

Signs: Doppler ECG- measures flow velocities as well as structure and can be used to repetitively examine the progression of the disease w/ time

Symptoms: angina, syncope

1. Valve cusps are thickened and adhere to each other
2. Obstruction to left ventricular outflow
3. Gradually increasing Pressure gradient across the calcified valve
4. Pressure overload
5. Concentric hypertrophy of the left ventricle.
6. Cardiac decompensation with CHF

1. Tetralogy of Fallot
2. Transposition of the great arteries
3. coarctation of the aorta
4. truncus arteriosus
5. tricuspid atresia
6. obstructive congenital abnormalities

1. Atrial septal defects (ASD)

2. Ventricular septal defects (VSD)

3. Patent ductus arteriosus (PDA)

4. Atrial Ventricular septal defect

1. Angina pectoris (occurs first)
2. Acute MI
3. Sudden cardiac death
4. Chronic IHD w/ CHF

-Accelerated removal of neutrophils from the circulating blood

- Reduced of ineffective production of neutrophils (ineffective granulopoiesis)

- immunologically mediated injury to the neutrophils (produced by exposure to drugs)

1. Erythropoietin synthesis incrases -> marrow expansion (skull)
2. Increased iron absorption -> iron overload in heart and liver
3. Tissue anoxia -> fatty change in the liver, myocardium and kidney

1. Nutritional deficiency
2. Decreased erythropoietin levels (chronic kidney disease)
3. Suppression of multipotent stem cells
4. Extensive replacement of marrow by tumors

1. Respiratory acidosis and coma
2. Right sided heart failure
3. Massive collapse of lungs secondary to pneumothorax

Direct- SLE, tumors, emphysema, COPD and pulmonary fibrosis

Indirect- HD, thromboembolism, genetic predisposition.

• blockage
• decreased space
• decreased recoil ability of the lungs- can't get O2, become weak, become tired.

• Profound dyspnea and tachypnea,
• respiratory insufficiency
• cyanosis and arterial hypoxemia increases
• Respiratory failure

1. Diffuse damage to the alveolar capillary walls
2. followed by Relatively nonspecific, often predictable series of morphological and physiological changes leading to resp. failure

• Acute infections
• Nasopharygeal carcinoma
• Laryngeal tumors (non malignance, carcinoma of the larynx)

Acute- ARDS

Chronic-

1. Diffuse alveolar damage,
2. idiopathic pulmonary fibrosis,
3. hypersensitivity pneumonitis,
4. sarcoidosis,
5. diffuse pulmonary hemorrhage syndrome

1. Pulmonary HTN
2. Vascular sclerosis
3. Pulmonary thromboembolism (hemmorhage, infarction)