Cardiovascular System: Disease Conditions


Cardiovascular System: Disease Conditions

1. Hypertension (High Blood Pressure)
  • Definition: A chronic elevation of arterial blood pressure (BP ≥ 130/80 mmHg per current guidelines).
  • Etiology: Primary (essential, unknown cause, 90-95% of cases) or secondary (e.g., renal disease, endocrine disorders).
  • Pathophysiology: Increased peripheral resistance or cardiac output overworks the heart, damaging vessels and organs.
  • Clinical Manifestations: Often asymptomatic; may include headache, dizziness, blurred vision in severe cases.
  • Diagnostic Evaluations: BP measurement, blood tests (lipids, glucose), ECG, echocardiogram.
  • Medical Management: Antihypertensives (e.g., ACE inhibitors, diuretics), lifestyle changes.
  • Surgical Management: Rarely needed unless secondary cause (e.g., renal artery stenosis repair).
  • Nursing Care: Monitor BP, educate on medication adherence, assess for side effects.
  • Dietary Management: Low-sodium DASH diet, limit alcohol, increase potassium-rich foods.
  • Postoperative Care: N/A unless surgery for secondary cause; monitor BP and incision site.
  • Rehabilitation: Exercise programs, stress management, regular follow-ups.
2. Coronary Artery Disease (CAD)
  • Definition: Narrowing of coronary arteries due to atherosclerosis, reducing blood flow to the myocardium.
  • Etiology: Risk factors include smoking, hypertension, diabetes, hyperlipidemia.
  • Pathophysiology: Plaque buildup causes ischemia, potentially leading to infarction.
  • Clinical Manifestations: Angina, fatigue, shortness of breath.
  • Diagnostic Evaluations: ECG, stress test, coronary angiography, cardiac biomarkers.
  • Medical Management: Nitrates, beta-blockers, statins.
  • Surgical Management: Angioplasty, coronary artery bypass grafting (CABG).
  • Nursing Care: Monitor vitals, pain management, post-op wound care.
  • Dietary Management: Low-fat, high-fiber diet, limit saturated fats.
  • Postoperative Care: Monitor for bleeding, infection; encourage gradual activity.
  • Rehabilitation: Cardiac rehab with supervised exercise, lifestyle counseling.
3. Heart Failure
  • Definition: Heart’s inability to pump blood effectively to meet body needs.
  • Etiology: CAD, hypertension, cardiomyopathy, valve disease.
  • Pathophysiology: Reduced cardiac output leads to fluid overload and organ hypoperfusion.
  • Clinical Manifestations: Dyspnea, edema, fatigue, orthopnea.
  • Diagnostic Evaluations: Echocardiogram, BNP levels, chest X-ray.
  • Medical Management: Diuretics, ACE inhibitors, beta-blockers.
  • Surgical Management: Ventricular assist devices, heart transplant in severe cases.
  • Nursing Care: Monitor fluid status, weight, educate on symptom recognition.
  • Dietary Management: Low-sodium, fluid restriction if prescribed.
  • Postoperative Care: Monitor hemodynamics, prevent infection.
  • Rehabilitation: Tailored exercise, energy conservation techniques.
4. Myocardial Infarction (MI)
  • Definition: Death of myocardial tissue due to prolonged ischemia.
  • Etiology: Coronary artery occlusion (usually thrombus).
  • Pathophysiology: Blocked blood flow causes necrosis, impairing heart function.
  • Clinical Manifestations: Chest pain, nausea, diaphoresis, dyspnea.
  • Diagnostic Evaluations: ECG (ST elevation), troponin levels, angiography.
  • Medical Management: Aspirin, thrombolytics, oxygen.
  • Surgical Management: Percutaneous coronary intervention (PCI), CABG.
  • Nursing Care: Pain relief, monitor arrhythmias, emotional support.
  • Dietary Management: Heart-healthy diet post-recovery.
  • Postoperative Care: Watch for complications (e.g., bleeding, restenosis).
  • Rehabilitation: Gradual return to activity, risk factor modification.
5. Atrial Fibrillation (AF)
  • Definition: Irregular, rapid atrial contractions impairing ventricular filling.
  • Etiology: Hypertension, heart failure, thyroid disease, alcohol use.
  • Pathophysiology: Chaotic atrial impulses increase stroke risk via clot formation.
  • Clinical Manifestations: Palpitations, fatigue, syncope.
  • Diagnostic Evaluations: ECG, Holter monitor, echocardiography.
  • Medical Management: Anticoagulants (e.g., warfarin), rate/rhythm control drugs.
  • Surgical Management: Catheter ablation, maze procedure.
  • Nursing Care: Monitor heart rate, educate on bleeding risks.
  • Dietary Management: Avoid caffeine, alcohol; maintain consistent vitamin K intake.
  • Postoperative Care: Monitor for arrhythmia recurrence, incision care.
  • Rehabilitation: Lifestyle adjustments, regular monitoring.
6. Aortic Aneurysm
  • Definition: Abnormal dilation of the aorta wall.
  • Etiology: Atherosclerosis, hypertension, connective tissue disorders (e.g., Marfan syndrome).
  • Pathophysiology: Weakened vessel wall expands, risking rupture.
  • Clinical Manifestations: Often asymptomatic; may have pulsatile abdominal mass, pain.
  • Diagnostic Evaluations: Ultrasound, CT, MRI.
  • Medical Management: BP control (beta-blockers).
  • Surgical Management: Endovascular stent graft, open repair.
  • Nursing Care: Monitor vitals, assess for rupture signs.
  • Dietary Management: Heart-healthy diet to manage risk factors.
  • Postoperative Care: Prevent infection, monitor graft patency.
  • Rehabilitation: Avoid heavy lifting, regular imaging follow-ups.
7. Peripheral Artery Disease (PAD)
  • Definition: Atherosclerotic narrowing of peripheral arteries, typically in legs.
  • Etiology: Smoking, diabetes, hypertension, hyperlipidemia.
  • Pathophysiology: Reduced blood flow causes ischemia in extremities.
  • Clinical Manifestations: Intermittent claudication, cool skin, weak pulses.
  • Diagnostic Evaluations: Ankle-brachial index (ABI), Doppler ultrasound.
  • Medical Management: Antiplatelets (e.g., aspirin), statins, cilostazol.
  • Surgical Management: Angioplasty, bypass grafting.
  • Nursing Care: Assess pulses, skin integrity, educate on foot care.
  • Dietary Management: Low-cholesterol, high-fiber diet.
  • Postoperative Care: Monitor circulation, wound healing.
  • Rehabilitation: Supervised walking programs.
8. Cardiomyopathy
  • Definition: Disease of the heart muscle impairing pumping ability.
  • Etiology: Genetic, alcohol, viral infections, chemotherapy.
  • Pathophysiology: Structural changes (dilated, hypertrophic, restrictive) reduce efficiency.
  • Clinical Manifestations: Fatigue, dyspnea, edema.
  • Diagnostic Evaluations: Echocardiogram, MRI, biopsy.
  • Medical Management: Beta-blockers, ACE inhibitors, diuretics.
  • Surgical Management: Implantable defibrillators, heart transplant.
  • Nursing Care: Monitor symptoms, support adherence.
  • Dietary Management: Low-sodium, balanced nutrition.
  • Postoperative Care: Prevent rejection (transplant), monitor device function.
  • Rehabilitation: Tailored activity plans.
9. Valvular Heart Disease (e.g., Mitral Regurgitation)
  • Definition: Dysfunction of heart valves causing improper blood flow.
  • Etiology: Rheumatic fever, congenital defects, endocarditis.
  • Pathophysiology: Backflow or obstruction alters cardiac workload.
  • Clinical Manifestations: Murmur, fatigue, dyspnea.
  • Diagnostic Evaluations: Echocardiogram, cardiac catheterization.
  • Medical Management: Diuretics, vasodilators.
  • Surgical Management: Valve repair or replacement.
  • Nursing Care: Monitor heart sounds, anticoagulation therapy.
  • Dietary Management: Low-sodium diet.
  • Postoperative Care: Prevent infection, monitor for bleeding.
  • Rehabilitation: Gradual activity increase.
10. Deep Vein Thrombosis (DVT)
  • Definition: Blood clot in a deep vein, usually legs.
  • Etiology: Immobility, surgery, hypercoagulability.
  • Pathophysiology: Clot obstructs venous return, risking embolism.
  • Clinical Manifestations: Swelling, pain, redness in affected limb.
  • Diagnostic Evaluations: Doppler ultrasound, D-dimer test.
  • Medical Management: Anticoagulants (e.g., heparin, warfarin).
  • Surgical Management: Thrombectomy (rare), IVC filter.
  • Nursing Care: Monitor for pulmonary embolism signs, apply compression.
  • Dietary Management: Consistent vitamin K intake if on warfarin.
  • Postoperative Care: Monitor bleeding, filter placement.
  • Rehabilitation: Ambulation encouragement, compression stockings.





CARDIOVASCULAR SYSTEM

1. Hypertension

Definition: Chronic elevation of blood pressure (≥130/80 mmHg).
Etiology: Genetics, obesity, high salt intake, stress, sedentary lifestyle.
Clinical Manifestations: Headache, dizziness, blurred vision, epistaxis.
Diagnostic Evaluations: BP measurement, ECG, lipid profile, renal function tests.
Medical Management: Antihypertensives (ACE inhibitors, beta-blockers).
Surgical Management: Rare; renal denervation for resistant cases.
Nursing Care: Monitor BP, educate on lifestyle modifications.
Dietary Management: Low sodium, DASH diet.
Post-Operative Care: Not typically applicable.
Rehabilitation: Regular exercise, weight management, stress reduction.

2. Myocardial Infarction (Heart Attack)

Definition: Ischemic necrosis of myocardial tissue due to occluded coronary artery.
Etiology: Atherosclerosis, smoking, diabetes, hypertension.
Clinical Manifestations: Chest pain, dyspnea, diaphoresis, nausea.
Diagnostic Evaluations: ECG, cardiac enzymes (troponin), echocardiogram.
Medical Management: Thrombolytics, antiplatelets, beta-blockers.
Surgical Management: PCI (stents), CABG.
Nursing Care: Oxygen therapy, monitor vitals, pain management.
Dietary Management: Low-fat, low-cholesterol diet.
Post-Operative Care: Monitor for bleeding, cardiac rehab program.
Rehabilitation: Gradual physical activity, lifestyle modifications.

3. Heart Failure

Definition: Inability of the heart to pump blood effectively.
Etiology: Hypertension, CAD, valvular diseases.
Clinical Manifestations: Dyspnea, edema, fatigue, orthopnea.
Diagnostic Evaluations: Echocardiogram, BNP levels, chest X-ray.
Medical Management: Diuretics, ACE inhibitors, beta-blockers.
Surgical Management: LVAD, heart transplant.
Nursing Care: Fluid balance monitoring, daily weights, oxygen therapy.
Dietary Management: Low sodium, fluid restriction.
Post-Operative Care: Wound care, infection prevention.
Rehabilitation: Cardiac rehabilitation, exercise therapy.

4. Atrial Fibrillation

Definition: Irregular heart rhythm leading to poor blood flow.
Etiology: Hypertension, heart disease, hyperthyroidism.
Clinical Manifestations: Palpitations, dizziness, fatigue.
Diagnostic Evaluations: ECG, Holter monitor, echocardiography.
Medical Management: Anticoagulants, beta-blockers, antiarrhythmics.
Surgical Management: Catheter ablation, pacemaker implantation.
Nursing Care: Monitor heart rate, prevent thromboembolism.
Dietary Management: Avoid excessive caffeine, alcohol.
Post-Operative Care: Monitor for bleeding, infection.
Rehabilitation: Physical activity, stress reduction.

5. Peripheral Artery Disease

Definition: Narrowing of peripheral arteries due to atherosclerosis.
Etiology: Smoking, diabetes, high cholesterol.
Clinical Manifestations: Claudication, weak pulses, ulcers.
Diagnostic Evaluations: Ankle-brachial index, Doppler ultrasound.
Medical Management: Antiplatelets, statins, vasodilators.
Surgical Management: Angioplasty, bypass surgery.
Nursing Care: Promote circulation, monitor for ischemia.
Dietary Management: Low-fat, high-fiber diet.
Post-Operative Care: Wound care, prevent thrombosis.
Rehabilitation: Smoking cessation, supervised exercise therapy.

6. Endocarditis

Definition: Inflammation of the inner lining of the heart.
Etiology: Bacterial or fungal infections, dental procedures, IV drug use.
Clinical Manifestations: Fever, chills, heart murmur, petechiae.
Diagnostic Evaluations: Blood cultures, echocardiography.
Medical Management: IV antibiotics, antifungals.
Surgical Management: Valve replacement if severe.
Nursing Care: Monitor for embolic events, administer medications.
Dietary Management: Balanced diet, hydration.
Post-Operative Care: Wound care, infection control.
Rehabilitation: Long-term antibiotic therapy, follow-up care.

7. Cardiomyopathy

Definition: Disease of the heart muscle affecting function.
Etiology: Genetics, alcohol use, infections, hypertension.
Clinical Manifestations: Fatigue, dyspnea, palpitations.
Diagnostic Evaluations: Echocardiogram, MRI, cardiac biopsy.
Medical Management: Beta-blockers, diuretics, ACE inhibitors.
Surgical Management: ICD implantation, heart transplant.
Nursing Care: Monitor cardiac output, fluid balance.
Dietary Management: Low sodium, fluid restriction.
Post-Operative Care: Post-transplant immunosuppression.
Rehabilitation: Cardiac rehab, lifestyle modification.

8. Aortic Aneurysm

Definition: Abnormal dilation of the aortic wall.
Etiology: Hypertension, atherosclerosis, connective tissue disorders.
Clinical Manifestations: Often asymptomatic; severe cases may have pulsatile mass, pain.
Diagnostic Evaluations: Ultrasound, CT angiography.
Medical Management: Blood pressure control.
Surgical Management: Aneurysm repair or grafting.
Nursing Care: Monitor for rupture signs, BP control.
Dietary Management: Low-fat, heart-healthy diet.
Post-Operative Care: Monitor for graft leakage, infection prevention.
Rehabilitation: Gradual return to activity, BP monitoring.

9. Rheumatic Heart Disease

Definition: Chronic heart valve damage from rheumatic fever.
Etiology: Streptococcal infection.
Clinical Manifestations: Heart murmur, chest pain, joint pain.
Diagnostic Evaluations: Echocardiogram, ASO titer.
Medical Management: Antibiotics, anti-inflammatories.
Surgical Management: Valve repair or replacement.
Nursing Care: Infection prevention, monitor heart function.
Dietary Management: Balanced diet, adequate hydration.
Post-Operative Care: Anticoagulation therapy if valve replacement.
Rehabilitation: Regular cardiac follow-up.

10. Deep Vein Thrombosis (DVT)

Definition: Blood clot formation in deep veins.
Etiology: Immobility, hypercoagulability, endothelial injury.
Clinical Manifestations: Swelling, pain, warmth, redness.
Diagnostic Evaluations: Doppler ultrasound, D-dimer test.
Medical Management: Anticoagulants, thrombolytics.
Surgical Management: Thrombectomy, IVC filter.
Nursing Care: Encourage mobility, compression therapy.
Dietary Management: Hydration, vitamin K monitoring if on warfarin.
Post-Operative Care: Monitor for bleeding, PE prevention.
Rehabilitation: Gradual mobilization, long-term anticoagulation.

Pediatric Disease Conditions: System-Based Approach

 


Pediatric Disease Conditions: System-Based Approach

Introduction

Pediatric diseases can be classified based on the affected organ systems. Proper medical and surgical management ensures effective treatment and better outcomes in children.


1. Respiratory System Disorders

a. Asthma

  • Symptoms: Wheezing, shortness of breath, coughing.
  • Medical Management:
    • Bronchodilators (Salbutamol, Ipratropium)
    • Corticosteroids (Budesonide, Prednisolone)
    • Leukotriene receptor antagonists (Montelukast)
  • Surgical Management: Not typically required unless complications arise.

b. Pneumonia

  • Symptoms: Fever, cough, difficulty breathing.
  • Medical Management:
    • Antibiotics (Amoxicillin, Azithromycin)
    • Oxygen therapy for hypoxia
    • Antipyretics for fever control
  • Surgical Management: Drainage of empyema if present.

2. Cardiovascular System Disorders

a. Congenital Heart Defects (CHD)

  • Symptoms: Cyanosis, poor feeding, murmurs.
  • Medical Management:
    • Diuretics (Furosemide)
    • ACE inhibitors (Enalapril)
    • Digoxin for heart failure
  • Surgical Management:
    • Surgical correction (Tetralogy of Fallot repair, ASD/VSD closure, valve replacement)

b. Kawasaki Disease

  • Symptoms: Fever, rash, conjunctivitis, swollen lymph nodes.
  • Medical Management:
    • IV Immunoglobulin (IVIG)
    • Aspirin therapy
  • Surgical Management: Coronary artery intervention if aneurysm develops.

3. Gastrointestinal System Disorders

a. Gastroesophageal Reflux Disease (GERD)

  • Symptoms: Regurgitation, irritability, feeding difficulties.
  • Medical Management:
    • Proton pump inhibitors (Omeprazole, Lansoprazole)
    • Feeding modifications (small, frequent meals)
  • Surgical Management: Fundoplication in severe cases.

b. Intussusception

  • Symptoms: Severe abdominal pain, vomiting, bloody stools.
  • Medical Management:
    • IV fluids, nasogastric decompression
    • Air/contrast enema for reduction
  • Surgical Management: Resection if non-operative methods fail.

4. Neurological System Disorders

a. Epilepsy

  • Symptoms: Recurrent seizures, altered consciousness.
  • Medical Management:
    • Antiepileptic drugs (Carbamazepine, Valproate)
    • Lifestyle modifications
  • Surgical Management: Epilepsy surgery in refractory cases.

b. Hydrocephalus

  • Symptoms: Enlarged head, vomiting, irritability.
  • Medical Management: Symptomatic relief with diuretics.
  • Surgical Management: Ventriculoperitoneal (VP) shunt placement.

5. Endocrine System Disorders

a. Diabetes Mellitus (Type 1)

  • Symptoms: Polyuria, polydipsia, weight loss.
  • Medical Management:
    • Insulin therapy
    • Blood glucose monitoring
  • Surgical Management: Pancreatic transplant in select cases.

b. Congenital Hypothyroidism

  • Symptoms: Poor feeding, lethargy, delayed growth.
  • Medical Management: Thyroid hormone replacement (Levothyroxine).
  • Surgical Management: Not typically required.

6. Musculoskeletal System Disorders

a. Rickets

  • Symptoms: Bone pain, deformities, delayed growth.
  • Medical Management:
    • Vitamin D and calcium supplementation
  • Surgical Management: Correction of deformities if severe.

b. Clubfoot

  • Symptoms: Foot deformity at birth.
  • Medical Management:
    • Serial casting (Ponseti method)
  • Surgical Management: Tendon release if needed.

Conclusion

Early diagnosis and appropriate medical and surgical management of pediatric diseases help improve outcomes. Regular check-ups, vaccinations, and proper nutrition play a key role in preventing many childhood conditions.

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