Pathophysiology
Definition:
HTN (primary vs secondary vs orthostatic vs malignant) : High Blood Pressure
o Primary hypertension:
NO known etiology---idiopathic disorder
Most common form of disease in ADULTS (from age 18)
Associated w/ positive family history of hypertension, obesity and lifestyle
factors ; can risk development of other diseases like stroke
Non-modifiable: increasing age and family history
Modifiable: some lifestyle changes
Childhood (intrauterine): occurred because of maternal smoking etc
Known as a “silent killer” bc it can cause end-organ damage (damaged
organs before diagnosis)
o Secondary Hypertension:
Has a SPECIFIC identifiable cause (ex: drugs, foods, chemicals)
Most common form in INFANTS & CHILDREN
Becomes a risk factor for renal disorders and coarctation of the
aorta; kidney’s can’t excrete sodium effectively (RAAS) & SNS
Intervention: removing the cause, drug therapy
o Orthostatic Hypotension
hypotension caused by standing up from a sitting/lying position
o Malignant Hypertension
extremely high blood pressure that develops rapidly and causes some
type of organ damage.
Caused by secondary hypertension or uncontrolled primary hypertension
Sepsis
o Most common cause of death in ICU from underlying diseases like trauma,
peritonitis, cancer and immunodeficiency dis.
Cardiac tamponade
o Accumulation of pericardial fluid that can be life threatening
o It causes compression of the heart chambers that heart filling is affected
o The pressure prevents the heart's ventricles from expanding fully and keeps your
heart from functioning properly.
o Si/sx: reduced stroke volume and bc of that, heart rate INCREASES
o Fluid must be drained
Sleep apnea
o a common and serious sleep disorder that causes you to stop breathing
during sleep. The airway repeatedly becomes blocked, limiting the amount of
air that reaches your lungs.
Orthopnea reperfusion therapy
, o medical treatment to restore blood flow, either through or around, blocked
arteries, typically after a heart attack (myocardial infarction (MI)). Reperfusion
therapy includes drugs and surgery.
Catheterization
o Takes direct measurements of pressures within cardiac chambers to determine
important structural and hemodynamic (flow of blood) characteristics
o It was associated with risks—bleeding etc.—replaced with noninvasive ways
Antiplatelet drugs
Stroke volume vs end-diastolic volume vs end systolic volume
Sympathetic vs parasympathetic nervous system
Chapter 16
Blood pressure:
o Factors creating BP, measurement of BP
Factors creating BP
BP= (Cardiac Output) x (Systemic Vascular Resistance)
o CO: the amount of blood ejected from heart every minute
(CO=SV x HR)
Stroke Volume: blood leaving the heart every
contraction and it is determined by the preload
Heart Rate: SNS--Beta receptors stimulation (INC.
HR); PSNS--Vagal nerve stimulation (DEC HR)
o SVR: radius of arteries—constricts and dilates
Alpha stimulation=vasoconstrict=INC. SVR=INC BP
Measurement of BP
Direct Measurement:
o Uses a catheter within an artery; hemodynamic
monitoring; most ACCURATE method
Indirect Measurement
o Uses a sphygmomanometer and stethoscope at the
brachial artery; EASIEST method
o systolic vs diastolic vs pulse pressure
Systolic pressure:
peak in pressure, heart muscle CONTRACTION, SV is the major
influence affecting the pressure
Diastolic Pressure:
Minimum pressure heart muscle RELAXATION, SVR is the major
influence affecting the pressure
Pulse Pressure:
PP=Systolic-Diastolic
o MAP = CO x TPR (systemic vascular resistance)
o Control: quick vs slow
Quick:
Definition:
HTN (primary vs secondary vs orthostatic vs malignant) : High Blood Pressure
o Primary hypertension:
NO known etiology---idiopathic disorder
Most common form of disease in ADULTS (from age 18)
Associated w/ positive family history of hypertension, obesity and lifestyle
factors ; can risk development of other diseases like stroke
Non-modifiable: increasing age and family history
Modifiable: some lifestyle changes
Childhood (intrauterine): occurred because of maternal smoking etc
Known as a “silent killer” bc it can cause end-organ damage (damaged
organs before diagnosis)
o Secondary Hypertension:
Has a SPECIFIC identifiable cause (ex: drugs, foods, chemicals)
Most common form in INFANTS & CHILDREN
Becomes a risk factor for renal disorders and coarctation of the
aorta; kidney’s can’t excrete sodium effectively (RAAS) & SNS
Intervention: removing the cause, drug therapy
o Orthostatic Hypotension
hypotension caused by standing up from a sitting/lying position
o Malignant Hypertension
extremely high blood pressure that develops rapidly and causes some
type of organ damage.
Caused by secondary hypertension or uncontrolled primary hypertension
Sepsis
o Most common cause of death in ICU from underlying diseases like trauma,
peritonitis, cancer and immunodeficiency dis.
Cardiac tamponade
o Accumulation of pericardial fluid that can be life threatening
o It causes compression of the heart chambers that heart filling is affected
o The pressure prevents the heart's ventricles from expanding fully and keeps your
heart from functioning properly.
o Si/sx: reduced stroke volume and bc of that, heart rate INCREASES
o Fluid must be drained
Sleep apnea
o a common and serious sleep disorder that causes you to stop breathing
during sleep. The airway repeatedly becomes blocked, limiting the amount of
air that reaches your lungs.
Orthopnea reperfusion therapy
, o medical treatment to restore blood flow, either through or around, blocked
arteries, typically after a heart attack (myocardial infarction (MI)). Reperfusion
therapy includes drugs and surgery.
Catheterization
o Takes direct measurements of pressures within cardiac chambers to determine
important structural and hemodynamic (flow of blood) characteristics
o It was associated with risks—bleeding etc.—replaced with noninvasive ways
Antiplatelet drugs
Stroke volume vs end-diastolic volume vs end systolic volume
Sympathetic vs parasympathetic nervous system
Chapter 16
Blood pressure:
o Factors creating BP, measurement of BP
Factors creating BP
BP= (Cardiac Output) x (Systemic Vascular Resistance)
o CO: the amount of blood ejected from heart every minute
(CO=SV x HR)
Stroke Volume: blood leaving the heart every
contraction and it is determined by the preload
Heart Rate: SNS--Beta receptors stimulation (INC.
HR); PSNS--Vagal nerve stimulation (DEC HR)
o SVR: radius of arteries—constricts and dilates
Alpha stimulation=vasoconstrict=INC. SVR=INC BP
Measurement of BP
Direct Measurement:
o Uses a catheter within an artery; hemodynamic
monitoring; most ACCURATE method
Indirect Measurement
o Uses a sphygmomanometer and stethoscope at the
brachial artery; EASIEST method
o systolic vs diastolic vs pulse pressure
Systolic pressure:
peak in pressure, heart muscle CONTRACTION, SV is the major
influence affecting the pressure
Diastolic Pressure:
Minimum pressure heart muscle RELAXATION, SVR is the major
influence affecting the pressure
Pulse Pressure:
PP=Systolic-Diastolic
o MAP = CO x TPR (systemic vascular resistance)
o Control: quick vs slow
Quick:
