1. CARDIOVASCULAR
DISORDERS
BY;
Mr. M.K LAMBA M.Sc. Nsg

2. The cardio vascular disorders includes the
disorders related to heart and blood
vessels like infections of heart layers and
heart, valvular disorders, arithmetic
disorders etc.

3. HEART DISORDERS
PERICARDITIS
It is an inflammation of the pericardium
the outer most covering the heart. It may
be primary illness or a variety of medical
and surgical disorders. It is an acute and
chronic illness.

4. CAUSES OF PERICARDITIS:
• Infections: viral, bacterial, parasitic, fungal
• Myocardial injuries: cardiac trauma, surgery
• Collagen diseases: Rheumatic fever,
scleroderma (connective tissue disease that
involves changes in the skin, blood vessels,
muscles, and internal organs), rheumatoid
arthritis
• Drug reactions
• Radiation therapy
• Cobalt therapy
• Anemia
• Neoplasm

5. PAHOPHYSIOLOGY:
Due to any of the above reason
↓
Either from infection or any other reason there
will be increased WBC and chance of fluid
accumulation in the cavity
↓
Leads to dyspnea and pain aggravated by
breathing due to pericardial compression
↓
Results in decrease cardiac output and cardiac
temponade

6. SIGNS AND SYMPTOMS
• Pain: over precordium and may felt beneath of
clavicle, in neck and pain left to scapular
region.
• Pain aggravated by breathing, relieving by
sitting
• Dyspnea may occur as a result of pericardial
compression which leads to decreased cardiac
output
• Fever may be present.
• ↑ WBC count

7. • Echocardiogram: accurately detects all
pericardial effusions and provides clinically
relevant information about their size and
hemodynamic.
• Magnetic resonance imaging (MRI) and
computed tomography (CT) in detecting
pericardial thickening/ constriction and
calcification as well as small loculated
effusions is extremely useful in these
conditions.

8. MEDICAL MANAGEMENT:
 Analgesics to relieve pain
 NSAID (Non steroidal anti- inflammatory agents):
eg. Spirin, Indomethacin (Indocin) These
drugs with analgesic and antipyretic effects and which have, in
higher doses, anti-inflammatory effects.
 Corticosteroids: are two types;
1. Gluco-corticoids such as cortisol control carbohydrate,
fat and protein metabolism and are anti-inflammatory by
preventing phospho- lipid release,
decreasing eosinophil action and a number of other
mechanisms.
2. Mineralo-corticoids such as aldosterone control
electrolyte and water levels, mainly by promoting sodium
retention.

9. MYOCARDITIS
It is an inflammatory process of myocardium It
may cause heart dilation, thrombi on the
heart wall, infiltration of blood cells around
the coronary vessels and between the muscle
fibers and degeneration of the muscle fibers
themselves.

10. CAUSES
• Infections
• Rheumatic fever
• Immunosuppressive therapy
• Infective endocarditis
• Dilated cardiomyopathy

11. SIGNS AND SYMPTOMS
Fatigue
Dyspnea
Palpitation
Occasionally discomfort in chest and abdomen
May have sudden congestive cardiac failure
due to the damage of myocardial tissues.

12. DIAGNOSTIC FINDING
Auscultation; it shows faint heart sound and
systolic murmur.
Pulsus alternans (a pulse in which there is
regular alteration of weak and strong beats).
Fever
Tachycardia
Symptoms of CHF
Endomyocardial biopsy

13. MEDICAL MANAGEMENT
Bed rest the patient to decrease cardiac work load
and to decrease myocardium damage.
Penicillin antibiotic to treat streptococci
If CHF Treatment;
• ACE (angiotension converting enzyme) promote vasodilation
which leads to diuresis.
• Digitalis like digoxin, medication increase the force of
myocardial contraction and slows down the conduction
through AV needs
• Dobutamin which increases cardiac contractility

14. ENDOCARDITIS
Endocarditis is an inflammation of endocardium,
especially the valves. It is common in old age due
to the decreased immunologic response.
The types;
i. Sub acute bacterial endocarditis: develop
gradually in several weeks to months caused by
streptoccus viridans.
ii. Acute bacterial endocarditis: develop in days to
weeks caused by staphylococcus aurens.

15. iii. Native valve endocarditis: Caused to a damaged
valve.
iv. Non bacterial thrombotic endocarditis: caused
by thrombotic lesions.

16. ETIOLOGY
• Infection by an organism; staphylococcus,
streptococci and fungi etc.
• Structural abnormalities of heart and great blood
vessels.
• History of infective endocarditis.
• Rheumatic fever
• Valvalar dysfunction
• Cardiomyopathy

17. Some procedures may cause bacterial entry;
• Dental procedure
• Tonsillectomy
• Bronchoscopy
• Esophageal varices
• Esophageal dilation
• Gall bladder surgery
• Cystoscopy
• Urethral catheterization
• UTI surgery

18. PATHOPHYSIOLOGY
Micro organism enter into the blood stream through any way
Once the colonization of bacteria begins on endothelium and within
layers of platelets
Bacteria stimulate immune system to produce antibodies
But bacteria protected by fibrin and form clots
Bacteria severely damage heart valves by deforming leaflets
The amount of damage depends on the type of organism causing
infection

19. SIGN AND SYMPTOMS
• Due to infection the symptoms are;
 Fever
 Chills
 Weakness
 Anorexia
 Wt loss
 Pallor
 Backache
 Splenomegaly
 Headache
 Joint pain

20. • Due to complications;
 Systemic embolization occur in 30-40% of clients with left
sided endocarditis.
 Stroke, aphasia (impaired speech), ataxia (lack of muscular
coordination).
 Loss of vision due to embolization of the brain or retinal
artery.
 Petechiae (hemorrhagic spots) on neck, conjunctiva, chest,
abdomen and mouth.
 Pulmonary embolus
 Finger clubbing
 Cardiac murmur
 Finally heart failure.

21. DIAGNOSTIC FINDING
Physical examination
Auscultation – cardiac murmur
Blood culture
ECG and echo
CBC
Chest x- ray

22. MEDICAL MANAGEMENT
Eradicating the infective organism- by antibiotics
Proper treating complication
Anti micro bacterial therapy
- Penicillin
- Gentamicin