Category Archives: Cardiovascular disease

Thromboangiitis obliterans

(Buerger’s disease) This disease, involving the small vessels of the lower limbs, occurs in young men who smoke. It is thought by some workers to be indistinguishable from atheromatous disease. However, pathologically there is inflammation of the vessels that may indicate a separate disease activity. Clinically it presents with peripheral ischaemia and patients must stop smoking. Takayasu’s syndro

Peripheral vascular disease

ARTERIAL DISEASE This can be due to a number of pathological processes. Arteriosclerosis This is the term applied to generalized, age-related arterialchanges, which are exaggerated in hypertension. In arteries down to 1 mm in diameter these changes initially take the form of compensatory muscular hypertrophy of the media, which is followed by fibrosis and dilatation of the lumen. In hypertensive vessels of this

The heart in pregnancy

In pregnancy the cardiac output and blood volume increase from the second month up to the thirtieth week to 30-50% above the normal levels. This, along with the increased metabolic work, produces the physical signs of warm extremities, a tachycardia with a large-volume pulse and a slight rise in venous pressure. The apex beat is  displaced, owing partly to cardiomegaly and partly to a raised diaphragm. The i

Heart disease in the elderly’

As the average age of the population increases, cardiac disease predominates. The elderly population are vulnerable to most forms of heart disease, especially coronary artery disease, hypertension, arrhythmias and degenerative pathologies. NORMAL FINDINGS IN THE ELDERLY Diagnosis of mild forms of heart disease may be difficult in the elderly. The wear and tear of age results in some features that would be reg


In the young, the secondary causes of hypertension should be excluded before treatment is commenced. When the blood pressure is only mildly or moderately elevated, it may be difficult to persuade an asymptomatic patient that treatment is necessary. However, there are definite advantages from treating diastolic blood pressures in excess of 100 mmHg. If the diastolic blood pressure is between 90 and 100 mmHg i

The cardiovascular system in systemic disease

Systemic hypertension Blood pressure within a population has a skewed distribution, i.e. there is a single peak frequency of blood pressure and there are more individuals with high pressures than low pressures. Different populations have different levels of blood pressure, with those of African origin tending to have higher pressure than Caucasians, i.e. the whole distribution is shifted to the left. The distr

Pericardial disease

The normal pericardium lubricates the surface of the heart, prevents sudden deformation or dislocation of the heart, and acts as a barrier to the spread of infection. There are three common presentations of pericardial disease: 1 Acute pericarditis 2 Pericardial effusion 3 Constrictive pericarditis Acute pericarditis Inflammation of the pericardium gives rise to chest pain that is substernal and sharp. It may b

Myocardial disease

Myocardial disease that is not due to a specific heart  muscle disorder or a known infiltrative, metabolic/toxic or neuromuscular disorder may be caused by: • An acute or chronic inflammatory pathology (myocarditis) • Idiopathic myocardial disease (cardiomyopathy) MYOCARDITIS Myocarditis, whether idiopathic or infective, is the most common form of inflammatory endomyocardial disease. A definitive aetiology

Atrial myxoma

This is the commonest primary cardiac tumour. A myxoma usually develops in the left atrium and is a polypoid, gelatinous structure attached by a pedicle to the atria septum. The tumour may obstruct the mitral valve or may be a site of thrombi that then embolize. It is also associated with constitutional symptoms: the patient may present with dyspnoea, syncope or a mild fever. The most important physical sign

Pulmonary heart disease

Pulmonary hypertension An elevated pulmonary arterial pressure, known as pulmonary hypertension, has numerous causes: CHRONIC LUNG DISEASE, which is diagnosed clinically and by abnormalities of lung function. INCREASED PULMONARY BLOOD FLOW because of leftto- right shunting through a VSD, ASD or PDA. LEFT VENTRICULAR FAILURE, MITRAL VALVE DISEASE, LEFT ATRIAL TUMOUR OR THROMBUS, OR PULMONARY VENO-OCCLUSIVE DI