Q:
What’s the pathology of hypertensive heart disease?
A:
- Systemic Hypertension:
Hypertension occurs when the persistent systolic pressure is greater than 140 and diastolic pressure, more than 90 mm Hg.
The major causes of systemic hypertension:
- Renal:
- a) Vascular disease
- b) Parenchymal renal disease
- c) Perinephric disease
- Cerebral:
- a) Increased intracranial pressure
- b) Anxiety states
- c) Lesions of brainstem
- Cardiovascular: Coarction of aorta
- Endocrine:
- a) Pheochromocytoma
- b) Adrenocortical adenomas
- c) Pituitary adenomas
d)Hyperthyroidism.
- Preeclampsia and eclampsia.
- Unknown causes
- Systemic Hypertensive Heart Disease:
Hypertensive heart disease is a typical form of heart disease.
1)Features:
– Patient once had hypertension.
-LVH, concentric type.
-No other lesions that might cause cardiac hypertrophy. Eg: Aortic valve stenosis.
2) Pathogenesis:
-There is myocytic hypertrophy as aresult of the increased work.
-Thickened myocardium reduces left ventricle compliance, destroying diastolic filling.
-Individual myocyte hypertrophy raises the distance for oxygen and nutrient diffusion from adjacent capillaries.
-In many patients there is associated coronary atherosclerosis accompanying hypertension which may further lead to ischemia.
3) Fate:
-Patients die from congestive heart failure;
-Complications of coronary artery disease, such as myocardial infarction may take pace;
-There is added risk of sudden death;
-Some patients die from renal disease, stroke etc. ;
-Fibrinous pericarditis may be obvious in patients who die from uraemia ;
-Therapeutic control of pressure may cause regression of the enlarged myocytes and reduction of heart size.
Keywords: pathology hypertensive heart disease; pathophysiology hypertensive heart disease.
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