What’s Pathology of Hypertensive Heart Disease?

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:

  1. Renal:
  2. a) Vascular disease
  3. b) Parenchymal renal disease
  4. c) Perinephric disease
  5. Cerebral:
  6. a) Increased intracranial pressure
  7. b) Anxiety states
  8. c) Lesions of brainstem
  9. Cardiovascular: Coarction of aorta
  10. Endocrine:
  11. a) Pheochromocytoma
  12. b) Adrenocortical adenomas
  13. c) Pituitary adenomas

d)Hyperthyroidism.

  1. Preeclampsia and eclampsia.
  2. 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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