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Common Congenital Heart Lesions - page 55 / 126

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55 / 126

55 of 126

  • Aorta

    • o

      Accelerated atherosclerosis can cause lesions to form in the aorta

      • Can lead to aortic aneurysms, especially in the abdomen (AAA), below the level of the renal arteries

      • Big ones are more likely to rupture (> 6 cm)

      • o

        Aortic Dissection

        • I don’t understand how this works, but I think blood goes in a weird place within the aorta and prevents normal blood flow

        • Very seriousÆemergency surgery is required

  • Kidney

      • o

        HTN induced kidney disease

        • Vessel walls are thickened with hyaline atherosclerosis

        • HTN can induce necrosis of capillary walls

        • Usually not a problem with mild HTN

        • But severe HTN Æ permanent damage, dialysis

        • Progressive renal failure prevents it from regulating blood volume, so BP goes up = more HTN

  • Retina

      • o

        Not so much damage to the eye as a clinical tool for assessing BP

      • o

        Hypertensive retinopathy

      • o

        Acute severe HTN Æ burst small retinal vessel

        • maybe some blurred vision

        • Papilledema: swelling of optic disc resulting from high intracranial pressure

      • o

        Chronic HTN

        • NO PAPILLEDEMA

        • Vasoconstriction, arterial narrowing with medial hypertrophy

        • Arteries will “nick” crossing veins

        • Increased reflection of light thru ophthalmoscope

Hypertensive Crises = severe elevation in BP, caused by acute hemodynamic insults on top of chronic HTN

  • Symptoms

    • o

      Increased intracranial pressure

      • o

        Headache

      • o

        Blurred vision

      • o

        Confusion

      • o

        Somnolence

      • o

        Coma

      • o

        Retinal exam: hemorrhages, exudates, papilledeka

      • o

        Angina

      • o

        Pulm edema

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