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Institute of Nursing
SY. 2016-2017
Geriatric Nursing
HEART
DISEASE
Buenaflor, Miguel
De Leon, Alyana N.
Del Rosario, Charlene V.
King, Angelica
Rapisora, Catleya
Sacasas, John Ezekiel
Decreased elasticity
Decrease in compliance
Atherosclerosis
Alterations in the heart
Fibrosis
Increase in mass
Calcification
HYPERTENSION
Geriatric hypertension is generally of a salt-sensitive nature, with a disproportionate frequency of ISH. Agerelated increases in salt sensitivity result, in part, from a reduced ability to appropriately excrete a salt load,
which is due to a decline in renal function and to a reduced generation of natriuretic substances, such as
prostaglandin E2 and dopamine. Age-associated declines in the activity of membrane sodium/potassiumadenosine triphosphatase (Na+-K+-ATPase) may also contribute to geriatric hypertension because this results in
increased intracellular sodium that may cause reduced sodium-calcium exchange and thereby increase
intracellular calcium and vascular resistance.
Although the strength of the association weakens with age, the absolute difference in cardiovascular risk
between the highest and lowest usual blood pressure levels is much greater in older subjects. Thus, the burden of
disease that is potentially avoidable by blood pressure-lowering treatment would be expected to be greater in
older individuals.
MECHANISMS OF HYPERTENSION
a) Aging is associated with reduction in arterial compliance as a result of both structural and functional changes
primarily affecting the intima and media of large compliance arteries.
b) Collagen becomes increasingly rigid, causing sclerosis and fibrosis of various tissues, including the blood
vessels; the elastic fibers of the media gradually decrease in number as the collagen matrix increases,
reducing the elasticity of large arteries.
c) There are increases in the relative wall thickness-to-vessel lumen ratio, together with reductions in luminal
cross-sectional area. The renin-aldosterone-angiotensin system becomes less responsive with aging, partially
as a result of reduced activity of the sympathetic nervous system; plasma renin activity, angiotensin II and
aldosterone levels decrease.
d) Although plasma norepinephrine levels increase with age, there is a decrease in beta receptor sensitivity as
well as in a receptor responsiveness; there is also a decrease in myocardial catecholamine concentration,
which may explain the decreased myocardial contractility seen in the aged.
DIAGNOSIS
ELECTROCARDIOGRAM: monitors and records your hearts electrical activity. Your doctor will attach
patches to your chest, legs, and arms. The results will be visible on a screen, and your doctor will interpret them.
ECHOCARDIOGRAM: takes a detailed picture of your heart and using ultrasound
CORONARY ANGIOGRAPHY: examines the flow of blood through your heart. A thin tube called a catheter is
inserted through your groin or an artery in your arm and up into the heart.
EXERCISE STRESS TEST: looks at how exercise affects your heart. You may be asked to pedal an exercise
bike or walk on a treadmill.
NUCLEAR STRESS TEST: examines the flow of blood into the heart. The test is usually conducted while
youre resting and exercising.
TREATMENT
A common symptom of coronary heart disease (CHD) is angina. Angina is chest pain or discomfort that occurs if
an area of your heart muscle doesn't get enough oxygen-rich blood.
Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw,
or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with
rest. Emotional stress also can trigger the pain.
Another common symptom of CHD is shortness of breath. This symptom occurs if CHD causes heart failure.
When you have heart failure, your heart can't pump enough blood to meet your bodys needs. Fluid builds up in
your lungs, making it hard to breathe.
The severity of these symptoms varies. They may get more severe as the buildup of plaque continues to narrow
the coronary arteries.
DIAGNOSIS
EKG (Electrocardiogram)
Stress Testing
Echocardiography
Chest X Ray
Blood Tests
Coronary Angiography and Cardiac Catheterization
TREATMENT
Treatments for coronary heart disease include heart-healthy lifestyle changes, medicines,medical procedures and
surgery, and cardiac rehabilitation. Treatment goals may include:
Lowering the risk of blood clots forming (blood clots can cause a heart attack)
Preventing complications of coronary heart disease
Reducing risk factors in an effort to slow, stop, or reverse the buildup of plaque
Relieving symptoms
Widening or bypassing clogged arteries