Answer To: 2808NRS Assessment 2: Trimester 2, 2018 Weighting: 30% Due Date: Week 6; Monday 20 th August by 5pm...
Sumayya K. answered on Jul 28 2020
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HF
SMOKING
AGE
SYSTEMIC INFLAMMATION
COPD induced PH
VASCULAR REMODELLING
ENDOTHELIAL DYSFUNCTION
INFLAMMATION
SKELETAL MUSCLE ATROPHY
DYSPNEA
CHEST PAIN
JVD
PARASTERNAL HEAVE
HEPATOMEGALY
PROMINENT S2
OVERLAP SYNDROME
NATRIURETIC PEPTIDES
RHC
MRI
PFT
O2 THERAPY
Β- BLOCKERS & β-AGONISTS
DIURETICS
VASODILATORS
ACE & ARB
IVABRADINE
Pathophysiology
Risk Factors
Aetiology
Clinical manifestations
Diagnostic tests
Treatment
CONCEPT
MAP
OF
COPD related
HF
KEYS
COPD
HYPOXIA
VASO
CONSTRICTION
PULMONARY ARTERY
CHANGES
RV OVERLOAD
TNFa
ACTIVATE CRP
ATHERO
SCLEROSIS
INTRODUCTION
Heart Failure (HF) is often known to coexist with chronic obstructive pulmonary disease in the clinical scenario with more
than 20% of HF patients affected by COPD.(De Miguel, Morgan, and García, 2013). The common risk factors and
pathogenic mechanisms contribute to the complication causing diagnostic and treatment difficulties
(Hawkins, Virani, and Ceconi, 2013).
RISK FACTORS
Both HF and COPD share common risk factors like smoking, age and systemic inflammation (De Miguel, Morgan, and
García, 2013), (Güder et. al., 2014).
ETIOLOGY
Pulmonary hypertension is a major cause of concurrent HF and COPD (Ibrahim, 2016).
Endothelial dysfunction, vascular remodeling, skeletal muscle atrophy and inflammatory reactions also contribute to the
coexistence. (Soliman et. al., 2015), (Celutkiene et. al., 2016)
PATHOPHYSIOLOGY
The hypoxia due to COPD causes constriction in the pulmonary arteries. This leads to structural changes across all layers
of the pulmonary arterial walls which, in effect, impact right ventricular function causing heart failure. (MacNee, 2010)
Evidence suggests that stable COPD is linked to low-grade systemic inflammation with elevated levels of circulating
cytokines. TNFa trigger cardiac and pulmonary inflammation by activating secondary mediators like C-reactive protein (CRP)
and pro-inflammatory cytokines causing coronary atherosclerosis which in turn leads to heart failure. Also, functional genes
capable of producing both COPD and cardiovascular conditions have not been identified yet. (Hawkins, Virani, and Ceconi,
2013)
Studies have also shown that sleep apnoea along with COPD, known as overlap syndrome attribute to vascular endothelial
dysfunction, high inflammatory mediators and atherosclerosis. (De Miguel, Morgan, and García, 2013)
DIAGNOSIS
Of the COPD...