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Extra resources for Disease & Drug Consult: Cardiovascular Disorders
Within several minutes, oxygen deprivation forces the myocardium to shift from aerobic to anaerobic metabolism, leading to an accumulation of lactic acid and reduced cellular pH. The combination of hypoxia, reduced energy availability, and acidosis rapidly impairs left ventricular function. The strength of contractions in the affected myocardial region is reduced as the fibers shorten inadequately. Moreover, wall motion is abnormal in the ischemic area, resulting in less blood being ejected from the heart with each contraction.
Chest examination reveals findings characteristic of the underlying lung disease. Signs of cor pulmonale and rightsided heart failure include dependent edema; distended jugular veins; prominent parasternal or epigastric cardiac impulse; hepatojugular reflux; an enlarged, tender liver; ascites; and tachycardia. Decreased cardiac output may cause a weak pulse and hypotension. Chest examination yields various findings depending on the underlying cause of cor pulmonale. In COPD, auscultation reveals wheezing, rhonchi, and diminished breath sounds.
Moreover, wall motion is abnormal in the ischemic area, resulting in less blood being ejected from the heart with each contraction. Restoring blood flow through ATHEROSCLEROTIC PLAQUE DEVELOPMENT The coronary arteries are made up of three layers: intima (the innermost layer), media (the middle layer), and adventitia (the outermost layer). Adventitia Media Lipoprotein Intima With damage to the vessel, a fatty streak begins to build up on the intimal layer. Fatty streak Fibrous plaque and lipids progressively narrow the lumen and impede blood flow to the myocardium.