Question

In: Anatomy and Physiology

Scenario: DW is a 65-year-old, 135 kg male who visited his primary care physician for a...

Scenario: DW is a 65-year-old, 135 kg male who visited his primary care physician for a routine examination. His blood pressure was 158/100 mmHg and his heart rate was 71 bpm. Stroke volume and cardiac output were normal. Serum renin levels were in the normal range. A chest x-ray revealed left ventricular hypertrophy. Other clinical findings were unremarkable.

Given the 3 hemodynamic factors responsible for determining blood pressure - CO, resistance and volume - which one of them is responsible for the elevated blood pressure in this patient? Why did you choose this one over the other two?

What is left ventricular hypertrophy? Why is it only on the left side? In this patient, what would you predict to be the physiological cause of the left ventricular hypertrophy

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Anaswer

1. The person is 65 year old with 135 kg weight. this means he will be obese with more fatty body.

his bp reading is 158 / 100 mmhg. here both systolic and daistolic bp are elevated.

systolic bp is pressure when heart beats , while heart is pumbing blood into blood vessel.

distolic bp is the pressure on blood vessels when heart muscle relaxes.

factors which affect bp in cludes -

cardiac output

peripheral vascular resistance

volume of circulating blood

viscosity of blood

elasticity of blood vessels

here the person is obese and chance of atherosclerosis in periphereal and central blood vessels like aorta are very high. and blood vessel thickening will be high, so heart cannot pumb easily , because of these obstructive factors. so heart pump blood into aorta with pressure. that is the reason for high bp in this patient . more over his cardiac output and stroke volum normal, that means heart has to maintain the normal amound of blood ejected from left ventricle during each heart beat , but to do this heart has to increaes the pressure.

2 . left ventricular hypertrophy is enlargment and thickening of walls of heart mainly left ventricle (main blood pumbing chamber) . it occurs to various factors such as high blood pressure , volume overload that causes heart to work harder,  

here eventhough the heart muscle hypertrophy occures, the effective chamber volume decreases and eventualy leads to heart failure.

left ventricle is doing more work during normal cardiac cycle , because it has to pumb blood to all peripheral part of body . in this patient peripheral artery or central artery atherosclerosis and arteriosclerosis leads heart to work harder to oppose thsese resistance . so day by day left ventricle will change its size and became hypertrophied.

Sydney Mullin answered 1 year ago
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