Medical Pathology Commons^™

Using Noninvasive Calibrated Cuff Plethysmography To Observe The Effects Of Cold-Water Immersion On Arterial Compliance, Rita M. Grigorian

Master's Theses

As the prevalence of cardiovascular diseases continues to exponentially grow in populations across the globe, the necessity of determining underlying factors, effective methods of diagnoses, and universally available preventive measures also grows. Early detection of endothelial dysfunction, a proven precursor of cardiovascular diseases, can be extremely impactful in encouraging preventative measures and early intervention before medical conditions become chronic. In recent years, ice plunging, a form of cryotherapy involving full body immersion in cold water, has gained popularity within circles of fitness and health practitioners, gaining the interest of people of all backgrounds. Certain parallels observed between the human physiological …

Perioperative Risks Of The Patient With Heart Failure, Gabrielle Metoyer

Nursing Student Class Projects (Formerly MSN)

Perioperative Risks of the Patient with Heart Failure

Gabrielle Metoyer

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology

Dr. Deanna Batross and Dr. Shivani Bhatnagar

August 5, 2022

Abstract

According to the CDC (2020), heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is an epidemic disease affecting 1-2% of the population worldwide (Schwinger, 2020). It is one of the leading causes of morbidity and mortality worldwide with an estimated 6.5 million adults with heart failure in the United States (Lo et al., 2021). Medical advances …

Mechanisms Underlying Enhanced Bone Marrow Adipogenesis In Diabetes, Jina J.Y. Kum

Electronic Thesis and Dissertation Repository

Morbidity and mortality associated with diabetes are due to secondary vascular complications that include both micro- and macro-vascular organ dysfunctions. Our recent studies show that vascular dysfunction and inadequate vessel repair in diabetes may potentially be due to impaired vasculogenesis (de novo vessel formation). Specifically, we have shown that diabetes enhances adipogenesis in the bone marrow and reduces the number of marrow-resident vascular regenerative stem cells. In this study, I have determined the mechanisms of deleterious bone marrow adipogenesis, which may alter the cellular composition of the marrow and lead to the depletion of vascular regenerative stem cells.

My …

Novel Imaging Tools Reveal The Dynamics Of The Myocardial Growth Hormone Secretagogue Receptor In Heart Disease And Heart Failure, Rebecca Sullivan

Electronic Thesis and Dissertation Repository

Heart disease (HD) is the leading cause of mortality worldwide. Currently, diagnosis is based on clinical features, imaging, and circulating cardiac biomarkers. Cardiac imaging technologies, such as echocardiography and cardiac magnetic resonance imaging (cMRI), enable the non-invasive detection of changes in heart function. Although these modalities can detect changes in structure and anatomy, it is usually at later stages, where prevention may not be possible. In conjunction with imaging, circulating biomarkers of heart failure (HF), notably B-type natriuretic peptide (BNP) and cardiac troponin I and T, can be detected with increased levels in the blood. These biomarkers are associated with …

The Epidemiology Of Infective Endocarditis Among People Who Inject Drugs In London, Ontario., Brian Hallam

Electronic Thesis and Dissertation Repository

Infective endocarditis is an infectious disease that affects the valves of the heart. Injection drug use is currently a leading risk factor among patients with endocarditis. We conducted a prospective study using data from hospital chart records among patients with endocarditis in London, Ontario, which has a relatively high prevalence of people who inject drugs to assess the severity of the issue and the major risk factors of mortality pertaining to this population. This study had a sample size of 353 and included a review of the incidence of admissions of endocarditis, as well as a survival analysis, using both …

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones, 2016 to 2019

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations …

Takotsubo Cardiomyopathy, Angela J. Occidental

Nursing Student Class Projects (Formerly MSN)

Takotsubo cardiomyopathy is a rare, reversible form of cardiomyopathy. First cases of takotsubo cardiomyopathy were described in Japan, twenty years ago (Milinis, & Fisher, 2012). takotsubo cardiomyopathy is a transient left ventricular dysfunction, typically triggered by severe emotional or physical distress. Left ventricular ballooning is characteristic of Takotsubo syndrome. Images of this ballooning resemble a takotsubo vessel used in Japan for collecting octopus, thus the reason for the syndrome name (Pelliccia, et. al, 2014). In recent years, this cardiomyopathy has been described as “Broken heart syndrome” because severe emotional stress has been implicated as the cause of this cardiomyopathy in …

Thrombotic Thrombocytopenia Purpura, Ann Oliva

Nursing Student Class Projects (Formerly MSN)

Patients with Thrombotic Thrombocytopenia Purpura, or TTP, are often times seen in the emergency department and subsequently admitted to the inpatient or the critical care unit. The problems that TTP patients can present with vary greatly and astute nursing assessment plus knowledge of the pathophysiology behind the diagnosis is vital to deliver excellent nursing care. Thrombotic Thrombocytopenia Purpura or TTP is a rare but potentially fatal condition that occurs as result of decreased levels of ADAMTS-13, a cleaving protease for von Willebrand factor (vWF), which causes platelet aggregation and microvascular thrombi and subsequent end-organ damage, along with thrombocytopenia, hemolytic anemia, …

Cardiac Tamponade, Ashley Miner

Nursing Student Class Projects (Formerly MSN)

The topic the author chose to research is cardiac tamponade. Cardiac tamponade occurs when fluid builds up in the pericardial cavity, which is the cavity that surrounds the heart. Cardiac tamponade can occur due to various reasons, including myocardial infarctions, pericarditis, traumas, and placement of pacer wires. Palpitations, chest pain, and shortness of breath are common symptoms that occur with cardiac tamponade. Pericardiocentesis and a pericardial window are two interventions that are commonly used to treat cardiac tamponade. Cardiac tamponade is a medical emergency and without any intervention, may lead to cardiac arrest and possible death. The author chose cardiac …

Gout As A Significant Risk Factor For Cardiovascular Disease: A Case Study, Emily Leonhard

Nursing Student Class Projects (Formerly MSN)

Gout, an inflammatory arthritis caused by elevated serum uric acid levels, is emerging as a significant risk factor for cardiovascular disease (CVD). Recently, a nurse practitioner (NP) was caring for a patient who was suffering from a particularly severe gout attack while being treated in the ICU for new onset Atrial Fibrillation. The patient reported that he had never had an attack this severe before. He asked the NP if his history of gout could be related to his recent heart problems. The nurse practitioner, in order to answer the patient’s question, spent time researching the disease process of gout, …

Non-Valvular Atrial Fibrillation And Stroke: Novel Oral Anticoagulants Versus Vitamin K Antagonists, Kathryn A. Viglietta

Nursing Student Class Projects (Formerly MSN)

Atrial fibrillation (afib) is the most common sustained cardiac arrhythmia and second most common cardiovascular condition in adults in the United States (Zarraga & Kron, 2012). •2.2 million affected, increases risk of stroke 4 to 6 times (National Institute of Neurological Disorders and Stroke [NINDS], 2015). •Vitamin K antagonists (VKAs) have been mainstay of therapy for over 60 years (King, Holley& Moores, 2013). •Limitations with VKAs such as variability in response, need for frequent lab draws, food and drug interactions which decrease patients adherence and under prescribing by physicians (Halperin & Goyette, 2012). •Novel oral anticoagulants (NOACs) have been approved …

Deep Venous Thrombosis In Surgical Orthopedic Patients, Kelly Marsh

Nursing Student Class Projects (Formerly MSN)

•The term venous thromboembolism (VTE) is defined as a syndrome that collectively comprises both deep vein thrombosis (DVT) and pulmonary embolism (PE). Each year approximately 350,000-900,000 people in the United States develop VTE and approximately 100,000 people die according to this cause (Streiff et al., 2014). Unfortunately, the reoccurrence rate for VTE remains very high, with an estimated risk of 10%-30% of VTE patients will develop another VTE within five years of the first incident (Streiff et al., 2014). •Deep vein thrombosis (DVT) is blood clot that forms in a large vein, usually in areas of slow blood flow such …

The Pathology Of Heart Failure, Kevin Ahman

Nursing Student Class Projects (Formerly MSN)

The topic I have chosen to research is heart failure. I have chosen this topic because I have treated many patients in the ICU with this condition, and find it an interesting pathology. Heart failure affects a significant portion of the patient population, and the rates are increasing. 5.1 million Americans ≥20 years of age have heart failure, projections show that by 2030, the prevalence of HF will increase 25% from 2013 estimates. At 40 years of age, the lifetime risk of developing HF for both men and women is 1 in 5. At 80 years of age, remaining lifetime …

Abdominal Aortic Aneurysm: A Silent Killer, Kristen Springer

Nursing Student Class Projects (Formerly MSN)

Rupture of an abdominal aortic aneurysm (AAA) is a significant cause of mortality in the United States. “Often asymptomatic, AAA is considered a silent killer because it frequently remains undiagnosed until the time of rupture or the patient’s death” (Gordon & Toursarkinssian, p. 242). As healthcare professionals, being aware of the pathophysiology, risk factors and symptoms influencing this disease is important in aiding early diagnosis and treatment, helping to reduce complications and mortality rates of those affected.

Effects Of Enhanced External Counter Pulsation Therapy On Patients With Angina, Valerie Jones

Nursing Student Class Projects (Formerly MSN)

According to the literature, coronary heart disease (CHD) is responsible for 370,000 deaths annually in the United States (Centers for Disease Control and Prevention [CDC], 2015). A symptom commonly associated with CHD is angina (US Department of Health & Human Services, National Institute of Health, National Heart, Lung, and Blood Institute [NIH], 2011). An estimated 300,000 to 900,000 patients in the United States have refractory angina pectoris (RAP), with nearly 100,00 new cases diagnosed yearly (Manchanda, Aggarwal, Aggarwal, & Soran, 2011). Kones describes refractory angina as continued angina class III/IV, in the nonsurgical candidate, with objective evidence of ischemia despite …

Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick

Nursing Student Class Projects (Formerly MSN)

According to the Sudden Cardiac Arrest Foundation (2014), each year, 424,000 people in the U.S. (more than 1,000/day) experience EMS-assessed out-of-hospital non-traumatic sudden cardiac arrest. This is roughly equivalent to the number of people who die from Alzheimers’ disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicides combined (Sudden Cardiac Arrest Foundation, 2014). It is estimated that the likelihood of surviving an out-of-hospital cardiac arrest (OHCA) to hospital discharge can be as low as 6% to 8% (Williams, Calder, Cocchi & Donnino, 2013). Additionally an estimated 200,000 hospitalized …

Takotsubo Cardiomyopathy, Kari Patterson

Nursing Student Class Projects (Formerly MSN)

Term Takotsubo was introduced in 1991 to describe the shape of the left ventricle during an episode of cardiomyopathy. Takotsubo is a Japanese term for a narrow-necked fishing pot used to catch octopus. The left ventricle assumes the shape of the octopus pot during Takotsubo cardiomyopathy. Takotsubo cardiomyopathy is commonly known as Broken Heart Syndrome due to its association with an emotional stressor. Mimics acute coronary syndrome without coronary artery blockage/stenosis. Affects more women than men. Occurs mainly in postmenopausal women (women over the age of 50) Believe a hormonal effect on catecholamine release plays a role.

Atrial Fibrillation Post-Lung Lobectomy, Laura Adorni

Nursing Student Class Projects (Formerly MSN)

According to the American Heart Association, atrial fibrillation affected 2.66 million individuals in the United States in 2010 and is expected to double by year 2050 (Sanoski, 2010, p. S11). Post-operative atrial fibrillation (POAF), a classification of atrial fibrillation (AF), can occur after thoracic surgery and is an ongoing source of morbidity and mortality (Imperatori et al., 2012). There is a 10-20% occurrence rate of POAF after non-cardiac surgery, such as a lung lobectomy, and a 40% incidence rate after a pneumonectomy (Omae & Kanmura, 2012, p. 429). Cardiovascular events such as heart failure, cerebral infarction, renal failure, and infection …

Cerebral Venous Sinus Thrombosis (Cvst), Meghan N. Delong

Nursing Student Class Projects (Formerly MSN)

Cerebral venous sinus thrombosis (CVST) is an uncommon condition with incidence resulting in approximately 1-3 % of all strokes. Cerebral venous sinus thrombosis remains often unrecognized initially due to its vague manifestations of symptoms which range from isolated headaches to focal neurological signs and symptoms. CVST is slightly more common in women, particularly in the age group of 20 to 35, due to pregnancy, puerperium and oral contraceptive use (Stam, 2005).

Accurate Intervention In Visceral Aneurysms, Megan Hoying

Nursing Student Class Projects (Formerly MSN)

A 30 year old male presented to the ED with a one week history of fever, abdominal pain, and poor PO intake due to nausea and emesis. He was given a GI cocktail and sent home for a presumed diagnosis of gastritis. After having persistent pain the patient returned to the ER the following day and was admitted for further testing. The patient died 3 days later. This is an interesting case presentation, and was in no way straightforward.

Cardiomems Heart Failure System: Keeping Patients Out Of The Hospital, Michelle Leyland

Nursing Student Class Projects (Formerly MSN)

It is well known that heart disease is the leading cause of death in the United States, with about 670,000 new diagnoses of congestive heart failure (CHF) each year (Suh et al., 2011). CHF results from a number of different causes, produces many different symptoms and occurs when the heart muscle cannot efficiently pump blood to the rest of the body (Suh et al., 2011). In the United States, heart failure (HF) and associated hospitalizations are leading contributors to high health care costs (Feltner et al., 2014). Up to one fourth of patients hospitalized with HF are readmitted within 30 …

Myocardial Infarction (Mi) In Women, Samuel Agyenim Boateng

Nursing Student Class Projects (Formerly MSN)

Cardiovascular disease (CAD) is the most common cause of death for men and women in the US. The disease has been extensively studied in males (Gulati & Bairey Merz, 2012, p. 141). CVD poses an obvious challenge to the health of women. Coronary heart disease (CHD) is described as a "modern epidemic" (Banner, 2010, p. 3123). Although, the prevalence of CVD has prompted many studies for prevention and treatment, little is known about CVD in women. It Is now known that the mortality rates In women have surpassed that of men. Recent reports Indicate that CVD killed more women in …

Spontaneous Coronary Artery Dissection Among Women, Stacy Hudepohl

Nursing Student Class Projects (Formerly MSN)

It has been noted that women often place their own health care on the bottom of their priority lists. Many times, they ignore simple pain and dismiss symptoms that may be troubling to health care providers. Health care providers especially to young women may dismiss complaints of chest pain as heartburn or anxiety. Changes seen in pregnancy and with menses can mimic some of these same complaints. As both an female professional in health care and as a patient it is very easy to get busy with the day and not recognize simple signs and symptoms that may lead to …

Enterococcus Faecalis Endocarditis: A Case Study, Torri Curtis

Nursing Student Class Projects (Formerly MSN)

Infectious endocarditis is an uncommon disease of the heart stemming from a bacterial or fungal infection on the endocardial surface of the heart or heart valve (Pierce, Calkins, & Thornton, 2012). From review of the literature, infective endocarditis is fairly uncommon and may be difficult to initially diagnose. Per Sabe, Shrestha, and Menon, occurrence of infective endocarditis (IE) is nearly 0.9-6.2 per 100,000 persons per year (2013). Several preexisting conditions such as aging, heart valve disease, implantable cardiac devices, a history of heart disease such as rheumatic fever, and invasive procedures can put a patient at higher risk for IE …

Hypertrophic Obstructive Cardiomyopathy, Tiffany Branson

Nursing Student Class Projects (Formerly MSN)

Hypertrophic obstructive cardiomyopathy or HOCM, is a genetic disease that is described as hypertrophy or enlargement of the left ventricle which obstructs the blood flow to the body (Yue-Cheng et al., 2012). HOCM is a disease that cannot be cure, but can be treated. One of the main goals of treatment is to focus on treating the symptoms. HOCM can be asymptomatic or symptomatic and can cause some major complications. Some of the complications of HOCM are arrhythmias and sudden cardiac death, “which is defined as natural death to due cardiac causes, heralded by abrupt loss of consciousness within one …

Dvt And Economy Class Syndrome, Troy Perkins

Nursing Student Class Projects (Formerly MSN)

Traveling long distances can be very stressful on the body. Deep vein thrombosis (DVT) has often been linked to long air flights or long distance travel in a vehicle. DVT is a blood clot usually formed in the legs. Economy Class Syndrome (ECS) has been referred to as the formation of a DVT occurring during (or just after) a long airplane flight, especially in economy class where there is the least space allotted per passenger and one’s legs especially tend to be immobilized for lack of leg room (MedicineNet, 2012). Developing a DVT can lead to other life-threatening illnesses such …

Diagnosis, Pathophysiology, And Clinical Treatment Of A Patient With A Pheochromocytoma, Tricia L. Hale

Nursing Student Class Projects (Formerly MSN)

Hypertension is an extremely common diagnosis today. This condition can be caused by a multitude of factors, and can inversely cause numerous unfavorable processes in the body. One rare but significant source of hypertension is a tumor known as a pheochromocytoma, or PCC. This usually benign tumor is most often located on an adrenal gland, and can have a grave impact on the cardiovascular system. The tumor intermittently secretes an excess of the catecholamine norepinephrine, and if large enough, also secretes epinephrine [9]. These episodic bursts can cause extreme hypertension and tachycardia, leading to, at times fatal results. By understanding …

An Analysis Of Abnormal Electrocardiograms In First And Second Year Medical School Students, Molly Anne Kalish

PCOM Biomedical Studies Student Scholarship

The high stress level placed upon medical school students, particularly during their first and second didactic years, may have a negative effect on their health. Although surveys and subjective questionnaires have been used to evaluate the effects medical school has upon a student’s cardiovascular health, there has been little clinical data obtained to confirm this notion. The aim of this longitudinal study was to demonstrate whether any abnormal cardiovascular parameters, specifically QTc wave interval, cardiac axis vector and blood pressure abnormalities, could be documented to occur in two different classes of medical students during their first two years. Such information …

Vascular Stem Cells In Diabetic Complications, Emily C. Keats

Electronic Thesis and Dissertation Repository

Diabetes leads to a variety of secondary complications. At the heart of these complications lies endothelial cells (ECs) – cells that take up unregulated plasma glucose, experience various biochemical alterations, and provide the basis for whole organ vascular dysfunctions. With the purpose of generating new vascular networks for the treatment of these chronic complications, my initial work focused on vascular stem cells (VSCs). VSCs have the ability to differentiate into both endothelial (EPC) and mesenchymal (MPC) progenitor cells, both of which are necessary for the creation of stable and functional blood vessels. To establish whether these progenitor populations retain their …