Unit 2 – Disorders of Cardiovascular, Respiratory and Renal Systems Notes (B. Pharmacy)

Human health depends on the proper functioning of vital systems such as the heart, lungs, and kidneys. Any disturbance in these organs can lead to serious and chronic conditions that require medical attention. In this unit, we explore some of the most important disorders affecting the cardiovascular system, respiratory system, and renal system, focusing on their causes, mechanisms, and consequences.

UNIT – 2

Cardiovascular System Disorders

The cardiovascular system includes the heart, blood vessels, and blood. Several disorders can affect this system, often related to blood flow and pressure.

Hypertension

Hypertension, or high blood pressure, is a condition where the force of blood against the artery walls is consistently too high.

Causes: It often has no single identifiable cause (primary hypertension) but can be linked to genetics, age, and lifestyle factors like diet and lack of exercise. It can also be a symptom of another condition (secondary hypertension), such as kidney disease or thyroid problems.
Consequences: Chronic high blood pressure can damage the arteries and put a strain on the heart, increasing the risk of heart attack, stroke, and kidney disease.

Congestive Heart Failure (CHF)

Congestive heart failure is a chronic condition where the heart muscle can’t pump enough blood to meet the body’s needs. This is not a sudden “heart stoppage” but a gradual weakening of the heart’s pumping ability.

Mechanism: A weakened heart leads to blood backing up in the veins (congestion), especially in the lungs, legs, and other tissues.
Symptoms: This congestion causes symptoms like shortness of breath, fatigue, and swelling in the legs and ankles.

Ischemic Heart Disease

Ischemic heart disease is a group of conditions caused by a reduced blood supply to the heart muscle, typically due to narrowed coronary arteries.

Angina Pectoris

Angina is a symptom of ischemic heart disease, characterized by chest pain or discomfort. It occurs when the heart muscle doesn’t get enough oxygen-rich blood, especially during physical exertion or stress. The pain is a temporary warning sign that blood flow to the heart is restricted, but it doesn’t cause permanent damage to the heart muscle.

Myocardial Infarction (Heart Attack)

A myocardial infarction occurs when the blood supply to a part of the heart muscle is completely blocked, usually by a blood clot. Without oxygen, that section of the heart muscle begins to die.

Symptoms: Symptoms include severe chest pain, shortness of breath, and pain radiating to the arm, neck, or jaw.
Treatment: A heart attack is a medical emergency that requires immediate treatment to restore blood flow and minimize heart damage.

Atherosclerosis and Arteriosclerosis

These two conditions are often confused but are distinct.

Arteriosclerosis: This is the general term for the hardening and thickening of artery walls. It’s a natural part of aging but is accelerated by conditions like hypertension.
Atherosclerosis: This is the most common form of arteriosclerosis. It is a specific disease process where a type of plaque (atherosclerotic plaque) builds up inside the walls of arteries. This plaque is made of cholesterol, fatty substances, and cellular waste products. The buildup narrows the arteries, restricting blood flow and leading to conditions like angina and myocardial infarction.

Respiratory System Disorders

Respiratory system disorders are a broad category of diseases that affect the lungs and the airways that bring air into and out of them. These conditions range from common, temporary infections to chronic, life-threatening illnesses. They can be broadly categorized into three types: airway diseases, lung tissue diseases, and lung circulation diseases.

Here is an overview of some of the most common respiratory system disorders:

1. Chronic Obstructive Pulmonary Disease (COPD)

COPD is a progressive, chronic lung disease that makes it difficult to breathe. It is a major cause of disability and death worldwide. It is an umbrella term that includes two main conditions:

Chronic Bronchitis: The lining of the airways becomes inflamed and thick, and a large amount of mucus is produced, causing a persistent cough.
Emphysema: The tiny air sacs in the lungs (alveoli) are damaged, which reduces their ability to take in oxygen and release carbon dioxide.
Causes: The primary cause of COPD is long-term exposure to lung irritants, with cigarette smoking being the most significant risk factor. Other causes include secondhand smoke, air pollution, and occupational exposure to dust and chemicals.
Symptoms: Shortness of breath, a chronic cough with mucus production, wheezing, and chest tightness.

2. Asthma

Asthma is a chronic inflammatory disease of the airways that causes them to narrow, swell, and produce extra mucus, making breathing difficult.

Causes: The exact cause is unknown, but it is often linked to genetics and environmental factors. Symptoms are triggered by allergens (like pollen, dust mites, or pet dander), exercise, cold air, or irritants like smoke and air pollution.
Symptoms: Recurrent episodes of wheezing, coughing, chest tightness, and shortness of breath. The severity and frequency of these attacks vary greatly among individuals.
Treatment: Asthma is managed with inhalers that can either provide quick relief during an attack (bronchodilators) or provide long-term control by reducing inflammation (corticosteroids).

3. Pneumonia

Pneumonia is an infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus.

Causes: It can be caused by various pathogens, including bacteria (the most common cause in adults), viruses (a common cause in children), and fungi.
Symptoms: Fever, chills, a cough that may produce phlegm (mucus), chest pain when breathing or coughing, and shortness of breath.
Treatment: Treatment depends on the cause. Bacterial pneumonia is treated with antibiotics, while viral pneumonia may require supportive care.

4. Cystic Fibrosis (CF)

Cystic fibrosis is a genetic disorder that affects cells that produce mucus, sweat, and digestive juices. In CF, these fluids become thick and sticky, clogging tubes and ducts in various organs, most notably the lungs.

Causes: An inherited gene mutation that is passed down from parents.
Symptoms: A persistent cough with thick mucus, frequent lung infections, wheezing, shortness of breath, and poor growth. Over time, the constant infections and inflammation lead to progressive lung damage.
Treatment: While there is no cure, treatments focus on managing symptoms and preventing complications. This includes medications to thin mucus, antibiotics to fight infections, and physical therapy to clear the airways.

Renal System Disorders

Renal system disorders are a group of conditions that affect the kidneys and other parts of the urinary tract. The kidneys are vital for filtering waste from the blood, regulating blood pressure, and maintaining fluid and electrolyte balance. When they fail to function properly, it can lead to serious health issues.

1. Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD) is a long-term, progressive condition where the kidneys gradually lose their function over time. It is often called a “silent killer” because symptoms may not appear until the disease is in its advanced stages.

Causes: The two leading causes are diabetes (uncontrolled high blood sugar damages the filtering units in the kidneys) and hypertension (high blood pressure damages the blood vessels in the kidneys). Other causes include autoimmune diseases and genetic disorders.
Symptoms: In early stages, there are often no symptoms. As the disease progresses, symptoms can include fatigue, swelling in the feet and ankles (edema), changes in urination frequency, and persistent itching.
Treatment: There is no cure for CKD, but treatment focuses on slowing its progression by managing the underlying cause, such as controlling blood sugar and blood pressure. In its final stage, known as End-Stage Renal Disease (ESRD), the kidneys have failed completely, requiring either dialysis or a kidney transplant to sustain life.

2. Acute Kidney Injury (AKI)

Acute Kidney Injury (AKI), formerly known as acute renal failure, is a sudden and temporary loss of kidney function. It can happen within hours or days and is a medical emergency.

Causes: AKI is often caused by a sudden drop in blood flow to the kidneys (e.g., from severe dehydration or blood loss), direct damage to the kidneys from toxins or infections, or a sudden blockage in the urinary tract that prevents urine flow (e.g., from kidney stones or an enlarged prostate).
Symptoms: Decreased urine output is a key symptom, though it may not always be present. Other signs can include fluid retention leading to swelling, confusion, fatigue, and nausea.
Treatment: The primary goal is to address the underlying cause. If blood flow is the issue, it needs to be restored. If a blockage is present, it must be cleared. In some severe cases, temporary dialysis may be needed to support the kidneys while they recover.

3. Kidney Stones (Nephrolithiasis)

Kidney stones are hard, crystalline deposits that form inside the kidneys. They can range in size from a grain of sand to a golf ball.

Causes: Kidney stones are most often formed from a buildup of minerals like calcium, oxalate, and uric acid in concentrated urine. Dehydration, diet high in salt and animal protein, and genetic factors are major risk factors.
Symptoms: A kidney stone may not cause any symptoms until it begins to move down the ureter, the tube connecting the kidney to the bladder. This can cause severe, sharp pain in the back, side, or lower abdomen, often accompanied by nausea, vomiting, and blood in the urine.
Treatment: Small stones may be passed naturally by drinking plenty of water and taking pain medication. Larger stones may require medical intervention to break them up, such as shock wave lithotripsy or ureteroscopy.

4. Urinary Tract Infection (UTI)

A UTI is an infection in any part of the urinary system, but most commonly in the bladder and urethra. While often considered a minor ailment, if left untreated, it can spread to the kidneys and cause a serious condition called pyelonephritis.

Causes: UTIs are typically caused by bacteria (most commonly E. coli) that enter the urinary tract through the urethra.
Symptoms: A strong, persistent urge to urinate, a burning sensation during urination, passing frequent and small amounts of urine, and cloudy or strong-smelling urine. If the infection reaches the kidneys, it can cause fever, back pain, and chills.
Treatment: Most UTIs are effectively treated with a short course of antibiotics. It is important to complete the entire course of medication to prevent the infection from returning or spreading.