myocardial ischemia

  Patients with angina have a high prevalence of hypertension. Hypertension ia an estabilished risk factor the development of coronary artery disaese, almost doubling the risk. the development of ischemia in patients with hypertension is multifactorial.
  Importanly, in patients with hypertension, angina can occur in the absense of epicardial coronary artery disaese. the reason is 2-fold. increased afterload secondary to hypertension leads to an increase in left ventricular wall tension and transmural pressure,

Read more »

left atrial abnormalities.

  Frequently underappreciated, structural and functional changes of the left atrium (LA) are very common in patients with hypertension. the increased imposed the LA by elevated left ventricle(LV) and-diastolic pressure secondary to increased blood pressure (BP) leads ro impairment of the left atrium (LA) and left atrium(LA) appendage function plus increased left atrium(LA) size and thickness.

Read more »

pathophysiology

the pathophysiology of hypertensive heart disease is a complex interplay of various hemondynamic, structural, neuroendocrine, celluler, and mollecular factors. on the one hand, these factor play integral roles in the development of hypertension and its complications; on the other hand. elevated BP(blood  pressure) itself can modulate these factors.

Read more »

management and diagnosis of chronic rheumatic heart disease

Implementing guidelines on the diagnosis and management of chronic RHD has clinical importsnce to reducace recurrent of RHD among patients. in addition to accsess to appropriate primary care services, best, practice for RHD requires:
-access to a specialist physician and/or cardiologist(preferably the same specialist over a long time)
-acces to echocardiograpy- portable echocardiography may be required so that all RHD patients have access to echocardiography, regardless of location;
-adequate monitoring of anticoagulation therapy in patiens with atrial fibrillation and/ or mechanical prostheric valves: and
-secondary prevention with penicillin prophylaxis.

Read more »