MPAT12001 Medical Pathophysiology Lecture Series

Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Lecture Material is adapted from © 2017 Wolters Kluwer Health, Lippincott Williams & Wilkins
Applied Pathophysiology:
A Conceptual Approach to the
Mechanisms of Disease
Chapter 2: Altered Cells and Tissues
Module 4: Clinical Models
Dr. Henrik Pallos
MPAT12001 Medical Pathophysiology Lecture Series – 2017
Pathophysiology
Clinical
manifestations
Diagnosis
Treatment
Environmental Toxins and Cardiovascular Disease
• Toxic injury for cells
• Exposure to environmental chemicals:
• Physical cell injury, leads to disease and illness
• Examples of environmental toxins: CO, Nitrates, SO2, ozone, lead, secondhand tobacco
smoke
• Airborne particulate matter:
• Causes oxidative damage and inflammation
• Associated with increased mortality (death rate)
• Cardiovascular disease
• Evidence is strong:
• Air pollution is a known risk factor for cardiovascular
disease
Environmental Toxins and Cardiovascular Disease
Pathophysiology
https://www3.epa.gov/pm/basic.html FINE http://www.medscape.org/viewarticle/584109_2
PARTICLE
MATTERS
• Cigarette smoking is one of the most common environmental pollutants
known to cause cellular damage
• Tar and gas in smoke: free radicals with various toxicity potential
• Present in both mainstream (active) and side stream (passive or secondhand) smoke
• Free radicals promote oxidative stress in lung
• Smoking is a causative and additive factor to
cardiovascular disease
Environmental Toxins and Cardiovascular Disease
Pathophysiology
Bullock S, Hales M. Principles of pathophysiology. 1st ed. Frenchs Forest, Pearson Australia; 2012.
Smoking affects nearly all body systems
US Surgeon General findings:
• Smoking is harmful to every organ
• Smoking causes many diseases, reducing the health of smokers
• Smoking cigarettes with reduced tar and nicotine does not offer any health benefit
Health consequences
• Aortic aneurysm
• Acute myeloid leukemia
• Cataract
• Cancer (many types)
• Pneumonia
• Periodontitis
• Chronic lung disease
• Coronary heart disease
• Stroke
• Reproductive effects
• Sudden infant death syndrome
Environmental Toxins and Cardiovascular Disease Clinical
Manifestations
Smoking is causative and additive factor in cardiovascular disease
• History and physical examination
• Reduced exercise tolerance (impaired ability of hear to meet demand)
• Difficulty breathing
• Blood clot (pale and cold extremities)
• Hypertension
• Increased heart rate
• Reduced cardiac output
• Laboratory studies
• May find markers of cardiovascular disease
• Hyperlipidemia (increased LDL concentration, bad cholesterol)
Environmental Toxins and Cardiovascular Disease
Diagnosis
• Smoking cessation: STOP SMOKING!
• Pharmacologic treatment: drugs that assist with smoking cessation and management
of cardiovascular complications
• Persistent health consequences of smoking:
• Disease specific
• Long term symptom management
• Risk reduction for air pollution
• Indoor
• Outdoor
Environmental Toxins and Cardiovascular Disease
Treatment
http://www.cdc.gov/nceh/publications/books/housing/figure_cha07.htm
STOP SMOKING!
SAYONARA!