Predisposing Factors Precipitating Factors:

 Sedentary Lifestyle  Alcohol drinker

 Age: 67 years old  Diet: High Fat, High Cholesterol
 Gender: Male  Type 2 DM
 Past history of mild stroke  Hypertension (140/90 mmHg -
 Type A personality 180/100 mmHg)

Increase fat intake Increase of glucose and lipids in the

blood stream
Increase of triglyceride and
Decrease in HDL Increased blood viscosity

Increase radical cells

Oxidative Stress Dysregulation of infarction

Metabolism of MMP and
Inhibitors (TIMPS)
Damage to endothelium of arterial walls

Increased degradation of
Fats, cholesterol and cellular waste products fibrillar collagen and extra-
Accumulates in arterial wall cellular matrix

Inflammation of arterial wall Activation of RAAS

Monocytes travel to damaged site Liver produce angiotensinogen

Stimulation of oxidized cholesterol converted Kidneys release renin

monocytes to macrophage
Renin converts
angiotensinogen to
angiotensinogen I
Phagocytosis of cholesterol by macrophages

Lung secretes ACE

Oxidized LDL accumulates on macrophage

ACE converts angiotensinogen I to

Foam cells promotion angiotensinogen II

Plaque formation on tunica Vasoconstriction

 Intima of arteries

HCVD
Atherosclerosis

Smooth muscle in arterial wall multiply

Smooth muscle move to surface of the plaque

Formation of firm fibrous cap covering the plaque

Plaque cap eroded

Plaque travels to bloodstream

Myocyte stretch Intracellular
calcium
Blood clot formation release
Angiotensinogen II converts to
Angiotensinogen III

Initiate transcription of genes

(aldosterone synthesis
and calcium moderative gene) Calcium
overload
Increased Na,
Sodium retention Increased BP
Edema, DOB,
SOB, Back pain
Distendedabdom
Myocyte hypertrophy en, Constipation
(December
25-30, 2018)

Cardine fibroblast undergo phenotypic change

Myofibroblast formation

Interfere with propagation of electrical

Signals

Electrical impulse/signal fire off from left

atrium

MVR:
Irregular Atrial Fibrillation
heart beat
Fibrillatory
P Wave
Blood inefficiently pumped
QRS less
than 1.2
seconds
Blood Stagnation
 Blood clot formation

Clot travels to ventricles

Body

Lodged in brain

Ischemia

Damage to cerebellum
Damage to parietal and Damage to optic Damage to Damage to left frontal lobe
(sensory function)
occipital lobe nerve hypothalamus (Broca’s area)

- Vomiting (December - Numbness -Visual - Altered LOC -Slurred

25-30, 2018) (November 2018) disturbances (December 25-30, speech
- Nausea (December - Sensory Changes (November- 2018) (December
25-30, 2018) (November 2018) December 2018) 25,2018)

CEVD