As the cardiac muscle begins to weaken due to the increased workload and pressure, the myocytes, or muscle cells, and the nonmyocytes of the myocardium begin reparation. As the heart muscle is damaged, there is an increase in nonmyoctes such as cardiac macrophages, fibroblasts, vascular smooth muscle and endothelial cells. As the nonmyoctes increase, the amount of cardiac fibroblast increases as well. The increase in fibroblast results in increased synthesis of collagen fibers, myocardial fibrosis and ventricular wall stiffness (Grossman & Porth, 2014, chap. 34). As the ventricular wall stiffens, the diastole and systole process of the ventricles are impaired. If the ventricles are not able to fully relax or fully contract, the ejection fraction (EF) is reduced. The EF is the amount of blood that is pumped out of the heart to the body with each heartbeat (Cleveland Clinic Staff, 2016a) As the EF is reduced, the amount of blood that reaches the body’s tissues and organs is also reduced. When the amount of blood within the cardiovascular system is low, the autonomic nervous system sends a message to the brain to work harder in order to compensate for the decreased blood volume which results in hypertension.
Hypertension is a...
... middle of paper ...
...e, presented six days ago to Lynchburg General Hospital with complaints of dizziness and falling. She has a past medical history of hypertension, chronic CHF, asthma and hypothyroidism. After the conduction of lab testing, Room 337 was diagnosed with syncope. Her syncope was most likely a result of insufficient O2 delivery to the brain caused by a decreased CO produced by the weakening of her heart muscle. Despite hypertension medications, Room N337’s dizziness and muscle fatigue persists demonstrated by fluctuations in her orthostatic BP readings reflecting the inability to get out of bed and move freely. In order for her condition to improve, Room 337 must continue taking her medications to improve her hypertension, asthma and hypothyroidism. These medical interventions can help prevent further syncopal episodes and increase the amount of O2 received by the brain.
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