Case Study 2
Maria is a sedentary, 68-year-old woman who is overweight. She
complains that her hands and feet are always cold, and she tires quickly when
cleaning the house. At her most recent visit to her doctor, her blood pressure
was 184/98 mm Hg. She has edema around her ankles and legs, and her physician
is concerned about an echocardiogram that indicates Maria has an enlarged
heart.
1. Identify two
reasons why Maria will have tissue ischemia. How might this lead to hypoxia?
2. What two early
and reversible changes occur to tissue cells when they are hypoxic?
3. What specific type of cellular adaptation has
taken place in Maria’s enlarged heart? What made you come to this conclusion?
4. Predict why Maria’s heart has become enlarged.
Why doesn’t this enlargement give her the same cardiac strength and endurance
as a well-trained athlete?
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Expert Solution Preview
Introduction:
This case study involves a 68-year-old woman named Maria who is experiencing symptoms related to tissue ischemia and hypoxia. Additionally, she has an enlarged heart. In this assignment, we will discuss the reasons for Maria’s tissue ischemia, the early and reversible changes that occur to tissue cells during hypoxia, the type of cellular adaptation that has taken place in Maria’s enlarged heart, and why her heart has become enlarged.
1. Two reasons why Maria will have tissue ischemia:
Maria may have tissue ischemia due to two possible reasons: reduced blood flow or diminished oxygen-carrying capacity of the blood. Inadequate blood flow occurs when blood vessels are constricted, blocked, or damaged, reducing blood flow to tissues. Diminished oxygen-carrying capacity may occur due to anemia, carbon monoxide poisoning, or respiratory diseases. Hypoxia can occur due to tissue ischemia, leading to the death of cells and damage to tissues.
2. Two early and reversible changes occur to tissue cells when they are hypoxic:
The two early and reversible changes that occur in tissue cells during hypoxia are a decrease in adenosine triphosphate (ATP) and the accumulation of lactic acid. ATP is the energy currency of cells, and hypoxia reduces its production. The accumulation of lactic acid occurs due to anaerobic respiration in the absence of oxygen, which causes a decrease in pH, leading to acidosis. These changes can be reversed once blood and oxygen supply are restored.
3. The specific type of cellular adaptation that has taken place in Maria’s enlarged heart:
Maria’s enlarged heart has undergone a specific type of cellular adaptation called cardiac hypertrophy. This adaptive response is a result of the heart responding to increased workload or stress. Increase in workload causes an increase in muscle mass, specifically the ventricular muscle mass of the heart. This results in an enlarged heart with thicker walls and increased ventricular volume. The cellular adaptation of cardiac hypertrophy is detected through an echocardiogram which indicated an enlarged heart in Maria’s case.
4. Why Maria’s heart has become enlarged:
Maria’s heart has become enlarged due to continuous exposure to high blood pressure. Hypertension, or high blood pressure, is a leading cause of cardiac hypertrophy. The heart has to pump harder to push blood against the high resistance of blood vessels, leading to increased workload. This increased workload leads to cardiac hypertrophy and an enlarged heart. However, this enlargement does not give Maria the same cardiac strength and endurance as a well-trained athlete because cardiac hypertrophy can affect the heart’s function and lead to heart failure over time. Therefore, Maria’s heart may not be able to pump efficiently, causing her to tire quickly and experience other symptoms.
Conclusion:
In conclusion, Maria’s symptoms are a result of tissue ischemia and hypoxia, which occur due to reduced blood flow or reduced oxygen-carrying capacity of blood. Additionally, Maria’s enlarged heart is a result of cardiac hypertrophy caused by prolonged exposure to high blood pressure. Understanding these underlying mechanisms is crucial in the diagnosis, treatment, and prevention of cardiovascular diseases.
