Introduction
Alterations in cardiac and hematologic functions refer to the changes in the normal functioning of both the blood-forming organs and the heart. These changes may result from various medical conditions and have a significant impact on an individual’s overall health and well-being. Understanding the underlying causes and symptoms of these alterations is therefore crucial in providing effective treatment and management of the associated ailments.
The objective of this paper is to demonstrate an understanding of how changes in cardiac and hematologic functions may affect overall health and lead to various medical conditions. This knowledge can be used to diagnose and treat heart and blood disorders, as well as to prevent and manage related health problems. Moreover, studying and understanding cardiac and hematologic functions can help identify risk factors for these conditions and develop strategies for maintaining cardiovascular and blood health.
Hematologic function refers to the function of the blood and the cells that comprise it, including red blood cells, white blood cells, and platelets. Alterations in hematologic function can occur in various conditions, including anemia, leukemia, and bleeding disorders (Dorobantu, Mancia, Grassi, & Voicu, 2019). Understanding the underlying causes of these conditions, as well as the diagnostic tests and treatment options available, is essential for providing effective care for patients with hematologic disorders.
Anemia
Iron deficiency anemia is the most common type of anemia caused by a lack of iron in the body. Symptoms include fatigue, weakness, pallor, and hair loss (McCance & Huether, 2018). Diagnosis is typically made through blood tests, such as a complete blood count (CBC) and iron studies. Vitamin deficiency anemia, specifically folic acid and vitamin B12 deficiency, can cause symptoms such as weakness, fatigue, and a smooth, beefy-red tongue (Bruyere, 2009).
Folic acid deficiency anemia has similar diagnostic tests to vitamin B12 deficiency anemia. Nonetheless, hemolytic anemia, in which red blood cells are destroyed faster than they can be replaced, can be caused by genetic disorders, infections, or adverse reactions to certain medications. Symptoms include jaundice, dark urine, and an enlarged spleen (Khan Academy Medicine, 2012). Diagnosis is made through blood tests, such as a CBC, reticulocyte count, and bilirubin levels.
It is sufficient to mention that aplastic anemia refers to a condition in which the body stops producing enough new blood cells; this can be caused by bone marrow failure, exposure to toxins, or certain infections (Dorobantu et al., 2019). Patients typically present with symptoms like weakness, fatigue, and increased infection rates. To diagnose the condition, doctors perform blood tests (like a CBC) and a bone marrow aspiration or biopsy.
Sickle cell anemia presents itself in the form of pain, fatigue, weakness, jaundice, frequent infections, dactylitis (swelling of the hands and feet), leg ulcers, and priapism, primarily caused by inheritance. It is an inherited disorder caused by a genetic mutation in the hemoglobin molecule. Diagnostic tests are done through CBC, hemoglobin electrophoresis, sickle solubility test, and hemoglobin S quantification. Pernicious anemia is an Autoimmune disorder that affects the stomach’s ability to absorb vitamin B12. Diagnostic tests are CBC, Vitamin B12, Homocysteine, Methylmalonic acid, Intrinsic Factor antibody, and Parietal cell antibody.
Cardiac Output
The body employs several compensatory mechanisms to restore cardiac output when it is decreased. Regarding the Frank-Starling mechanism, the heart’s contractility tends to increase with increasing preload, i.e., the amount of blood in the ventricles before contraction, which in turn increases cardiac output (McCance & Huether, 2018). The baroreceptor reflex is located in the carotid and aortic sinuses. When the baroreceptors sense a decrease in blood pressure, they send signals to the brain to increase heart rate and contractility, thereby increasing cardiac output (Bruyere, 2009).
The compensatory mechanisms in an attempt to restore cardiac output also employ the Renin-Angiotensin-Aldosterone System (RAAS); this means that when blood pressure drops, the kidneys release the enzyme renin, which activates the RAAS system and leads to an increase in blood pressure by constricting blood vessels and retaining sodium and water.
The sympathetic nervous system increases heart rate and contractility in response to a decrease in blood pressure, increasing cardiac output. Over time, the heart muscle can thicken (hypertrophy) in response to an increased workload, allowing it to pump more blood and increase cardiac output (Khan Academy Medicine, 2012). However, it can also increase the risk of heart failure if the heart muscle becomes too thick and stiff to pump effectively.
It is also important to note that many of these compensatory measures have a threshold. If the cardiac output is decreased for an extended period, the body will be unable to compensate, resulting in an insufficient cardiac output to meet the body’s needs (McCance & Huether, 2018).
Heart Failure: Right- and Left-Side
Heart failure (HF) refers to a condition whereby the heart becomes unable to pump enough blood to meet the body’s needs. There are two main types of heart failure: right-sided heart failure (RHF) and left-sided heart failure (LHF). RHF occurs when the right ventricle of the heart is unable to pump enough blood to the lungs for oxygenation (Bruyere, 2009).
Causes of RHF include conditions that affect the left side of the heart, such as left-sided heart failure, lung disease, and high blood pressure in the lungs, viz, pulmonary hypertension (Khan Academy Medicine, 2012). RHF diagnostics are not necessarily intrusive and may be carried out within a few hours. The diagnostic tests are as mentioned above.
On the other hand, left-sided heart failure (LHF) occurs when the left ventricle of the heart cannot pump enough blood to the rest of the body. Causes of LHF include conditions that affect the heart’s ability to pump blood, such as coronary artery disease, hypertension, and heart valve disease (Dorobantu et al., 2019).
The majority of LHF diagnostics are also non-intrusive, except for the two main blood tests, namely BNP and troponins (McCance & Huether, 2018). It is also worth noting that in some cases, both the right and left sides of the heart can be affected simultaneously, a condition known as biventricular heart failure. In such cases, the symptoms and diagnostic tests are a combination of those mentioned above.
Leukemia
Leukemia is a type of cancer that affects the blood and bone marrow. There are two main types of leukemia: acute leukemia and chronic leukemia. The clinical presentations, prognosis, and management of these two types of leukemia differ in several ways. Acute leukemia is a rapidly progressing form of leukemia that is characterized by the accumulation of immature white blood cells, known as blasts, in the bone marrow and blood (Bruyere, 2009).
This can lead to a shortage of healthy white blood cells, red blood cells, and platelets, leading to infections, bleeding, and anemia. The prognosis for acute leukemia varies depending on the type, the stage of the disease, and the patient’s age and overall health. With prompt treatment, the survival rate for acute leukemia can be as high as 90% (Khan Academy Medicine, 2012). However, if the disease is not diagnosed and treated promptly, it can be fatal.
The management of acute leukemia typically involves a combination of chemotherapy, radiation therapy, and/or bone marrow transplantation. The goal of treatment is to destroy the cancer cells and allow the bone marrow to produce healthy blood cells. In some cases, targeted therapies, immunotherapy, and CAR T-cell therapy can also be used (Dorobantu et al., 2019). In acute lymphoblastic leukemia (ALL), a combination of chemotherapy and immunotherapy can lead to a high remission rate.
Chronic leukemia, on the other hand, is a slowly progressing form of leukemia characterized by the accumulation of mature white blood cells in the blood and bone marrow (McCance & Huether, 2018). This can lead to an overproduction of white blood cells, which can crowd out healthy blood cells, leading to anemia, infections, and bleeding. The most common types of chronic leukemia are chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML) (Bruyere, 2009). Clinical presentations of chronic leukemia may be subtle and may not appear for a long time.
While chronic leukemia generally has a better prognosis than acute one, the actual outcome still depends on the disease’s type and stage, alongside the patient’s age and overall wellness (Khan Academy Medicine, 2012). With proper treatment, patients with chronic leukemia can live for many years. However, the disease can eventually progress to a more advanced stage and require more aggressive treatment.
Essentially, acute and chronic leukemia are distinct in their clinical signs, prognosis, and necessary care. Acute leukemia is a fast-moving disease demanding quick intervention to be non-fatal. In contrast, chronic leukemia progresses slowly and is typically managed long-term with consistent monitoring and treatment (Dorobantu et al., 2019). Despite these differences, both require careful, continuous management to maximize the patient’s chances for a positive outcome.
Conclusion
In conclusion, alterations in cardiac and hematologic functions can have a significant impact on an individual’s well-being and health. The findings of this particular research suggest that early detection and proper management of these changes may lead to improved outcomes. However, further research is needed to fully understand the underlying causes and develop new treatment options for individuals affected by these alterations.
References
McCance, K. A. & Huether, S.E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby. Web.
Bruyere, H. (2009). 100 case studies in pathophysiology (1st ed.). Lippencott Williams & Wilkins.
Khan Academy Medicine. (2012). Hypertension effects on the heart. [Video]. YouTube. Web.
Dorobantu, M., Mancia, G., Grassi, G. & Voicu, V. (2019). Hypertension and heart failure: Epidemiology, mechanisms and treatment. Springer.