Heamodynamic Disorders (Patho) - Dr. Anood

Haemodynamic
Disorders
Presented by Dr. Anood Naz
(Lecturer at Ziauddin University)
Define Edema and explain its types.
Define the following terms:
-Hyperemia /congestion
Learning -Hemorrhage
Objectives -Thrombosis
-Embolism
-Infarction
-Shock
Edema and
its Types
Definition:
• Edema is the abnormal accumulation of fluid within the
interstitial spaces of tissues, leading to swelling.
• Example:
• Pleural Cavity Edema: Hydrothorax
• Pericardial Cavity Edema: Hydropericardium
• Subcutaneous edema is also commonly referred to as "anasarca."
• Peritoneal Cavity Edema: Ascites or Hydroperitoneum
TYPES OF EDEMA
• Hydrostatic Edema: Due to increased pressure in the blood vessels,
causing fluid to leak into tissues.
• Osmotic Edema: Caused by decreased plasma protein levels, leading to
reduced osmotic pressure and fluid retention in tissues.
• Lymphatic Edema: Resulting from impaired lymphatic drainage,
leading to the accumulation of interstitial fluid.
• Inflammatory Edema: Associated with increased capillary permeability
due to inflammation, allowing fluid and proteins to leak into tissues.
EXAMPLES of each Types:
1. Hydrostatic Edema: Pulmonary edema, Peripheral
edema
2. Osmotic Edema: Cerebral edema, Macular edema
3. Lymphatic Edema: Lymphedema, Elephantiasis
4. Inflammatory Edema:
Periorbital edema, Ankle swelling and Ascites
Hyperemia
/congestion
Definition:
• Hyperemia Or congestion, is a condition characterized by
increased blood flow into a specific tissue or organ.
• But Hyperemia comes under active type where arterial
dilation leads to increased blood flow, where as congestion
is a passive process , where impaired venous outflow causes
blood to accumulate in the tissue.
Hemorrhage
Definition:
Hemorrhage is defined as the escape of blood from the
vascular system into tissues or body cavities due to vessel
wall rupture or other underlying causes.
TYPES OF HEMORRHAGES
Petechiae: Pinpoint (less than 2mm) hemorrhages in skin/mucous membranes
Purpura: Larger bruise-like hemorrhages (2mm-1cm)
1. Ecchymosis: Subcutaneous hemorrhages (>1cm)
TYPES OF HEMORRHAGES
4. Hemarthrosis: Bleeding into joint spaces, seen in hemophilia or

trauma.
5. Intracranial Hemorrhage: Bleeding within the skull, caused by
trauma, aneurysm rupture, or hypertension.
6. Gastrointestinal Hemorrhage: Bleeding in the GI tract, presenting as
melena or hematemesis, associated with ulcers, gastritis, or varices.
Thrombosis
Definition
• Pathologic formation of an intravascular blood clot
(thrombus)
• It can occur in an artery or vein
• The most common location is the deep veins (DVT) of
the leg below t he knee.
Histopathology:
• It is Characterized by
(I) lines of Zahn (alternating layers of

platelets/fibrin and RBCs)
(II) attachment to vessel wall
• Both features distinguish thrombus
from postmortem clot.
Risk Factors: (Virchow triad)
• Three major risk factors for thrombosis are
1. Disruption in blood flow i.e. STASIS
2. Endothelial cell damage i.e TRAUMA
3. Hypercoagulable State.
Embolism
Definition
Embolism is the obstruction of a blood vessel by a
foreign substance or blood clot, which travels
through the bloodstream and becomes lodged in
a smaller vessel, blocking blood flow.
Types of Embolism:
1. Thromboembolism: Caused by a blood clot (thrombus) that
dislodges from its site of origin and travels through the
bloodstream.
2. Air embolism: Results from the entry of air bubbles into the
bloodstream, often due to trauma, medical procedures, or
decompression sickness.
3. Fat embolism: Caused by the release of fat droplets into the
bloodstream, commonly associated with long bone fractures or
trauma.
Infarction
Definition:
Obstruction of the blood supply to an organ or region of
tissue, typically by a thrombus or embolus, causing local
death of the tissue i.e ischemic necrosis.
On the basis of Color:
1. RED INFARCTION: Hemorrhagic
Red infarctions typically occur in loose, highly vascularized tissues, such as the
lungs or intestines.
These infarctions are characterized by the presence of dual blood supply or
reperfusion of the affected tissue by collateral circulation.
As a result, there is significant hemorrhage into the necrotic tissue, giving it a red
or hemorrhagic appearance.
• Red infarctions often occur in organs with a single blood supply when venous
drainage is obstructed, allowing blood to enter but preventing its exit, leading to
congestion and hemorrhage.
1. Histopathology of Red Infarction
• Histopathologically, red infarction shows evidence of hemorrhage
and congestion within the affected tissue.
• Microscopically, red infarctions typically exhibit abundant red blood

cells (RBCs) within the necrotic tissue.
• There may be evidence of blood vessel rupture, leading to

extravasation of RBCs into the surrounding tissue spaces.
• The tissue architecture may be disrupted, and there could be

infiltration of inflammatory cells, particularly in the later stages of
infarction.
• In organs with dual blood supply or extensive collateral circulation,

such as the lungs or intestines, the hemorrhagic nature of the infarct
is more prominent.
2. WHITE INFARCTION: Ischemic/Anemic
White infarctions typically occur in solid organs with end-arterial circulation, such
as the heart, kidneys, or spleen.
These infarctions are characterized by a lack of collateral circulation, leading to a
more complete obstruction of blood flow to the affected tissue.
Without collateral circulation, there is minimal hemorrhage into the necrotic
tissue, resulting in a pale or white appearance.
• White infarctions are often seen in organs with single or limited blood supply,
where occlusion of the supplying artery results in ischemic necrosis without
significant hemorrhage.
Histopathology of White Infarction
Histopathologically, white infarction is characterized by coagulative necrosis and lack of significant
hemorrhage within the affected tissue.
Microscopically, white infarctions typically show pale or ischemic tissue with a lack of red blood
cells.
There is coagulative necrosis, where the tissue architecture is preserved initially but eventually
becomes necrotic and devoid of viable cells.
The infarcted tissue may appear pale or white due to the absence of blood and hemorrhage.
• In organs with single blood supply or limited collateral circulation, such as the heart, kidneys, or
spleen, white infarction is more commonly observed due to the lack of reperfusion and
significant hemorrhage.
Shock
Lymphadenitis
Lymphadenitis
• Lymphadenitis is the inflammation
of lymph nodes, which are small,
bean-shaped structures found
throughout the body’s lymphatic
system. This condition typically
occurs in response to an infection,
such as bacterial, viral, or fungal.
Thank you

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Haemodynamic

4. Hemarthrosis: Bleeding into joint spaces, seen in hemophilia or

(I) lines of Zahn (alternating layers of

• Microscopically, red infarctions typically exhibit abundant red blood

• There may be evidence of blood vessel rupture, leading to

• The tissue architecture may be disrupted, and there could be

• In organs with dual blood supply or extensive collateral circulation,

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