Diseases of the Cardiovascular System

General Terminology

Hypoxia-deficiency of oxygen.

Anoxia-absence of oxygen.

Necrosis-cell or tissue death.

Gangrene-necrotic tissue that has become invaded with anaerobic microorganisms.

Thrombus-a blood clot attached to the wall of a blood vessel.

Embolus-a free floating blood clot, clump of fat, mass of cholesterol crystals, mass of tissue, or even mass of bacteria.

Cyanosis-bluish discoloration of the skin caused by a deficiency of oxygen in the blood.

Disorders

Hypertension-high blood pressure

            Cause: exact cause unknown, but many factors contribute (e.g., old age, obesity, smoking, genetic factors, stress).

            Contraindications/indications: obtain advice and approval of client's doctor before performing bodywork; massage is contraindicated in extreme cases because thrombus (clot) formation is possible; avoid deep tissue work or painful massage in all cases; soothing massage may reduce high blood pressure and associated stress.

Hypotension-low blood pressure.

            Cause: overall good health; loss of blood.

            Contraindications/indications: consult with client's doctor; be careful when the client sits up or stands after massage in completed.

Anemia-a decrease in the oxygen-carrying capacity of the blood; accompanied by dizziness, fatigue, nausea, lightheadedness, and pale coloration of the skin.

            Cause: see following definitions of specific types of anemia.

            Contraindications/indications: avoid deep massage because extreme fluid movement or pressure on surface blood vessels may be harmful; massage should be light and soothing.

Sickle cell anemia-a genetic condition causing malformed hemoglobin molecules; produces fragile sickle or crescent-shaped red blood cells that are easily destroyed; causes thickening of the blood, which strains the heart and reduces blood flow.

Hemorrhagic anemia-anemia resulting from a loss of blood volume.

Hemolytic anemia-anemia resulting from excessive destruction of red blood vessels.

Iron deficiency anemia-anemia resulting from decreased hemoglobin production; caused by a lack of dietary iron.

Aplastic anemia-anemia in which the number of functioning stem cells in the bone marrow is decreased; resulting from drugs, chemicals, radiation, or cancer.

Pernicious anemia-anemia resulting from deficiency or malabsorption of vitamin B12.

Leukemia-q disease in which many immature and ineffective white blood cells (WBCs) are produced; classified according to the type of predominant WBC, the severity of symptoms, and the total WBC count.

            Cause: disease in which malignant stem cells develop in the bone marrow.

            Contraindications/indications: obtain approval from client's doctor before performing bodywork; all massage should be light because of tendency for bleeding and bruising; energy work could be effective.

Hemophilia-characterized by the inability to form a blood clot because of a deficiency of blood clotting factors (e.g., classic hemophilia is caused by a deficiency of clotting factor VII).

            Cause: sex linked genetic disorder.

            Contraindications/indications: obtain approval from client's doctor before performing bodywork; all massage should be light because of tendency for bleeding and bruising; energy work could be effective.

Shock-a condition in which there is inadequate delivery of oxygenated blood to the tissues, particularly to the central nervous system; signs and symptoms include pale or bluish skin, overall weakness, rapid and faint pulse, restless and anxious behavior, severe thirst, nausea, dilated pupils, sweating, and shallow and rapid breathing.

            Causes: see following definitions of specific types of shock.

            Contraindications/indications: massage is contraindicated; refer to first aid procedures.

Hypovolemic shock-shock caused by a decrease in blood volume because of hemorrhage or excessive fluid loss.

Cardiogenic shock-shock caused by inadequate pumping action of the heart; usually the result of myocardial infarction; leads to decreased blood pressure.

Septic shock-shock caused by bacterial infection; results in localized vasodilation and increased blood vessel permeability, and thus decreased blood pressure.

Anaphylactic shock-shock caused by systemic release of a large amount of histamine during an allergic response; results in widespread vasodilation and increased blood vessel permeability, and thus decreased blood pressure.

Arrhythmia-an abnormal or irregular heartbeat; often benign.

            Cause: impulse variations coming into the sinoatrial node from the vagus nerve; electrolyte  imbalances.

Contraindications/indications: obtain approval of client's doctor; any massage should be light and soothing.

Pericarditis-inflammation of the pericardium (sac that surrounds the heart).

            Causes: bacterial or viral infection; calcium and fibrous deposits around the heart.

            Contraindications/indications: obtain approval of client's doctor before performing bodywork; the presence of infection is a contraindication to massage.

Phlebitis-inflammation of a vein; quite common; not very serious in superficial veins; more serious in deep veins.

            Cause: unknown; injury; predisposing factors include obesity and lack of activity.

            Contraindications/indications: avoid affected area.

Hemorrhoids- a condition characterized by varicose veins of the rectum and anus.

            Causes: increased pressure of the veins of the anus; pregnancy.

            Contraindications/indications: do not massage the surrounding gluteal and coccygeal areas.

Coarctation of the aorta-localized narrowing of the aorta; impedes blood flow.

            Cause: congenital defect.

            Contraindications/indications: consult with client's doctor.

Aneurysm-a localized bulge in the wall of an artery.

            Cause: weakening in the arterial wall.

Contraindications/indications: avoid the area where the aneurysm is located; avoid abdominal massage.

Murmur-sound heard when blood escapes through the valve of the heart.

            Cause: leaky heart valve (congenital condition); previous infection of heart tissue.

            Contraindications/indications: many heart murmurs are benign, but consult with client's doctor to be sure.

Myocardial infarction-sudden insufficient blood supply to a segment of heart muscle; results in an area of necrotic cardiac muscle tissue; symptoms include angina, shortness of breath, and radiating pain.

            Cause: usually atherosclerosis of the coronary arteries.

            Contraindications/indications: if client has symptoms of infarcation, refer to doctor immediately.

Angina pectoris-pain in the chest and arm that may be described as dull, sharp, burning, or aching.

            Cause: myocardial ischemia.

            Contraindications/indications: massage can overwork the heart, so obtain approval of client's doctor before performing bodywork; massage should be light and soothing; avoid endangerment areas and abdominal massage (which may cause increased pressure on the heart); client is best positioned supine with a cushion under the right hip to avoid pressure on the inferior vena cava.

Heart block-a block in the conduction pathway of the heart; results in uncoordinated contractions of the atria and ventricles.

            Cause: damage to a portion of the conduction system in the heart.

            Contraindications/indications: refer to doctor.

Varicose vein-a vein that swells with accumulating blood; condition is usually permanent.

            Cause: excessive pressure on the veins causing failure of the one-way valves.

            Contraindications/indications: avoid massage to directly on or distal to affected areas because clots that may form could be broken off into the general circulation; work done proximal to the area can be beneficial.

Arteriosclerosis-a group of pathologic conditions characterized by thickening and hardening of the arteries; decreased blood flow to the brain and extremities may cause dizziness and headaches.

Artherosclerosis-hardening and thickening of the arteries resulting from buildup of plaque made of cholesterol and lipids; decrease in elasticity causes narrowing of lumen, leading to decreased blood flow through the artery; eventually alters the function of the tissues.

            Causes: diabetes; obesity; steroid use; some hereditary metabolic disorders.

            Contraindications/indications: obtain approval from client's doctor before performing bodywork; avoid localized massage around the carotid artery (may cause plaque to break loose); avoid deep tissue work; avoid head and neck region.

Raynaud disease-a condition characterized by peripheral vasoconstriction, most commonly in the digits; most common in women; symptoms include extreme cold, numbness, and pain in the digits; differential diagnoses include scleroderma, thoracic outlet syndrome, stress, and exposure to vibrating machinery.

            Cause: unknown.

            Contraindications/indications: massage may increase circulation, reduce associated stress, and relax affected muscles.