Pathophysiology case study #1

Maria is a sedentary 68 years old woman who is overweight . She complains that her feet and hands are always cold and she tires quickly when cleaning the house. At her most recent visit to the doctor her Blood pressure was 184/98. Sh has edema around her ankles and legs and her physician is concerend about her echocardigram that indidcates Maria has an enlarged heart. 

Questions;

1.Identify two reasons why Maria will have tissue ischemia . How might this lead to hypoxia?

2.What are two early and reversible changes that occur to tissue cells when they are hypoxic?

3.What specific type of cellular adaptations has taken place in Maria enlarged heart? What made you come to that conclusion.