Cardiovascular Health Chapter 15

Cardiovascular Disease (CVD) Leading cause of death in the U.S. Affects nearly 81 million Americans Claims one life every 38 seconds The high rate of CVD is primarily caused by lifestyle choices

Major Risk Factors That Can Be Changed Tobacco Use Number-one preventable cause of CVD in U.S. Smoking harms the CV System in many ways: Damages the lining of arteries Reduces HDL’s Raises triglycerides and LDL’s Nicotine increases blood pressure & HR CO displaces O2 Causes platelets to become sticky, leading to clotting Speeds the development of fatty deposits in the arteries

Major Risk Factors That Can Be Changed Diabetes Death from CVD is 2 to 3 times more likely in obese people than in lean people. Higher rates of other CVD risk factors: Hypertension Obesity Unhealthy blood lipid levels Damaged endothelial cells More vulnerable to atherosclerosis

Major Risk Factors That Can Be Changed Blood Pressure Normal adult: 120/80 Hypertensive adult : 140/90 Cholesterol Levels Total cholesterol (mg/dl): Less than 200 is desirable LDL: less than 100 is optimal HDL:60 or more is desirable Level of Physical Activity Physical activity lowers CVD risk by helping to decrease blood pressure and resting heart rate, etc.

Major Risk Factors That Can’t Be Changed Heredity Multiple genes contribute to the development of CVD and its risk factors Having a first-degree relative with CHD you have a two-fold increased risk of developing it Aging 70% of Heart Attack victims are over the age of 65 Over the age of 55 incidence of stroke doubles each decade Being male Men have higher risk of heart attack (& hypertension until 55 yrs.) esp. earlier in life Ethnicity African Americans have higher risk of hypertension; Hispanics have a greater risk of HBP and angina; Asians have lower rates of CVD

The Cardiovascular System

Components of the Cardiovascular System Heart: central pump Blood vessels: convey blood through the CV system Arteries - carry blood away from heart Veins – carry blood towards heart Capillaries –connect arteries and veins; where gas exchange occurs Blood: ~6-8 liters

The Cardiovascular System Each heartbeat has two phases: Systole = Contraction phase when blood is being pumped to other locations Diastole =Relaxation phase when chambers are filling w/ blood Reporting BP: Systolic / Diastolic Pressure

Anatomy of the Heart

Great Vessels of the Heart From left to right (front view of heart): Superior and Inferior vena cava Returns blood from body to heart Aorta Delivers blood to entire body from heart Pulmonary trunk Delivers blood to the lungs from the heart

Great Vessels of the Heart Figure 15-3 Blood supply to the heart

Chambers of the Heart Left Atrium Right Atrium Left Ventricle Right Ventricle

Circulation in The Heart

Chambers of the Heart Right Atrium Receives deoxygenated blood from entire body Blood passes to right ventricle via tricuspid valve Right ventricle Pumps deoxygenated blood to lungs Left Atrium Receives oxygenated blood from lungs Blood passes to left ventricle via bicuspid valve Left Ventricle Pumps oxygenated blood to the body

Circulation in The Heart Figure 15-2 Circulation in the heart

Coronary Circulation Definition: Blood vessels that supply the heart w/blood Coronary arteries are the first arteries that branch from the aorta

Cardiovascular Disease

Major Forms of Cardiovascular Disease Hypertension Atherosclerosis Coronary Artery (Heart) Disease (heart attack, angina) Arrhythmias and Sudden Cardiac Death Stroke Congestive Heart Failure

Hypertension Blood pressure is the pressure exerted by blood on walls of arteries High BP is dangerous because it can damage the walls of arteries leading to inflammation and clot formation.

Major Forms of Cardiovascular Disease Atherosclerosis –hardening of arteries due to fatty deposit build-up on artery walls

Coronary Artery Disease Coronary Artery Disease is when a coronary artery becomes blocked with plaque buildup which can lead to heart attack A Heart Attack is the death of the heart’s muscle tissue due to a lack of blood flow Symptoms of Heart Attack include: chest pain/pressure, arm, neck, jaw pain, difficulty breathing excessive sweating, nausea & vomiting, loss of consciousness. If an artery in a limb becomes narrowed or blocked this results in Peripheral arterial disease (PAD) Figure 15-7 Stages of plaque development

Angina Angina is pain/discomfort that occurs when not enough oxygenated blood delivered to the heart Usually felt during times of increased stress Usually felt as an extreme tightness in the chest, heavy pressure behind the breastbone or in the shoulder, neck, arm, hand, or back

Arrhythmias and Sudden Cardiac Death An Arrhythmia is when the electrical conduction system of the heart is disrupted. As a result, the heart beats irregularly, and may not be able to distribute blood to the body Can be unnoticeable or cause death

Stroke A Stroke occurs when cells of the brain die if they are starved of oxygenated blood for more than a few minutes. Types of Strokes Ischemic stroke – blockage in a blood vessel Thrombotic stroke - clot forms in a cerebral artery Embolic stroke - blood clot travels from elsewhere Hemorrhagic stroke – a blood vessel in the brain ruptures Intracerebral hemorrhage Subarachnoid hemorrhage Aneurysm .

Types of stroke Figure 15-8 Types of stroke

The Effects of a Stroke Can Include Paralysis (possible) Walking disability Speech impairment Memory loss Behavior changes The area of brain damage will determine which part of the body is affected

Congestive Heart Failure Congestive Heart Failure: when the blood flow out of the heart is reduced and fluid begins to accumulate in lungs and body tissues. Pulmonary edema – If the heart can’t maintain regular pumping rate; fluid backs up and can accumulate in the lungs

Other Forms of Heart Disease Congenital Heart Disease Defect/malformation of heart/blood vessels that you are born with Ex. “A hole in the heart” Hypertrophic Cardiomyopathy (HCM) Enlarged heart Can cause arrhythmias Rheumatic Heart Disease Resulting from a sequence of untreated streptococcal throat infections Up to 3% of untreated strep. Infections lead to rheumatic fever

Detecting and Treating Heart Disease

Detecting Stroke A quick way to recognize a stroke is to ask the person to do three things: 1. “Smile”. If her smile droops on one side, or if she is unable to move or open one side of her mouth… 2. “Hold your arms out”. If the person cannot move one arm or hold one arm still… 3. “Repeat a simple, short sentence”. If she has trouble speaking…

Treating Stroke For Hemorrhagic Stroke For Ischemic Stroke Clot-dissolving drugs Angioplasty and stenting For Hemorrhagic Stroke Drugs to lower blood pressure Transient Ischemic Attack (TIA) Ministroke, days/weeks before a full blown stroke If a stroke is detected late Rehabilitation (physical therapy, occupational therapy)

Tests Used to Detect Heart Disease Electrocardiogram (EKG) A record of the electrical activity in the heart EKG is examined while elevating HR (stress test) Magnetic resonance imaging (MRI) Use of a magnetic field to look inside the body and generate pictures of the heart and blood vessels

Tests Used to Detect Heart Disease Angiogram Dye injected into coronary arteries and heart/blood vessels examined with an X-ray Narrowed or blocked arteries can be identified

Treating Heart Disease Balloon angioplasty Deflated balloon inserted & passed through to narrowed/blocked artery Balloon is inflated to widen artery by flattening plaque Artery kept open w/ a stent

Treating Heart Disease Coronary Bypass Surgery A healthy blood vessel is removed from an area of the patients body and used to bypass a blocked artery

Protecting Yourself Against Cardiovascular Disease Exercise regularly Eat heart healthy Avoid tobacco Know and manage your blood pressure (monitored once every two years) Know and manage your cholesterol levels Develop effective ways to handle stress and anger