 Consists of the heart and blood vessels  With lungs, known as the cardiorespiratory system  The Heart  Four-chambered, fist-sized muscle located just beneath the sternum  Blood travels through two separate circulatory systems:  Pulmonary circulation › Right side of heart pumps blood to lungs.  Systemic circulation › Left side of heart pumps blood through the rest of the body  Path of blood flow: 1. Through VENA CAVA into RIGHT ATRIUM (RA) 2. From RA to RIGHT VENTRICLE (RV) 3. From RV to PULMONARY ARTERY into the lungs 4. In LUNGS, picks up oxygen and discards carbon dioxide 5. Leaves lungs through PULMONARY VEINS into heart’s LEFT ATRIUM(LA) 6. LA fills, pumps blood into LEFT VENTRICLE(LV) 7. When LV full, pumps blood through AORTA for distribution to the rest of the body’s blood vessels 8. Once oxygen has been distributed blood flows back to the heart through the VENA CAVA. 2

 Cardiovascular disease (CVD) Leading cause of death in the U.S. Affects nearly 81 million Americans Claims one life every 38 seconds About 2,300 Americans die every day CVD is largely due to our way of life 3

 Two categories of increased risk for CVD 1. Major risk factors 2. Contributing risk factors  Controllable aspects of lifestyle that can be changed  Major risk factors that can be changed › American Heart Association identified six major risk factors. 1. Tobacco use 2. High blood pressure 3. High cholesterol 4. Physical inactivity 5. Obesity 6. Diabetes 4

 Hypertension › Too much pressure against blood vessel walls  Short periods of high blood pressure are normal, but chronic high blood pressure is a health risk  Atherosclerosis › Heart has to work harder, weakens, enlarges, arteries narrow, scar, and harden  About 33% (73 million) of adults have hypertension  37% of adults have prehypertension  Test your blood pressure at least once every two years 5

 Fatty, waxlike substance that circulates through the bloodstream › Important component of:  Cell membranes  Sex hormones  Vitamin D  Fluid that coats the lungs  Protective sheaths around nerves  Excessive cholesterol clogs the arteries › Increased risk of CVD  Good versus bad cholesterol › Low –density lipoproteins (LDL) (“bad” cholesterol)  Shuttle cholesterol from the liver to organs and tissues › High-density lipoproteins (HDL) (“good” cholesterol)  Shuttle unused cholesterol back to the liver for recycling  By removing cholesterol from blood vessels, HDL helps protect against atherosclerosis  Recommended blood cholesterol levels  Benefits of controlling cholesterol 6

 million Americans are so sedentary that they are at high risk for developing CVD  Exercise reduces risk › Closest thing we have to a magic bullet against heart disease › Controls blood pressure and resting heart rate › Lowers LDL › Increases HDL › Maintains weight › Improves the condition of blood vessels › Helps prevent or controls diabetes 7

 Risk of death from CVD is two to three times more likely in obese people (BMI ≥ 30)  Increased strain on the heart  Strongly associated with: Hypertension High cholesterol Insulin resistance Diabetes Physical inactivity Increasing age Endothelial cell dysfunction  Coronary arteries constrict instead of dilate Hypertrophy (ventricular enlargement) 8

 Doubles the risk of CVD for men  Triples the risk of CVD for women  Loss of 5-10 years off your life  Higher risk Hypertension Obesity Unhealthy blood lipid levels Elevated blood glucose and insulin can damage the endothelial cells lining the arteries More vulnerable to atherosclerosis 9

 High triglyceride levels › Blood fats that are a reliable predictor of heart disease  Psychological and social factors › Stress › Chronic hostility and anger › Suppressing psychological distress › Depression › Anxiety › Social isolation › Low socioeconomic status  Alcohol and drugs 10

 Heredity › CVD has genetic component; high cholesterol levels, hypertension, diabetes, and obesity  Aging › Over the age of 65  Being male › Men have higher risk earlier in life  Ethnicity › African Americans higher risk of hypertension; Hispanics greater risk of HBP and angina; Asians lower rates of CVD 11

 Atherosclerosis - narrowed by fatty deposits › Plaques accumulate in artery walls › Coronary heart disease (CHD) › Coronary artery disease (CAD) › Peripheral arterial disease (PAD)  Heart attack – heart tissue is damaged and part of it may die from lack of blood › Myocardial infarction (MI) › American Heart Association  785,000 people have a first heart attack each year  470,000 people have recurrent attack  195,000 people suffer a symptomless or “silent” heart attack each year 12

 Chest pain or pressure  Arm, neck, or jaw pain  Difficulty breathing  Excessive sweating  Nausea and vomiting  Loss of consciousness 13

 Angina – arteries narrowed by disease, but under stress heart cannot receive enough oxygen Angina pectoris Usually felt as an extreme tightness in the chest and heavy pressure behind the breastbone or in the shoulder, neck, arm, hand, or back  Arrhythmias and sudden cardiac death – electrical conduction system is disrupted Sudden cardiac death (cardiac arrest) often caused by an arrhythmia called ventricular fibrillation 14

 Electrocardiogram (ECG or EKG)  Electron-beam computed tomography (EBCT)  Echocardiography – sound waves  Multi-slice computed tomography (MSCT)  Magnetic resonance imaging (MRI)  Nuclear myocardial perfusion imaging  Positron Emission Tomography (PET)  Angiogram  Balloon angioplasty  Coronary bypass surgery 15

 2 million brain cells die per minute during a stroke  Ischemic stroke – blockage in a blood vessel Thrombotic stroke - clot forms in a cerebral artery Embolic stroke - wandering blood clot  Hemorrhagic stroke - blood vessel ruptures in the brain Intracerebral hemorrhage Subarachnoid hemorrhage Aneurysm 16

 Interruption of the blood supply to any area of the brain prevents the nerve cells from functioning, in some cases causing death  Usually suffer some lasting disability › Paralysis › Walking disability › Speech impairment › Memory loss › Changes in behavior 17

 PAD – atherosclerosis in the leg (or arm) arteries, which can limit or block the blood flow  Patients typically also have coronary artery disease  About 8 million people in the U.S. have PAD  Risk factors: Smoking Diabetes Hypertension High cholesterol  Symptoms Claudication (aching or fatigue in the affected leg) Rest pain (limb artery cannot supply enough blood at rest) 18

 Number of conditions › High blood pressure › Heart attack › Atherosclerosis › Alcoholism › Viral infections › Rheumatic fever › Birth defects  Pulmonary edema - f luid accumulates in the lungs › Heart can not maintain regular pumping rate; fluid backs up  Controlled by: › Reducing cardiac load › Eliminating excess fluid › Restriction of salt › Drug therapy 19

 Congenital heart defects › Malformation of the heart or major blood vessel  Hypertrophic cardiomyopathy (HCM) › Occurs in 1 out of 500 people › Most common cause of sudden death in athletes younger than 35 › May be identified by a murmur  Rheumatic heart disease › Streptococcal infections cause damage to the heart muscle and valves › Strep throat needs to be treated  Heart valve disorders › Congenital heart defects and certain types of infections › Mitral valve prolapse 20