1. Cardiovascular Diseases Overview M Rich, RN, BSN
Atherosclerosis, Coronary heart disease (CHD), Chest pain (angina pectoris), Irregular heartbeat (arrhythmia), Congestive heart failure (CHF), Congenital and rheumatic heart disease, Stroke

2. Bell Work: Diagnosis of the Day Questions
Go to or click on link on my Web site. Read and Answer Questions
What is mucoid sputum without hemoptysis? (research on your phone)
What is Hepatosplenomegaly?
What is pitting edema?
What was the patient’s diagnosis?
What was the treatment?
Define pericarditis, pleural effusion and cardiac tamponade
What are the 3 classic signs of cardiac tamponade?
What two diagnostic procedures were used in this study and what do they do?
How do you treat TB pericarditis?

3. Bell Work Answers
1. Mucoid sputum is clear, white or grey and occurs in asthma and chronic bronchitis and in acute viral respiratory infections before secondary bacterial infection ensues Hemoptysis is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, and certain cardiovascular conditions.

4. Bell Work Answers
2. Hepatosplenomegaly is a disorder where both the liver and spleen swell beyond their normal size, usually due to an infection such mononucleosis or viral hepatitis.

5. Bell Work Answers
3. Pitting edema is the term used to describe edema when pressure applied to the skin of the swollen area is released and an indentation is left behind 

6. Bell Work Answers
4 and 5. The physical examination suggested and cardiac ultrasound confirmed cardiac tamponade.  An emergency pericardiocentesis was performed by a subxiphoid approach using ultrasound guidance.
6. Pericarditis: Inflammation of the Pericardium
Pericardial effusion is fluid in the space between the heart and the pericardial sac.
Cardiac tamponade occurs when fluid in the pericardial space accumulates faster than the pericardial sac can stretch and so causes high pressure compressing the heart and preventing the heart from expanding fully

7. Bell Work Answers
7. hypotension, jugular venous distention, and muffled heart sounds
An elevated JVP (pressure) is the classic sign of venous hypertension (e.g. right-sided heart failure).
JVP elevation can be visualized as jugular venous distention, whereby the JVP is visualized at a level of the neck that is higher than normal.

8. Bell Work Answers 8. Chest X-Ray and Ultrasound (sound waves)
9. It is generally recommended that patients with TB pericarditis are also prescribed steroids, although there are only a few clinical trials to support this recommendation [3]. The dose recommended is 60mg prednisolone daily .

9. An Epidemiological Overview
Cardiovascular disease (CVD) is the leading cause of death in the U.S.
That’s about 1 of every 3 deaths in the US.
About 2,200 Americans die of cardiovascular disease each day, an average of 1 death every 40 seconds.
Cardiovascular diseases claim more lives each year than all forms of cancer and Chronic Lower Respiratory Disease combined.
About 92.1 million American adults are living with some form of cardiovascular disease or the after-effects of stroke.

10. An Epidemiological Overview
About 92.1 million American adults are living with some form of cardiovascular disease or the after-effects of stroke.
Nearly half of all NH black adults have some form of cardiovascular disease, 47.7 percent of females and 46.0 percent of males.

11. Types Of Cardiovascular Disease
Atherosclerosis
Coronary heart disease (CHD)
Chest pain (angina pectoris)
Irregular heartbeat (arrhythmia)
Congestive heart failure (CHF)
Congenital and rheumatic heart disease
Stroke

12. Artherosclerosis
Characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of the artery
Hyperlipidemia – abnormally high blood lipid level Cholesterol
Plaque – the buildup of deposits in the arteries

13. Coronary Heart Disease
Damage or disease in heart’s major blood vessels
Cause: Artherosclerosis
Signs and Symptoms: Chest pain, indigestion, lightheadedness, sweating, increased heart rate, SOB
Can lead to
Myocardial infarction (MI) or heart attack – blood supplying the heart is disrupted
Coronary thrombosis – blood clot in the artery
Embolus – when the blood clot is dislodged and moves through the circulatory system

14. Reducing Your Risk For Cardiovascular Diseases
Lifestyle Changes
Avoid tobacco
Cut back on saturated fat and cholesterol
Maintain a healthy weight
Modify dietary habits
Exercise regularly
Control diabetes
Control blood pressure
Systolic – upper number
Diastolic – lower number
Manage stress

15. Reducing Your Risk For Cardiovascular Diseases
Risks you cannot control
Heredity
Age
Gender
Race

16. CAD Treatment Medications Cholesterol-modifying medications
Beta blockers - these drugs slow your heart rate and decrease your blood pressure, which decreases your heart's demand for oxygen. If you've had a heart attack, beta blockers reduce the risk of future attacks.

17. Aspirin For Heart Disease?
Aspirin - thins blood and prevent obstruction of your coronary arteries.
Research shows that 80 milligrams of aspirin every other day is beneficial to heart patients due to its blood thinning properties
Some side effects of aspirin: gastrointestinal intolerance and a tendency for difficulty with blood clotting

18. CAD MedicationTreatment
Angiotensin-converting enzyme (ACE) Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). These similar drugs decrease blood pressure and may help prevent progression of coronary artery disease.
Nitroglycerin - temporarily dilating your coronary arteries and reducing your heart's demand for blood.

19. Surgical Treatment
Coronary artery bypass surgery. A surgeon creates a graft to bypass blocked coronary arteries using a vessel from another part of your body.
This allows blood to flow around the blocked or narrowed coronary artery. Because this requires open-heart surgery, it's most often reserved for cases of multiple narrowed coronary arteries.
Coronary artery bypass graft: Abbreviated CABG. A form of bypass surgery that can create new routes around narrowed and blocked coronary arteries, permitting increased blood flow to deliver oxygen and nutrients to the heart muscle.

20. Angioplasty Versus Bypass Surgery
Cardiac Catheterization (Angiogram) Angioplasty – a thin catheter is threaded through the blocked arteries. The catheter has a balloon on the tip which is inflated to flatten the fatty deposits against the wall of the artery
Coronary bypass surgery – a blood vessel is taken from another site and implanted to bypass blocked arteries and transport blood

21. Angina Pectoris/CHEST PAIN
Ischemia – reduction of the heart’s blood and oxygen supply
The more serious the oxygen deprivation the more severe the pain
Nitroglycerin – drug used to relax (dilate) the veins
It causes arterial and venous dilatation, which decreases the workload of the heart and reduces myocardial oxygen demand. Can cause hypotension
Beta blockers control potential overactivity of the heart muscle
MONA: Morphine, Oxygen, Nitroglycerin and Aspirin (chew it)

22. Arrythmias An irregularity in heart rhythm
Tachycardia – racing heart in the absence of exercise or anxiety
Bradycardia – abnormally slow heartbeat
Fibrillation – heart beat is sporadic, quivering pattern

23. Congestive Heart Failure (CHF)
Damaged or overworked heart muscle is unable to keep blood circulating normally
Affects over 5 million Americans
Damage to heart muscle may result from: rheumatic fever, pneumonia, heart attack, or other cardiovascular problem
Lack of proper circulation may allow blood to accumulate in the vessels of the legs, ankles, or lungs
Diuretics relieve fluid accumulation

24. Congenital And Rheumatic Heart Disease
Congenital heart disease affects 1 out of 125 children born
May be due to hereditary factors, maternal diseases, or chemical intake (alcohol) during fetal development
Rheumatic heart disease results from rheumatic fever which affects connective tissue

25. Stroke Occurs when the blood supply to the brain is interrupted due to
Thrombus – blood clot
Embolus – free flowing clot
Aneurysm – bulging or burst blood vessel
Transient ischemic attack (TIA) – brief interruptions that cause temporary impairment

26. Thrombolysis
If victim reaches an emergency room and is diagnosed quickly, thrombolysis can be performed
Thrombolysis involves injecting an agent such as tissue plasminogen activator (TPA) to dissolve the clot and restore some blood flow

27. Blood Vessel Disorders
Thrombus: a stationary blood clot along the wall of a blood vessel
Embolus: a clot or other plug, usually part or all of a thrombus, brought by the blood from another vessel one
Embolism: an obstruction in a blood vessel due to a 
embolus or other foreign matter that gets stuck while  traveling through the bloodstream. 
The plural of embolism is emboli.

28. Blood Vessel Disorders
Hemorrhage: Can be internal or external, a copious or heavy discharge of blood from the blood vessels
Aneurysm: An aneurysm occurs when an artery’s wall weakens and causes an abnormally large bulge. This bulge can rupture and cause internal bleeding. 
Although an aneurysm can occur in any part of your body, they’re most common in the: brain, aorta, legs or spleen.

29. Common Blood Vessel Disorders
Figure 15.6

30. Mind Map Assignment Create a Cardiovascular Diseases Mind Map
What is a Mind Map?
Way of getting thoughts and ideas onto paper in a creative way.
The sheet of paper should be entirely full of thoughts, drawings, and phrases about the assigned topic.
There should be a central picture with roads that lead from it…it should resemble an actual road map in terms of roads going every which way with symbols and words describing different areas the roads pass through.
It must include at least three colors, three facts – organize by S&S, Causes, Treatment
Completed mind maps are absolutely a work of art!

31. Mind Map Example

32. Mind Map Example

33. Cardiovascular Diseases Mind Map
Coronary Artery Disease (atherosclerosis)
Chest pain (angina pectoris)
Irregular heartbeat (arrhythmia)
Congestive heart failure (CHF)
Stroke
Blood Vessel Disorders – Thrombus, Embolus, Hemorrhage, Aneurism
Cardiac Tamponade

34. Mind Map Assignment Due Wednesday, Nov. 8 Worth 20 points visit www
Mind Map Assignment Due Wednesday, Nov. 8 Worth 20 points visit if need ideas