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Cardiovascular DiseaseChapter 15

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Introduction

• Cardiovascular disease (CVD) is the leading cause of death in the U.S.

• One American dies from CVD every 33 seconds

• Nearly half of all Americans will die from CVD• CVD is the leading cause of death for both

men and women• 45% of all heart attacks occur in people

under the age of 65• Most of CVD risk is lifestyle-related

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The Cardiovascular System

Pulmonary circulationBlood to and from the lungs.

Systemic circulationLeft side of the heart pumps blood through the rest of the body.

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Cardiovascular System

Heart, blood vessels, hormones, enzymes and wastes.Four chambers (size of a fist).

Upper chambers (Atriums).Lower chambers (Ventricles).Vena cavaPulmonary Artery and Vein.Aorta.Coronary Arteries.

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Cardiovascular System

Systole and Diastole. action of the heart is controlled by an electrical signal which originates in the right atrium.

Veins carry blood back to the heart.Arteries carry blood away from the heart.Capillaries

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Risk Factors

Major Risk factorsContributing Risk FactorsSix Major Risk Factors that can be changed.

Tobacco use.Physical inactivity.ObesityHigh blood pressure.DiabetesHigh levels of cholesterol.

LDL’s and HDL’s

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Tobacco Use

Smokers have 2-3 times higher risk of heart attackReduces HDL’sCO displaces O2 Causes platelets to become sticky and increases blood thickness

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High Blood Pressure

Too much pressure against arterial wallsHeart has to work harder, weakens, enlarges, arteries scar and harden

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High Blood Pressure

Tachycardias. 100 or more beats per minute. Compromises the ability of the heart to pump effectively.

Ventricles can not completely fill.

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Low Blood Pressure

Bradychardia60 or less beats per minutePoor circulation of the blood Lack of 02 throughout to body and brain

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Cholesterol

Clogs the arteriesIncreased risk of CVDLDL’s - less than 120 dl/mgHDL’s - greater than 60 dl/mgTotal cholesterol should be below 200 dl/mgLevels over 240 indicates high risk of CVD

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Physical Inactivity

Exercise reduces risk by:

Lowering LDL’s Controlling Blood pressure Increasing HDL’s Maintaining weight Helps prevent or controls Diabetes

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Other Contributing Factors

ObesityMore than 30% above recommended weight.Increase strain on the heart.

DiabetesHaving doubles the risk of CVD.

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Body Weight

More than 30% High cholesterol levelsHigh blood pressure Excessive strain on the heartFat collected in the torso more dangerous

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Contributing Risk Factors That Can Be Changed

High Triglyceride LevelsPsychological factors

Chronic hostility and angerSuppressing psychological disordersDepression and anxiety

Social factorsSocial isolationLow socioeconomic status

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Elevated Triglycerides

Combines with LDL’sCauses lowered HDL’sLinked with ObesityLinked with DiabetesReliable predictor of CVDBest means of Reduction: Exercise weight loss, and dietary changes

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Factors Not Controllable

HeredityHeredity - CVD has genetic component; high cholesterol levels, blood clotting and obesityAgeAge - Over the age of 65SexSex - Men have higher risk earlier in lifeEthnicityEthnicity - African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians Lower rates of CVD

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Possible Risk Factors Currently Being Studied

HomocysteineLipoprotein(a)LDL Particle size.Infectious agentsInflammation and C-Reactive ProteinFibriongenBlood Viscosity and IronUric AcidSyndrome X

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Major Forms of Cardiovascular Disease

HypertensionHypertension - may cause damage even before it is ever detected.Atherosclerosis - Atherosclerosis - narrowed by fatty deposits. Starts during childhood fat.Heart AttackHeart Attack - Coronary thrombosis, coronary occlusion or myocardial infarction. Vessels in the heart become blocked.StrokeStroke - Impeded blood supply to a part of the brain.Congestive Heart FailureCongestive Heart Failure - Blood backs up in the veins leading to the heart, causing fluid retention in various body parts.

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Major Forms of Cardiovascular Disease

Angina Pectoris Angina Pectoris - Chest pain; heart doesn’t get enough O2. (Kehr’s sign.).

Arrhythmia’s Arrhythmia’s - Abnormal HeartbeatAbnormal Heartbeat - Disruption of the electrical system - can lead to sudden death.

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Helping a Heart Attack Victim

Most die within 2 hours from time of first symptoms.Cardiopulmonary resuscitation (CPR)

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Detecting and Treating Heart Disease

Electrocardiogram (ECG or EKG)Magnetic Resonance Imaging (MRI)AngiogramBalloon AngioplastyCoronary Bypass Surgery

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Stroke or Cerebrovascular Accident (CVA)

Ischemic stroke Ischemic stroke Thrombotic strokeThrombotic stroke clot forms in a cerebral artery

Embolic StrokeEmbolic Stroke - wandering blood clot

Hemorrhagic stroke- blood vessel ruptures in the brain

Aneurysm

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The Effects of a Stroke

600,000 Americans per yearOne-third die within a yearThose who survive have some lasting disability.

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Stroke Warning Signs

Sudden numbness or weakness of face, arm, leg or one side of the bodyLoss of Speech or difficulty speakingDimming or loss of vision in one eyeUnexplained dizziness in relation to other symptoms

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Detecting and Treating Stroke

Transient ischemic attack (TIA)Computed tomography (CT)Rehabilitation

Physical therapySpeech and Language therapyOccupational therapy

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Congestive Heart Failure

Number of conditionsPulmonary edema - Fluid 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 and drug therapy.

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Heart Disease in ChildrenCongenital Heart Disease

Most common are holes between the ventricles.Congenital narrowing of the aorta.Hypertrophic CardiomyopathyRheumatic Heart Disease - Streptococcal infections causes damage to the heart muscle and valves.

Strep throat needs to be treated, primary cause if not treated.

Heart Valve DisordersMitral valve prolapse

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Protecting Yourself Against CVD

Total Fats less than 30%Low Saturated FatsIncreased Dietary FiberModeration of AlcoholNo smokingOmega-3 fatty acids, vitamin E, folic acid, vitamin B-6 & B-12,soy protein, and total calories.

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Protecting Yourself

Moderate physical activityBlood pressure monitored twice a yearControl Cholesterol levelsEffective means of controlling stress

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DASH

Dietary Approaches to Stop HypertensionDASH DIET

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Thank You!