Cardiovascular Disease Chapter 15 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 The Cardiovascular System Pulmonary circulation Blood to and from the lungs. Systemic circulation Left side of the heart pumps blood through the rest of the body. Cardiovascular System Heart, blood vessels, hormones, enzymes and wastes. Four chambers (size of a fist). Upper chambers (Atriums). Lower chambers (Ventricles). Vena cava Pulmonary Artery and Vein. Aorta. Coronary Arteries.
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 Risk Factors Major Risk factors Contributing Risk Factors Six Major Risk Factors that can be changed. Tobacco use. Physical inactivity. Obesity High blood pressure. Diabetes High levels of cholesterol. LDL s and HDL s Tobacco Use Smokers have 2-3 times higher risk of heart attack Reduces HDL s CO displaces O2 Causes platelets to become sticky and increases blood thickness High Blood Pressure Too much pressure against arterial walls Heart has to work harder, weakens, enlarges, arteries scar and harden
High Blood Pressure Tachycardias. 100 or more beats per minute. Compromises the ability of the heart to pump effectively. Ventricles can not completely fill. Low Blood Pressure Bradychardia 60 or less beats per minute Poor circulation of the blood Lack of 02 throughout to body and brain Cholesterol Clogs the arteries Increased risk of CVD LDL s - less than 120 dl/mg HDL s - greater than 60 dl/mg Total cholesterol should be below 200 dl/mg Levels over 240 indicates high risk of CVD Physical Inactivity Exercise reduces risk by: Lowering LDL s Controlling Blood pressure Increasing HDL s Maintaining weight Helps prevent or controls Diabetes
Other Contributing Factors Obesity More than 30% above recommended weight. Increase strain on the heart. Diabetes Having doubles the risk of CVD. Body Weight More than 30% High cholesterol levels High blood pressure Excessive strain on the heart Fat collected in the torso more dangerous Contributing Risk Factors That Can Be Changed High Triglyceride Levels Psychological factors Chronic hostility and anger Suppressing psychological disorders Depression and anxiety Social factors Social isolation Low socioeconomic status Elevated Triglycerides Combines with LDL s Causes lowered HDL s Linked with Obesity Linked with Diabetes Reliable predictor of CVD Best means of Reduction: Exercise weight loss, and dietary changes
Factors Not Controllable Heredity - CVD has genetic component; high cholesterol levels, blood clotting and obesity Age - Over the age of 65 Sex - Men have higher risk earlier in life Ethnicity - African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians Lower rates of CVD Possible Risk Factors Currently Being Studied Homocysteine Lipoprotein(a) LDL Particle size. Infectious agents Inflammation and C-Reactive Protein Fibriongen Blood Viscosity and Iron Uric Acid Syndrome X Major Forms of Cardiovascular Disease Hypertension - may cause damage even before it is ever detected. Atherosclerosis - narrowed by fatty deposits. Starts during childhood fat. Heart Attack - Coronary thrombosis, coronary occlusion or myocardial infarction. Vessels in the heart become blocked. Stroke - Impeded blood supply to a part of the brain. Congestive Heart Failure - Blood backs up in the veins leading to the heart, causing fluid retention in various body parts. Major Forms of Cardiovascular Disease Angina Pectoris - Chest pain; heart doesn t get enough O2. (Kehr s sign.). Arrhythmia s - Abnormal Heartbeat - Disruption of the electrical system - can lead to sudden death.
Helping a Heart Attack Victim Most die within 2 hours from time of first symptoms. Cardiopulmonary resuscitation (CPR) Detecting and Treating Heart Disease Electrocardiogram (ECG or EKG) Magnetic Resonance Imaging (MRI) Angiogram Balloon Angioplasty Coronary Bypass Surgery Stroke or Cerebrovascular Accident (CVA) Ischemic stroke Thrombotic stroke clot forms in a cerebral artery Embolic Stroke - wandering blood clot Hemorrhagic stroke- blood vessel ruptures in the brain Aneurysm The Effects of a Stroke 600,000 Americans per year One-third die within a year Those who survive have some lasting disability. Stroke Warning Signs Sudden numbness or weakness of face, arm, leg or one side of the body Loss of Speech or difficulty speaking Dimming or loss of vision in one eye Unexplained dizziness in relation to other symptoms
Detecting and Treating Stroke Transient ischemic attack (TIA) Computed tomography (CT) Rehabilitation Physical therapy Speech and Language therapy Occupational therapy Congestive Heart Failure Number of conditions Pulmonary edema - Fluid accumulates in lungs (Cant maintain reg. pump rate; fluid backs up) Controlled by: Reducing cardiac load, eliminating excess fluid, restriction of salt and drug therapy. Heart Disease in Children Congenital Heart Disease Most common are holes between the ventricles. Congenital narrowing of the aorta. Hypertrophic Cardiomyopathy Rheumatic 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 Disorders Mitral valve prolapse Protecting Yourself Against CVD Total Fats less than 30% Low Saturated Fats Increased Dietary Fiber Moderation of Alcohol No smoking Omega-3 fatty acids, vitamin E, folic acid, vitamin B-6 & B-12,soy protein, and total calories.
Protecting Yourself Moderate physical activity Blood pressure monitored twice a year Control Cholesterol levels Effective means of controlling stress DASH Dietary Approaches to Stop Hypertension DASH DIET