GHTH 100A

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GHTH 100A

• Ch. 17
• Cardiovascular Disease

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Cardiovascular Diseases

• CVD is the number one cause of death in the U.S.
• Reducing risk factors is very important
• combining risk factors have multiplicative effect
  not additive

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Cardiovascular System

• Cardiovascular system includes the heart and all
  the blood vessels
• Body contains 6 quarts of blood
• The heart is a muscular, 4-chamber organ
• atria - upper chambers
• ventricles - lower chambers

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Vascular System

• Arteries carry oxygenated blood away from the
  heart
• exception pulmonary arteries
• The first arteries off the aorta are the coronary
  arteries
• Arteries divide into arterioles and then divide
  into capillaries

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Vascular System

• Gas exchange occurs in the capillaries
• Capillaries become venules, which then become
  veins
• Venules and veins carry carbon dioxide and waste
  products to the kidneys and back to the heart

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Atherosclerosis

• Thickening hardening of the arteries which
  leads to ischemia of the heart
• Atherosclerosis and arteriosclerosis are
  basically the same thing
• It is characterized by a build-up of plaque
  (fats, cholesterol, other substances) in the
  arteries

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Atherosclerosis

• Plaque is laid down where damage of the
  endothelial lining of the artery occurs
• 3 major causes of damage
• major fluctuations in blood pressure
• high blood pressure
• high cholesterol triglycerides
• cigarette smoking

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Atherosclerosis

• Then 2 things can happen
• bleeding into the plaque
• formation of a blood clot (thrombus) on the
  plaques surface
• This process further narrows the lumen
• Heart has to work harder to pump and to get more
  oxygen

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Heart Attack

• Medical term is myocardial infarction (MI)
• Occurs when blood supply to the heart is blocked
• Collateral circulation may be able to bypass some
  minor blockage
• The first hour after an MI is critical.
• Immediate emergency care transport to a
  hospital are important for survival

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Angina Pectoris

• Chest pain, usually from exertion
• Due to impaired oxygen deliver to the heart
  itself
• Treatment
• REST
• nitroglycerin - dilates veins
• calcium channel blockers - slows heart rate
• beta blockers - controls over-activity of heart

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Arrhythmias

• Irregularities of the heartbeat
• Several types (for you to know)
• tachycardia - fast heartbeat
• bradycardia - slow heartbeat
• fibrillation - quivering of heart
• often only one chamber

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Congestive Heart Failure (CHF)

• With a weak heart, blood backs up in the veins
• This causes fluid to accumulate in the
  extremities or the lungs
• Treatment
• diuretics - help get rid of excess fluid
• digitalis - increases pumping action of heart
• vasodilators - decrease peripheral resistance

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Congenital Heart Disease

• Present at birth
• may result from mother having rubella during
  pregnancy
• may result from chemical intake during pregnancy

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Rheumatic Heart Disease

• Due to rheumatic fever
• inflammatory disease of connective tissue
• causes autoimmune response that attacks the heart
• Rheumatic fever due to unresolved strep throat
  infection

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Stroke

• Cerebrovascular accident (CVA) is the medical
  term
• Occurs when blood supply (oxygen) is cut off to a
  part of the brain
• Causes
• thrombus (blood clot)
• embolus
• aneurysm

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Stroke

• Signs symptoms may include
• loss of motor control (weakness, numbness on one
  side)
• speech impairments
• disturbed or lost vision (usually one eye)
• sudden, severe headache
• unexplained dizziness, unsteadiness
• Where the CVA occurred will determine the signs
  and symptoms

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Stroke

• Transient ischemic attacks (TIAs) may precede a
  major stroke
• TIAs are small strokes with transient effects
• Fatalities from CVAs are declining

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Risk Factors for CVD

• Some risk factors we can control
• Some we cannot control

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Controllable Risk Factors

• Smoking
• High cholesterol high fat diet
• High blood pressure
• Lack of exercise
• Overweight
• Uncontrolled diabetes
• High stress

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Stop Smoking

• Smoking increases risk of CVD by 70
• Passive smoking increases risk by 30
• Explanation for increased risk
• nicotine increases heart rate, BP, oxygen use
  by the heart
• presence of CO increases O2 demand
• chemicals in smoke damage lining of arteries

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Lower Fat Intake and Cholesterol

• High fat diets make blood sludgy, therefore more
  prone to clot formation
• High cholesterol contributes to atherosclerosis
• cholesterol should be lt200 mg/dl
• HDL should be at least gt35 and preferably gt60
• LDL should be as low as possible

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Control Hypertension

• 2 types of hypertension
• essential
• secondary
• Blood pressure components
• systolic - pressure on arteries when heart
  contracts
• diastolic - pressure on arteries when heart
  relaxes

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Increase Exercise

• Even moderate activity can reduce your risk of
  cardiovascular disease
• 20-30 minutes of aerobic exercise 3x/ week will
  help

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Avoid being Overfat

• Being overweight increases the workload on the
  heart
• Where you carry your weight also influences your
  risk of CVD
• apple shape v. pear shape

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Control Diabetes

• CVD is the leading cause of death in diabetics
• Proper diet, exercise, and medication (insulin)
  will help reduce risk by keeping diabetes under
  control

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Manage Your Stress

• Research has shown a relationship between CVD
  risk and stress levels
• Stress can cause release of adrenaline
  (epinephrine) which affects the cardiovascular
  system
• hot reactors
• cold reactors

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Risk Factors You Cannot Control

• Heredity
• Age
• Gender
• Race

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Women and Heart Disease

• A womans risk of CVD increases when estrogen
  levels drop after menopause
• signs/ symptoms are sometimes different in
  postmenopausal women from men
• CVD research is a big part of the Womens Health
  Initiative

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Diagnostic Techniques

• Electrocardiogram (ECG or EKG)
• Angiography or cardiac catheterization
• PET Scan
• MRI
• Digital cardiac angiography

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Treatments for CVD

• Bypass surgery
• Angioplasty
• Aspirin
• Thrombolytic therapy
• Cardiac Rehabilitation

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