Ch12 cardiovascular health

Chapter 12Cardiovascular Health

Cardiovascular System and How it Works

• Blood – Red blood cells (carry oxygen)– Plasma (transport gases)– Platelets (clotting factor)– White blood cells (protect body from

infection)• Heart

– Four chambers (two atria and two ventricles)

– Coronary arteries supply heart with blood


• Blood vessels– Arteries– Veins– Capillaries


• Blood vessels– Arteries

• Carry blood away from the heart• Branch into smaller blood vessels called

arterioles, which branch into smaller vessels called capillaries


• Blood vessels– Capillaries

• Permeate tissues• Allow substances such as nutrients and

oxygen to move out of blood and waste products and carbon dioxide to move into blood


• Blood vessels– Veins

• Return blood to the heart• Have thinner walls than arteries• Have one-way valves which help prevent

the back-flow of blood


• Venous Disease– Varicose veins

• Distended or stretched veins found most frequently in the legs or trunk

• Increases with age • Men more likely to have severe venous

disease• Risk factors include family history, high

blood pressure, standing for prolong periods


• Coronary Arteries– Arise from the base of the aorta – Bring freshly oxygenated blood to heart

muscle– The left and right coronary arteries are the

two main coronary arteries • Branch into multiple arteries that supply

the entire heart with blood

Cardiovascular Disease

• Coronary Artery Disease (CAD)– Blocked coronary arteries

• Result in heart attack• Angina pectoris (chest pain)

– CAD is one type of cardiovascular disease (CVD), diseases of the heart and blood vessels.

– One out of every three Americans have one or more forms of CVD.


• Cardiovascular diseases include:– Hypertension (chronic high blood pressure)– Stroke (blood vessel disease of the brain)– Rheumatic heart disease – Atherosclerosis (blood vessel disease)

• Coronary artery disease and stroke result from atherosclerosis

Cardiovascular DiseaseAtherosclerosis

– Plaques (fatty deposits) develop inside arteries.– May begin with an injury to the artery lining.– Lipids, especially cholesterol, accumulate at

injury sites and cling to the interior of the blood vessel walls.• Narrows artery

– Scar tissue forms and calcium is deposited, hardening the artery.

Atherosclerosis


Atherosclerosis– Blood clots sometimes develop at this site.

• Blood clots are often the cause of heart attack or stroke.

– Incidence increases with age.• Not all elderly have extensive plaques and

some young people do.


Coronary Artery Disease (CAD)– In CAD, coronary vessels become partly or

completely blocked by plaque and/or blood clots.• Peripheral blood vessel disease refers to

blockages occurring in organs and tissues other than the heart.

Cardiovascular DiseaseCoronary Artery Disease (CAD)

– Thrombus (stationary blood clot) can block blood vessel where it forms.

– Coronary Thrombosis - the development of a thrombus that blocks a coronary artery

– Embolus (floating blood clot) forms and floats until it blocks a blood vessel downstream.

– Coronary Embolism – produced when an embolus blocks a coronary artery downstream from where it was formed


Coronary Artery Disease (CAD)– Blockage or spasm reduces blood flow to heart

muscle and results in angina pectoris. • Angina is felt beneath the breastbone and

extends into left shoulder and down left arm.• May also be felt in jaw, neck, or back.• Angina pain is described as aching,

squeezing, burning, heaviness, or pressure.– Angina attacks come and go.


Coronary Artery Disease (CAD)– Angina attacks can be brought on by:

• Physical exertion• Mental or emotional stress

– Angina should not be ignored.• Sign of serious CAD

– An echocardiogram, angiogram or MRI will detect blockages.


Unclogging Arteries– Angioplasty

• Method of reconstructing damaged arteries to improve bloodflow

• Balloon angioplasty a balloon is inserted and inflated, breaking up the plaque while compressing it against the arterial wall.

– Atherectomy• Use of a cutting-tipped catheter to remove

plaque


Unclogging Arteries– Stenting

• Implantation of a mesh device within artery to keep it open

• Some designed to inhibit clog reoccurrence– Coronary artery bypass graft surgery

• Blood vessel taken from another part of the body grafted to the aorta and to new blood vessel, bypassing the blocked portion of diseased vessels


Heart Attack– One-third to one-half of people with CAD are

stricken suddenly and unexpectedly with a heart attack (myocardial infarction).

– An infarction is an area of tissue that dies due to insufficient blood flow and lack of oxygen.• Arrhythmias• Heart failure• Cardiac arrest• Death

Cardiovascular DiseaseHeart Attack

– Congestive Heart Failure• Heart cannot pump effectively and veins

bringing blood to the heart become overfilled with blood.

• Causes include CAD, heart defects, and rheumatic heart disease.

• Primary signs and symptoms are shortness of breath, retention of fluid, congestion of lungs, and fatigue.


Heart Attack– Cardiac Arrest

• May occur as a result of heart attack.• Heart suddenly stops beating.• Immediate defibrillation is needed to avoid

death.• About 325,000 persons in the United States

die each year from sudden cardiac death.

Cardiovascular DiseaseHeart Attack

– Signs & Symptoms• Pressure or heaviness in the chest

–Pain is more severe and lasts longer than angina.

• Shortness of breath• Profuse sweating• Weakness• Anxiety

Cardiovascular DiseaseStroke

– A stroke occurs when arteries that supply brain become blocked, preventing blood flow.• Primary cause is atherosclerosis. • Plaque buildup or blood clot blocks an artery.

– May also occur if a blood vessel in the brain bursts (cerebral hemorrhage).• High blood pressure is often involved.• Aneurysm (swollen, weakened blood vessel)

may rupture.


Stroke– Signs and symptoms of stroke include:

• Weakness, numbness, or paralysis on one side of the body

• Loss or dimming of vision• Loss of speech or difficulty speaking or

understanding speech• Sudden severe headache• Sudden dizziness, unsteadiness, or episodes

of falling• Immediate care is needed!


Stroke– Prevention

• Carotid endarterectomy—removal of the inner lining of a partially blocked carotid artery

• Transient ischemic attacks (TIAs) are small strokes that usually cause no permanent damage but warn of bigger stroke.

• Blood-thinning drugs may be prescribed

Risk Factors for Cardiovascular Disease

• Certain CVD risk factors are modifiable.• Major risk factors include:

– Male gender– Increasing age – Family history of cardiovascular disease– Cigarette smoking– Obesity– Chronic high blood pressure


• Certain CVD risk factors are modifiable.• Major risk factors include:

– Abnormal blood lipid levels– Lack of physical activity– Obesity– Diabetes mellitus– Anxiety disorders– Elevated C-Reactive Protein


Family History– Twice as likely to suffer a heart attack if you

have a family history.


Abnormal Blood Lipid Levels– Major lipoproteins are high-density lipoproteins

(HDL) and low-density lipoprotein (LDL).– HDL or “good” cholesterol

–Helps remove cholesterol from the body–High levels of HDL lower risk of CAD

– LDL or “bad” cholesterol–Carries cholesterol to the cells, including

those that line arteries–High levels of LDL raise risk of CAD


Abnormal Blood Lipid Levels– Desirable HDL = 40mg/dl (50 for women– Triglycerides, which are plasma lipids different

from cholesterol, are also important in cardiovascular health.

– Excess triglycerides in the plasma are linked to CAD and stroke in some people.

– Normal fasting Triglyceride = less than 150mg/dl


Cigarette Smoking– Significantly increases the risk of heart attack

and stroke. Two to four times more likely than nonsmokers to develop CAD.

– Tend to have reduced HDL levels and increased LDL.

– Tend to have increased levels of clotting factors.

– Compounds in cigarette smoke damage blood vessels, leading to atherosclerosis.


High Blood Pressure– For people over 18, normal pressure is less

than 120/80 mm Hg.• 120 is systolic pressure (pressure exerted on

artery walls when the heart’s left ventricle contracts)

• 80 is diastolic pressure (pressure exerted on artery walls when left ventricle relaxes).

– Prehypertension occurs when systolic pressure is between 120 and 139 mm Hg, OR diastolic pressure is between 80 and 89 mm.


High Blood Pressure– Stage 1 hypertension: is indicated by a systolic

reading between 140 and 159, or a diastolic reading of 90 to 99.

– Stage 2 hypertension: is indicated by a systolic reading of 160 or more, or a diastolic reading of 100 or more.

– Persistently high arterial blood pressure contributes to the development of atherosclerosis


Physical Inactivity– Sedentary people are about twice as likely to

develop CAD as active people.– At least 150 minutes per week of physical

activity of moderate intensity to lower the risk of heart disease and stroke.

– More than 50% of American adults do not get enough physical activity to provide health benefits, and 25% are not active at all during leisure time.


Obesity– Obesity doubles the risk of CAD. Even being

mildly overweight increases this risk.Diabetes Mellitus

– Elevated blood glucose levels damage heart muscle, small coronary arteries, and major arteries.

– Atherosclerosis occurs more frequently and at an earlier age in diabetics, especially women.


Anxiety and Stress– Stress can result in spasms of the coronary

arteries, which can contribute to angina attacks.– People with anxiety disorders are 2-6 times as

likely to die from a heart attack as people without.

Elevated C-Reactive Protein– An elevated blood level C-reactive protein can

be a positive risk factor for CVD.

Maintaining Cardiovascular Health

Ways to reduce CV risk– stop smoking– Control/Lose weight– Exercise regularly– Lower Blood Pressure– Reduce Blood Cholesterol– Eat less fat, learn to relax, and reduce sodium intake

Across the Life Span

• Approximately 1% babies are born each year with a variety of heart and blood vessel abnormalities.

• Congenital heart defects can be diagnosed before birth with ultrasound of the heart (echocardiogram).

• CVD due to atherosclerosis has been shown to begin in childhood.

• The elderly should be treated with lipid-lowering therapy when needed to help prevent the progression of CVD and other diseases.

Ch12 cardiovascular health

Education

Transcript of Ch12 cardiovascular health