Download Coronary Heart Disease

Chapter 15
Cardiovascular
Disease:
Reducing Your Risk
PowerPoint® Lecture Slide Presentation
prepared by
Michael Hall
Copyright © 2008 Pearson Education, Inc.,
publishing as Pearson Benjamin Cummings
Objectives
 Discuss the incidence, prevalence, and outcomes of
cardiovascular disease.
 Describe the anatomy and physiology of the heart and
circulatory system and the importance of healthy heart
function.
 Review major types of heart disease, factors that contribute to
their development, diagnostic and treatment options and the
importance of fundamental lifestyle modifications aimed at
prevention.
 Discuss controllable and uncontrollable risk factors for
cardiovascular disease; your own risk profile, and determine
the risk factors you can and cannot control.
 Discuss methods of diagnosing and treating cardiovascular
disease.
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2001 Total Cardiovascular Disease Rates by State
and Gender, Age Adjusted
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Figure 15.1a
2001 Total Cardiovascular Disease Rates by State
and Gender, Age Adjusted (continued)
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Figure 15.1b
An Epidemiological Overview
 Cardiovascular disease (CVD) is the leading cause of
death in the U.S.
 In 2005 CVD accounted for approximately 38 percent
of all deaths
 CVD has been the number one killer in the U.S. since
1900 except for 1918 (influenza)
 More that 2,500 Americans die from CVD each day
 Among women, 1 in 2.6 deaths from CVD
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Prevalence of Cardiovascular Diseases in
American Men and Women, Ages 20 and Older
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Figure 15.2
Death Rates for Cardiovascular Disease, Including
CHD and Stroke for Selected Countries
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Figure 15.3
ABC News: Cardiovascular Disease
Play
Video
| Cardiovascular Disease
Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings
ABC News: Cardiovascular Disease
Discussion Questions:
 How does inflammation account for nearly 85% of all
heart attacks?
 What test measures inflammation and how expensive
is it?
 Why have physicians been hesitate to order tests to
measure inflammation?
 What dietary changes are recommended to lower
inflammation?
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Understanding The Cardiovascular System
 Cardiovascular system includes: the heart, arteries,
arterioles, capillaries, venules, and veins
 The heart
• Muscular, four chambered pump
• Contracts 100,000 times per day
• Two upper chambers: atria
• Two lower chambers: ventricles
• Tricuspid, pulmonary, mitral, and aortic valves
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Heart Function
 Deoxygenated blood enters the right atrium
 From the right atrium blood moves to the right
ventricle, pumped through the pulmonary artery to the
lungs
 Oxygen blood enters the left atrium
 Blood from the left atrium is forced into the left
ventricle
 The left ventricle pumps blood through the aorta to
various parts of the body
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Anatomy of the Heart
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Figure 15.4
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
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Percentage Breakdown of Deaths from
Cardiovascular Disease in the United States, 2001
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Figure 15.5
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
 Plaque – the buildup of deposits in the arteries
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Coronary Heart Disease
 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
 Collateral circulation - if blockage to the heart is
minor, an alternative blood flow is selected
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Angina Pectoris
 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
 Beta blockers control potential overactivity of the
heart muscle
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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
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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
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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
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Stroke
 Occurs when the blood supply to the brain is
interrupted
 Thrombus – blood clot
 Embolus – free flowing clot
 Aneurysm – bulging or burst blood vessel
 Transient ischemic attack (TIA) – brief interruptions
that cause temporary impairment
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Common Blood Vessel Disorders
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Figure 15.6
Reducing Your Risk For Cardiovascular Diseases
 Risks you can control
• 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
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Reducing Your Risk For Cardiovascular Diseases
 Risks you cannot control
• Heredity
• Age
• Gender
• Race
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Classification of LDL, Total, and HDL Cholesterol
(mg/dl) and Recommended Levels for Adults
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Table 15.1
Women And Cardiovascular Disease
 2003, CVD deaths
• 426,800 men
• 483,800 women
 Estrogen
• Once estrogen production stops, risk for CVD death increases
 Diagnostic and therapeutic differences
• Delay in diagnosing possible heart attack
• Complexity in interpreting chest pain in women
• Less aggressive treatment of female heart attack victims
• Smaller coronary arteries in women
 Gender bias in CVD research – typically CVD research has been
conducted on male subjects
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New Weapons Against Heart Disease
 Techniques for diagnosing heart disease
• Electrocardiogram (ECG)
• Angiography
• Positron emission tomography (PET)
• Single positron emission color tomography
(SPECT)
• Radionuclide imaging
• Magnetic resonance imaging (MRI)
• Ultrafast CT
• Digital cardiac angiography (DSA)
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Angioplasty Versus Bypass Surgery
 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
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Aspirin For Heart Disease?
 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
 Should only be taken under the advice of your
physician
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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
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Cardiac Rehabilitation
 Every year, 1 million people survive heart attacks
 Cardiac rehabilitation exercise training increases
stamina and strength, and promotes recovery
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Personal Advocacy And Heart-Smart Behaviors
 Know your rights as a patient
 Find out about informed consent procedures, living
wills, durable power of attorney, organ donation, and
other legal issues BEFORE you become sick
 Ask about alternative procedures
 Remain with your loved one as a personal advocate
 Monitor the actions of health care providers
 Be considerate of your care provider
 Be patient with the patient
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