Download Cardiovascular Disease

Chapter 12
Cardiovascular Disease
Reducing Your Risks
NON-COMMUNICABLE DISEASES
Degenerative Diseases:
• diseases that
significantly threaten
health/wellness
• chronic illness
• lifestyle / genetic
factors
Cardiovascular Diseases
Found in Heart and Blood Vessels
2000
• responsible for > 50% of
all deaths in Canada
• female deaths = male
deaths
• declined by 52% / males
& 64% females ( 1950 –
1993)
Blood Vessels
• Arteries - large
vessels
• Arterioles - smaller
• Capillaries - O2 /
CO2 exchange,
nutrients other
stuff.
• Venues
• Veins
RELATED TERMINOLOGY
• Calcium Channel Blockers –
reduce muscular contractions
+ reduce heart rate
• Diuretics: drugs that increase
the amount of urine produced
+ excreted
• Beta Blockers – block some
of the nervous impulses to the
heart muscle / prevent over
activity of the heart
RELATED TERMINOLOGY
• Occlusion: blockage of artery
• Vasodilators: (Nitroglycerin)
drugs that cause widening of
blood vessel
• Cyanosis: lack of oxygen,
resulting in blueness of skin
• Necrosis: tissue death
• CPR: Cardio-Pulmonary
Resuscitation
Common Forms of Cardiovascular
Diseases
Angina Pectoris: (Ischemia) – chest
pain
• Blood flow not totally occluded
• Insufficient to meet MVO2 (oxygen
consumption of myocardial muscle)
Arrhythmia: irregular heartbeat
• Tachycardia and Fibrillation
• Bradycardia (abnormally slow heart
rate)
Clogging the Pipes!
Atherosclerosis
• (fatty plaque buildup in
arteries) – hardening of the
arteries
• deposits of fatty
substances / cholesterol
/ cellular waste products
/ calcium / fibrin =
plaque
• can lead to a complete
blockage
Heart Attack!
• Myocardial Infarction
heart attack - occlusion is
complete and muscle has
permanent damage
• Coronary thrombosis –
blood clot
• Collateral circulation –
physiological response to
adapt to the heart attack
Stroke: a heart attack in the brain –
cerebrovascular
Thrombus (blood clot) /
Embolus (wondering blood clot) /
Aneurysm (blood vessel weakness)
• Damage location of brain effected
• Speech, memory, loss of motor control
or death (location of heart and lung
regulation)
• Transient ischemic attacks ( mild
stroke) indicator of a greater problem ?
Heart Disease
• Congestive Heart Failure weak / damaged heart – fluid
build up = poor heart
performance (heart chokes)
• Congenital Heart Disease development of heart disease
before birth (1 in 125 births)
e.g. murmurs – valve
irregularities
Rheumatic Heart Disease:
• childhood illness
(predisposition)
inflammatory disease /
effects
• connective tissues heart,
joints, joints, brain &
skin
• streptococcal infection
– (strep throat) –
reduction in immune
response
RISK FACTORS OF CORONARY
HEART DISEASE
BIOLOGICAL FACTORS:
cannot modify these factors
Family history:
• If grand-parents die of CHD
before 60 - 3-6 times risk of
CHD
• Genetic predisposition for
hypertension, obesity, and
diabetes = increased
incidence of CHD
Sex
• Males: greater risk / stress / lifestyle
• Women before menopause
CHD
risks of
• protective characteristic of estrogen on
CHD
• Women after menopause
CHD
risks of
• 60yrs. women = 50yrs. male // late 70’s
yr. = male
• Hormone Replacement Therapies /
reduce risks 12% to 25% /
• Increase HDL and decrease LDL
Women and Cardiovascular Disease
• HA - Kills 9500 / year
• Stroke - Kills 8500/year
• Breast Cancer - kills
5000/year
• Men have greater incidence
but survive more often
• Women lower incidence but
survival rate is lower
• Research has been MALE
orientated
Symptoms
Men and women show different
symptoms
• men chest pain - first sign is
MI
• women - chest discomfort/not
pain (angina)
• severe abdominal pain /
indigestion
• physicians ignore condition
Neglect of Symptoms
Physicians:
• may be gender-biased - not
looking for heart disease
• view male heart disease as a
more severe problem in men
• women decline major
procedures more often then
men
Age……….
• 80% of heart problems –
65yrs. more years of wear
‘n tear / lifestyle
PHYSIOLOGICAL AND
METABOLIC FACTORS:
• Hypertension (High Blood
Pressure) – 90% essential
no specific cause / 10%
secondary due to specific
factors = kidney disease,
obesity or tumors of the
adrenal glands
Blood Pressure
• Sphygmomanometer:
instrument measuring
blood pressure
• Systolic BP: pressure
when the blood leaves
the heart and enters the
aorta
• Diastolic BP: just before
contraction of left
ventricle (or when the
heart is relaxing);
peripheral resistance
Hyperlipidemia
• increased cholesterol levels +
increased blood clotting
potential – making blood sludgy
in hours!!
Diabetes:
• prolonged effects of insulin /
CAD
• if overweight increased blood
fat levels & atherosclerosis
• tendency towards deterioration
of small blood vessels
• eyes and extremities
Blood Pressures and What they Mean to You!
Classification
Systolic
Diastolic
Action
Normal
Below 130
below 85
Check Every Two Years
High Normal
130 to 139
85 to 89
Check Every Year
Mild Hypertension
140 to 159
90 to 99
Check in Two Months
Moderate
160 to 179
100 to 109
See Physician in a Month
Severe
180 and
110 and above
See Physician Immediately
Hypertension
above
Hypertension
Obesity………...
Obesity:
• Is it the high fat /
sugar / calorie diet or
• heart strain by
pumping blood
through many more
Km’s of extra blood
vessels!
LIFESTYLE FACTORS:
• Smoking
• Alcohol abuse
• Stress
• Physical Inactivity
Diagnostic / Assessment Procedures:
• ECG – Electrocardiogram –
a record of the heart’s
performance during stress
testing
• Angiography: a diagnosis
procedure examines to
blockages a catheter is inserted
/ dye released and X-ray
Positron Emission Tomography
(PET Scan):
Positron Emission Tomography (PET
Scan):
• 3-D view of heart – radioactive tracer
injected
• scanner picks up emissions and provide
image
Radionuclide Imaging:
• injected Radionuclides are injected and
produce info. on chamber functioning/
blood flow to the heart / parts damaged
Magnetic Resonance Imaging:
(MRI or NMR)
• powerful magnets produce
computer-generated images of
the aorta, heart, heart damage,
and congenital defects
Digital Cardiac Angiography:
• computer-aided imaging /
records pictures of heart & blood
vessels
How To Fix the Problem?
Coronary Bypass Surgery:
• procedure that reroutes the blood
supply in a coronary artery after that
artery was completely blocked
Angioplasty: a balloon catheter is
inserted into a blocked artery
• 1% - die
• 3 to 7% - blood vessel collapse
spontaneously (need bypass)
• 30% - clogged after 6 months
Aspirin:
• low dose (325mg) per
day or every other
day beneficial
• gastrointestinal
intolerance a
common problem!
Thrombolysis
If person is diagnosed
quickly then TPA (tissue
plasminogen activator) can
be used to dissolve some of
the clot
return some blood flow / save
some of the heart muscle
tissue / brain tissue
Or be Preventative………...
• Adopt health and lifestyle
practices that will reduce the
odds of developing
CHD / CAD / Stroke / Diabetes
• Nutritional Awareness
• Active Lifestyle
• Exercise
• Stress Management
• Weight Management