Download Cardiovascular Disease

Cardiovascular Disease and Cancer
Chapter 12
The Cardiovascular System

Pulmonary circulation


Systemic circulation


Blood to and from the lungs.
Left side of the heart pumps blood
through the rest of the body.
Total blood volume for a 150 pound
person is about 5 quarts, which
circulates once every minute
Chapter 12
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Cardiovascular System

Systole

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The hearts contraction
Diastole.

Chapter 12
The period of relaxation
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Chapter 12
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Cardiovascular System
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Heart, blood vessels, hormones, enzymes
and wastes.
Four chambers (size of a fist).
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Chapter 12
Upper chambers (Atriums).
 Right atrium contains the sinus node
Lower chambers (Ventricles).
Vena cava.
Pulmonary Artery and vein.
Aorta.
Coronary Arteries and veins.
Veins
Capillaries
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Chapter 12
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Chapter 12
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Risk Factors For
Cardiovascular Disease
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Major Risk factors
Contributing Risk Factors
Four Major Risk Factors that can be changed.
 Tobacco use.
 High blood pressure.
 High levels of cholesterol.
 Physical inactivity.
 Obesity.
 Diabetes.
Chapter 12
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Tobacco Use
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1 in 5 deaths from CVD is a smoker
Smokers have 2-4 times higher risk of
death from a heart attack, than nonsmokers
Reduces HDL’s
CO displaces O2
Causes platelets to become sticky and
increases blood thickness
Chapter 12
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High Blood Pressure
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Contributing factors
Hypertension
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Too much pressure against arterial walls
Atherosclerosis

Chapter 12
Heart has to work harder, weakens, enlarges,
arteries narrow, scar and harden
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High Blood Pressure
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Tachycardias.
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100 or more beats per minute.
Compromises the ability of the heart to
pump effectively.

Chapter 12
Ventricles cannot completely fill.
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Low Blood Pressure
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Bradychardia
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Chapter 12
60 or less beats per minute
Poor circulation of the blood
Lack of 02 throughout to body and brain
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Cholesterol
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LDL’s and HDL’s or good versus bad
Clogs the arteries
Increased risk of CVD
Recommended blood cholesterol levels:
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LDL’s - less than 120 mg/dl
HDL’s - greater than 60 mg/dl
Total cholesterol should be below 200 mg/dl
Levels over 240 mg/dl indicates high risk of CVD
Triglycerides – less than 150 mg/dl
Benefits of controlling cholesterol
Chapter 12
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Chapter 12
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Physical Inactivity
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Exercise reduces risk by:
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Controlling Blood pressure
Lowering LDL’s
Increasing HDL’s
Maintaining weight
Helps prevent or control Diabetes
Chapter 12
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Obesity
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More than 30% above recommended weight.
BMI equal to or greater than 30
Increase strain on the heart.
Strongly associated with
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Hypertension
High cholesterol
Insulin resistance
Diabetes physical inactivity
Increasing age
Endothelial cell dysfunction
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Chapter 12
Coronary arteries constrict instead of dilating
Inflammatory markers
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Diabetes
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Doubles the risk of CVD for men.
Triples the risk of CVD for women.
Loss of 5-10 years off your life
Higher risk
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Chapter 12
Hypertension
Obesity
Unhealthy blood lipid levels
Elevated blood glucose and insulin can damage
the endothelial cells lining the arteries
More vulnerable to atherosclerosis
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Contributing Risk Factors That
Can Be Changed
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High Triglyceride Levels
Psychological and Social factors
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Chapter 12
Chronic hostility and anger
Suppressing psychological distress
Depression
Anxiety
Social isolation
Low socioeconomic status
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Major Risk Factors That
Can’t Be Changed
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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
Chapter 12
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Major Forms of Cardiovascular
Disease
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Atherosclerosis - narrowed by fatty deposits.
Starts during childhood fat.
Heart Attack - Coronary thrombosis,
coronary occlusion or myocardial infarction.
Vessels in the heart become blocked.
Angina – narrowed by disease, but under
stress heart can not receive enough oxygen.
Arrhythmias and sudden cardiac death –
Electrical conduction system is disrupted
Chapter 12
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Chapter 12
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Helping a Heart Attack Victim
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Most die within 2 hours from initial
symptoms
Cardiopulmonary resuscitation (CPR)
Refer to Box “What to Do in Case of a
Heart Attack, Cardiac Arrest, or
Stroke”.
http://www.cnn.com/video/#/video/health/2009/10/13/cheat.death.cpr.demo.cnn
http://www.cnn.com/2009/HEALTH/10/14/cheating.death.harden.cpr/index.html
Chapter 12
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Detecting and Treating Heart
Disease
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Electrocardiogram (ECG or EKG)
Electron-beam computed tomography
(EBCT)
Echocardiograph – sound waves
Magnetic Resonance Imaging (MRI)
Angiogram
Balloon Angioplasty
Coronary Bypass Surgery
Chapter 12
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Stroke or Cerebrovascular
Accident (CVA)
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Ischemic stroke – blockage in blood vessels
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Thrombotic stroke clot forms in a cerebral artery;
hypertension
Embolic Stroke - wandering blood clot
Hemorrhagic stroke- blood vessel ruptures in
the brain
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Chapter 12
Subarachnoid hemorrhage
Intracerebral hemorrhage
Aneurysm
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Chapter 12
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The Effects of a Stroke
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700,000 Americans per year
One-third die within a year
Those who survive have some lasting
disability.
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Chapter 12
Paralysis
Walking disability
Speech impairment
Memory loss
Changes in behavior
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Detecting and Treating Stroke
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Prompt recognition of symptoms
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Chapter 12
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
Refer to “Stroke Warning Signs”
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Detecting and Treating Stroke
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Transient ischemic attack (TIA)
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Temporary stroke like symptoms.
Computed tomography (CT)
Carotid endarterectomy surgery – plaque is
removed from the artery
Rehabilitation
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Chapter 12
Physical therapy
Speech and Language therapy
Occupational therapy
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Congested Heart Failure
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Number of conditions
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Pulmonary edema - Fluid accumulates in the
lungs.
 Heart cannot maintain regular pumping rate;
fluid backs up.
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Controlled by:
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Chapter 12
Reducing cardiac load
Eliminating excess fluid
Restriction of salt
Drug therapy
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Other Forms of Heart Disease
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Congenital heart disease
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Hypertrophic Cardiomyopathy (HCM)
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Most common cause of sudden death in athletes
Rheumatic Heart Disease
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Malformation of the heart or major blood vessel
Streptococcal infections causes damage to the
heart muscle and valves.
Strep throat needs to be treated, primary cause if
not treated.
Heart Valve Disorders

Chapter 12
Mitral valve prolapse
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Protecting Yourself Against
CVD
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Eat heart-healthy
Decreased Fat and Cholesterol
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Total Fats less than 30% of total calories
Low Saturated Fats
Increased Dietary Fiber
Decreased sodium intake and increased
potassium intake
Moderation of Alcohol
Chapter 12
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Other Dietary Factors
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Omega-3 fatty acids
Plant stanols and sterols
Folic acid
Vitamins B-6 and B-12
Calcium
Soy protein
Healthy carbohydrates
DASH

Chapter 12
Dietary Approaches to Stop Hypertension
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Chapter 12
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Protecting Yourself
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Exercise Regularly
Avoid Tobacco
Know and manage your blood pressure
(monitored once every two years)
Know and manage your Cholesterol
levels
Effective means of controlling stress and
anger
Chapter 12
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What is Cancer?
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Definition: an abnormal and uncontrollable growth
of cells or tissue that can lead to death.
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Tumor: a mass of tissue that serves no purpose.
Benign versus malignant tumors
 Benign tumor: mass of cells enclosed in a membrane
that prevents their penetration of other tissues.
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Malignant tumor: (Neoplasm) cancerous, can invade
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surrounding tissues.
Every case of cancer begins as a change in a cell that
allows it to grow and divide when it should not.
Chapter 12
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How Cancer Spreads
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Metastasis: Primary tumor
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Definition: the spreading of cancer cells,
occurs because cancer cells do not stick
to each other as strongly as normal cells.
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Chapter 12
Cells break away from primary tumor and
invade surrounding tissues or travel through
the blood and lymphatic system.
Secondary tumor or metastases
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Tumor Development
Types of Cancer
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Classified according to the types of cells.
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Initially retain some of the original properties of the
host cell.
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Carcinomas - most common - arises from the
epithelial tissue that cover body surfaces. Linings,
tubes, cavities and secretion glands.
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Sarcomas: arise in connective and fibrous tissues.
Bone, muscle, cartilage and membranes covering
muscle or fat.
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Lymphomas: Cancers of the lymph nodes (neck,
armpit, and groin).
Leukemia: cancer of the blood-forming cells in bone
marrow.
Chapter 12
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The Incidence of Cancer
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1.4 million Americans are diagnosed yearly
More than half will be cured.
About 40% will die as a result of cancer.
1 in 2 men and 1 in 3 women will be develop
cancer during their lifetime.
American Cancer Society estimates
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Chapter 12
90% of skin cancer could have been prevented
87% of lung cancer could have been prevented
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Cancer cases and deaths by
site and sex
Chapter 12
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Lung Cancer
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Most common cause of cancer death in the
U.S.
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162,000 deaths per year
Risk Factors
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Tobacco smoking contributes to 87%.
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Detection and Treatment (Difficult to detect)
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Chapter 12
Combined with environmental carcinogens multiply by a
factor of 10.
Symptoms are not detected until cancer has reached
the invasive stage.
Persistent cough, chest pain, or recurring bronchitis.
Diagnosis - chest x-ray or sputum examination - fiberoptic bronchosectomy.
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Lung Cancer
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Treatment:
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Difficult to treat.
Caught early treated by surgery
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Chapter 12
Only 16% are detected prior to spreading
Radiation and chemotherapy are used in addition
Detected early 50%of patients are alive for
approximately 5 more years.
Overall the survival rate is only 15%
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Colon and Rectal
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Second leading cancer causing death.
 Risk Factors
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Directly linked to diet and genetic predisposition.
90% occurs after 50 yr. of age.
Heredity
Lifestyle
Up to 1/3 of the population is genetically prone.
Detection and Treatment

Diet low in fat and High in fiber

Screening
Sigmoidoscopy or colonoscopy
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Chapter 12
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Breast Cancer
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Second most common cancer in women
Causes almost as many deaths in women as lung
cancer
1:7 American women will develop it during her lifetime
(213,000).
1:30 Will die from the disease (41,000 deaths).

Risk Factors
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Most common in women over 50
5 year survival rate is 79%
“Disease of Civilization”
Common causes: Genetic predisposition, High fat, High
calorie diet and Sedentary lifestyle, Alcohol use, early onset
of menstruation, First child after 30 and obesity
Estrogen-cancer in estrogen-responsive sites
http://www.videojug.com/interview/breast-cancer-basics
Chapter 12
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Breast Cancer

Detection and Treatment

Early detection.
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Monthly breast self-exam for all women over 20.
Clinical breast exam by a physician every 3 yr.
Mammography- Every 1-2 years 40-50 yr. old.
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Treatment
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Ultrasonography
Biopsied
Survival rate
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Chapter 12
Over 50 every year.
98% if the cells did not metastasized
88% for all stages at 5 years
80% at 10 years
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Mammography
Mammography
http://www.youtube.com/watch?v=WUoqsBxgXWI
Prostate Cancer
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Most common cancer in men.
235,000 new cases per year
More than 27,000 deaths per year
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Risk Factors
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Age
Diet
Lifestyle
Genetic predisposition
Early detection is key. PSA Blood test
Treatment - surgical removal of the prostate and radiation
Survival

All stages near 100% after 5 years
http://www.cbsnews.com/video/watch/?id=5103355n
Chapter 12
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Prostate Anatomy
http://www.youtube.com/watch?v=7EPmP2DAKBk
Cancers of the Female
Reproductive Tract

Cervical cancer - sexually transmitted.

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Cervical cancer most common in women in their 20’s and 30’s.

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Most cases stem from infection by the papillomavirus - transmitted
by unprotected sex.
Smoking
Infection by genital herpes
Factors: sexual intercourse before 18, multiple sex partners,
cigarette smoking and low socioeconomic status.
Screening:

PAP Test
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Treatment

Chapter 12
Cervical dysplasia
All sexually active women ages 18-65 should be tested
Surgery
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Cancers of the Female
Reproductive Tract
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Uterine, or Endometrial:
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Occurs after 55
Risk factors similar to breast cancer
Determined by Pelvic Exam
Treatment is surgery
Ovarian Cancer:
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Difficult to detect and diagnosis, No warning signs
Family history or genetic factors
Determined
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Pelvic Exam
Blood test – tumor marker called CA-125
Treatment is surgery & radiation
DES (diethylstilbestrol):
A synthetic non-steroidal substance having estrogenic properties and used in
the treatment of prostatic cancer.

Helps prevent miscarriage

DES daughters have an increased risk of vaginal or cervical cancer.
Chapter 12
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Skin Cancer
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Most common form
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1 million cases per year
62,000 are melanoma
Easily detected and highly curable
Exposure to ultraviolet rays during childhood
Common cause - sunburns and suntans
Types:
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Basal and Squamous
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Melanoma - more dangerous form
Prevention

http://www.youtube.com/watch?v=DsznOhIs-6E
Avoid long term overexposure to sunlight

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http://abcnews.go.com/Health/story?id=5661274
Blistering and peeling sunburns
Detection and Treatment

Chapter 12
ABCD screen test
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ABCD Test for Melanoma
Moles vs. Melanoma
Melanoma
Normal Moles
Causes of Cancer

The Role of DNA
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Each cells has 23 pairs of chromosomes
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Each controls the way a cell will work
A gene
DNA Mutations and Cancer
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Chapter 12
Changes the way the cells function
Mutagens – radiation, certain viruses and chemical
substances
Oncogenes – a gene involved in the transformation of a
normal cell into cancer
Tumor suppressor genes – type of oncogene that restrains
cellular growth
©2008 McGraw-Hill Companies. All Rights Reserved.
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Dietary Factors
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Dietary Fat and Meat
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High in fat and meat has a direct impact of rates
of cancers.
Alcohol
Fried Foods
Dietary Fiber
Fruits and Vegetables
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Chapter 12
Anticarcinogens
Carotenoids
Antioxidants versus Free radicals
Phytochemicals
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Carcinogens in the Environment
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Ingested Chemicals
Environmental and Industrial pollution
Radiation - UV rays or man made
Chapter 12
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Detecting, Diagnosing, and
Treating Cancer
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A sore that does not heal
Biopsy
Magnetic resonance imaging (MRI)
Computed tomography (CT)
Ultrasonography
Treatment:

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Self-monitoring
CAUTION acronym
Diagnosing:

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Change in bowel/bladder
habits
Detecting:
Surgery
Chemotherapy
Radiation Therapy

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Gene therapy
Bone marrow and Stem Cell
transplants
Biological therapies
Proteasome inhibitors
Enzyme activators/blockers
Chapter 12
Thickening of tissues
(schlerotic change)
Indigestion or difficulty
swallowing
New and Experimental:

Unusual bleeding or
discharge
Obvious change in a
wart/mole
Nagging cough
http://video.healthination.com/answers/cancer-treatments.html
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58
Prevention

Lifestyle choices
 Avoid tobacco
 Controlling diet and weight
 Regular exercise
 Protecting skin from the sun
 Avoiding environmental and occupational
carcinogens
Recommended screening tests
 Be aware of the early signs and symptoms
Chapter 12
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59
Connect Assignments, Exam II, and Reminder

Chapter 12 Connect Assignments Due Tuesday, March
23rd Note: There are two assignments for Chapter 12.

Exam II available on Wednesday, March 24th, 8:00A –
11:00P, on Connect. The exam is open book and timed for
three hours.

Study guide for Exam II available on the instructor’s
website.

Reminder: No class meeting next Wednesday, March 24th
© 2010 McGraw-Hill Higher Education. All rights reserved.