1. For MDG Trainers

2. Cardiovascular Disease OBJECTIVES By the end of this session, the CHW should be able to: Recognize signs of heart disease Explain dietary and lifestyle changes for people with heart disease Counsel people on preventing heart disease METHODS CASE STUDY Samuel is a 58-year old male who smokes and is overweight. He has recently begun to experience episodes of crushing chest pain after physical activity. He is also short of breath (difficulty breathing) fairly often. QUESTIONS AND ANSWERS 1) Why is Samuel experiencing these symptoms? He has heart disease. His heart is not getting enough blood. 2) What are some risk factors Samuel has for heart disease? He is older, overweight, and a smoker. Diagnosis Treatment Cardiovascular disease is a term that refers to heart disease. There are different types of heart diseases that require different medicines. Heart disease is more frequent in older people, especially those who are fat, who smoke, or who have high blood pressure. Symptoms include chest pain, difficulty breathing, irregular heartbeat, and swelling of the feet. Signs of heart disease can differ between men and women. People with heart trouble should seek medical help, so that they can Of the17.5 million who died from cardiovascular disease in 2005, 80% of these deaths occurred in low- and middle-income countries.

3. get the right medicines for their heart disease. In addition to medicines, there are diet and lifestyle changes that people with heart trouble need to make: Regular exercise – though not so much that they get chest pain or have trouble breathing Little or no salt in the diet No greasy food No smoking or drinking alcohol Weight loss (if overweight) One aspirin tablet a day If the person begins to have chest pain, s/he should rest very quietly in a cool place until the pain goes away. If the chest pain is very strong and does not go away with rest, the person should be referred for medical help. Many of the ways to prevent heart disease are similar to the diet and lifestyle changes, including: Eating nutritious foods, but not too much rich, greasy, or salty foods. Avoiding too much alcohol No smoking Physical and mental activity Enough rest and sleep Dealing with stress positively These tips can help to reduce high blood pressure and hardening of the arteries, both of which lead to heart disease. People with high blood pressure should have it regularly checked. If the suggestions above are not effective in lowering blood pressure, there are medications (called antihypertensives) that may help. Prevention

4. COURSE ASSESSMENTS Ramona is a 61-year old woman with high blood pressure who recently started to develop swollen feet. She has gained a lot of weight over the past ten years, due to bad eating habits. She is also having much more difficulty breathing during moderate physical activity. At night, she sometimes wakes up wheezing. She then props herself up with extra pillows before going back to sleep. 1)What is Ramonas condition? She has heart disease. More specifically, she is experiencing congestive heart failure. 2)What are some risk factors that Ramona has for heart disease? She is older, has high blood pressure, and is overweight. 3)How would you counsel Ramona? Encourage her to get medical attention for her high blood pressure and heart disease. She should start eating nutritious foods and eliminate salty and fatty foods from her diet. She should avoid smoking or drinking alcohol.

5. For CHWs

6. Of the17.5 million who died from cardiovascular disease in 2005, 80% of these deaths occurred in low- and middle-income countries. Cardiovascular Disease It might be useful to have a graphic of a person here. The signs of heart problems can point to the corresponding body part. A rapid, weak, or irregular heartbeat Difficulty breathing after exercise; attacks of wheezing at night or while lying down. Swelling of the feet (worse in the afternoons) Shortness of breath at rest, unexplained tiredness and weakness Sudden, painful attacks in the chest, left shoulder or arm during exercise Sharp, crushing chest pain that does not go away with rest In women: nausea, jaw pain, sensation of being damp or cool (clamminess) Signs of Heart Problems: Treatment: Refer to doctor or hospital, especially for strong chest pain.

7. For Households

8. Cardiovascular Disease Eat nutritious foods. Avoid greasy or salty foods. Avoid drinking alcohol and smoking. Keep physically and mentally active Image (same as CHW trainer images if this is used) Of the17.5 million who died from cardiovascular disease in 2005, 80% of these deaths occurred in low- and middle-income countries. There are some important steps you can take to prevent or treat heart disease. Image (same as CHW trainer images if this is used)