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Cardiovascular Health Chapter 15. Cardiovascular Disease (CVD)Cardiovascular Disease (CVD) –Leading cause of death in the U.S. –Affects nearly 81 million.

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Presentation on theme: "Cardiovascular Health Chapter 15. Cardiovascular Disease (CVD)Cardiovascular Disease (CVD) –Leading cause of death in the U.S. –Affects nearly 81 million."— Presentation transcript:

1 Cardiovascular Health Chapter 15

2 Cardiovascular Disease (CVD)Cardiovascular Disease (CVD) –Leading cause of death in the U.S. –Affects nearly 81 million Americans –Claims one life every 37 seconds –About 2400 Americans every day –CVD is due to our way of life 2

3 CARDIOVASCULAR TERMS ATHEROSCLEROSIS THROMBUS EMBOLUS MYOCARDIAL INFARCTION ANGINA PECTORIS ANEURYSM COLLATERAL CIRCULATION

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6 Pulmonary circulationPulmonary circulation –Blood to and from the lungs. Systemic circulationSystemic circulation –Left side of the heart pumps blood through the rest of the body. Path of blood flow:Path of blood flow: 1.Venae Cavae 2.Right Atrium Sinoatrial node (pacemaker)Sinoatrial node (pacemaker) 3.Right Ventricle 4.Pulmonary Artery To the lungsTo the lungs 5.Pulmonary Vein 6.Left Atrium 7.Left Ventricle 8.Aorta 6

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9 Characteristics of the Heart 4 chambered pump (atria, ventricles)4 chambered pump (atria, ventricles) Size of a fistSize of a fist Weighs about 1 poundWeighs about 1 pound Function - creates pressure to circulate blood throughout the bodyFunction - creates pressure to circulate blood throughout the body Blood enters via the Vena Cava into the right atrium (see Figure 15-2 on blood circulation)Blood enters via the Vena Cava into the right atrium (see Figure 15-2 on blood circulation)

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11 Cardiovascular System Systole and Diastole. Systole and Diastole. – action of the heart is controlled by an electrical signal which originates in the right atrium. Veins carry blood back to the heart.Veins carry blood back to the heart. Arteries carry blood away from the heart.Arteries carry blood away from the heart. CapillariesCapillaries

12 Heart, blood vessels, hormones, enzymes and wastes.Heart, blood vessels, hormones, enzymes and wastes. The Blood VesselsThe Blood Vessels –Veins Carry blood to the heartCarry blood to the heart Thin wallsThin walls –Arteries Carry blood away from the heartCarry blood away from the heart Thick elastic walls which expand and relax with the volume of bloodThick elastic walls which expand and relax with the volume of blood Coronary arteryCoronary artery –Two large vessels that supply blood to the heart –Capillaries One cell thickOne cell thick –Venules Blood empties from the capillaries into the venules which connect to veins that return the blood back to the heartBlood empties from the capillaries into the venules which connect to veins that return the blood back to the heart –150-pound person has about 5 quarts of blood, which circulates about once each minute. 12

13 Two categories of increased CVDTwo categories of increased CVD 1.Major Risk factors 2.Contributing Risk Factors Controllable aspects of lifestyle that can be changed.Controllable aspects of lifestyle that can be changed. Major risk factors that can be changedMajor risk factors that can be changed –American Heart Association identified Six major risk factors. 1.Tobacco use. 2.High blood pressure. 3.High levels of cholesterol. 4.Physical inactivity. 5.Obesity. 6.Diabetes. 13

14 1 in 5 deaths from CVD is a smoker1 in 5 deaths from CVD is a smoker Smokers have 2 to 3 times higher risk of death from a heart attack, than non-smokersSmokers have 2 to 3 times higher risk of death from a heart attack, than non-smokers Damages the lining of arteriesDamages the lining of arteries Reduces HDL’sReduces HDL’s Raises triglycerides and LDL’sRaises triglycerides and LDL’s Nicotine increases blood pressureNicotine increases blood pressure CO displaces O 2CO displaces O 2 Causes platelets to become sticky and increases blood thicknessCauses platelets to become sticky and increases blood thickness Speeds the development of fatty deposits in the arteriesSpeeds the development of fatty deposits in the arteries 14

15 HypertensionHypertension –Too much pressure against arterial walls Short periods of high blood pressure is normal but chronic high blood pressure is a health riskShort periods of high blood pressure is normal but chronic high blood pressure is a health risk AtherosclerosisAtherosclerosis –Heart has to work harder, weakens, enlarges, arteries narrow, scar and harden About 33% (73 million) of adults have hypertensionAbout 33% (73 million) of adults have hypertension 37% of adults have prehypertension37% of adults have prehypertension Test your blood pressure at least once every two yearsTest your blood pressure at least once every two years 15

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17 Tachycardias.Tachycardias. – 100 or more beats per minute. – Compromises the ability of the heart to pump effectively. Ventricles can not completely fill.Ventricles can not completely fill. 17

18 BradychardiaBradychardia –60 or less beats per minute –Poor circulation of the blood –Lack of 0 2 throughout to body and brain 18

19 Is a fatty, wax like substance that circulates through the bloodstreamIs a fatty, wax like substance that circulates through the bloodstream –Important component of: Cell membranesCell membranes Sex hormonesSex hormones Vitamin DVitamin D Fluid that coats the lungsFluid that coats the lungs Protective sheaths around nervesProtective sheaths around nerves Excessive cholesterol clogs the arteriesExcessive cholesterol clogs the arteries –Increased risk of CVD Good versus Bad CholesterolGood versus Bad Cholesterol –Low –density lipoproteins (LDL)-BAD Shuttle cholesterol from the liver to the organs and tissuesShuttle cholesterol from the liver to the organs and tissues –High-density lipoproteins (HDL)-GOOD Shuttle unused cholesterol back to the liver for recyclingShuttle unused cholesterol back to the liver for recycling By removing cholesterol from blood vessels, HDL helps protect against atherosclerosisBy removing cholesterol from blood vessels, HDL helps protect against atherosclerosis Benefits of controlling cholesterolBenefits of controlling cholesterol 19

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22 CHOLESTEROL FACTS HIGH – 240 AND ABOVE BORDERLINE HIGH – DESIRABLE – BELOW 200 TOTAL CHOLESTEROL TO HDL RATIO: 4.5 OR LOWER – GOOD FOR MEN 4.0 OR LOWER – GOOD FOR WOMEN

23 WAYS TO LOWER LDL: 1.LOSING BODY FAT 2.MAINTAINING A LOW FAT AND HIGH FIBER DIET 3.TAKING MEDICATION IF NECESSARY WAYS TO INCREASE HDL: 1.MAINTAIN REGULAR AEROBIC EXERCISE 2.WEIGHT LOSS 3.QUITTING SMOKING

24  million Americans are so sedentary that they are at high risk for developing CVD Exercise reduces risk by:Exercise reduces risk by: –Closest thing we have to a magic bullet against heart disease –Controlling Blood pressure and resting heart rate – Lowering LDL’s – Increasing HDL’s – Maintaining weight –Improve the condition of blood vessels – Helps prevent or control Diabetes 24

25 Risk of death from CVD is two to three times more likely in obese people (BMI > 30)Risk of death from CVD is two to three times more likely in obese people (BMI > 30) Increase strain on the heart.Increase strain on the heart. Strongly associated with:Strongly associated with: –Hypertension –High cholesterol –Insulin resistance –Diabetes physical inactivity –Increasing age –Endothelial cell dysfunction Coronary arteries constrict instead of dilatingCoronary arteries constrict instead of dilating –Inflammatory markers 25

26 Doubles the risk of CVD for men.Doubles the risk of CVD for men. Triples the risk of CVD for women.Triples the risk of CVD for women. Loss of 5-10 years off your lifeLoss of 5-10 years off your life Higher risk:Higher risk: –Hypertension –Obesity –Unhealthy blood lipid levels –Elevated blood glucose and insulin can damage the endothelial cells lining the arteries –More vulnerable to atherosclerosis 26

27 High Triglyceride LevelsHigh Triglyceride Levels –Reliable predictor of heart disease Psychological and Social factorsPsychological and Social factors –Stress –Chronic hostility and anger –Suppressing psychological distress –Depression –Anxiety –Social isolation –Low socioeconomic status Alcohol and DrugsAlcohol and Drugs 27

28 HeredityHeredity –CVD has genetic component; high cholesterol levels, blood clotting and obesity AgingAging –Over the age of 65 Being maleBeing male – Men have higher risk earlier in life EthnicityEthnicity –African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians Lower rates of CVD 28

29 Inflammation and C-reactive protein (CRP)Inflammation and C-reactive protein (CRP) Insulin resistance and metabolic syndromeInsulin resistance and metabolic syndrome HomocysteineHomocysteine –Amino acid circulating in the blood Infectious agentsInfectious agents –Chlamydia pneumoniae – flu-like respiratory infections Lipoprotein(a) – Lp(a)Lipoprotein(a) – Lp(a) –Strong genetic component LDL Particle sizeLDL Particle size –Particles differ in shape and size Blood Viscosity and IronBlood Viscosity and Iron Uric AcidUric Acid Time of day and time of yearTime of day and time of year –More heart attacks and sudden death occur between 6:00AM and noon –50% more occur in winter months than in summer months 29

30 Atherosclerosis - narrowed by fatty deposits.Atherosclerosis - narrowed by fatty deposits. –Starts during childhood fat. –Coronary heart disease (CHD) –Coronary artery disease (CAD) –Peripheral arterial disease (PAD) Heart Attack – heart tissue is damaged and part of it may die from lack of bloodHeart Attack – heart tissue is damaged and part of it may die from lack of blood –Myocardial infarction (MI) –American Heart Association 600,000 people have a first heart attack each year600,000 people have a first heart attack each year 320,000 people have recurrent attack320,000 people have recurrent attack 190,000 people suffer a symptomless or “silent” heart attack each year190,000 people suffer a symptomless or “silent” heart attack each year 30

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32 Chest pain or pressureChest pain or pressure Arm, neck, or jaw painArm, neck, or jaw pain Difficulty breathingDifficulty breathing Excessive sweatingExcessive sweating Nausea and vomitingNausea and vomiting Loss of consciousnessLoss of consciousness 32

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34 Angina – narrowed by disease, but under stress heart can not receive enough oxygen.Angina – narrowed by disease, but under stress heart can not receive enough oxygen. –Angina pectoris –Usually felt as an extreme tightness in the chest and heavy pressure behind the breastbone or in the shoulder, neck, arm, hand, or back. Arrhythmias and sudden cardiac death – Electrical conduction system is disruptedArrhythmias and sudden cardiac death – Electrical conduction system is disrupted 34

35 Most die within 2 hours from initial symptomsMost die within 2 hours from initial symptoms Cardiopulmonary resuscitation (CPR)Cardiopulmonary resuscitation (CPR) Refer to Box “What to Do in Case of a Heart Attack, Cardiac Arrest, or Stroke”.Refer to Box “What to Do in Case of a Heart Attack, Cardiac Arrest, or Stroke”. 35

36 Electrocardiogram (ECG or EKG)Electrocardiogram (ECG or EKG) Electron-beam computed tomography (EBCT)Electron-beam computed tomography (EBCT) Echocardiograph – sound wavesEchocardiograph – sound waves Magnetic Resonance Imaging (MRI)Magnetic Resonance Imaging (MRI) Nuclear myocardial perfusion imagingNuclear myocardial perfusion imaging Positron Emission Tomography (PET)Positron Emission Tomography (PET) AngiogramAngiogram Balloon AngioplastyBalloon Angioplasty Coronary Bypass SurgeryCoronary Bypass Surgery 36

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38 780,000 Americans suffer strokes each year780,000 Americans suffer strokes each year 2 million brain cells die per minute during a stroke.2 million brain cells die per minute during a stroke. Ischemic stroke – blockage in blood vesselsIschemic stroke – blockage in blood vessels –Thrombotic stroke clot forms in a cerebral artery; hypertension –Embolic Stroke - wandering blood clot Hemorrhagic stroke- blood vessel ruptures in the brainHemorrhagic stroke- blood vessel ruptures in the brain –Intracerebral hemorrhage –Subarachnoid hemorrhage –Aneurysm 38

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40 Interruption of the blood supply or any area of the brain prevents the nerve cells from functioning in some cases causing death.Interruption of the blood supply or any area of the brain prevents the nerve cells from functioning in some cases causing death. Those who survive have some lasting disability.Those who survive have some lasting disability. –Paralysis –Walking disability –Speech impairment –Memory loss –Changes in behavior 40

41 Prompt recognition of symptomsPrompt recognition of symptoms –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 “Three Simple Ways to Recognize a Stroke” 41

42 PAD – atherosclerosis in the leg (or arm) arteries, which can limit or block the blood flow.PAD – atherosclerosis in the leg (or arm) arteries, which can limit or block the blood flow. Patient’s typically also have coronary artery disease.Patient’s typically also have coronary artery disease million people in the U.S. have PAD8-12 million people in the U.S. have PAD Risk factors:Risk factors: –Smoking –Diabetes –Hypertension –High cholesterol SymptomsSymptoms –Claudication and rest pain 42

43 Number of conditionsNumber of conditions –High blood pressure –Heart attack –Atherosclerosis –Alcoholism –Viral infections –Rheumatic fever –Birth defects Pulmonary edema - Fluid accumulates in the lungs.Pulmonary edema - Fluid accumulates in the lungs. –Heart can not maintain regular pumping rate; fluid backs up. Controlled by:Controlled by: –Reducing cardiac load –Eliminating excess fluid –Restriction of salt –Drug therapy 43

44 Congenital heart defectsCongenital heart defects –Malformation of the heart or major blood vessel Hypertrophic Cardiomyopathy (HCM)Hypertrophic Cardiomyopathy (HCM) –1:500 people –Most common cause of sudden death in athletes younger than 35 –Mummur Rheumatic Heart DiseaseRheumatic Heart Disease –Streptococcal infections causes damage to the heart muscle and valves. –Strep throat needs to be treated, primary cause if not treated. Heart Valve DisordersHeart Valve Disorders –Congenital heart defects and certain types of infections –Mitral valve prolapse 44

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