Cardiovascular System Diseases 63,400,000 Americans have one or more forms of heart or blood vessel disease 50% of all deaths are cardiovascular disease Temple College EMS Program

HYPERTENSION Hypertension is the number one killer in USA. Often no symptoms. Called the silent killer Treatment with medications when B/P reaches 140/90. Can lead to Heart disease, Kidney Failure, and stroke Temple College EMS Program

Hypertension Risk Factors Major Uncontrollable Age Sex Race Heredity Temple College EMS Program

Hypertension Risk Factors Major Controllable Smoking High BP High blood cholesterol Diabetes Temple College EMS Program

Hypertension Risk Factors Minor Controllable Obesity Lack of exercise Stress Personality Temple College EMS Program

Coronary Artery Disease Myocardium (heart muscle) requires continuous oxygen and nutrient supply Myocardial blood supply passes through coronary arteries Temple College EMS Program

Coronary Artery Disease Atherosclerosis Narrowing of lumen plaque formation - related to Risk Factors results in decreased myocardial perfusion Poor tissue perfusion causes: tissue damage (ischemia) tissue death (infarction) Temple College EMS Program

Atherosclerotic Plaque Formation Temple College EMS Program

Angina Pectoris During stress the myocardium demands more O2 Coronary arteries would normally dilate to supply more blood and O2 In Angina Pectoris, the coronary arteries are unable to dilate sufficiently to increase perfusion Temple College EMS Program

Symptoms -Angina Pectoris Pain Substernal Squeezing/Crushing/Heaviness May radiate to arms, shoulders, jaw, upper back, upper abdomen back May be associated with shortness of breath, nausea, sweating Temple College EMS Program

Symptoms -Angina Pectoris Pain usually associated with 3E’s Exercise Eating Emotion Temple College EMS Program

Symptoms -Angina Pectoris Pain seldom lasts > 30 minutes Pain relieved by Rest Nitroglycerin Temple College EMS Program

Symptoms -Angina Pectoris Great anxiety/Fear Fixation of the body Pale, ashen, or livid face Dyspnea (SOB) may be associated Temple College EMS Program

Symptoms -Angina Pectoris Nausea Diaphoresis BP usually up during attack Dysrhythmia may be present Temple College EMS Program

Angina Pectoris Following an angina attack there is no residual damage to the myocardium Temple College EMS Program

Acute Myocardial Infarction “Heart Attack” Inadequate perfusion of myocardium Death of myocardium Infarct Damage to myocardium Ischemia Temple College EMS Program

Symptoms - AMI Chest Pain - cardinal sign of myocardial infarction Occurs in 85% of MI’s Substernal “Crushing,” “squeezing,” “tight,” “heavy” Temple College EMS Program

Symptoms - AMI Chest Pain May radiate to arms, shoulders, jaw, upper back, upper abdomen back May vary in intensity Unaffected by: swallowing coughing deep breathing movement Temple College EMS Program

Symptoms - AMI Chest Pain Unrelieved by rest/nitroglycerin Pain lasts longer than angina pain (up to 12 hours) “Silent’ MI 15% of patients with MI, particularly common in elderly and diabetics Temple College EMS Program

Symptoms - AMI Shortness of breath Weakness, dizziness, fainting Nausea, vomiting Pallor and diaphoresis (heavy sweating) Temple College EMS Program

Symptoms - AMI Sense of impending doom Denial 50% of deaths occur in first two hours Average patient waits 3 hours before seeking help Temple College EMS Program

Other Conditions Arrhythmias- Irregular heart beats. Usually impulse to start irregular beat comes from a source other than the SA node Atrial Fibrillation – Source comes from somewhere in the Atria- Usually not ,llife threatening Ventricular Fibrillation- Source comes from Ventricles and can be life threatening Temple College EMS Program

ANEURYSM- Abnormal dilation of a blood vessel, usually an artery, due to a congenital defect, or weakness in vessel wall. Most dangerous are in brain and aorta Temple College EMS Program

Blood Disorders Phlebitis- Inflammation of a vein. Usually caused by a thrombus or emboli. Causes pain, swelling, heat at site. Hemophilia- Genetic disease where blood is missing “factors” that help it to clot. These factors can be given intravenously to prevent deadly bleeding Temple College EMS Program

Leukemia- A malignant cancer of the blood forming cells in the bone marrow. Can be many different varieties. Treated with chemotherapy, radiation and/or bone marrow transplant Temple College EMS Program