1. Continuing Medical Education Programs Dr. Anika Niambi Al-Shura, Lecturer Copyright 2014 Niambi Wellness. All rights reserved

2. Integrative Cardiovascular Clinical Therapies Copyright 2014 Niambi Wellness. All rights reserved

3. This course is approved by the following agencies: National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for 9.5 PDA points and Florida State Board of Acupuncture for 10 CEUs. The companion textbook: Advanced Clinical Therapies in Cardiovascular Chinese Medicine must be ordered at www.elsevier.com Copyright 2014 Niambi Wellness. All rights reserved

5. This informational course describes diseases according to the section of the cardiovascular system it affects. The treatments involve the use of Chinese medicine and Western medicine. Copyright 2014 Niambi Wellness. All rights reserved Course Description

6. Course Objectives -Describe the basic etiology of lipoprotein disorders, including genetic disorders -Describe the clinical presentations of lipoprotein disorders as a sign of cardiovascular diseases -Describe Western medicine and Traditional Chinese medicine prescriptions for lipoprotein disorders. -Describe the suggested medicated diet for patients on a treatment course. Copyright 2014 Niambi Wellness. All rights reserved

8. Course Modules Copyright 2014 Niambi Wellness. All rights reserved

9. Module 1: Overview of Diseases Module 2: Cardiac Rhythm Diseases Module 3: Chamber and Valve Diseases Module 4: Vascular System Diseases Copyright 2014 Niambi Wellness. All rights reserved

11. Module 4 Vascular System Diseases Copyright 2014 Niambi Wellness. All rights reserved

12. Chapter 9: Key Points of Vascular Disorders Chapter 10: Key Points of Vascular Disorders in TCM Contents Copyright 2014 Niambi Wellness. All rights reserved

14. Chapter 9: Key Points of Vascular System Disorders Copyright 2014 Niambi Wellness. All rights reserved

15. Part 1: Hypertension Part 2: Angina Pectoris Part 3: Hyperlipidemia Contents Copyright 2014 Niambi Wellness. All rights reserved

16. Part 4: Thromboangiitis Obliterans Part 5: Takayasu Arteritis Part 6: Answers to Textbook Questions Contents Copyright 2014 Niambi Wellness. All rights reserved

18. Part 1: Hypertension Copyright 2014 Niambi Wellness. All rights reserved

19. Prolonged stress, anxiety and environmental factors can increase the blood pressure. Copyright 2014 Niambi Wellness. All rights reserved

20. Vascular narrowing due to physiological changes can contribute to increase in blood pressure. Copyright 2014 Niambi Wellness. All rights reserved

21. Treatment of hypertension requires a close relationship between physician and patient, with high patient interest and compliance. Copyright 2014 Niambi Wellness. All rights reserved

23. Part 2: Angina Pectoris Copyright 2014 Niambi Wellness. All rights reserved

24. Angina pectoris is a condition often connected to arrhythmias. Often invasive procedures can identify the affect on the heart vessels. Copyright 2014 Niambi Wellness. All rights reserved

25. Signs include: low oxygen distribution blood clots arterial spasms plaque deposits in the main and micro- arteries of the heart Copyright 2014 Niambi Wellness. All rights reserved

27. Part 3: Hyperlipidemia Copyright 2014 Niambi Wellness. All rights reserved

28. Signs include: plaque deposits in the main arteries and micro-arteries of the heart Copyright 2014 Niambi Wellness. All rights reserved

30. Part 4: Thromboangiitis Obliterans Copyright 2014 Niambi Wellness. All rights reserved

31. The ischemic period is characterized by inflammation, ulceration, gangrene and claudication. Copyright 2014 Niambi Wellness. All rights reserved

32. The nutritional deficiency period is characterized by pain and muscle atrophy. Copyright 2014 Niambi Wellness. All rights reserved

33. The necrosis period is characterized by severe ulcerations and gangrene. Copyright 2014 Niambi Wellness. All rights reserved

35. Part 5: Takayasu Arteritis Copyright 2014 Niambi Wellness. All rights reserved

36. The 1990 American College of Rheumatology Criteria is still used to diagnose this rare condition with specific symptoms: Copyright 2014 Niambi Wellness. All rights reserved

37. This condition usually affects young Asian women. The age of onset is usually between 20- 40 years old. Copyright 2014 Niambi Wellness. All rights reserved

38. Claudication may be particularly bothersome in the arms with the legs. Copyright 2014 Niambi Wellness. All rights reserved

39. The pulse may be diminishing or absent in one or both brachial arteries. Copyright 2014 Niambi Wellness. All rights reserved

40. The blood pressure difference may be as much as 10 mm Hg between arms. Copyright 2014 Niambi Wellness. All rights reserved

41. An audible bruit may be heard over the subclavian or abdominal aorta. Copyright 2014 Niambi Wellness. All rights reserved

42. The aorta may be severely damaged. Though the disorder will not be related to atherosclerosis. Copyright 2014 Niambi Wellness. All rights reserved

43. Part 6:Textbook Answer Copyright 2014 Niambi Wellness. All rights reserved

44. #13 140/150 and 90/100 may #14 Thyroid disease and sleep apnea #15 lack or insufficient physical activity, excessive smoking, excessive alcohol consumption, excessive sodium intake, insufficient balancing nutrients, and other minerals. Copyright 2014 Niambi Wellness. All rights reserved Answer block

45. #16 up to 14 days #17 Increased risk of infarction #18 Damage to myocardial cells #19 hypothyroidism, elevated estrogen levels in pre-, peri-, and postmenopausal women and sex hormones in men. Copyright 2014 Niambi Wellness. All rights reserved Answer block

46. #20 elevated blood pressure levels and LDL levels with reduced HDL levels. #21 palliative care option which mostly addresses symptoms. #22 chronic inflammatory Copyright 2014 Niambi Wellness. All rights reserved Answer block

47. Copyright 2014 Niambi Wellness. All rights reserved

48. Chapter 10: Key Points of Vascular System Disorders in TCM Copyright 2014 Niambi Wellness. All rights reserved

49. Part 1: Hypertension Part 2: Angina Pectoris Part 3: Hyperlipidemia Contents Copyright 2014 Niambi Wellness. All rights reserved

50. Part 4: Thromboangiitis Obliterans Part 5: Takayasu Arteritis Part 6: Answers to Textbook Questions Contents Copyright 2014 Niambi Wellness. All rights reserved

52. Part 1: Hypertension Copyright 2014 Niambi Wellness. All rights reserved

53. In Chinese medicine, hypertension is included in the category of xuan yun (vertigo). Copyright 2014 Niambi Wellness. All rights reserved

55. Part 2: Angina Pectoris Copyright 2014 Niambi Wellness. All rights reserved

56. The extreme changes of weather during the summer and winter seasons can cause adverse symptoms. Copyright 2014 Niambi Wellness. All rights reserved

57. During summer the heat can cause extreme sweating which leads to a loss of qi and yin fluids. Copyright 2014 Niambi Wellness. All rights reserved

58. During winter, the cold can cause deficiency of qi and yang which can cause stress during physical efforts. Copyright 2014 Niambi Wellness. All rights reserved

59. Part 3: Hyperlipidemia Copyright 2014 Niambi Wellness. All rights reserved

60. A hyperactive liver yang is known to create several organ disharmonies which can be seen in specific symptoms. Copyright 2014 Niambi Wellness. All rights reserved

61. It overacts upon the spleen which results in an acute digestive impairment. The digestive impairment will cause a failure of fat to metabolize properly. Copyright 2014 Niambi Wellness. All rights reserved

62. The result is a high concentration of blood fats which contributes to obesity and arterial build-up of plaque. Copyright 2014 Niambi Wellness. All rights reserved

63. Part 4: Thromboangiitis Obliterans Copyright 2014 Niambi Wellness. All rights reserved

64. In Chinese medicine this condition is called tuo ju with five characteristics: Copyright 2014 Niambi Wellness. All rights reserved

65. congenital deficiencies weak kidney qi, yin and yang cold and dampness abnormal diet poor psycho-emotional adaptation Copyright 2014 Niambi Wellness. All rights reserved

66. Part 5: Takayasu Arteritis Copyright 2014 Niambi Wellness. All rights reserved

67. The condition is differentiated as toxic phlegm heat during the active phases of the disease. Copyright 2014 Niambi Wellness. All rights reserved

68. This differentiation is particular to the condition affecting the aorta, and also the vessels of the limbs causing claudication. Copyright 2014 Niambi Wellness. All rights reserved

70. Part 6: Answers to Textbook Questions Copyright 2014 Niambi Wellness. All rights reserved

71. #23 blood stasis and turbid phlegm obstruction. #24 is a chronic Inflammatory condition #25 active and stable phases Copyright 2014 Niambi Wellness. All rights reserved Answer block

72. Copyright 2014 Niambi Wellness. All rights reserved

73. Module 4 Review Questions

74. Complete the Module 4 review interactive practice quiz. Copyright 2014 Niambi Wellness. All rights reserved

75. Course Conclusion Copyright 2014 Niambi Wellness. All rights reserved