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Cardiovascular Health

Lecture 8

Lecture 9

1. Heart

2. Cardiovascular Health

3. Stroke

4. Contributing Factor

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The Heart

The Heart• Muscular Pump

• Receives blood low pressure then increases the pressure

• Heart consists of 4 chambers:

– Atria (2) receive venous blood from the lungs and body circulation.

– Ventricles (2) – receive blood from the Atria and pumps blood out of the heart to lungs and body

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The Heart

Heart

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RA

LVRV

LARA - Right Atria

LA - Left Atria

RV - Right Ventricle

LV - Left Ventricle

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Heart

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RA

LVRV

LARA - Right Atria

LA - Left Atria

RV - Right Ventricle

LV - Left Ventricle

Heart

RA

LVRV

LA

To

Lungs

From

Lungs

To

Body

From

Body

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Cardiovascular System

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The Cardiovascular System

• Cardiovascular System - the heart and blood vessels that circulate blood throughout the body

• Pulmonary Circulation - the pumping of oxygen-poor blood to the lungs and oxygen-rich blood back to the heart by the right side of the heart

• Systemic Circulation - the pumping of oxygen-rich blood to the body and oxygen-poor blood back to the heart by the left side of the heart

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The Heart Vascular System

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Cardiovascular Health

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Cardiovascular Disease

• Cardiovascular Disease (CVD) - any disease

involving the heart and/or blood vessels

• CVD include heart attack, stroke, peripheral artery

disease, congestive heart failure, and others

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CVD the leading cause of death in the United States,

accounting for one-third of all deaths

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Heart Disease and Stroke account for 65.4% of

deaths from CVD in the U.S.

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Atherosclerosis• The disease process underlying many forms of CVD is

atherosclerosis

• A thickening or hardening of the arteries due to the buildup

of fats and other substances

Atherosclerosis• Starts with damage to the inner lining of vessels and the

formation of a fatty streak(s)

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Atherosclerosis

• Once an injury exists on the artery, white blood cells, collagen,

and other proteins are formed, creating plaque (accumulation

of debris in an artery wall)

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Atherosclerosis• Eventually the artery becomes blocked, or…

• Plaque can break off and completely block artery elsewhere

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Coronary Heart Disease

• Coronary Heart Disease (CHD) - atherosclerosis of the coronary arteries, which can result in a heart attack

• CHD is the leading form of all cardiovascular diseases

• An estimated 16.3 million Americans are living with CHD

• Those who survive a heart attack are often left with damaged hearts and significantly altered lives, lead to CHF

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Coronary Heart Disease

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Coronary Heart Disease

• Ischemia - insufficient supply of oxygen and nutrients to tissue,

caused by narrowed or blocked arteries

– Angina - pain, pressure, heaviness, or tightness in the center of the chest

caused by a narrowed coronary artery

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Coronary Heart Disease• Myocardial Infarction (Heart Attack!) - lack of blood flow to the

heart muscle with resulting death of heart tissue

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Coronary Heart Disease• Coronary Thrombosis (also a heart attack) - blockage of a

coronary artery by a blood clot that may cause sudden death

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Testing /Treatment for Heart Disease• Diagnostic Testing

– Electrocardiogram (ECG or EKG)

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Testing /Treatment for Heart Disease• Diagnostic Testing

– Exercise Stress Test - involves doing brisk cardiovascular

activity while your heart beat, blood pressure, and

breathing are monitored.

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Testing /Treatment for Heart Disease• Diagnostic Testing

– Echocardiogram (sound waves)

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Treatment: Angioplasty (balloon catheter)

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Coronary Artery Bypass Grafting

Congestive Heart Failure

• CHF is chronic progressive condition that affects the

pumping power of your heart muscles.

• Usually follows a severe heart attack

• Eventually the heart muscle weakens

• Person with this condition experiences difficulty breathing,

shortness of breath, coughing, fatigue, and confusion. Fluid

build up in lungs and extremities

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Congestive Heart Failure

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Chambers of the heart stretch to hold more blood, or

heart muscle becomes thick and stiff (heart tries to

compensate)

Systolic Heart Failure Diastolic Heart Failure

• Smoking

• High blood pressure

• High blood cholesterol and

high triglycerides

• Overweight/obesity

• Physical inactivity

• Diabetes and prediabetes

• Metabolic syndrome

Risk Factors You Can Control

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• Family history of early

heart disease

• Age (55 and older)

• History of preeclampsia

during pregnancy

Risk Factors You Cannot Control

• Sleep apnea

• Stress or depression

• Too much alcohol

• Birth control pills

(particularly for women

who are over age 35 and

smoke)

• Anemia

• Unhealthy diet

Other Risk Factors

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• Blood pressure

• Blood cholesterol (total:

HDL, LDL, triglycerides)

• Fasting plasma glucose

(diabetes test)

• Body mass index (BMI)

and waist circumference

• Electrocardiogram

• Stress test

Key Tests for Heart Disease Risk

• Begin today—make changes one step at a time

• Don’t smoke—if you are a smoker, ask your health care

provider for help in quitting

• Be physically active—2 hours and 30 minutes of moderate-

intensity aerobic activity each week

• Add strength training—2 to 3 times a week

You Can Lower Heart Disease Risk

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Arrhythmias and

Sudden Cardiac Death

• Arrhythmia - irregular or disorganized heartbeat

• Ventricular Fibrillation - type of arrhythmia in which

the ventricles contract rapidly and erratically, causing

the heart to quiver or “tremor” rather than beat

• Sudden Cardiac Death - abrupt loss of heart function

caused by an irregular or ineffective heartbeat

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Stroke

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Stroke• A Stroke or Cerebrovascular Accident (CVA) - when blood

flow to the brain or part of the brain is blocked

– Fourth leading cause of death in the United States; leading cause of

severe, long-term disability

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StrokeIschemic Stroke - caused by blockage in a blood vessel in the

brain (accounts for 87% of all strokes)

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Stroke

Transient Ischemic Attacks (TIAs) “ministrokes” - periods of

restricted blood supply that produce the same symptoms as a

stroke

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StrokeHemorrhagic Stroke - caused by rupture of a blood vessel in the

brain, with bleeding into brain tissue

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Management of Stroke

• Management

– medications can dissolve clot and restore blood flow to the

brain

– If hemorrhagic, depends on the underlying cause of the

bleed; sometimes surgery is necessary

– Rehabilitation, usually including physical therapy, an

important component

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Contributing Factors

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Hypertension

• Hypertension - blood pressure that is forceful

enough to damage artery walls

• “the silent killer” – many people don’t know they

have it until its too late

• Untreated high blood pressure/hypertension:

– Can weaken and scar the arteries and make the heart

work harder

– Can cause heart attacks, strokes, kidney disease,

peripheral artery disease, and blindness

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Hypertension

Systolic

Pressure

Diastolic

Pressure

Hypertension

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Other Contributing Factors

• Triglyceride Levels – fat in blood

– Levels in blood should be less than 150 to achieve desired

levels

• Alcohol Intake

– Heavy drinking (more than 3 drinks/day) can damage the

heart

– Light drinking (less than 2 drinks/day) can increase HDL

levels, therefore protecting against heart disease and stroke

risk

• Psychosocial Factors

– Personality, chronic stress, socioeconomic status, depression,

and social support

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Cholesterol

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Noncontrollable Factors in

Cardiovascular Health

• Age

• Gender

• Genetics and Family History

• Ethnicity and Race

• Postmenopausal Status

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Major Controllable Factors in

Cardiovascular Health

• Tobacco Use

• Blood Pressure Levels

• Cholesterol Levels

• Physical Activity

• BMI

• Blood Glucose Levels

• Diet

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Areas of Interest for Future CVD

Research

• Researchers are looking at how the following are associated with CVD:

– Low levels of vitamin D

– High blood levels of homocysteine (amino acid red meat)

– Metabolic syndrome (a set of conditions associated with CVD)

– Inflammation (body’s response to protect itself)

– High levels of C-reactive protein in the blood

– Infections that may cause atherosclerotic plaques to break free

– Lower birth weight

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Other Cardiovascular Diseases

• Heart Valve Disorders

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Other Cardiovascular Diseases• Congenital Heart Disease

– Structural defect at birth

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Other Cardiovascular DiseasesPeripheral Vascular Disease (PVD) - Atherosclerosis in the

arms and legs

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Other Cardiovascular Diseases

Cardiomyopathy - Disease of the heart muscle

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