ch15 lecture

Copyright © 2008 Pearson Education, Inc.,publishing as Pearson Benjamin Cummings

PowerPoint® Lecture Slide Presentation

prepared by

Michael Hall

Chapter 15

Cardiovascular Disease:

Reducing Your Risk

Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings

Objectives

Discuss the incidence, prevalence, and outcomes of cardiovascular disease.

Describe the anatomy and physiology of the heart and circulatory system and the importance of healthy heart function.

Review major types of heart disease, factors that contribute to their development, diagnostic and treatment options and the importance of fundamental lifestyle modifications aimed at prevention.

Discuss controllable and uncontrollable risk factors for cardiovascular disease; your own risk profile, and determine the risk factors you can and cannot control.

Discuss methods of diagnosing and treating cardiovascular disease.


2001 Total Cardiovascular Disease Rates by State and Gender, Age Adjusted

Figure 15.1a


2001 Total Cardiovascular Disease Rates by State and Gender, Age Adjusted (continued)

Figure 15.1b


An Epidemiological Overview

Cardiovascular disease (CVD) is the leading cause of death in the U.S.

In 2005 CVD accounted for approximately 38 percent of all deaths

CVD has been the number one killer in the U.S. since 1900 except for 1918 (influenza)

More that 2,500 Americans die from CVD each day

Among women, 1 in 2.6 deaths from CVD


Prevalence of Cardiovascular Diseases in American Men and Women, Ages 20 and Older

Figure 15.2


Death Rates for Cardiovascular Disease, Including CHD and Stroke for Selected Countries

Figure 15.3


ABC News: Cardiovascular Disease

PlayVideoPlay

Video| Cardiovascular Disease


ABC News: Cardiovascular Disease

Discussion Questions:

How does inflammation account for nearly 85% of all heart attacks?

What test measures inflammation and how expensive is it?

Why have physicians been hesitate to order tests to measure inflammation?

What dietary changes are recommended to lower inflammation?


Understanding The Cardiovascular System

Cardiovascular system includes: the heart, arteries, arterioles, capillaries, venules, and veins

The heart

• Muscular, four chambered pump

• Contracts 100,000 times per day

• Two upper chambers: atria

• Two lower chambers: ventricles

• Tricuspid, pulmonary, mitral, and aortic valves


Heart Function

Deoxygenated blood enters the right atrium

From the right atrium blood moves to the right ventricle, pumped through the pulmonary artery to the lungs

Oxygen blood enters the left atrium

Blood from the left atrium is forced into the left ventricle

The left ventricle pumps blood through the aorta to various parts of the body


Anatomy of the Heart

Figure 15.4


Types Of Cardiovascular Disease

Atherosclerosis

Coronary heart disease (CHD)

Chest pain (angina pectoris)

Irregular heartbeat (arrhythmia)

Congestive heart failure (CHF)

Congenital and rheumatic heart disease

Stroke


Percentage Breakdown of Deaths from Cardiovascular Disease in the United States, 2001

Figure 15.5


Artherosclerosis

Characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of the artery

Hyperlipidemia – abnormally high blood lipid level

Plaque – the buildup of deposits in the arteries


Coronary Heart Disease

Myocardial infarction (MI) or heart attack – blood supplying the heart is disrupted

Coronary thrombosis – blood clot in the artery

Embolus – when the blood clot is dislodged and moves through the circulatory system

Collateral circulation - if blockage to the heart is minor, an alternative blood flow is selected


Angina Pectoris

Ischemia – reduction of the heart’s blood and oxygen supply

The more serious the oxygen deprivation the more severe the pain

Nitroglycerin – drug used to relax (dilate) the veins

Beta blockers control potential overactivity of the heart muscle


Arrythmias

An irregularity in heart rhythm

Tachycardia – racing heart in the absence of exercise or anxiety

Bradycardia – abnormally slow heartbeat

Fibrillation – heart beat is sporadic, quivering pattern


Congestive Heart Failure (CHF)

Damaged or overworked heart muscle is unable to keep blood circulating normally

Affects over 5 million Americans

Damage to heart muscle may result from: rheumatic fever, pneumonia, heart attack, or other cardiovascular problem

Lack of proper circulation may allow blood to accumulate in the vessels of the legs, ankles, or lungs

Diuretics relieve fluid accumulation


Congenital And Rheumatic Heart Disease

Congenital heart disease affects 1 out of 125 children born

May be due to hereditary factors, maternal diseases, or chemical intake (alcohol) during fetal development

Rheumatic heart disease results from rheumatic fever which affects connective tissue


Stroke

Occurs when the blood supply to the brain is interrupted

Thrombus – blood clot

Embolus – free flowing clot

Aneurysm – bulging or burst blood vessel

Transient ischemic attack (TIA) – brief interruptions that cause temporary impairment


Common Blood Vessel Disorders

Figure 15.6


Reducing Your Risk For Cardiovascular Diseases

Risks you can control

• Avoid tobacco

• Cut back on saturated fat and cholesterol

• Maintain a healthy weight

• Modify dietary habits

• Exercise regularly

• Control diabetes

• Control blood pressure

• Systolic – upper number

• Diastolic – lower number

• Manage stress


Reducing Your Risk For Cardiovascular Diseases

Risks you cannot control

• Heredity

• Age

• Gender

• Race


Classification of LDL, Total, and HDL Cholesterol (mg/dl) and Recommended Levels for Adults

Table 15.1


Women And Cardiovascular Disease

2003, CVD deaths

• 426,800 men

• 483,800 women Estrogen

• Once estrogen production stops, risk for CVD death increases Diagnostic and therapeutic differences

• Delay in diagnosing possible heart attack

• Complexity in interpreting chest pain in women

• Less aggressive treatment of female heart attack victims

• Smaller coronary arteries in women Gender bias in CVD research – typically CVD research has been

conducted on male subjects


New Weapons Against Heart Disease

Techniques for diagnosing heart disease

• Electrocardiogram (ECG)

• Angiography

• Positron emission tomography (PET)

• Single positron emission color tomography (SPECT)

• Radionuclide imaging

• Magnetic resonance imaging (MRI)

• Ultrafast CT

• Digital cardiac angiography (DSA)


Angioplasty Versus Bypass Surgery

Angioplasty – a thin catheter is threaded through the blocked arteries. The catheter has a balloon on the tip which is inflated to flatten the fatty deposits against the wall of the artery

Coronary bypass surgery – a blood vessel is taken from another site and implanted to bypass blocked arteries and transport blood


Aspirin For Heart Disease?

Research shows that 80 milligrams of aspirin every other day is beneficial to heart patients due to its blood thinning properties

Some side effects of aspirin: gastrointestinal intolerance and a tendency for difficulty with blood clotting

Should only be taken under the advice of your physician


Thrombolysis

If victim reaches an emergency room and is diagnosed quickly, thrombolysis can be performed

Thrombolysis involves injecting an agent such as tissue plasminogen activator (TPA) to dissolve the clot and restore some blood flow


Cardiac Rehabilitation

Every year, 1 million people survive heart attacks

Cardiac rehabilitation exercise training increases stamina and strength, and promotes recovery


Personal Advocacy And Heart-Smart Behaviors

Know your rights as a patient

Find out about informed consent procedures, living wills, durable power of attorney, organ donation, and other legal issues BEFORE you become sick

Ask about alternative procedures

Remain with your loved one as a personal advocate

Monitor the actions of health care providers

Be considerate of your care provider

Be patient with the patient

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