CHAPTER 9: Cardiovascular Disease

Ece Tathan Merve Kültepe

CARDıOVASCULAR SYSTEM

Heart Arteries (atardamar) Veins (toplardamar)

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*Purpose of Cardiovascular System- pump blood throughout body- provide transportation for oxygen and nutrients- disposal of wastes

*Integration of systems-cardiovascular-respiratory-digestive-endocrine

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ARTERIES (atardamar), ARTERIOLES, CAPILLARIES, VEINS (toplardamar)

CARDIOVASCULAR DISEASES

Coronary Artery DiseaseCoronary Heart DiseaseStroke

MYOCARDIUM

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STRAIN IN THE HEART Safe Route: Small scar tissue and no problem Injury Route:

Atheromatous PlaquesAtherosclerosis

InelasticityArterisclerosis

ATHEROSCLEROSIS

ARTERISCLEROSIS

Damage to coronary arteries (atherosclerosis, arterisclerosis)

Damage to myocardium (insufficient blood supply)

Coronary Artery Disease Coronary Heart Disease

CORONARY ARTERY DISEASE

blood platelets (pıhtı hücresi) are formedstick to blood clotsform plaquesfully close the arteriesrestriction of blood flowIschemia (iskemi)

Damage to coronary arteries (atherosclerosis, arterisclerosis)

Damage to myocardium (insufficient blood supply)

Coronary Artery Disease Coronary Heart Disease

CORONARY HEART DISEASE

Myocardial Infarction (heart attack)

No blood flow/no oxygen supply to myocardium causes death of myocardial tissue

MYOCARDIAL INFARCTION

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MYOCARDIAL INFARCTION

Signals for Myocardial Infarction* feeling of weakness, dizziness* nausea* cold sweating* difficulty in breathing* sensation of crushing or squeezing pain in

arms, shoulders, jaw or back * rapid loss of consciousness (sometimes

alertness through the process)

ANGINA PECTORIS

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ANGINA PECTORIS

Symptoms* pain in chest * difficulty in breathing

Reasons* exercise* stress

TREATMENT OF CORONARY ARTERY DISEASES

Bypass surgery Cardiac rehabilitation

BYPASS SURGERY

TREATMENT OF CORONARY ARTERY DISEASES

Bypass surgery Cardiac rehabilitation by psychologists

minimize risk factorslessen chances of future attacks

CARDIOVASCULAR DISEASES

Coronary Artery DiseaseCoronary Heart DiseaseStroke

STROKE

Atherosclerosis & Arterisclerosis

Arteries in the neck and brain

Stroke by restriction of blood flow to that area of brain (damage in brain due to lack of oxygen)

Other causes:bubble of air (air embolism) / infectionaneurysm____hemorrhagic stroke

STROKE

Damages in neurons- no replacement Billions of neurons, remaining healthy

neurons Most common cause of stroke:

Atherosclerosis

BLOOD PRESSURE

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SYSTOLIC AND DIASTOLIC BLOOD PRESSURE

ELEVATIONS OF BLOOD PRESSURE

Normal/adaptive elevations sympathetic nervous system:

increase in heart rate constriction of blood vessels

blood pressure elevation parasympathetic returns it normal level so no permanent increase.

ELEVATIONS OF BLOOD PRESSURE

HYPERTENSION Best predictor of heart attack and stroke Can cause eye damage and kidney failure Primary (essential) Hypertension

no cause, related to age, race, weight, sodium intake, tobacco use and lack of exercice

Secondary Hypertensionless common, caused by other diseases

HYPERTENSION

People with hypertension cannot diagnose their own blood pressure reliably.

Progression of hypertensionelevated systolic pressure with

normal/slightly elevated diastolic pressure

elevations of both systolic and diastolic pressure

HYPERTENSION

Systolic higher than 200 mm Hg danger!!! rupture in arterial walls, rupture in

aorta/cerebral artery Diastolic higher …vascular damage, damage

in organs such as kidneys, liver, pancreas, brain and retina

Underlying cause??? No treatment for basic cause Treatment by drugs or changes in behavior or lifestyle to decrease blood pressure.

Behavioral changes & Health psychologists

MEASURES OF CARDIOVASCULAR FUNCTION

Blood pressure tests: easy but not enough to detect cardiovascular problems

Measurements of electrical activity in the heart

Electrocardiogram (ECG)Stress Test

AngiographyAngioplasty

MEASUREMENTS OF ELECTRICAL ACTIVITY IN THE HEART Electrocardiogram: electrical impulses produced by

heartbeat, abnormalities in heartbeat but not reveal plaques in coronary arteries.

Stress test: during exercise to measure heart’s electrical impulses. More useful and sensitive than electrocardiogram. can be used with angina pectoris, myocardial infarction, bypass surgery

New techniques: nuclear perfusion technique, echocardiography

ANGIOGRAPHY & CATHETERIZATION

Most definite method of diagnosis of coronary artery disease, used to determine coronary artery disease in angina pectoris, after a positive result from stress test/after myocardial infarction.

Invasive surgical procedures, patients are awake, slight risk of death/injury.

Cardiac catheterization is a treatment process by clot dissolving drugs and inflatable tips.

Angioplasty: balloon tip catheter into blocked arteries, inflating tip to reduce artery blockage.

Catheterization by installing a stent to the artery.

ANGIOPLASTY

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CATHETERIZATION (STENT)

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THE CHANGING RATES OF CARDIOVASCULAR DISEASE

From 1920s to 1950s & 1960s…rise in CVD deaths in US

From 1950s &1960s to 2000…decline in CVD deaths in US

31% of deaths: heart disease, 6.7% of deaths: stroke in US

During 20th Century, rate of deaths due to heart disease changed in men and women. Men died from CVD at younger ages than women…gender gap

REASONS FOR THE DECLINE IN DEATH RATES

Improved emergency coronary care Changes in lifestyle: smoking less, be aware of

blood pressure levels, control serum cholesterol levels, watch weight, follow exercise program

Two studies prompted awareness: Framingham Heart Study & 1964 Surgeon General’s Report

Which factor contributed most to the declining of death rate from heart disease? 50% behavior and lifestyle changes 43% improvements in treatment

HEART DISEASE MORTALITY THROUGHOUT THE WORLD

30% of all deaths throughout the world In US, dramatic reductions due to lifestyle

changes In Finland, from 1970s to 1990s CVD rates

decreased 70% due to effort to change risk factors In New Zealand & Australia: 3% decline per year

from mid 1980s to mid 1990s In Soviet Union, increase in CVD in last 10 years In Eastern part of Europe: 80% of all deaths by

CVD, due to lack of social support and stress Both industrialized and developing, undeveloped

countries, CVD is the leading cause of death