Consists of the heart and blood vessels With lungs, known as the cardiorespiratory system

The Heart Four-chambered, fist-sized muscle located just beneath the sternum Blood travels through two separate circulatory systems: Pulmonary circulation

› Right side of heart pumps blood to lungs. Systemic circulation

› Left side of heart pumps blood through the rest of the body

Path of blood flow:1. Through VENA CAVA into RIGHT ATRIUM (RA)2. From RA to RIGHT VENTRICLE (RV)3. From RV to PULMONARY ARTERY into the lungs4. In LUNGS, picks up oxygen and discards carbon dioxide5. Leaves lungs through PULMONARY VEINS into heart’s

LEFT ATRIUM(LA)6. LA fills, pumps blood into LEFT VENTRICLE(LV)7. When LV full, pumps blood through AORTA for

distribution to the rest of the body’s blood vessels8. Once oxygen has been distributed blood flows back to

the heart through the VENA CAVA.

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Cardiovascular disease (CVD)• Leading cause of death in the U.S.• Affects nearly 81 million Americans• Claims one life every 38 seconds• About 2,300 Americans die every day• CVD is largely due to our way of life

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Two categories of increased risk for CVD1. Major risk factors2. Contributing risk factors

Controllable aspects of lifestyle that can be changed

Major risk factors that can be changed› American Heart Association identified six

major risk factors.• Tobacco use• High blood pressure• High cholesterol• Physical inactivity• Obesity• Diabetes

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Hypertension› Too much pressure against blood vessel walls

Short periods of high blood pressure are normal, but chronic high blood pressure is a health risk

Atherosclerosis› Heart has to work harder, weakens, enlarges,

arteries narrow, scar, and harden About 33% (73 million) of adults have

hypertension 37% of adults have prehypertension Test your blood pressure at least once every

two years5

Fatty, waxlike substance that circulates through the bloodstream

› Important component of: Cell membranes Sex hormones Vitamin D Fluid that coats the lungs Protective sheaths around nerves

Excessive cholesterol clogs the arteries› Increased risk of CVD

Good versus bad cholesterol› Low –density lipoproteins (LDL) (“bad” cholesterol)

Shuttle cholesterol from the liver to organs and tissues› High-density lipoproteins (HDL) (“good” cholesterol)

Shuttle unused cholesterol back to the liver for recycling

By removing cholesterol from blood vessels, HDL helps protect against atherosclerosis

Recommended blood cholesterol levels Benefits of controlling cholesterol

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40-60 million Americans are so sedentary that they are at high risk for developing CVD

Exercise reduces risk› Closest thing we have to a magic bullet against

heart disease› Controls blood pressure and resting heart rate› Lowers LDL› Increases HDL› Maintains weight› Improves the condition of blood vessels› Helps prevent or controls diabetes

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Risk of death from CVD is two to three times more likely in obese people (BMI ≥ 30)

Increased strain on the heart Strongly associated with:

• Hypertension• High cholesterol• Insulin resistance• Diabetes• Physical inactivity• Increasing age• Endothelial cell dysfunction

Coronary arteries constrict instead of dilate• Hypertrophy (ventricular enlargement)

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Doubles the risk of CVD for men Triples the risk of CVD for women Loss of 5-10 years off your life Higher risk

• Hypertension• Obesity• Unhealthy blood lipid levels• Elevated blood glucose and insulin can damage

the endothelial cells lining the arteries• More vulnerable to atherosclerosis

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High triglyceride levels› Blood fats that are a reliable predictor of heart

disease Psychological and social factors

› Stress› Chronic hostility and anger› Suppressing psychological distress› Depression › Anxiety› Social isolation› Low socioeconomic status

Alcohol and drugs

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Heredity › CVD has genetic component; high

cholesterol levels, hypertension, diabetes, and obesity

Aging › Over the age of 65

Being male› Men have higher risk earlier in life

Ethnicity › African Americans higher risk of

hypertension; Hispanics greater risk of HBP and angina; Asians lower rates of CVD

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Atherosclerosis - narrowed by fatty deposits› Plaques accumulate in artery walls› Coronary heart disease (CHD)› Coronary artery disease (CAD)› Peripheral arterial disease (PAD)

Heart attack – heart tissue is damaged and part of it may die from lack of blood› Myocardial infarction (MI)› American Heart Association

785,000 people have a first heart attack each year 470,000 people have recurrent attack 195,000 people suffer a symptomless or “silent”

heart attack each year12

Chest pain or pressure Arm, neck, or jaw pain Difficulty breathing Excessive sweating Nausea and vomiting Loss of consciousness

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Angina – arteries narrowed by disease, but under stress heart cannot receive enough oxygen• Angina pectoris• Usually felt as an extreme tightness in the chest

and heavy pressure behind the breastbone or in the shoulder, neck, arm, hand, or back

Arrhythmias and sudden cardiac death – electrical conduction system is disrupted• Sudden cardiac death (cardiac arrest) often

caused by an arrhythmia called ventricular fibrillation

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Electrocardiogram (ECG or EKG) Electron-beam computed tomography

(EBCT) Echocardiography – sound waves Multi-slice computed tomography

(MSCT) Magnetic resonance imaging (MRI) Nuclear myocardial perfusion imaging Positron Emission Tomography (PET) Angiogram Balloon angioplasty Coronary bypass surgery

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2 million brain cells die per minute during a stroke

Ischemic stroke – blockage in a blood vessel• Thrombotic stroke - clot forms in a cerebral

artery• Embolic stroke - wandering blood clot

Hemorrhagic stroke - blood vessel ruptures in the brain• Intracerebral hemorrhage• Subarachnoid hemorrhage• Aneurysm

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Interruption of the blood supply to any area of the brain prevents the nerve cells from functioning, in some cases causing death

Usually suffer some lasting disability› Paralysis› Walking disability› Speech impairment› Memory loss› Changes in behavior

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PAD – atherosclerosis in the leg (or arm) arteries, which can limit or block the blood flow

Patients typically also have coronary artery disease About 8 million people in the U.S. have PAD Risk factors:

• Smoking• Diabetes• Hypertension• High cholesterol

Symptoms• Claudication (aching or fatigue in the affected leg)• Rest pain (limb artery cannot supply enough blood at rest)

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Number of conditions› High blood pressure› Heart attack› Atherosclerosis› Alcoholism› Viral infections› Rheumatic fever› Birth defects

Pulmonary edema - fluid accumulates in the lungs› Heart can not maintain regular pumping rate; fluid backs

up Controlled by:

› Reducing cardiac load› Eliminating excess fluid› Restriction of salt › Drug therapy

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Congenital heart defects› Malformation of the heart or major blood vessel

Hypertrophic cardiomyopathy (HCM)› Occurs in 1 out of 500 people › Most common cause of sudden death in athletes

younger than 35› May be identified by a murmur

Rheumatic heart disease › Streptococcal infections cause damage to the heart

muscle and valves› Strep throat needs to be treated

Heart valve disorders› Congenital heart defects and certain types of

infections› Mitral valve prolapse

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