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3/19/2020
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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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