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
Play
Video
Play
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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