TOPIC 4 LIPID METABOLISM.

1. TOPIC 4
LIPIDS METABOLISM
BASIC CHEMISTRY
AF 1082

2. LEARNING OUTCOME
AT THE END OF THIS TOPIC, STUDENT WILL BE ABLE TO:
• EXPLAIN LIPIDS AND IDENTIFY THE CHARACTERISTICS OF LIPIDS
• IDENTIFY AND DESCRIBE DIFFERENT CLASSIFICATION OF LIPIDS
• DESCRIBE THE METABOLIC PATHWAY OF LIPIDS
• EXPLAIN THE METABOLIC DISORDER OF LIPIDS: DIABETIC KETOACIDOSIS,
CARDIOVASCULAR DISEASE

3. WHAT ARE LIPIDS?
• LIPIDS ARE ORGANIC COMPOUNDS THAT CONTAIN HYDROGEN, CARBON, AND
OXYGEN ATOMS, FORMING NONPOLAR MOLECULES THAT ARE SOLUBLE IN
NONPOLAR SOLVENT AND INSOLUBLE IN POLAR SOLVENT SUCH AS WATER.
• LIPIDS ARE NOT DEFINED BY THE PRESENCE OF SPECIFIC FUNCTIONAL GROUP LIKE
CARBOHYDRATE, BUT BY PHYSICAL PROPERTY – SOLUBILITY.
• LIPIDS ARE FATTY, WAXY, OR OILY COMPOUNDS. LIPIDS INCLUDE:
• FATS AND OILS (TRIGLYCERIDES)
• PHOSPHOLIPIDS
• WAXES
• STEROIDS

4. CHARACTERISTICS OF LIPIDS
• ENERGY-RICH ORGANIC MOLECULES
• INSOLUBLE IN WATER
• SOLUBLE IN ORGANIC SOLVENT LIKE ALCOHOL, CHLOROFORM, ACETONE,
BENZENE ETC
• ON HYDROLYSIS THEY GIVE FATTY ACIDS
• SOLID TRIGLYCEROLS (FATS) HAVE HIGH PROPORTIONS OF SATURATED FATTY
ACIDS
• LIQUID TRIGLYCEROLS (OILS) HAVE HIGH PROPORTIONS OF UNSATURATED
FATTY ACIDS

5. FUNCTIONS OF LIPIDS
• ENERGY STORAGE, MOBILIZATION, AND UTILIZATION
• CELL DIFFERENTIATION AND GROWTH
• CELL MEMBRANE STRUCTURE
• SIGNAL TRANSMISSION
• HORMONE SYNTHESIS
• BILE ACIDS SYNTHESIS

6. CLASSIFICATION OF LIPIDS
LIPIDS
SIMPLE LIPIDS
Esters of fatty acids with various alcohols
FATS (TRIGLYCERIDES)
Esters of fatty acids with glycerol. Oils are fats
in the liquid state
WAXES
Esters of fatty acids with higher molecular weight
monohydric alcohols
COMPLEX LIPIDS
Esters of fatty acids containing groups in addition to
alcohol and fatty acids
PHOSPHOLIPIDS
This lipids contain additional phosphate
group. Frequently have nitrogen-containing
base and other substituent.
GLYCOLIPIDS
Containing fatty acids, sphingosine and
carbohydrate
LIPOPROTEIN
Containing lipid and protein
PRECURSOR AND DERIVED LIPIDS
These compounds are produces by hydrolysis of simple and
complex lipids
STEROIDS
CHOLESTEROLS
SEX
HORMONES

7. FATTY ACIDS

8. WHAT IS FATTY ACIDS?
• COMMON FEATURES OF LIPIDS IS THAT THEY ARE ALL
ESTERS OF MODERATE TO LONG CHAIN OF FATTY
ACIDS AS IT IS THE SIMPLEST FROM OF LIPID.
• FATTY ACIDS IS A CARBOXYLIC ACID WITH A LONG
SIDE CHAIN OF HYDROCARBON
• IT IS PRODUCED BY THE BREAKDOWN OF FATS
(USUALLY TRIGLYCERIDES OR PHOSPHOLIPIDS)
THROUGH A PROCESS CALLED HYDROLYSIS.
• FATTY ACID MAY BE PRESENTED BY R-COOH, WHERE
R STANDS FOR THE ALIPHATIC MOIETY AND COOH
AS THE CARBOXYLIC GROUP
Aliphatic: compound composed of carbon
and hydrogen arranged in straight or
branched chains, not containing rings

9. CLASSIFICATION OF FATTY ACIDS
• FATTY ACIDS CAN BE CLASSIFIED BY THE PRESENCE AND NUMBER OF CARBON-
TO-CARBON DOUBLE BOND THERE ARE THREE TWO TYPES FATTY ACIDS:
1. SATURATED FATTY ACIDS: ALL CARBON ATOMS IN THE CHAIN ARE SINGLE BONDS,
AND REMAINING BONDS ARE ATTACHED TO HYDROGEN
2. NON SATURATED FATTY ACIDS: CONTAIN ONE OR MORE CARBON-TO-CARBON
DOUBLE BONDS
Fatty Acids
Saturated
Unsaturated
1
2
1

10. COMPARISON OF SATURATED &
UNSATURATED FATTY ACIDS
Saturated Fatty Acid Basis for
Comparison
Unsaturated Fatty Acid
Have carbon atoms with maximum
possible hydrogen atoms bound to
them
Hydrogen
atoms
Do not have maximum possible
hydrogen atoms bound to the
carbon atoms
Hydrocarbon chain are linear and
unbranched
Hydrocarbon
chain
Hydrocarbon chains are bent and
branched
Mostly found in animal fats like
butter, meat, and whole milk
Sources Mostly found via plant source like
vegetable oil, sunflower oil, mustard
oil, avocado oil.
Higher melting point Melting point Lower melting point
Solid state State at room
temperature
Liquid state
Higher shelf life, can be stored for a
long time without spoilage
Shelf life Less shelf life, cannot be stored for
a long time without being spoiled
Might lead to heart diseases Excessive Might result in the reduction of

11. SIMPLE LIPIDS
1. TRIGLYCERIDES (FATS AND OILS)

12. TRIGLYCERIDES (FATS AND OILS)
• ESTERS MADE UP OF GLYCEROL AND 3 FATTY ACIDS.
• TRIACYLGLYCEROL IS THE CORRECT CHEMICAL NAME, BUT COMMONLY KNOWN
AS TRIGLYCERIDE.
• MAIN STORAGE OF FATTY ACIDS
• MAJOR DIETARY FAT

13. PHYSICAL PROPERTIES OF FATS AND OILS
• COLOURLESS, ODOURLESS AND TASTELESS
• LIGHTER THAN WATER, DENSITIES OF ABOUT 0.8G/CM3
• POOR CONDUCTORS OF HEAT AND ELECTRICITY>>EXCELLENT INSULATOR FOR
THE BODY, SLOWING DOWN THE LOSS OF HEAT THROUGH THE SKIN
• FAT IS SOLID AT 25OC, CONTAIN HIGH PROPORTION OF SATURATED FATTY
ACIDS
• OIL IS LIQUID AT 25OC, CONTAINS HIGH PROPORTION OF UNSATURATED FATTY
ACIDS

14. FUNCTIONS OF FATS IN THE BODY
1. ENERGY SOURCE: FATS PRODUCE MORE THAN DOUBLE THE ENERGY
PRODUCED BY PROTEINS AND CARBOHYDRATES
2. STORAGE: A MEAN TO TORE FOOD IN THE BODY FOR ENERGY AND TO
PROTECT INTERNAL ORGANS
3. KEEPS BODY WARMS IN COLD WEATHER
4. PRESENT IN CELL STRUCTURE AND NERVE TISSUES

15. SIMPLE LIPIDS
2. WAXES

16. WAXES
• CONSIST OF LONG CHAIN FATTY ACIDS LINKED THROUGH ESTER OXYGEN TO A
LONG-CHAIN ALCOHOL
• COMPLETELY WATER INSOLUBLE AND GENERALLY SOLID AT BIOLOGICAL
TEMPERATURES.
• STRONG HYDROPHOBIC NATURE, ALLOWS THEM TO FUNCTION AS WATER
REPELLENTS
• NATURALLY FOUND ON PLANTS AS A PROTECTIVE COATING TO CONTROL
EVAPORATION AND HYDRATION.
• BEST KNOWN ANIMAL WAX IS BEESWAX, WHICH BEES USE FOR CONSTRUCTING
HONEYCOMB
• SYNTHETIC AND WAXES ARE USED IN ADHESIVES, COSMETICS, FOOD, CANDLES AND
MANY OTHER COMMERCIAL PRODUCTS

17. COMPLEX LIPIDS
1. PHOSPHOLIPIDS

18. PHOSPHOLIPIDS
• MAJOR COMPONENTS OF THE PLASMA
MEMBRANE, THE OUTERMOST LAYER OF
ANIMAL CELLS.
• PHOSPHOLIPID MOLECULE: A MOLECULE
WITH 2 FATTY ACIDS AND A MODIFIED
PHOSPHATE GROUP ATTACHED TO
GLYCEROL BACKBONE.
• PHOSPHOLIPID MOLECULE IS AN
AMPHIPATHIC MOLECULE WHICH MEANS IT
HAS BOTH HYDROPHOBIC AND
HYDROPHILIC COMPONENT
• IN CELL MEMBRANE, PHOSPHOLIPIDS ARE
ARRANGED IN A BILAYER MANNER,
PROVIDING CELL PROTECTION AND SERVING

19. FUNCTIONS OF PHOSPHOLIPIDS
• AS MEMBRANE COMPONENT, PHOSPHOLIPIDS ARE SEMI-PERMEABLE, ALLOWS ONLY
CERTAIN MOLECULES PASS THROUGH THEM TO ENTER THE CELLS. MOLECULES THAT
ARE NONPOLAR OR SMALL POLAR MOLECULES SUCH AS O2, CO2, AND UREA. LARGE,
POLAR MOLECULES LIKE GLUCOSE OR ION LIKE SODIUM AND POTASSIUM CANNOT
PASS THROUGH EASILY. THIS HELPS KEEPS THE CONTENT OF THE CELL WORKING
PROPERLY AND SEPARATE THE INSIDE OF THE CELL FROM SURROUNDING
ENVIRONMENT.
• PHOSPHOLIPIDS CAN BE BROKEN DOWN IN THE CELL AND USED FOR ENERGY
• FOUND IN LUNG AND JOINTS WHERE THEY HELP LUBRICATE CELLS.
• IN PHARMACEUTICALS, IT IS USED AS PART OF DRUG DELIVERY SYSTEMS, IT HELPS
TRANSPORT S DRUG THROUGHOUT THE BODY TO THE AREA THAT IT IS MEANT TO
AFFECT. EG: VALIUM
• IN FOOD INDUSTRIES, PHOSPHOLIPIDS ACT AS EMULSIFIER, WHICH SUBSTANCE THAT
DISPERSE OILS DROPLET IN WATER SO THAT THE OIL AND WATER DO NOT FORM
SEPARATE LAYER. EG: EGG YOLKS CONTAIN PHOSPHOLIPIDS, USED IN MAYONNAISE

20. COMPLEX LIPIDS
2. GLYCOLIPIDS

21. GLYCOLIPIDS
• TYPE OF COMPLEX LIPIDS
COMPRISING CARBOHYDRATE,
FATTY ACIDS, SPHINGOLIPIDS OR A
GLYCEROL GROUP
• THESE MOLECULES ARE WIDELY
DISTRIBUTED IN TISSUE, BRAIN AND
ALSO NERVE CELLS

22. TWO MAIN CLASSES OF GLYCOLIPIDS:
1. GLYCOSPHINGOLIPIDS: A TYPE OF GLYCOLIPID CONTAINING SPHINGOSINE,
FATTY ACIDS AND CARBOHYDRATE
 SPHINGOMYELIN: AN INSULATOR IN MYELIN SHEATH OF NERVE CELLS
 CEREBROSIDES: OFTEN FOUND WITHIN BRAIN TISSUE
2. GLYCOGLYCEROLIPIDS: A TYPE OF GLYCOLIPID CONTAINING GLYCEROL,
FATTY ACIDS AND CARBOHYDRATE
 GLYCOPHOSPHOLIPIDS: FOUND IN RED BLOOD CELLS
 SULFOGLYCOGLYEROLIPIDS: LOCATED IN THE PHOTOSYNTHETIC CELLS OF PLANTS

23. FUNCTION OF GLYCOLIPIDS
• PROVIDE ENERGY TO CELLS
• ESSENTIAL PART OF CELL MEMBRANE
• HELPS DETERMINING BLOOD GROUP OF AN INDIVIDUAL
• ACT AS RECEPTORS AT THE SURFACE OF RED BLOOD CELLS
• IT ALSO FUNCTIONS BY ASSISTING IMMUNE SYSTEM BY DESTROYING AND
ELIMINATING PATHOGEN FROM BODY

24. COMPLEX LIPIDS
3. LIPOPROTEIN

25. LIPOPROTEIN
• LIPIDS THAT CONTAIN PROTEINS
• BINDING OF THE PROTEIN ALLOWS THE
FATS TO MOVE THROUGH THE WATER
INSIDE AND OUTSIDE CELLS

26. CLASSIFICATION OF LIPOPROTEINS
LIPOPROTEIN
CLASSIFICATIO
N
Cholesterol
composition
Triglycerides
composition
Functions
High density
lipoprotein
(HDL)
High Lowest Functions to deliver cholesterol from
extrahepatic tissue to the liver for
elimination
Low density
lipoprotein
(LDL)
Highest Low Functions to deliver cholesterol to the
peripheral tissues and to liver
Very low
density
lipoprotein
(VLDL)
Low High Functions to deliver triglycerides from
liver to peripheral tissues
Chylomicrons Lowest Highest Functions to deliver dietary triglycerides
to peripheral tissues

27. PRECURSOR AND DERIVED LIPIDS
CHOLESTEROL

28. CHOLESTEROL
• MOST ABUNDANT STEROID IN THE HUMAN BODY
• CHOLESTEROL IS THE WAX-LIKE SUBSTANCE, AN
IMPORTANT LIPID FOUND IN THE CELL MEMBRANE.
IN HUMAN BODY, CHOLESTEROL IS SYNTHESIZED
IN THE LIVER.
• FUNCTION:
• MAJOR COMPONENT OF CELL MEMBRANE
(ESPECIALLY ABUNDANT IN NERVE AND BRAIN
TISSUE)
• IMPORTANT IN THE SYNTHESIS OF BILE ACIDS. BILE
ACID IS ESSENTIAL FOR DIGESTION OF FAT
• PRECURSOR OF ALL STEROID HORMONES, NAMELY
ANDROGENS, ESTROGENS, PROGESTINS,

29. LIPIDS METABOLISM

30. 1. DIGESTION AND ABSORPTION OF LIPID
1. LIPID DIGESTED IN THE FORM OF TRIGLYCERIDE
2. DIETARY TRIGLYCERIDE BROKEN DOWN BEFORE BEING
ABSORBED BY THE INTESTINE
3. BILE SALT SECRETED BY LIVER, STORED IN GALLBLADDER
ARE RELEASED INTO SMALL INTESTINE TO SOLUBILIZE THE
TRIGLYCERIDES
4. PANCREATIC LIPASE IS PRODUCED BY PANCREAS AND
RELEASED INTO SMALL INTESTINE TO BREAK DOWN
TRIGLYCERIDES INTO MONOGLYCERIDES, FATTY ACIDS
AND GLYCEROL
5. IN THE INTESTINAL MUCOSAL CELLS, THE FATTY ACIDS
AND MONOGLYCERIDES ARE RESYNTHESIZED INTO
TRIGLYCERIDES AND PACKAGED INTO CHYLOMICRONS
WHICH THEN ENTERS THE LYMPH VESSEL.
6. CHYLOMICRONS ENABLE FATS AND CHOLESTEROL TO
MOVE WITHIN AQUEOUS ENVIRONMENT OF LYMPHATIC
AND CIRCULATORY SYSTEM.
7. THEY CAN GO TO LIVER OR BEING STORED IN FAT CELLS
(ADIPOCYTES) THAT COMPRISE ADIPOSE TISSUE FOUND

31. 2.A) LIPOLYSIS
• TO OBTAIN ENERGY, TRIGLYCERIDES ARE BROKEN DOWN BY HYDROLYSIS INTO
FATTY ACIDS AND GLYCEROL. THIS PROCESS IS CALLED LIPOLYSIS
• LIPOLYSIS PROCESS TAKES PLACE IN CYTOPLASM
Triglycerides from
adipocytes
Fatty Acid Glycerol
lipolysis
FA undergo oxidation
by β-oxidation into acetyl
CoA which is use in TCA
cycle
Glycerol  Glycerol-3-Phosphate  dihydroxyacetone phosph
ATP ADP NAD+ NADH + H+
gluconeogenesis
Glycerol kinase Glycerol
phosphate
dehydrogena
se

32. 3.A) FATTY ACIDS CATABOLISM
1. BREAKDOWN OF FATTY ACIDS (BETA OXIDATION)
• DEGRADATION OF FATTY ACIDS BY REMOVING TWO CARBONS AT A TIME.
• TAKES PLACE IN MITOCHONDRIAL MATRIX.
• BETA OXIDATION END PRODUCT:
• NADH
• FADH
• ACETYL COA WHICH IS USE IN TCA CYCLE TO MAKE ATP

33. 4.A) KETOGENESIS
• IF EXCESS ACETYL COA CREATED, AND OVERLOADS CAPACITY OF TCA CYCLE,
THE ACETYL COA CAN BE USED TO SYNTHESIZE KETONE BODIES.
• KETOGENESIS HAPPENS IN THE MITOCHONDRIA
• KETONE BODIES WILL BE USED BY THE HEART AND SKELETAL MUSCLES TO
PRESERVE THE LIMITED GLUCOSE LEVEL DURING STARVATION.
• 3 MAJOR TYPES OF KETONES:
1. ACETOACETATE
2. ACETONE
3. ΒETA-HYDROXYBUTYRATE.
• KETONES HAVE A CHARACTERISTIC FRUITY SMELL.

34. 5.A) UTILIZATION OF KETONE BODIES
• ACETONE IS NOT PRODUCTIVE MOLECULE, AND EXPELLED THROUGH THE
LUNGS.
• ACETOACETATE AND BETA-HYDROXYBUTYRATE ARE WATER-SOLUBLE, ABLE TO
TRAVEL FREELY THROUGH BLOOD TO THE EXTRAHEPATIC TISSUES.
• THEY ARE CONVERTED BACK TO ACETYL-COA WHEN IN NEEDS AND ENTERS THE
TCA CYCLE. ADDITIONAL KETONE BODIES EXCRETED BY URINE.

35. 2.B) BLOOD CHOLESTEROLS FORMATION
• AFTER CIRCULATING THROUGHOUT THE BODY, CHYLOMICRONS GRADUALLY RELEASE THEIR
TRIGLYCERIDES UNTIL ALL THAT IS LEFT OF THEIR COMPOSITION IS CHOLESTEROL-RICH
REMNANTS.
• THIS REMNANTS USED BY THE LIVER TO FORMULATE SPECIFIC LIPOPROTEINS.
i. VLDLS: TRANSPORT TRIGLYCERIDES FROM LIVER TO VARIOUS TISSUES IN BODY. AS VLDL TRAVELS,
THE LIPOPROTEIN LIPASE REMOVE TRIGLYCERIDES FROM VLDL. VLDL NOW BECOME IDL.
ii. IDL: WHILE TRAVELLING, CHOLESTEROL IS GAINED FROM OTHER LIPOPROTEINS. WHILE
CIRCULATING ENZYMES REMOVES ITS PHOSPHOLIPID COMPONENT. IDL RETURN TO LIVER AND
TRANSFORMED INTO LDL.
iii. LDL: “BAD CHOLESTEROL”. LDL DELIVER CHOLESTEROL AND OTHER LIPIDS TO CELLS, EACH CELL’S
SURFACE HAS RECEPTOR SYSTEMS SPECIFICALLY DESIGNED TO BIND WITH LDL. ONCE INSIDE THE
CELL, LDL TAKEN APART AND ITS CHOLESTEROLS IS RELEASED. IN LIVER CELLS, THESE RECEPTOR
SYSTEMS AID IN CONTROLLING BLOOD CHOLESTEROL LEVELS AS THEY BIND THE LDL.
iv. HDL: “GOOD CHOLESTEROL” RESPONSIBLE FOR CARRYING CHOLESTEROL OUT OF THE BLOOD-

36. SUMMARY OF LIPID METABOLISM
DIGESTION OF
LIPID AND FORM
CHYLOMICRONS
LYMPH VESSEL
CIRCULATORY
SYSTEM
ADIPOSE TISSUE
GLYCEROL
LIPOLYSIS
GLUCONEOGENESIS
BLOOD
CHOLESTEROLS
FORMATION
UTILIZATION OF
KETONE
KETOGENESIS
FATTY ACIDS
CATABOLISM
FATTY ACIDS

37. LIPID METABOLISM DISORDER
1. DIABETIC KETOACIDOSIS
2. CARDIOVASCULAR DISEASE

39. 1. DIABETIC KETOACIDOSIS
• DIABETES KETOACIDOSIS (DKA) IS A CONDITION CHARACTERISED BY INCREASE
OF GLUCOSE LEVEL IN BLOOD (HYPERGLYCAEMIA), HIGH KETONE LEVEL IN
BLOOD, AND PRESENCE OF KETONE IN URINE (KETONURIA).
• DKA OCCURS WHEN THERE IS INSULIN DEFICIENCY.
1. INSULIN: FUNCTIONS TO LOWERS BLOOD GLUCOSE BY ENHANCE RATE OF
GLYCOLYSIS FOR ENERGY PRODUCTION
2. WITHOUT INSULIN: LIVER RAPIDLY BREAKS DOWN FAT TO EMPLOY AS A FUEL
SOURCE, RESULTS IN OVERPRODUCTION OF KETONE BODY IN BLOOD AND URINE,
LEADING TO DIABETIC KETOACIDOSIS.
• MAINLY OCCURS IN DM TYPE 1 BUT NOT UNCOMMON IN DM TYPE 2

40. DIABETIC
KETOACIDOSIS

41. RISK FACTOR OF DKA
• PEOPLE WITH DM TYPE 1 SINCE
THEIR BODY DOESN’T MAKE
INSULINS.
• MISSING INSULIN DOSE OFTEN
• NOT TAKING INSULIN AS
PRESCRIBED
• STOMACH ILLNESS
• INFECTIONS
• HEART DISEASE
• RECENT STROKE
• BLOOD CLOT IN LUNGS
• SERIOUS ILLNESS OR TRAUMA
• PREGNANCY
• MEDICINES LIKE STEROIDS OR
ANTIPSYCHOTIC
• USING ILLEGAL DRUGS SUCH AS
COCAINE

42. SIGNS AND SYMPTOMS OF DKA
EARLY SYMPTOMS:
• VERY THIRSTY
• URINATING A LOT MORE THAN
USUAL
IF UNTREATED:
• FAST, DEEP BREATHING
• DRY SKIN AND MOUTH
• FLUSHED FACE
• FRUITY-SMELLING BREATH
• HEADACHE
• MUSCLE STIFFNESS OR ACHES
• BEING VERY TIRED
• NAUSEA AND VOMITING
• STOMACH PAIN

43. DIAGNOSIS AND TREATMENT OF DKA
DIAGNOSIS OF DKA:
• BLOOD GLUCOSE LEVEL:
>250MG/DL
• URINE ANALYSIS: + KETONE,
+GLUCOSE
• ARTERIAL BLOOD GAS:
• BLOOD PH <7.3
• SERUM KETONE: +
• SERUM ELECTROLYTE
TREATMENT OF DKA
• REPLACING FLUID FROM FREQUENT
URINATING, HELP DILUTE EXCESS
SUGAR IN BLOOD
• REPLACING ELECTROLYTES. TOO
LITTLE INSULINS CAN LOWER
ELECTROLYTE LEVEL
• RECEIVING INSULIN. INSULIN REVERSE
THE CONDITION THAT CAUSE DKA
• TAKING MEDICINES FOR ANY
UNDERLYING ILLNESS THAT CAUSE
DKA SUCH AS ANTIBIOTIC FOR AN

44. CARDIOVASCULAR DISEASE

45. CARDIOVASCULAR DISEASE
• GENERAL CONDITIONS AFFECTING THE HEART OR BLOOD VESSELS
• USUALLY ASSOCIATED WITH BUILD UP OF FATTY DEPOSITS INSIDE ARTERIES
(ATHEROSCLEROSIS) AND AN INCREASED RISK OF BLOOD CLOTS
• TYPES OF CVD:
• CORONARY HEAR DISEASE: BLOCKAGE OF BLOOD VESSELS SUPPLYING THE OXYGEN TO
HEART MUSCLE
• PERIPHERAL ARTERIAL DISEASE: BLOCKAGE OF BLOOD VESSELS SUPPLYING THE ARMS AND
LEGS
• RHEUMATIC HEART DISEASE: DAMAGE TO HEART MUSCLE AND HEART VALVES FROM
RHEUMATIC FEVER, CAUSED BY STREPTOCOCCAL BACTERIA
• CONGENITAL HEART DISEASE: BIRTH DEFECTS THAT AFFECT THE NORMAL DEVELOPMENT
AND FUNCTIONING OF HEART.

46. RISK FACTOR AND GENERAL SYMPTOMS OF
CVD
RISK FACTOR
• UNHEALTHY DIET
• PHYSICAL INACTIVITY
• TOBACCO USE
• HARMFUL USE OF ALCOHOL
• OBESITY
GENERAL SYMPTOMS
• PAIN OR DISCOMFORT IN CENTRE OF
CHEST
• PAIN OR DISCOMFORT IN ARMS, LEFT
SHOULDER, ELBOWS, JAW OR BACK
• HEART ATTACK/STROKE
• DIFFICULTY TO BREATH, NAUSEA,
FAINTNESS, COLD SWEAT, PALE

47. THANK YOU!!