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Cardiovascular Disease. Chapter 9. Causes of Death (2003). Types of Cardiovascular Disease. Hypertension 50,000,000. Coronary Artery Disease (CAD) 12,400,000. Angina pectoris 6,400,000. Myocardial Infarction (Heart Attack) 7,300,000. Cerebral Vascular Accident (Stroke) 4,500,000.
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Cardiovascular Disease Chapter 9
Types of Cardiovascular Disease • Hypertension • 50,000,000. • Coronary Artery Disease (CAD) • 12,400,000. • Angina pectoris • 6,400,000. • Myocardial Infarction (Heart Attack) • 7,300,000. • Cerebral Vascular Accident (Stroke) • 4,500,000.
Blood Pressure Systolic Category Diastolic Optimal <120 <80 Normal <130 <85 High Normal 85-89 130-139
Classifications of Hypertension Systolic Diastolic Mild (1) 140-159 90-99 Moderate (2) 160-179 100-109 Severe (3) 180-209 110-119 Very Severe (4) > 210 > 120
Types of Hypertension • Essential Hypertension – No known cause. • Age • Weight • Ancestry • Sodium intake • Smoking • Secondary Hypertension – Secondary to other diseases. Renal, Endocrine
Consequences of HBP • Stroke • Angina • Myocardial infarction • Heart failure • Renal dysfunction • Blindness • Death from a cardiovascular cause
Coronary Artery Disease • Disease of the arteries supplying blood to the heart resulting from: • Arteriosclerosis • Atherosclerosis
Arteriosclerosis • Hardening of the arterial walls. • Reduces elasticity of arteries • Increases stress on heart
Atherosclerosis • The formation of atheromatous plaques resulting in restricted blood flow • Deposits of cholesterol, other fats, connective tissue, and muscle tissue from healing of arterial damage
In a Nutshell • We need special molecules to transport fats (lipids) – LDL (bad) HDL (good) • LDL infiltrate arterial wall and oxidize (change) • Changed LDL’s alter wall to express “adhesion molecule.” • Adhesion molecules attract macrophages • Macrophages eat LDLs --- Foam Cells • Cap forms over this • Foam cell secrete inflammatory chemicals • Cap breaks and clots form. • Debris the sticks and builds
Consequences of CAD • HBP • Angina Pectoris • Heart Attack • Stroke • Conditions related to the above
Myocardial Infarction • Cardiac necrosis resulting from ischemia (blocked blood flow) • Necrotic tissue does not regenerate • Consequences related to amount of necrosis • Slightly more than half of those with first MI survive
Consequences of MI • Impaired cardiac function • Limits physical ability • Death • Increased risk for future attacks
Cerebrovascular Accident • Decreased blood supply to a part of the brain • Caused by rupture , occlusion, or stenosis of the blood vessels • Onset may be sudden or gradual • Symptoms and patient problems depend on location and size of area of brain with reduced or absent blood supply • Common vs. Hemorrhagic • Third leading cause of death
Stroke Rate by State (per 100,000) • 1 South Carolina 81.4 • 2 North Carolina 78.5 • 2 Tennessee 78.5 • 4 Arkansas 77.2 • 5 Georgia 74.8 • 6 Mississippi 74 • 7 Oregon 71.6 • 8 Alabama 71.5 • 8 Indiana 71.5 • 10 Oklahoma 69.5 • 11 Washington 68.7 • 41 North Dakota 55.5 • 42 Vermont 54.9 • 43 Arizona 53.8 • 44 Massachusetts 51.5 • 45 Connecticut 51.4 • 46 New Mexico 50.6 • 47 Florida 49.6 • 48 New Jersey 49 • 49 Rhode Island 45.6 • 50 DColumbia 44.4 • 51 New York 40.9
Common Stroke • Stoke resulting from vascular blockage • Thrombosis • Blockage due to build-up • Embolus • Build-up (clot) breaks away and travels until it block cerebral vessel
Hemorrhagic Stroke • CVA secondary to bleeding • Rupture • Aneurysm
CVASigns and Symptoms • Altered LOC • Change in mental status • Decreased attention span • Decreased ability to think and reason • Difficulty following simple directions • Communication; motor and sensory aphasia difficulty with reading ,writing, speaking, or understanding • Bowel and bladder dysfunction retention impaction or incontinence
CVASigns and Symptoms • Seizures • Limited motor function; paralysis, dysphgia, weakness , hemiplegia, loss of function or contractures • Loss of sensation/ perception • Headaches and syncope • Loss of temp regulation elevated TPR and BP • Absent of gag reflex ( aspiration) • Unusual emotional responses; depression, anxiety, anger, verbal outburst, and crying: emotional lability • Problems related with immobility