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Cardiovascular and Cerebrovascular Diseases. Chapter 12. Physiology of the Cardiovascular System. Cardiovascular system Heart Blood vessels Lymphatics. Conduction System. Specialized conducting tissue Sinoatrial node The pacemaker Initiates electrical contraction in the heart
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Cardiovascular and Cerebrovascular Diseases Chapter 12
Physiology of the Cardiovascular System • Cardiovascular system • Heart • Blood vessels • Lymphatics
Conduction System • Specialized conducting tissue • Sinoatrial node • The pacemaker • Initiates electrical contraction in the heart • Atrioventricular node (AV node) • Atrioventricular bundle • Purkinhe fibers
Conduction System cont. • Abnormal rhythms • Cardiac arrhythmias • Cardiac dysrhythmias • Disturbance of the heart’s electrical conduction and amount of blood pumped from the heart • Ventricular fibrillation
Prevention of Cardiovascular Disease • Heredity • Environment • Lifestyle • Good nutritional habits • Abstention from smoking • Regular activity • Weight control • Stress management
Types of Cardiovascular Disease • Atherosclerosis (AS) • Hardening and thickening of the arteries • Loss of elasticity of the vessel walls • Lifestyle is a significant contributer • Myocardial infarcts (MIs) • Heart attacks • Cerebrovascular accidents (CVAs) • strokes
Types of Cardiovascular Disease cont. • Formation of Atheromas • Atherogenesis • Overabundance of LDLs • Accumulation • Macrophages foam cells • T lymphocytes • Atheroma (plaque formation)
Types of Cardiovascular Disease cont. • Atheromas (cont.) • Atherosclerotic plaque expands outward • Little effect • Expands inward • Restricts blood flow • Arterial remodeling • Predisposing factors
Types of Cardiovascular Disease cont. • Atheromas (cont.) • Predisposing factors: • Age • Gender • Familial hyperlipoproteinemias • Inborn abnormalities in lipid metabolism • hypercholesterolemia • Socially supported lifestyle habits
Types of Cardiovascular Disease cont. • Atheromas (cont.) • Predisposing factors (preventable): • Hyperlipidemia • Diet high in cholesterol • Lipoproteins: HDL vs. LDL • Hypertension, High Blood Pressure • Smoking • Diabetes Mellitus • Inflammation • Physical Inactivity • Obesity and Overweight • Miscellaneous Factors • Stressful lifestyle • Hyperuricemia
Types of Cardiovascular Disease cont. • Atheromas (cont.) • Symptoms • Don’t appear until disease is very advanced • Severe pain near heart and down left arm • Leg pain when walking • Dizziness • Nausea, weakness, sudden perspiration • Prevention • Treatment
Types of Cardiovascular Disease cont. • Atheromas (cont.) • Prevention • Controlling or eliminating risk factors • Treatment • Depends on severity and location of diseased arteries • Lifestyle adjustments • Diet, exercise, weight control, quitting smoking • Drugs to decrease lipidemia
Types of Cardiovascular Disease cont. • Hypertension • Multiple readings of 140/90 or higher • Essential Hypertension • Primary or idiopathic hypertension • Most common • Predisposing factors • Family history, race, stress, obesity, high intake of saturated facts or sodium, tobacco use, oral contraceptives, insufficient physical activity
Types of Cardiovascular Disease cont. • Primary Hypertension (cont.) • Symptoms • Nothing until it causes changes in the blood vessels • Severely elevated blood pressure • Damaged vessel in the brain: Stroke • Damaged vessel in the retina: Blindness • Damaged vessel in the kidneys: proteinuria • Prevention • Eliminate preventable risk factors • Annual checkup • Treatment • Eliminate/reduce preventable risk factors • Annual checkup
Types of Cardiovascular Disease cont. • Secondary Hypertension • Results from identifiable causes • Renal disease • Endocrine, vascular, and neurogenic disorders
Types of Cardiovascular Disease cont. • Coronary Artery Disease (CAD) • Insufficient blood supply to the heart • Predisposing Factors • Atheromas • Narrowing of a vessel slows the movement of blood
Types of Cardiovascular Disease cont. • Coronary Artery Disease (CAD) (cont.) • Symptoms • Angina pectoris • Prevention • Same as for atheromas • Treatment • Lifestyle changes • Drugs to reduce oxygen consumption or increase oxygen supply to the heart • Angioplasty • Atherectomy
Types of Cardiovascular Disease cont. • Myocardial Infarct (Heart Attack) • Coronary artery blood flow is reduced by AS or a clot • Predisposing Factors • Family history of MI, hypertension, smoking, elevated serum triglyceride and cholesterol levels, obesity…
Types of Cardiovascular Disease cont. • Myocardial Infarct (Heart Attack) • Symptoms • Persistent crushing pain beneath the sternum • Prevention • Same as for AS • Treatment • CPR • Drugs to relieve chest pain, stabilize heart rhythm • Aspirin
Types of Cardiovascular Disease cont. • Rheumatic Heart Disease • Inflammation of the heart • A result of a systemic inflammatory disease of childhood (Rheumatic Fever) • Antibiotic treatment has decreased the incidence of rheumatic fever
Types of Cardiovascular Disease cont. • Rheumatic Heart Disease • Predisposing Factors • Rheumatic fever • Symptoms • Murmur (valve dysfunction) • Chest pain, extra heart sounds, heart block, atrial fibrillation • Prevention • Early treatment of streptococcal infections • Treatment • surgery
Types of Cardiovascular Disease cont. • Congestive Heart Failure (CHF) • Usually damage to left ventricle • Right sided heart failure • cor pulmonale • Predisposing Factors • Hypertension, mitral stenosis, aortic stenosis
Types of Cardiovascular Disease cont. • Congestive Heart Failure (CHF) • Symptoms • Fatigue, dyspnea, nocturia, liver enlargement • Coldlike symptoms • Prevention • Same as for AS • Treatment • Bed rest with diuretics • Digitalis • vasodilators
Types of Cardiovascular Disease cont. • Thrombophlebitis • Inflammation of a vein PLUS • Formation of a thrombus • Can become an embolism in deep veins • Predisposing factors • Alteration of the epithelial lining of the vein • Surgery or trauma • Prolonged bed rest, oral contraceptives, heredity, obesity…
Types of Cardiovascular Disease cont. • Thrombophlebitis • Symptoms • Superficial • Chemicals are released causing pain, heart, swelling, redness, tenderness, hardness • Deep • Pain, fever, chills, malaise, swelling, cyanosis • Prevention • Reducing risk factors for AS • Treatment • Pain relief • Bed rest and elevation
Types of Cardiovascular Disease cont. • Varicose Veins • Dilated and twisted veins • Predisposing factors • Obesity, hormonal changes during pregnancy or menopause, extended standing • Symptoms • Cramps, dull aching, pain in feet and ankles • Prevention • Lifestyle choices to avoid obesity • Avoiding long periods of standing • Treatment • Antiembolism stockings, exercise, rest, elevation of the extremity • Surgery in severe cases
Types of Cardiovascular Disease cont. • Congenital Heart Defects • Abnormality of the heart that is present at birth • Ventricular septal defect (VSD) • Patent ductus arteriosus (PDA) • Artial septal defect (ASD) • Pulmonic stenosis • Coarctation of the aorta • Tetralogy of Fallot
Types of Cardiovascular Disease cont. • Congenital Heart Defects • Symptoms • May not appear until adulthood • Difficulty breathing • May tire rapidly with activity • Predisposing Factors • 90% of the cases have an unknown cause • Environmental • During pregnancy: Rubella, smoking, alcoholism, other drug use • Age of the mother
Types of Cardiovascular Disease cont. • Congenital Heart Defects • Prevention • Pregnant or possibly pregnant women • Abstain from alcohol • Avoid contact with anyone with rubella • Only doctor approved drugs should be taken • Treatment • Rest, oxygen, various drugs • Surgery • valvuloplasty
Cerebrovascular Disease Accidents that are caused by disorders in or of the blood vessels that affect the brain
Cerebrovascular Disease cont. • Cerebrovascular Accident (CVA or Stroke) • Sudden impairment of cerebral circulation • Thrombus • Most common cause in older people • Embolus • Second most common cause • Likely among people with a history of heart disease • Hemorrhage • Chronic hypertension or aneurysms
Cerebrovascular Disease cont. • Cerebrovascular Accident (CVA or Stroke) • Over half who survive are permanently disabled • Predisposing factors • History of transient ischemic attacks, gout, postural hypotension
Cerebrovascular Disease cont. • Cerebrovascular Accident (CVA or Stroke) • Symptoms • Transient ischemic attack • Progressive stroke • Completed stroke • Unconsciousness, heavy breathing, partial paralysis… • Prevention • Elimination or reduction of controllable predisposing factors • Treatment • Anticonvulsants, stool softeners, corticosteroids, analgesics • Surgery • Neurogenesis