Chapter 12 Cardiovascular

During a stroke

the cells normally supplied by the vessel (blocked/burst) do not receive O2. As a result, these cells die. Pressure builds in the brain due to the blood being spilled out of the vessel. When the blood clots, it damages brain tissue causing physical damage.

Coronary Thrombosis

the development of a thrombus that blocks a coronary artery

Echocardiogram

ultrasound is used to see the beating heart

Angiogram

x-ray of blood vessel after injecting a contrast medium (usually I2)

Peripheral vascular disease

blockage to vessels at sites other than the heart ie: erectile dysfunction.

Cigarette Smoking

2 - 4 x more likely than nonsmokers to develop CAD & 10x more likely to develop PVD Majority of CVD in women under 50 Compound in cigarette smoke enter the blood vessel lining directly, which leads to formation of plaque (atherosclerosis). This include second-hand smoke.

CV System

A body system that pumps blood enclosed in blood vessels to all parts of the body.

Arrhythmias

Abnormal heart beat.

angina pectoris

Angina is felt beneath the breastbone and extends into the left shoulder & arm Angina attacks can be brought on: Physical exertion Mental or Emotional stress *Angina should not be ignored, sign of CAD Treatment: rest & drugs to reduce heart workload & its need for O2

Coronary Arteries

Arise from the base of the aorta Bring freshly oxygenated blood to the heart muscle itself There are left and right coronary arteries. They branch further into multiple arteries that supply the entire heart with blood

Thrombus

stationary blood clot; can block blood vessel where it forms.

Importance of a Healthy CV System

Cardiovascular system aka circulatory system Cardio = heart Vascular = vessels Cardiovascular Disease (CVD): Dysfunction of the heart and blood vessels.

Arteries

Carry blood away from the heart; branch into smaller blood vessels called arterioles, which branch into smaller vessels called capillaries

Major CVD

Coronary artery disease (CAD): blocked coronary artery Stroke: blood vessel disease of the brain Hypertension: chronic high blood pressure Rheumatic heart disease: complication of strep throat Atherosclerosis: blood vessel disease; underlying cause of CVD

Diabetes

Elevated blood glucose levels damage heart muscle, small coronary arteries, and major arteries; allowing atherosclerosis to occur. Diabetics are 5x as likely to develop CVD

Gender

First major CV event occur 10 years later in women than in men.

Hypertension

For people over 18, normal pressure is less than 120/80 mm Hg. 120 is systolic pressure (pressure exerted on artery walls when the heart's left ventricle contracts) 80 is diastolic pressure (pressure exerted on artery walls when left ventricle relaxes).

Heart Attack

aka myocardial infarction Victims of CAD are unaware that the arteries supplying their heart with blood have become blocked.

Heart

Four chambers (two atria and two ventricles) Coronary arteries supply heart with blood

Cardiac Arrest

Heart suddenly stops beating. Immediate defibrillation is needed to avoid death and/or heart, lung, or brain damage.

Tissue Plasminogen Activator (tPA)

Is a clot-dissolving drug If given within 3 hours of a stroke's onset, it raises the chances that no permanent brain damage will occur.

Elevated C-Reactive Protein

It is protein made by the liver during acute inflammation. Inflammation can be present at the site of plaque, but in other sites as well. An elevated blood level C-reactive protein can be a positive risk factor for CVD

Blood

Red blood cells (carry oxygen) Plasma (transport gases) Platelets (clotting factor) White blood cells (protect body from infection)

Veins

Return blood to the heart At the veins, blood has lost most of its pressure. Have thinner walls than arteries, contain less muscle and elastic tissue. Have one-way valves which help prevent the back-flow of blood Blood from the lower body combats gravity, but it has the help of skeletal muscle to propel it to the heart.

Physical Inactivity

Sedentary people are about 2x as likely to develop CAD as active people.

Obesity

Shows a strong association between weight & heart disease in men and women.

Risk Factors for CVD

Some risk factors are modifiable (people can reduce their risk by changing behavior) Major CV disease risk factors 1. Gender 2. Increasing age 3. Family history of CV disease 4. Cigarette smoking 5. Obesity 6. *Hypertension

Ways to reduce CV risk

Stop smoking Control/Lose weight Exercise regularly Lower Blood Pressure Reduce Blood Cholesterol Eat less fat, Learn to relax, Reduce sodium intake

Anxiety and Stress

Stress can result in spasms of the coronary arteries, which can contribute to angina attacks. People with anxiety disorders are 2-6 times as likely to die from a heart attack as people without.

Importance of CV Health Early in Life

Studies show young people with RF for CVD began developing fatty streaks within their arteries in their teen years. The conclusion was: reducing the likelihood of developing CVD later in life involves controlling RF early in life.

Blood vessels

arteries, arterioles, capillaries, venules, veins, & coronary arteries

Increasing Age

The incidence of CAD rises in both men & women with each decade (from age 40-79).

Family History

Twice as likely to suffer a heart attack if you have a family history.

Signs and symptoms of stroke

Weakness, numbness, or paralysis on one side of the body Loss or dimming of vision Loss of speech or difficulty speaking or understanding speech Sudden severe headache Sudden dizziness, unsteadiness, or episodes of falling

Capillaries

Where exchange of nutrient occurs Permeate tissues (walls are only 1 cell thick). Allow substances to move out of blood and waste products to move into blood. Capillaries join to form larger vessels called venules

Heart Attack M F

Women tend to have more subtle signs and symptoms than men. Most heart attacks result of coronary artery thrombosis.

Bypass Surgery

aka Coronary artery bypass graft surgery (CABG) : it bypasses the blocked portion of the diseased vessel

Heart Failure

aka congestive heart failure: ineffective pumping

Coronary Artery Disease

aka coronary heart disease In CAD, coronary vessels become partly or completely blocked.

Cerebral embolism

caused by a clot formed elsewhere & becomes lodged in a cerebral artery blocking blood flow.

Cerebral thrombosis

caused by a stationary clot

Cerebral hemorrhage

caused by an artery in the brain bursting. Due to: High blood pressure & atherosclerosis. Head injury A burst aneurysm:swollen, weakened blood vessel

Coronary angiography

done when a Dr suspects blockage; locates degree & location of blockage.

Stress test

exercise while being connected to test equipment which measures the performance of the heart

Embolus

floating blood clot; this can happen by the thrombus dislodging; it can block a blood vessel downstream.

Venous Disease

happens if the veins walls are weak or valve is damaged: Varicose veins: distended or stretched veins Deep tissue thrombosis: blood clot in the deep veins Chronic venous insufficiency: swollen legs

Atherosclerosis

hardening of the arteries Begins as an injury to the inner lining. Compound accumulation takes place at the site, narrowing the interior. Scar tissue is formed and Ca is deposited causing the "hardening" Blood clots may develop at the site blocking the passage of blood and causing heart attack

infarction

is an area of tissue that dies due to insufficient blood flow & lack of oxygen.

Atherectomy

methods that remove plaque from the interior of an artery.

Transient ischemic attacks

minor strokes that usually cause no permanent damage & have signs that last for only a short time. *TIAs are a serious warning that a stroke may occur within weeks or months.

Stenosis

narrowing of 1 or both of the carotid arteries.

stroke

occurs when arteries that supply the brain become blocked, preventing blood flow.

Blood clots

often form suddenly when the plaque in an artery breaks apart and platelets clump at the site.

Coronary Embolism

produced when an embolus blocks a coronary artery downstream from where it was formed

MRI

radio waves, creates images of the heart & vessels

Angioplasty

reconstruction of damaged blood vessels Balloon angioplasty a balloon is inserted & inflated, breaking up the plaque. Usually a stent (springlike mesh device; help to prevent re-clogging) is used.

Atrial fibrillation

results in the formation of floating blood clots that can travel to the brain