PLTW- Heart Disease

Stentin LAD

- Coronary arteries are blocked and stent opens up the vessels to allow for blood flow

Mitral Valve Prolapse

- Mitral valve doesn't close properly - It can lead to mitral valve regurgitation (some blood flows back into the L.A.) • Complications include arrhythmias and heart valve infection (endocarditis)

Peripheral Vascular Disease

- Plaques are beginning to form in the vessels of the legs

Atherosclerosis

- The formation of plaques on the inside of vessels. - Excess of cholesterol deposited on the inside of arteries supplying both the heart and the brain • Complications include heart attack and stroke

SA node- pacemaker, sets rhythm

1

A

1. Which is the correct direction of blood flow? a. Right atrium -> right ventricle -> pulmonary artery b. Right atrium -> left atrium -> pulmonary artery c. Left ventricle -> pulmonary artery -> aorta d. Left ventricle -> left atrium -> aorta

A

10.Regarding the diagram of an EKG to the right, the QRS interval represents a. Ventricular contraction b. Ventricular repolarization c. Atrial repolarization d. Atrial contraction

D

11.Regarding the diagram of an EKG to the right, the P wave represents a. Ventricular contraction c. Atrial repolarization b. Ventricular repolarization d. Atrial contraction

A

12. Typically more attention is paid to the top number of your blood pressure, the systolic number. Generally, in adults, this number rises. This can be caused by all of the following except a. Increasing incidences of angioplasty b. Narrowing of the arteries because of plaque deposits, due to diet c. Increasing stiffening of the arteries over time d. Increasing incidence of vascular disease

C

13.The following are the four major parts regarding the electrical impulses of the heart. Order them from start of the impulse to the end. a. AV node, SA node, Purkinje fibers, Bundle of His b. AV node, SA node, Bundle of His, Purkinje fibers c. SA node, AV node, Bundle of His, Purkinje fibers d. SA node, AV node, Purkinje fibers, Bundle of His

B

14.Which of the following is considered the heart's natural pacemaker? a. AV node b. SA node c. Purkinje fibers d. Bundle of His

A

16.LDL is responsible for a. Transporting cholesterol to cells b. Removing excess cholesterol from the bloodstream c. Transposing cholesterol to the liver d. Both A and C are correct

D

17. HDL is responsible for a. Transporting cholesterol to cells b. Removing excess cholesterol from the bloodstream c. Transposing cholesterol to the liver d. Both B and C are correct

C

18.Veins contain ____ to make sure and maintain proper direction of blood flow a. Calcium b. Plaque deposits c. Valves d. Cilia

D

19.Uncontrolled hypertension can lead to a. Heart attack c. Kidney damage d. All of the answer choices are correct

AV node- impulses pauses, allowing atria to empty

2

B

2. Compared with the walls of arteries, the walls of capillaries a. Are thicker c. Lack valves b. Are thinner d. Have more resistance

B

20. The sudden death of brain cells when their blood supply is interrupted is called a. A heart attack c. Hypertension d. Atherosclerosis

C

25.Cholesterol is naturally produced in the a. Kidneys b. Gall bladder c. Liver d. Intestines

B

26.Cholesterol is a a. Lipid b. Lipoprotein c. Protein d. hormone

B

27.DNA is a. Positively charged b. Negatively charged d. Hormone c. Neutral d. Polar

A

28.Which is not true of a myocardial infarction a. It can lead to death b. It is caused by a blocked heart valve c. It's also known as a heart attack d. It can lead to tissue death

C

29.Metabolic syndrome is marked by 3 group factors. Which of the following is not a group factor? a. High blood pressure b. Abdominal obesity c. Low LDL levels d. High fasting blood glucose

Purkinje fibers- cause ventricles to contract, pushing blood out of heart

3

A

3. Through which path does blood typical flow through the circulatory system? a. Arteries -> capillaries -> veins b. Veins -> capillaries -> arteries c. Arteries -> veins -> capillaries d. Capillaries -> arteries -> veins

A

30.An angiogram would a. Visualize blood vessels after the injection of radio plaque substance b. Open the blood vessels feeding the heart tissues c. Require the use of a wire mesh and balloon d. Shunt blood around an obstruction

D

31.An EKG can indicate a. irregular speed of contraction b. myocardial infarction c. angina d. all of these

D

32.DNA is ________________ and will move through the gel toward the _______________ end of the electrophoresis chamber. a. Neutral, negative b. Negative, neutral c. Positive, negative d. Negative, positive

B

33.Which of the following is the most correct regarding the flow of blood through the body a. Body, heart, lungs, body, heart... b. Body, heart, lungs, heart, body... c. Body, lungs, heart, body... d. Body, lungs, body, heart, body...

A

34.What is the function of valves in the heart? a. Keep blood from flowing backwards b. Carry oxygen Please do not write on this assessment. Use the answer form provided. c. To pump blood d. To regulate HDL and LDL in the heart tissues

D

35.Which of the following are not known to influence heart rate? a. Diet b. Stress c. Exercise d. All of the above are known to influence heart rate

C

36.Which of the following is something that cholesterol does not do in the body? a. Make sex hormones b. Contribute to plaque build up c. Transport oxygen d. Contribute to building cell membranes

B

37.Which of the following is not used to treat a blocked blood vessel? a. A stent b. An angiogram c. A balloon angioplasty d. A coronary bypass

His bundle

4

B

4. Which type of blood vessel carries blood away from the heart? a. Veins c. Capillaries b. Arteries d. Lymph nodes

The average adult has a resting heart rate of ____ beats per minute.

72 bpm

B

9. Regarding the diagram of an EKG to the right, the T-wave represents a. Ventricular contraction b. Ventricular repolarization c. Atrial repolarization d. Atrial contraction

vein

A blood vessel that returns blood towards the heart.

valve

A body structure that temporarily closes a passage or orifice, or permits movement of fluid in only one direction.

HDL (high density lipoprotein)

A cholesterol-carrying particle in the blood, made up of cholesterol and other lipids surrounded by a single layer of phospholipids in which proteins are embedded. An HDL particle carries less cholesterol than a related lipoprotein, LDL, and may be correlated with a decreased risk of blood vessel blockage.

LDL (low density liproprotein)

A cholesterol-carrying particle in the blood, made up of cholesterol and other lipids surrounded by a single layer of phospholipids in which proteins are embedded. An LDL particle carries more cholesterol than a related lipoprotein, HDL, and high LDL levels in the blood correlate with a tendency to develop blocked blood vessels and heart disease.

restriction enzyme

A degradative enzyme that recognizes specific nucleotide sequences and cuts up DNA.

PCR (polymerase chain reaction)

A laboratory technique for amplifying DNA in vitro by incubating with special primers, DNA polymerase molecules, and nucleotides.

cholesterol

A lipid that forms an essential component of animal cell membranes and acts as a precursor molecule for the synthesis of other biologically important steroids.

heart rate

A measure of cardiac activity usually expressed as the number of beats per minute.

electrocardiogram (EKG)

A measurement of heart electrical activity.

familial hypercholesterolemia

A metabolic disorder that is caused by defective or absent receptors for LDLs on cell surfaces, that is marked by an increase in blood plasma LDLs and by an accumulation of LDLs in the body resulting in an increased risk of heart attack and coronary heart disease, and that is inherited as an autosomal dominant trait.

mutation

A rare change in the genetic material, ultimately creating genetic diversity.

sinoatrial node

A small mass of tissue that is made up of Purkinje fibers, ganglion cells, and nerve fibers, that is embedded in the musculature of the right atrium, and that originates the impulses stimulating the heartbeat -- called also S-A node, sinus node.

atrioventricular node

A specialized mass of conducting cells located at the atrioventricular junction in the heart.

coronary bypass

A surgical bypass operation performed to shunt blood around an obstruction in a coronary artery that involves grafting one end of a segment of vein removed from another part of the body into the aorta and the other end into the coronary artery beyond the obstructed area to allow for increased blood flow. or in other words a procedure that creates an alternate pathway for the blood around a blocked artery

stenting

A surgical procedure or operation for inserting a stent, a mold designed to keep a passageway open, into an anatomical vessel.

metabolic syndrome

A syndrome marked by the presence of usually three or more of a group of factors (as high blood pressure, abdominal obesity, high triglyceride levels, low HDL levels, and high fasting levels of blood sugar) that are linked to increased risk of cardiovascular disease and Type 2 diabetes.

mitral valve

A valve in the heart that guards the opening between the left atrium and the left ventricle; prevents the blood in the ventricle from returning to the atrium. Alternative name is bicuspid valve.

tricuspid valve

A valve that is situated at the opening of the right atrium of the heart into the right ventricle and that resembles the mitral valve in structure but consists of three triangular membranous flaps.

inferior vena cava

A vein that is the largest vein in the human body and returns blood to the right atrium of the heart from bodily parts below the diaphragm.

superior vena cava

A vein that is the second largest vein in the human body and returns blood to the right atrium of the heart from the upper half of the body.

genotype

All or part of the genetic constitution of an individual or group.

allele

Alternative versions of a gene that produce distinguishable phenotypic effects.

heart disease

An abnormal organic condition of the heart or of circulation.

hypertension

An abnormally high blood pressure.

heart attack

An acute episode of heart disease marked by death or damage of heart muscle due to insufficient blood supply to the heart muscle usually as a result of coronary thrombosis or a coronary occlusion and that is characterized especially by chest pain.

atrium

An anatomical cavity or passage; especially a chamber of the heart that receives blood from the veins and forces it into a ventricle or ventricles.

pacemaker

An electrical device for stimulating or steadying the heartbeat or reestablishing the rhythm of an arrested heart.

sphygmomanometer

An instrument for measuring blood pressure and especially arterial blood pressure.

tissue

An integrated group of cells with a common function, structure, or both.

artery

Any of the tubular branching muscular and elastic-walled vessels that carry blood from the heart through the body.

diastolic pressure

Blood pressure that remains between heart contractions.

atherosclerosis

Changes in the walls of large arteries consisting of lipid deposits on the artery walls.

Pulmonary Circulation

Circulation that sends the blood from the heart to the lungs to be purified, then back to the heart again. It carries deoxygenated blood to the lungs to unload CO2 and pick up O2

Systemic Circulation

Circulation that supplies blood to all the body except to the lungs

-The superior and inferior vena cava brings in deoxygenated blood to the heart -The deoxygenated blood enter the right atrium and then goes through the tricuspid valve into the right ventricle where it is pushed through the pulmonary semilunar valve -The pulmonary semilunar valve drops it into the pulmonary artery which brings it to the right and left lung -The pulmonary artery branches to the right and left side and drops off the CO2 and picks up O2 -Rich oxygenated blood reenters the heart by the pulmonary veins and delivers the oxygenated blood into the left atrium, it goes through the bicuspid valve into the left ventricle where its pushed to the aortic semilunar valve into the aorta where the blood is carried throughout the body

Describe how deoxygenated blood goes through the heart.

familial hypercholesterolemia

FH is a genetically inherited disease that is dominant (but sort of co-dominant with the non-disease). You cannot get FH unless at least one parent has it (or the mutation spontaneously occurs in your DNA, but odds of that are super slim). FF is the worst genotype because a person with that has 2 diseased alleles. Ff still gives a person the disease. The normal (non-diseased) genotype is ff. The diseased allele causes a mutation in the LDL receptor proteins, making less of them. Since those proteins help remove LDL from the blood, a mutation that limits them causes the buildup of LDL and can lead to atherosclerosis and heart disease or stroke. It is diagnosed via genetic testing like electrophoresis.

heterozygous

Having two different alleles for a given gene.

homozygous

Having two identical alleles for a given gene.

High risk for heart disease

High LDL means...

What is hypertension?

High blood pressure

What are 3 causes of hypertension?

High salt diet, being overweight & lack of exercise, caffeine

• High LDL levels carry too much cholesterol to the cells, which then builds up in the arteries. • Low HDL levels means not enough HDL to clear the arteries of the excess LDL. • Build of LDL causes Atherosclerosis, which reduces blood flow and can cause high blood pressure and heart attacks

How are LDL, HDL, and cholesterol related to heart disease? How do doctors interpret the results of a cholesterol test?

• Exercise • Diet low in fat and excessive carbohydrates • Medication • Quit smoking • Maintain a healthy weight

How can a person decrease his or her risk of heart disease?

PCR - is used to make many copies of the FHgene (amplify the DNA) • Restriction Enzymes are used to cut the FH Gene. Depending on the bases the enzyme will cut at different places, making different sized fragments, called RFLPs • Gel electrophoresis is used to separate the fragments bytheir lengths.The negativelycharged phosphates on the DNA movetowards the positive end and shorter fragments move farther. • The bands from each person can be compared to controls to identify the genotype that person has.

How can techniques of molecular biology be used to analyze DNA for the presence of the FHmutation?

Diagnosis - Use an angiogram to detect a blocked blood vessel - A radioactive dye is injected into the blood and X-rays are used to view the passage of the blood through the blood vessels • Treatments - Angioplasty - Atiny balloonis inserted via a catheter and is blown up to expand the artery to push the plague against the walls and restore blood flow Treatments - Stent - Wire mesh is inserted into the artery and compresses the plague. It then stays that way allowing for proper blood flow. - Coronary bypass - A vessel, usually from the leg, is taken and inserted on the heart to bypass the clogged area of the coronary artery to restore blood flow.The artery is connected to the coronary artery, continues passed the blockage, and is connected to the aorta.

How do doctors treat a blocked bloodvessel?

Veins have thinner walls

How do veins compare to arteries?

Systolic BP is when the heart is beating and should be below 120. Anything higher is either prehypertension or hypertension. • Diastolic BP is when the heart is at rest and should be below 80.

Howdo systolic and diastolic blood pressure values relate to the movement of blood in arteries? What factors can influence bloodpressure?

the atria are not contracting and if it was the ventricles it would be the QRS wave

In the EKG, if the P wave is completely absent, what does this indicate?

Heart rate monitors and EKG can pick up the electrical signals sent through the heart by measuring impulses in the skin. Sphygmomanometer (Blood pressure cuffs) can be linked to a computer to measure blood pressure.

In what ways can technology be used to collect and analyze cardiovascular data?

What is a sphygmanometer and what is it used to do?

It is literally a "pulse measurer" and is used to measure blood pressure (it's a blood pressure cuff).

What does a pacemaker do?

It sets the rhytym of the heart (replaces SA node)

What does EKG stand for and what is an EKG used to do?

It stands for electrocardiograph or electrocardiogram and shows the heart's electricity visually.

Radial pulse

Locate the radial pulse at the wrist. If you have trouble finding this pulse, turn the wrist being measured palm up. Wrap your other wrist (palm up also) around it until your fingers fold over the radial artery. What pulse is this?

Carotid pulse

Locate this pulse using your index and middle fingers on your neck. Slide your fingers alongside your jaw bone and down into the depression on the side of your neck.

What is considered NORMAL blood pressure? Record it. Label the systolic measurement and the diastolic measurement and explain the difference.

Normal is 120/80. Systolic is 120 and diastolic is 80. Systolic is the pressure in the arteries when the heart contracts (highest pressure) and diastolic is the pressure when it relaxes (lowest pressure).

blood pressure

Pressure exerted by the blood upon the walls of the blood vessels, especially arteries, usually measured by means of a sphygmomanometer and expressed in millimeters of mercury.

What are 3 ways to treat hypertension?

Reduce salt & caffeine intake exercise lose weight (meds to dehydrate also work)

risk factor

Something which increases risk or susceptibility.

stroke

Sudden loss of consciousness, sensation, and voluntary motion caused by rupture or obstruction (as by a clot) of a blood vessel of the brain.

angioplasty

Surgical repair or recanalization of a blood vessel or in other words a procedure that uses a tiny balloon to open a blood vessel

systemic circulation

The branch of the circulatory system that supplies all body organs and then returns oxygen-poor blood to the right atrium via the veins.

Explain how to take carotid pulse & radial pulse. Also list the normal pulse for an adult.

The carotid pulse is in the neck and the radial is in the arm (wrist). Use 2 fingers to feel for the pulse. Count it for a period of time, such as 10 s. Then multiply to get a count per minute (i.e. 8 beat/10 sec x 6 = 48 bpm). Normal pulse for an adult at rest is 72 bpm.

aorta

The large arterial trunk that carries blood from the heart to be distributed by branch arteries through the body.

electrophoresis

The movement of suspended particles through a fluid or gel under the action of an electromotive force applied to electrodes in contact with the suspension

pulmonary circulation

The passage of venous blood from the right atrium of the heart through the right ventricle and pulmonary arteries to the lungs where it is oxygenated and its return via the pulmonary veins to enter the left atrium and participate in systemic circulation.

phenotype

The physical and physiological traits of an organism that are determined by its genetic makeup.

systolic pressure

The pressure generated by the left ventricle during systole.

angiogram

The radiographic visualization of blood vessels after the injection of radiopaque substance or in other words a procedure using dye and x-rays to provide an image of the heart's blood vessels

pulse

The rhythmic expansion and recoil of arteries resulting from heart contraction; can be felt from the outside of the body.

aortic valve

The semilunar valve separating the aorta from the left ventricle that prevents blood from flowing back into the left ventricle.

cell

The smallest structural unit of living matter capable of functioning independently.

systole

The stage of the heart cycle in which the heart muscle contracts and the chambers pump blood.

diastole

The stage of the heart cycle in which the heart muscle is relaxed, allowing the chambers to fill with blood.

cardiology

The study of the heart and its action and diseases.

cardiovascular system

The transport system of the body responsible for carrying oxygen and nutrients to the body and carrying away carbon dioxide and other wastes; composed of the heart, blood vessels, and blood.

HDL - High Density Lipoprotein (made of mostly protein). - Job is to carry cholesterol from the arteries to the liver to be digested • LDL - Low Density Lipoprotein (made of mostly lipids). - Job is to carry cholesterol to the cells

What are LDL andHDL?

The risk factors for heart disease are: - Smoking - Diabetes - Family History - High blood sugar - High cholesterol (High LDL, low HDL) - Obesity - High triglycerides - High Blood Pressure - The last make up metabolic syndrome if you have 3 or more, which increases your risk of heart disease.

What are risk factors for the development of heart disease? What is metabolic syndrome?

• Common cholesterol medication, statins, will decrease LDL, triglycerides, and even CRP (involved in strokes), while slightly elevating HDL • However it can lead to side effects, such as muscle weakness and pain, even in the heart (since it is a muscle) • They can also cause amnesia for minutes to hours, headaches, dizziness, and liver dysfunction

What are the pros and cons of using cholesterol loweringmedications?

the length of the fragment

What determines how the DNA fragments separate during gel electrophoresis?

• EKG (Electrocardiogram) measures the electric impulse through the heart • SA node "pacemaker" signalsatriumto contract (formsP wave) • AV node receives signal from SA node • Purkinje fibers signalventricles to contract(formsQRS complex • T-wave-ventricles relax

What is anEKG?

Atherosclerosis is the build up of plaque, which can be due to excess LDL along the arterial walls, reducing blood flow • Atherosclerosis of the coronary artery can cause lack of oxygen to fuel the heart • It can cause lack of blood flow to the extremities, including the brain, causing strokes

What is atherosclerosis?How can cholesterol plaques affect the overall function of the heart?

Blood pressure is the amount of force placed on the arteries • It is taken using aSphygmomanometer • Systolic Blood pressure is the amount of pressure when a pulse is first heard when pressure is released. • Diastolic pressure is the amount of pressure when the pulse is no longer heard again.

What is bloodpressure?How do systolic and diastolic blood pressure values relate to the movement of blood in arteries?

Cholesterol is an important lipid that is made in the liver • It acts as a stabilizer for cell membranes and used for cell to cell communication. • It is a precursor to steroid hormones and Vitamin D • It helps for bile acids, which are important in fat digestion. • It also makes up the myelin sheath around nerve cells to improve the speed of nerve impulses

What is cholesterol?What roles does cholesterol play in our cells and in the body

Mutation of the LDL receptors on the cell membrane, which leads to a build of LDL in the blood stream. • It is an autosomal dominant trait so heterozygotes will still be affected

What is familial hypercholesterolemia and how is it inherited?

Heart disease is when the heart damaged, which affects heart function and circulation • Heart attacks occur due to lack of oxygen to the heart muscle, which cause cells to die.

What is heart disease?What happens inside the heart to cause a heart attack?

Decreased flow and increased pressure

What is the effect of narrowed arteries on a person's blood flow and blood pressure?

• To prevent the backflow of blood. - The A-V valves prevent backflow of blood into the atria - The semilunar valves prevent backflow of blood into the ventricles

What is the function of valves in the heart?

myocardial infarction

What is the medical term for a heart attack?

• Limit Trans and Saturated Fat as they increase LDL • Eat unsaturated fats to increase HDL • Exercise daily • Maintain healthy weight • Manage stress and do not smoke • Take medications, like statins if needed

What lifestyle changes may help a patient obtain healthy cholesterol levels?

The negative charge of the phosphate groups

What property of DNA causes it to migrate to the opposite pole of the electrophoresis chamber?

E. All of these increase risk

Which of the following increases the risk for heart disease? A. smoking B. diabetes C. family history D. abdominal obesity E. All of these increase risk

A. mitral valve replacement

Which of the following procedures is NOT used to treat a blocked or narrowed blood vessel? A. mitral valve replacement B. stent insertion C. coronary bypass surgery D. angioplasty

sino-atrial (SA) node

Which structure is the pacemaker of the heart?

capillary

Which type of blood vessel is the location of oxygen/CO2 exchange?

• In emergencies heart rate can tell us if the heart is working properly and pumping enough blood • Needs to be monitored if on certain medications or if you have a disease that lowers heart rate • Check your overall fitness/stress levels • Can be used to find the cause of symptoms such as lethargy and chest pain.

Why is it important to monitor the rate at which the heartbeats? What factors can influence heart rate?

Left ventricular hypertrophy

a condition in which the muscle wall of heart's left ventricle becomes thickened. -L.V. works too hard and becomes overly thick - Due to high blood pressure and obesity - Coronary arteries can cut off the blood supply to the heart - Linked to heart attacks, arrhythmias, and heart failure