ch. 8 Cardiovascular system diseases & disorders

human disease etiology

In 2022, what was the leading cause of death attributable to Cardiovascular Disease?

A.) Stroke

B.) Hypertensive Diseases

C.) Heart Failure

D.) Coronary Heart Disease

E.) Diseases of Arteries

D.) Coronary Heart Disease

Anatomy & Physiology

Network of vessels involving— The arteries, veins, and capillaries. And a pump, the heart. 

Cardiovascular system

Supplies the heart muscle with oxygen and nutrients

Coronary Arteries

Provides blood flow to the brain

Carotid artery

Carries blood throughout the body

Peripheral Arteries

Heart Characteristics

• Size of your fist

• Located slight left of the middle of the chest

• Composed of cardiac muscle, 4 chambers, 4 valves

Purpose of heart valves

To prevent backflow of blood

What heart muscle tissues contracts and provides the force behind the pumping heart?

Myocardium

Cardiac Anatomy & Physiology

This heart muscle tissue is part of the Pericardium and prevents excess expansion/ movement of the heart

Epicardium

Cardiac Anatomy & Physiology

This heart muscle tissue initiates contractions which drive the cardiac cycle. Innervated (provided with nerves) by the Purkinje Fibers.

Myocardium

This heart muscle tissue lines the cavities and valves

Endocardium

Arteries are represented by…

Red blood vessels

Carries oxygenated blood

Veins are represented by…

Blue blood vessels

Carries deoxygenated blood

Arteries

What structure promotes smooth blood flow?

Endothelium

Arteries

What structure can vasoconstrict (contract) and vasodilate (relax)?

Smooth muscles

Arteries

What structure protects from injury?

Outer Layer; Connective tissue

Blood goes to

• The lungs

• Where blood is oxygenated

Pulmonary circuit

Blood goes to

• The body

• Oxygenated blood is provided to the rest of the body

Systemic circuit

Common Signs & Symptoms of Cardiac disease

• Chest pain

• SOB

• Tachycardia (fast-beating heart)

• Cardiac palpitations- feelings of fast-beating, fluttering, or pounding heart

Diagnostic Tests, Noninvasive procedures

Auscultation

Listening to heart for Heart sounds, murmurs, or rubs

Diagnostic Tests, Noninvasive procedures

Blood tests

Lab tests used to detect risk factors for heart diseases

• includes detection of: fats, cholesterol, and lipid components of blood (LDL, HDL, Triglycerides)

Diagnostic Tests, Noninvasive procedures

Estimates the blood flow through your blood vessels by bouncing high-frequency sound waves off circulating red blood cells

• turned into pictures showing blood flow through the arteries/ the heart

Diagnostic Tests, Noninvasive procedures

Electrocardiogram (EKG/ECG)

Records the heart’s electrical activity

Diagnostic Tests, Noninvasive procedures

Echocardiography (echo test)

Uses sound waves (ultrasound) to examine the mechanical and structural function of the heart, providing info on shape, size,  workings, valves, and chambers of the heart. 

Diagnostic Tests, Noninvasive procedures

PET scan

Uses radioisotopes to produce images of the heart. Detects whether areas of the heart muscle are receiving enough blood.

Diagnostic Tests

Stress Test

Shows how well the heart works when the body is physically active; Detects presence/ absence of blockages/ narrowing in coronary arteries

Diagnostic Tests

Cardiac catheterization

Determines oxygen content & blood pressure; Provides information on how well the heart is functioning.

What happens during a Cardiac Catheterization?

A catheter (thin tube) is inserted into the heart through a blood artery in the arm or groin, directed to the heart and to the origin of the coronary arteries, as well as in the left ventricle (main pumping center). 

Diagnostic Tests

X-rays

Shows the shape and size of the heart lungs & major blood vessels. Determines normal function of heart and vessels; Angiography, Venogram

Diagnostic Tests

Blood tests, Enzyme detected when there is a sign of injury or stress in the muscles or heart

Creatine Phosphokinase (CPK)

Diagnostic Tests

Blood tests, Enzyme detected in various body tissues including the heart. May cause damage to the heart

Lactate Dehydrogenase (LDH)

Diagnostic Tests

Type of X-ray: pictures of the heart and its blood vessels after injecting a radiopaque substance

Angiocardiography

Diagnostic Tests

Type of X-ray: uses a special dye (contrast material) and sees how blood flows through the arteries in the heart

Angiography

Diagnostic Tests

Type of X-ray: uses a special dye and sees how healthy veins are

Venogram

Disease of Arteries

Primary Hypertension

Develops over time as you get older. Idiopathic with gradual onset.

Disease of Arteries

Secondary Hypertension

High blood pressure is caused by another medical condition or use of certain medicines

AKA as the “Silent Killer”

Hypertension

Measures highest pressure in artery when the ventricles contract

Systolic

Measures pressure in artery when ventricles relax

Diastolic

Hardening of the arteries; Arteries thicken and lose flexibility

Arteriosclerosis

What conditions can cause hardening and thickening of the arteries?

High cholesterol, High blood pressure, Diabetes or certain genetic influences

Buildup of fatty plaque in Arteries

Atherosclerosis

What is the plaque in Atherosclerosis made up of?

Cholesterol, calcium and fat

Diseases of Arteries

Bulge in a blood vessel cause by a weakness in the blood vessel

Aneurysm

The 2 most common places an Aneurysm can occur

Abdominal Aorta & the Brain

Diseases of Arteries

Circulation disorder that causes the blood vessel outside of the heart and brain to narrow, block, or spasm

Peripheral Vascular disease (PVD)

What is Peripheral Vascular disease (PVD) caused by?

Atherosclerotic plaque in arteries supplying blood to legs

Disease of Arteries

A group of diseases that result from atherosclerosis of coronary arteries

Coronary Artery disease (CAD); aka Coronary Heart disease or Ischemic heart disease

What are 2 common CADs?

Angina & Myocardial Infarction

Coronary Artery Diseases

Angina

Chest pain caused by reduced blood flow to the heart

How is Angina treated?

Vasodilaters

What is the purpose of a Vasodilator?

Medication that dilates or opens the blood vessel

CAD Treatments

Procedure that opens blocked coronary arteries and restores blood flow to the heart muscle without open-heart surgery

Angioplasty

How is an Angioplasty done?

A long, thin tube (catheter) with a balloon at its tip is put into a blood vessel and is guided to the blocked coronary artery. Once in place, the balloon is inflated at the narrow part of the heart’s artery.

What does catheter of an Angioplasty do?

Once the balloon is inflated, the plaque or blood clot is pushed against the sides of the artery, which makes more room for blood to flow

CAD treatments

a new artery is created and the damaged one is bypassed

Coronary Artery bypass graft (CABG)

How is Coronary Artery bypass graft (CABG) done?

A healthy piece of vein (either from leg, or artery from chest, or wrist) is attached to the coronary artery, just above and below the narrowed area or blockage

Diseases of the Heart

Pain on exertion when heart muscle cells do not receive enough blood flow and become starved of oxygen

Angina Pectoris

Predictable chest pain that occurs with exertion or stress and is relieved by rest or medication

Stable Angina

Unexpected chest pain that occurs at rest or with minimal exertion and is not relieved by rest or medication

Unstable Angina

Diseases of the Heart

Condition where the heart muscle doesn’t get enough oxygenated blood

Myocardial Infarction, aka Heart Attack

Symptoms of a Heart Attack

Pain to neck, arm, and jaw with discomfort (similar to indigestion)

Severe chest pain with diaphoresis and nausea

Long-term cardiac damage caused by either a single severe episode or multiple episodes of Acute Rheumatic Fever (AVR) or Scarlet fever

Rheumatic heart disease

Diseases of the Heart

Heart can’t pump enough oxygen-rich blood to meet the body’s needs. Blood often backs up and fluid can build up in the lungs, causing SOB

Congestive Heart Failure (CHF)

Diseases of the Heart

Symptoms of Congestive heart failure (CHF)

• Neck vein distention- large vein bulges visibly on neck

• Edema in ankles and lower legs

• Right sided leads to congestion of liver and spleen

• Left sided leads to congestion of lungs

How CHF be treated?

Diuretics; Helping remove excess sodium and water, which reduces swelling and lung congestion

Diseases of the Heart

Causes heart muscle to stretch, thicken, or become rigid and makes it harder for the heart to pump blood to the rest of the body

Cardiomyopathy

Diseases of the Heart

Inflammation of the heart muscle, reducing the heart’s ability to pump blood

Carditis

Diseases of the Heart

Heart valves are malfunctioning and causes irregular heart sounds

Valvular heart disease

Diseases of the Heart

Irregular heartbeat

Arrhythmias

What is the normal heart rhythm?

Sinus, 60 to 100 bpm

Diseases of the Veins

inflammation of a vein

Phlebitis, blood is clotting inside the vein or the vein walls are damaged

Diseases of the Veins

Formation of a blood clot associated with Phlebitis; Clotting in vessels of legs, thighs, and pelvis

Thrombophlebitis

What’s the difference between Phlebitis and Thrombophlebitis?

Phlebitis- inflammation of a vein

Thrombophlebitis- caused by one or more blood clots in a vein, which causes inflammation

Diseases of the Veins

Thrombus (blood clot) that traveled to the lungs

Pulmonary Embolism

Trauma

Body-wide deficiency of blood supply causing oxygen deprivation, buildup of waste products, and organ failure leading to death

Shock

What is Tissue perfusion?

Process of blood flowing through tissue to deliver oxygen and nutrients to cells, and remove waste

What can lead to a decreased tissue perfusion?

Extremely low blood pressure