CAD CVD

cardiomyopathy (damage to the heart)

• disease or weaking of the heart muscle (myocardium) → reduced pumping ability

infections cardiovascular disease

• pericarditis: inflammation of the outer lining (pericardium)

• myocarditis: inflammation of the heart muscle

• endocarditis: infection of the inner lining or valves

valve damage can lead to

• stenosis: narrowing of the valve opening

• regurgitation (leaking): backward flow of blood

• prolapse or improper closing: incomplete seal of the valve

atherosclerosis

• buildup of cholesterol-rich plaque in arteries

• causes narrowing, stiffness, and inflammation in vessels

Coronary artery disease (CAD)

• plaque in coronary arteries reduces blood flow to the heart muscle → risk of angina or heart attack (myocardial infarction)

abnormal heart rhythm (arrhythmias)

• Electrical conduction disturbances cause the heart to beat:

  • Too fast (tachycardia)

  • Too slow (bradycardia)

• Irregularly (fibrillation or flutter) Severe arrhythmias can prevent effective pumping or lead to sudden cardiac arrest

complications of heart disease

• heart failure

• heart attack

• stroke

• aneurysm

• peripheral artery disease

why hear need its own blood supply

• Myocardial cells are constantly active — they require continuous oxygen and nutrients to produce energy.

• They also need to remove carbon dioxide and metabolic waste.

• Because blood inside the heart chambers doesn’t nourish the muscle directly, the heart relies on its own network of vessels — the coronary arteries.

coronary circulation

• The right and left coronary arteries branch from the aorta, just above the aortic valve.

• They spread over the heart’s surface to supply oxygen-rich blood to all regions of the myocardium.

• Coronary veins then collect deoxygenated blood and return it to the right atrium via the coronary sinus.

Coronary Artery Disease (CAD)

• CAD develops when the inner lining of coronary arteries becomes damaged or inflamed, sometimes starting in childhood.

factors of CAD

• High blood pressure

• High cholesterol

• Smoking

• Diabetes

• Inflammation

• Damaged areas allow plaque buildup (atherosclerosis), which narrows or blocks arteries, reducing blood flow to the heart muscle.

• This can lead to angina (chest pain) or heart attack (myocardial infarction).

Arteriosclerosis

general term meaning “hardening of the arteries”

• Arteries lose elasticity and flexibility, making it harder for them to expand and contract with blood flow.

• Leads to increased blood pressure and reduced circulation.

Atherosclerosis

• a specific type of arteriosclerosis “narrowing of arteries”

• caused by plaque buildup inside the arterial walls

  • plaque is made up cholesterol, fat, calcium, and cellular debris

• Occurs when the arteries become thick and stiff - sometimes restricting blood flow to your organs and tissues.

• Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably.

• Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body.

how plaque forms during atherosclerotic disease

• LDL (“bad cholesterol”) deposits on the inner wall of arteries.

• Macrophages (immune cells) move in to remove LDL, but become foam cells instead.

• This process repeats, causing plaque buildup inside the vessel wall

plaque rupture during atherosclerosis

• Over time, the plaque cap can rupture or erode, exposing its contents to the bloodstream.

• The body reacts as if it’s an injury — platelets rush in and form a blood clot (thrombus).

risk factors of CAD

• Most common heart disease in the United States.

• Affects over 18 million adults nationwide.

• In 2021, CAD caused approximately 375,500 deaths in the U.S. •

• Often develops slowly over many years — symptoms may not appear until a heart attack occurs.

• Known as a “silent killer” because it can progress without warning signs.

symptoms of CAD

• Often no symptoms for many years (plaque buildup is slow)

• Stable angina: temporary chest pain or discomfort, often during activity

• Shortness of breath: especially with light activity

• Sometimes the first sign is a heart attack

non modifiable risk factors of CAD

• Age: Men >45 years, Women >55 years

• Family History: Especially if a biological parent has CAD (father in particular)

• Genetics/Ethnicity (certain populations at higher risk)

modifiable risk factors of CAD

• Tobacco & alcohol use

• High LDL cholesterol

• High blood pressure

• Sedentary lifestyle

• Poor dietary habits (e.g., high saturated fats)

• Obesity / overweight

• Diabetes (higher risk for women; varies by ethnicity)

• Chronic stress / psychosocial stressors

electrocardiography (ECG or EKG)

• Detects electrical impulses generated by polarization and depolarization of cardiac tissue

• Translates impulses into a waveform

• Provides information on: Heart rate, Heart rhythm / regularity of beats

ventricular fibrillation

• most deadly

• an arrhythmia that starts in your ventricle

• occurs when the electrical signals that tell your heart muscle to pump cause your ventricles to quiver (fibrillate) instead. The quivering means that your heart is not pumping blood out to the rest of your body

sudden cardiac arrest

• the heart is not beating effectively enough to pump blood

• Pacemaker cells stop initiating electrical signals altogether

• Other cells override pacemaker cells by sending very fast electrical signals

• Can become so fast that coordinated contraction fails → fibrillation

sudden cardiac arrest vs heart attack

• Heart attack: Blood flow to part of the heart is blocked; the heart usually keeps beating

• SCA trigger: A heart attack can sometimes cause an electrical disturbance that leads to sudden cardiac arrest

sudden cardiac arrest statistics

• prevalence & fatality:

  • 350,000-450,000 Americans affected per year

  • 95% fatality rate

• urgency:

  • death can occur within minutes if not treated

  • immediate action required: CPR

Cardiopulmonary resuscitation (CPR)

• Temporary life-saving measure when the heart can’t pump effectively

• Mechanism: Bystander manually compresses the heart via the ribcage to circulate blood

• Works without requiring normal electrical signaling

Automated External Defibrillators (AED)

• Deliver a controlled electrical shock to the heart

• Aim to reset the heart’s conduction system

• Stops uncoordinated ventricular fibrillation and allows normal rhythm to resume

hypertension (high blood pressure)

• Blood pressure: Pressure exerted by blood on the walls of blood vessels

• Hypertension: Blood pressure >140/90 mmHg

• Systole: Ventricles contract

• Diastole: Ventricles relax (atria contract)

effects of high blood pressure

• Damages blood vessel lining → increases risk of atherosclerosis

• Weakens blood vessels → can cause aneurysms and rupture

• Increases heart workload → heart must push blood against higher pressure

effects of uncontrolled hypertension

• stroke

• heart attack

• heart failure

• kidney damage

recommended sodium intake

• ≤ 2300 mg/day (~1 teaspoon of table salt)

• Average American intake: ~3400 mg/day

• For individuals with hypertension: Limit to ~1500 mg/day

stroke

• occurs when the blood supply to the brain is interrupted or severely reduced

• Brain cells begin to die within minutes due to lack of oxygen and nutrients

causes

• Blocked artery (ischemic stroke)

• Leaking or bursting blood vessel (hemorrhagic stroke)

special case

• Transient ischemic attack (TIA): temporary disruption of blood flow to the brain, often called “mini-stroke”

two main categories of strokes

• ischemic stroke (90%) caused by blocked artery

• hemorrhagic stroke (10%) caused by leaking or burst blood vessel

ischemic stroke

Caused by a blocked artery reducing blood flow to the brain

types:

• thrombotic stroke: blood clot forms directly in an artery supplying the brain

• embolic stroke: artery is blocked by debris (plaque or clot) that travels downstream and lodges in a brain artery

hemorrhagic stroke

• cause dby a leaking or burst blood vessel

• often linked to years of hypertension that weakens vessel walls

ischemic stroke treatments

• aspirin: prevents new blood clots

• intravenous tissue plasminogen activator (TPA): dissolves clot, may improve recovery

• mechanical removal: Physically breaks up or removes the clot

• Angioplasty & stents: Prevent future blockages

hemorrhagic stroke treatment

• Cannot use clot-dissolving medications

• Focus: Control bleeding and reduce pressure in the brain

• Supportive care: Bed rest while body absorbs blood

• Surgery: Repair blood vessel abnormalities if needed