Public Health 304 Exam Study Guide

Cardiovascular Disease, Renal Disease, Diabetes, Maternal and Child Health

CARDIOVASCULAR DISEASE

CARDIOVASCULAR DISEASE

oxygen poor blood

enters the heart from the body and goes out to the lungs

oxygen rich blood

enters the heart from the lungs and goes out to the body

Coronary Artery Disease

also called ischemic heart disease

narrowing or blockage of the coronary arteries

coronary arteries supply blood to the heart: therefore, arteries of the heart can't deliver oxygen-rich blood to the heart

Cause of ischemia

lack of enough blood; heart doesn't get the oxygen and nutrients it needs! Ischemia also can cause angina

Stable angina

chest pain that occurs when a person is active or under severe stress

Unstable angina

chest pain that occurs while a person is at rest and not exerting himself

Atherosclerosis

build up of plaque in arteries; causes the narrowing inside of the arteries

Athero: plaque

Vasospasms

arteries can undergo spasms (tightening) that temporarily narrow the arteries and block blood flow to the heart

Plaque and Vasospasms

Plaque buildup and vasospasms may occur individually, or may co-occur in the same artery.

obstructive coronary artery disease

arteries >50% blocked

Nonobstructive coronary artery disease

< 50% obstruction of heart's large arteries due to plaque buildup, or disease or injury affecting the lining of the large arteries

Plaque

a substance made of fat, cholesterol, calcium, and other substances that builds up and hardens in arteries

coronary microvascular disease

• affects tiny arteries in heart muscle

• Can happen either alone or with obstructive or nonobstructive coronary artery disease or other heart diseases

• most often occurs when molecular changes in the tiny blood vessels of the heart prevent normal blood flow through the small arteries

Heart Failure

also called Congestive Heart Failure; heart cannot pump enough blood

• does not mean the heart has stopped pumping

• fluid buildup in lungs, liver, GI tract, arms, and legs

• ONLY CURABLE with a heart transplant

POSSIBLE EXAM QUESTION: What is only curable with a heart transplant?

Heart Failure

Leading Causes of Heart Failure

• high blood pressure

• diabetes

• coronary artery disease can weaken the heart muscle, leading to heart failure

Heart Attack

also called a Myocardial Infarction

• Coronary artery disease is the major cause of heart attacks

• Heart attack happens when a part of the heart muscle doesn't receive enough blood; e.g., due to blood clot

• permanent damage to heart muscle

• Fast medical attention reduces heart damage

Heart attack symptoms

chest pain or discomfort, shortness of breath, pain or discomfort in the jaw, neck, back, arm, or shoulder, feeling nauseous, light-headed or unusually tired

Cardiomyopathy

Heart becomes enlarged stiff, or otherwise abnormal; can weaken heart

Cardiomyopathy causes

family history, hypertension, prior heart attacks, viral or bacterial infections

Congenital heart defects

Most common type of major birth defect

• EX: abnormal heart valves or holes in the walls of the heart

POSSIBLE EXAM QUESTION: What is a congenital heart problem?

Birth Defect

Cardiac Arrest

Heart STOPS Beating

Causes of Cardiac Arrest

coronary artery disease, cardiomyopathy (heart muscle becomes enlarged and can lead to irregular heartbeat), valvular heart disease (damage or disease affecting any heart valve), arrhythmias (electrical malfunction in heart that causes irregular heartbeat)

Arrythmias: Ventricular Fibrillation

Type of arrhythmia affecting heart ventricles

• Ventricles of heart (pumping chambers) don't pump effectively

• cuts off blood supply to vital organs

• can be DEADLY within seconds

Cardiac Arrest: Important Information

Without treatment, death occurs within minutes after cardiac arrest

• Heart attack can trigger ventricular fibrillation and sudden cardiac arrest!

Heart Disease Risk Factors: Nonmodifiable Risk Factors

Age, Sex, Family History, Genetic predisposition

Heart Disease Risk Factors: Modifiable Risk Factors

Smoking, Poor Diet, Alcohol Intake, Physical Inactivity, Dyslipidemias (Bad cholesterol being too high), Hypertension, Obesity, Diabetes, Metabolic syndrome, Stress!

Lipids and dyslipidemia (hyperlipidemia)

High triglycerides + low HDL (BAD) +high LDL (GOOD) --> increased risk of cardiovascular disease

-triglycerides: type of fat found in blood

Cholesterol is a waxy substance your body needs but too much LDL can cause problems

angioplasty and stent placement

• Long, thin tube (catheter) is inserted into narrowed section of artery

• A wire with a deflated balloon is passed through the catheter to the narrowed section

• Balloon is inflated, compressing the deposits against the artery walls

• The stent (a metal mesh) is often left in to help keep artery open, and may slowly release medication

Doctors use a tiny, thin tube (called a catheter) to reach the narrowed area in the artery. Then, they send a wire with a balloon (deflated at first) through the catheter to the blocked area. The balloon is inflated to push the blockage or deposits against the walls of the artery, creating more room for blood to flow. In many cases, a small metal tube called a stent is left behind to keep the artery open and stable. Some stents can also slowly release medication to prevent future blockages.

It's like fixing a clogged pipe by expanding it and placing a support inside!

Treatment: Coronary artery bypass surgery

• Requires open heart surgery

• Normally done if there are multiple narrowed coronary arteries

• Graft to bypass blocked artery is created with a vessel from another part of the patient's body; This means that when an artery is blocked and blood can't flow through it properly, doctors take a healthy blood vessel from another part of the patient's body (like the leg or chest) and use it to create a new path, or "detour," for the blood to flow around the blockage. It's like building a bridge to get around a roadblock.

Stroke (BRAIN ATTACK)

blood supply to the brain is interrupted; Brain tissue is deprived of oxygen and nutrients --> cell death within minutes

-Medical emergency- quick treatment can help reduce damage/disability

Stroke - Act FAST

Face

Arms

Speech

Time

Types of Stroke: Ischemic Stroke

occurs due to obstruction in blood vessel supplying blood to brain; accounts from 87% of all stroke cases

Types of Stroke: Hemorrhagic Stroke

occurs when a weakened blood vessel ruptures; most common cause is uncontrolled hypertension

Hemorr: Blood

Types of stroke: TIA (Transient Ischemic Attack)

caused by a temporary clot; often called a "mini-stroke". Produces stroke-like symptoms but often has no lasting effects; medical treatment for TIAs can reduce the risk of a major stroke

Risk Factors for Stroke

• Smoking

• Diabetes

• High LDL cholesterol

• Carotid artery or other artery disease (carotid arteries supply most of the blood to brain)

• Physical inactivity

• Obesity

• Personal or family history of stroke or TIA

• Atrial fibrillation (upper chambers of heart quiver, don't beat properly, can cause blood to pool & clot

• Sickle cell anemia

• Excessive alcohol intake

• Sleep apnea

• Use of illegal drugs including cocaine, ecstasy, amphetamines & heroin

• Increasing age

• Female gender: higher lifetime risk (birth

control pills contribute to this)

• Family history of stroke

• Race: Hispanics & African Americans have higher stroke risk

• Prior stroke

Following a Healthy Lifestyle

• Cutting salt intake by at least 1,000 mg/day will help lower blood pressure

• Regular physical activity for about 40 minutes, 3-4 times a week

RENAL DISEASE

RENAL DISEASE

Kidney functions include

• filter the blood to remove wastes, toxins, and excess fluids