HOSA - Medical Nutrition Therapy (Cardiovascular Disease)

Cardiovascular disease (CVD) affects the

Heart and blood vessels

Cardiovascular disease is the leading cause of

Death in permanent disability in the United States today

A group of risk factors have been identified and known as

Metabolic syndrome previously known as syndrome x

These risk factors are

• abdominal obesity

• High blood lipids such as high triglycerides low HDL and high LDL

• High blood pressure

• Insulin resistance

• Elevated highly sensitive C-reactive proteins in the flood

Those diagnosed with metabolic syndrome or at an increased risk of

Coronary heart disease and stroke peripheral vascular disease and type two diabetes

Cardiovascular disease can be

Acute (sudden) or chronic

myocardial infarction (MI)

Heart attack caused by the blockage of an artery leading to the heart

MI is an example of the

Acute form

Chronic heart disease develops

Overtime and causes the loss of heart function

If the heart can maintain blood circulation

The disease is classified as a compensated heart disease

Compensation usually requires that the

Heartbeat unusually fast and a heart in enlarges

If the heart cannot maintain blood circulation

The condition is classified as decompensated heart disease and congested heart failure (CHF) occurs

The myocardium vowels endocardium pericardium and or blood vessels may be

Affected by heart disease

Arteriosclerosis is a general term for

Vascular disease way in which the arteries harden; making passage of blood difficult if not impossible

Atherosclerosis is a form of

arteriosclerosis that Most frequently occurs in developing countries

Atherosclerosis is believed to begin in _____ and is considered one of the _____

Childhood; Major causes of heart attack

Atherosclerosis affects the

Inner lining of the arteries (intima) are where deposits of cholesterol fan other substances a car overtime thickening and weakening artery walls

Deposits are called

Plaque

Lumen

Hallo area and tube

Ischemia

Reduce blood flow causing an in adequate supply of nutrients and oxygen to and waste from tissues

angina pectoris

Pain in the heart muscle due to an adequate blood supply

When the lumen narrow so that a ______ occurs in a _______ and blood flow is cut off a ________

Thrombus (blood clot); coronary artery; heart attack occurs

Infarct

Dead tissue resulting from blocked artery

cerebrovascular accident (CVA)

Either a blockage or bursting of blood vessels leading to the brain; a stroke

peripheral vascular disease (PVD)

Narrowed arteries some distance from the heart

Hyperlipidemia

Excessive amounts of fat in the blood

Serum Cholesterol

Cholesterol in the blood

Some patients who experience MI will require

Surgery to bypass the clogged artery

Hyperlipidemia hypertension and smoking are all

Major risk factors for the development of atherosclerosis

Other contributing factors to atherosclerosis are

Obesity diabetes Male sex heredity personality type (ability to handle stress) age sedentary life

Elevated levels of LDL contribute to

Atherosclerosis

Glow serum levels of HDL

Tribute to atherosclerosis

Medical nutrition therapy is the

Primary treatment for hyperlipidemia

Medical nutrition therapy involves reducing the

Quantity and types of fat and other calories in the diet

And an overweight person weight loss alone can

Reduce serum cholesterol levels

The American heart association categorizes blood cholesterol level of

200 mg/dl or less to be desirable

200-239 mg/dL

borderline high cholesterol

240 mg/dl

high cholesterol

American heart Association develops guidelines which are

• Adult diet contain less than 200 mg of cholesterol a day

• Fats provide no more than 20 to 35% of calories

• Maximum of 7% from saturated and trans fats

• Maximum of 8% from polyunsaturated fats

• Maximum 15 to 20% from monounsaturated fats

• Carbs are 50 to 55% of calories

• Proteins are 12 to 20% of calories

Currently it is believed that

40% of calories in the average US diet come from fat

That restricted diet can be

Difficult for the client to except

A diet very low in fat will seem

Unusual and highly unpalatable (unpleasant tasting) to most clients

It will take about ____ to adjust to a low-fat diet

2-3 months

If they physician will allow the changes in nutritional make up of the diet should be made

Gradually

The client must be taught how to

Select whole fresh foods and to prepare them without the addition of any fat

Only lean meats should be

Selected

Visible fats should

Not be eaten

Fat three milk and fat free milk cheese should be

The only dairy selected

Desserts containing whole milk eggs and cream are to be

AVoided

Cholesterol is only found in

Animal tissue

Organ meats egg yolks and some shellfish are especially rich in cholesterol and

Should be used in limited quantities

Soft margarine in liquid vegetable oil's should be used

When cooking

It is thought that ______ soluble fiber a day will effectively lower cholesterol buy as much as _____

20-25 grams; 15%

This is a large amount of fiber and must be

Introduce gradually along with increase fluids or the client will suffer from flatulence

Some clients find the ________ useful for controlling fat content in their diet

Diabetic exchange list

Sometimes clients maybe deficient _______ in so a vitamin supplement may be needed

Fat soluble vitamins

If adequate blood to lipid levels cannot be obtained within 3 to 6 months of the fat restricted I alone if physician may prescribe a

Cholesterol lowering drug

Atherosclerosis is primary cause of heart attack but

Hypertension abnormal blood clotting an infection that caused by rheumatic fever are also causes

After the attack the client is in

Shark and will feel thirsty

NPO

nothing by mouth

The client should be given nothing by mouth until

The physician evaluate the condition

If the client remains nauseated after shock

IV infusions are given to prevent dehydration

After several hours after the attack the client may begin to

Eat

A liquid diet maybe recommended for

The first 24 hours after the attack

Food should not be extremely hot or cold and should be easy to

Chew and digest after the attack

After a heart attack _______ will be limited

Sodium fats and caffeine

Congestive heart failure is an example of

DeCompensation or a severe heart disease

Heart failure is caused by conditions that

Damage the heart muscle including coronary artery disease heart attack cardio myopathy valve disease heart defects present at birth diabetes in renal disease

coronary artery disease (CAD)

Severe narrowing of the artery that supplies blood to the heart

Cardiomyopathy

Damage to the heart muscle caused by infection alcohol or drug abuse

Shortness of breath and chest pain is common

When heart damage is extreme and heart cannot provide adequate circulation

Sodium builds up fluid retained and

Edema occurs because of reduced circulation

And attempted to compensate for this pumping deficit the heart

Beats faster and enlarges

With inadequate circulation body tissues do not receive sufficient amount of nutrients which can lead to

Mel nutrition and underweight although edema can mask these problems

Diuretics can aid in the

Excretion of water and sodium

Sodium restricted diet's are

Typically prescribed

Diuretics can cause an

Excessive loss of potassium so clients potassium levels should be watched closely

Essential or primary hypertension

High blood pressure with an unknown because 90% of cases

Secondary hypertension

High blood pressure caused by another condition such as kidney disease 10% of cases

Sphygmomanometer

Instrument used to monitor blood pressure

Normal blood pressure

120/80 mmHg

Pre-hypertension

120-139/80-88 mmHg

Stage one hypertension

140-150/90-99 mmHg

Stage two hypertension

160/>100 mmHg

Hypertension contributes to

Or attack stroke heart failure and kidney failure

Hypertension is often called silent disease because

Suffers can be asymptomatic

The frequency of hypertension

Increases with age

Hypertension is more prevalent among

African Americans than others

Heredity and obesity are

Pre-disposing factors to hypertension

Smoking and stress also contributes to

Hypertension