Cardiovascular System

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Cardiovascular System
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Cardiovascular System Components

• Circulatory system
• Pulmonary system
• Purposes
• Transport O2 to tissues and remove waste
• Transport nutrients to tissues
• Regulation of body temperature

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Circulatory System

• Heart
• Pumps blood
• Arteries and arterioles
• Carry blood away from heart
• Capillaries
• Exchange nutrients with tissues
• Veins and venules
• Carry blood toward heart

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Cardiac Cycle

• Systole
• Contractile phase of heart
• Electrical and mechanical changes

• Diastole
• Relaxation phase of heart
• Takes twice as long as systole

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Arterial Blood Pressure

• Expressed as systolic/diastolic
• Normal 120/80 mmHg
• High 140/90 mmHg
• Systolic pressure (top number)
• Pressure generated during ventricular contraction
• Diastolic pressure
• Pressure during cardiac relaxation

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Electrical Activity of the Heart

• Contraction of heart depends on electrical
  stimulation of myocardium
• Impulse is initiated on right atrium and spreads
  throughout the heart
• May be recorded on an ECG

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Heart Rate

• Range of normal at rest is 50 100 b.m
• Increases in proportion to exercise intensity
• Max. HR is 220 age
• Medications or upper body exercise may change
  normal response

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Autonomic Nervous System Control of Heart Rate

• Sympathetic control
• Stimulates fight or flight response
• Speeds up heart rate and stroke volume
• Sympathetic tone gt 100 bpm

• Parasympathetic control
• Connected to vagus nerves
• Slows down heart rate
• Parasympathetic tone 60 100 bpm

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Components of Blood

• Plasma
• Liquid portion of blood
• Contains ions, proteins, hormones
• Cells
• Red blood cells
• Contain hemoglobin to carry oxygen
• White blood cells
• Platelets
• Important in blood clotting
• Hematocrit
• Percent of blood composed of cells

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Changes in Cardiac Output

• Cardiac output increases due to
• Increase in heart rate
• Linear increase to max
• Max HR 220 - age
• Increased stroke volume
• Plateau at 40 of VO2 max
• Oxygen uptake by the muscle also increases
• Higher arteriovenous difference

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Causes of High Blood Pressure

• Age
• Race
• Heredity
• Diet
• Stress
• Inactivity

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How to have a heart attack

• Everyones doing it, so it must be the in thing
  to do

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Be Old

• Relative risk of CHD increases with age

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Have a family history of CHD

• The more blood relatives one has with CHD, and
  the younger they are (were), the higher the
  relative risk

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Be a Man

• Males have 5-6 times the relative risk of CHD of
  females
• Why? Estrogen may be protective

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Unalterable Risk Factors for CHD

• Age
• Family History
• Sex

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Alterable Risk Factors

• Things you can do something about

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Be fat

• Obesity increases CHD risk
• How much fat is too much?
• Males - gt 25
• Females gt 30

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Eat a high fat diet

• High fat foods increase plaque within arteries
  and contribute to atherosclerosis

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Have High Cholesterol

• Total cholesterol/HGH ratio above
• Males 4.5/1
• Females 4/1
• Increases relative risk of CHD

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Have High Blood Pressure

• High blood pressure forces the heart to work
  harder
• How high is too high?
• gt 140/90

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Smoke

• Smokers are more likely to die of heart attack
  than cancer
• Smoking is the single most important alterable
  risk factor

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Be a Type A personality

• Type A personalities are
• High-strung
• Achievement-oriented
• Aggressive
• Time-conscious

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Live a stressful lifestyle

• No one, lying on their deathbed, has said they
  wished they had spent more time at the office.

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Have Other Diseases

• Diabetes
• Ulcers
• Obesity

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Dont Exercise

• If you get the urge to exercise, lie down until
  the feeling passes.

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Heart Disease and Stroke Statistics 2010 Update
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CVD disease mortality trends for males and
females(United States 1979-2006). Source NCHS
and NHLBI.
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Age-adjusted death rates for CHD, stroke, lung
and breast for white and black females (United
States 2006).Source NCHS.
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Deaths from cardiovascular disease(United
States 19002006). Source NCHS and NHLBI.
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Percentage breakdown of deaths from
cardiovascular diseases (United States 2006)
- Not a true underlying cause.Source NCHS.
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Prevalence of CVD in adults age 20 and older by
age and sex (NHANES 2003-2006). Source NCHS and
NHLBI. These data include coronary heart
disease, heart failure, stroke and hypertension.
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Trends in Heart Transplants (UNOS
1975-2008). Source United Network for Organ
Sharing (UNOS), scientific registry data.
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Trends in Cardiovascular Operations and
Procedures (United States 1979-2006). Source
NCHS and NHLBI.
Note In-hospital procedures only.
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Number of Surgical Procedures in the 10 Leading
Diagnostic Groups (United States 2006). Source
NHDS/NCHS and NHLBI.
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Direct Costs of the 10 Leading Diagnostic Groups
(Billions of dollars) (United States 2010).
Source NHLBI.
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About cholesterol

• Soft, fat-like, waxy substance
• Bloodstream and cells
• Needed for cell membranes and hormones and to
  make vitamin D
• Comes from 2 sources
• Body produces it (mostly genetic) in liver (1000
  mg day)
• Food sources (animal products meats, poultry,
  fish, eggs, butter, whole milk, and cheese, not
  from plant sources) (100 500 mg day)
• Foods with trans fats or saturated fats may cause
  the body to produce more cholesterol

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About cholesterol

• Must be transported through blood
• Carriers are called lipoproteins
• Low-density lipoprotein (LDL)
• High-density lipoprotein (HDL)
• Lipoprotein protein fat
• LDL, more fat, less protein
• HDL, more protein, less fat

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LDL vs. HDL

• LDL bad
• Too much can clog arteries by forming plaque
• Atherosclerosis can cause heart attack or stroke

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LDL vs. HDL

• HDL good
• Tends to carry cholesterol away from arteries and
  back to liver
• May also remove excess cholesterol from plaque in
  arteries, slows buildup

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Triglycerides

• Form of fat
• Also made in body (body fat stored as
  triglyceride) and from food
• Help transport dietary fat, metabolism
• Trigger liver to make more cholesterol, rising
  LDL and total cholesterol

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Healthy Levels

• Total cholesterol
• Optimal under 200 mg/dL
• Borderline high risk 200-239 mg/dL
• High risk 240 mg/dL and up
• LDL
• Optimal less than 100 mg/dL
• Near/Above optimal 100-129 mg/dL
• Borderline high 130- 159 mg/dL
• High 160 189 mg/dL
• Very high 190 mg/dL

Source National Cholesterol Education Program,
National Heart, Lung, and Blood Institute
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Healthy Levels

• HDL
• Low - less than 40 mg/dL
• High above 60 mg/dL (may lower risk for heart
  disease)
• Women tend to have higher HDL due to estrogen
  (needs to be over 50 mg/dL)
• Triglycerides
• Normal less than 150 mg/dL
• Borderline high 150 199 mg/dL
• High above 200 mg/dL

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Common misconceptions

• Using margarine instead of butter will help lower
  my cholesterol
• Thin people dont have to worry about high
  cholesterol
• If a label lists no cholesterol, its a
  heart-healthy choice
• Eggs good or bad?
• Women dont need to worry about cholesterol
• Only middle-aged people should have their
  cholesterol checked

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What affects cholesterol?

• Diet
• Poly and monounsaturated fats may help lower
  cholesterol when used in place of saturated fats,
  but still limit
• High carbs, excessive alcohol may increase
  triglycerides
• Soluble fiber may lower LDL, not HDL
• Weight
• Physical activity
• Age
• Gender
• Heredity

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Why does it matter?

• Coronary heart disease is caused by
  atherosclerosis
• Single leading cause of death
• The higher LDL you have plus risk factors
  increases risk for heart attack
• Smoking
• High Blood pressure
• Low HDL
• Family history of early heart disease
• Age

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Atherosclerosis

• Healthy arteries are flexible, strong and
  elastic. Over time, however, too much pressure in
  your arteries can make the walls thick and stiff
  sometimes restricting blood flow to your organs
  and tissues. This process is called
  arteriosclerosis, or hardening of the arteries.
• Atherosclerosis is a specific type of
  arteriosclerosis, but the terms are often used
  interchangeably. Atherosclerosis refers to the
  buildup of fats in and on your artery walls
  (plaques), which can restrict blood flow. These
  plaques can also burst, causing a blood clot.
  Although atherosclerosis is often considered a
  heart problem, it can affect arteries anywhere in
  your body. Atherosclerosis is a preventable and
  treatable condition.

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• Symptoms
• Atherosclerosis develops gradually. There are
  usually no atherosclerosis symptoms until an
  artery is so narrowed or clogged that it can't
  supply adequate blood to your organs and tissues.
  Sometimes a blood clot completely obstructs blood
  flow, or even breaks apart and causes blood clots
  that can trigger a heart attack or stroke.
• Atherosclerosis symptoms depend on which arteries
  are affected. For example
• If you have atherosclerosis in your heart
  arteries, you may have symptoms similar to those
  of a heart attack, such as chest pain (angina).
• If you have atherosclerosis in the arteries
  leading to your brain, you may have symptoms such
  as sudden numbness or weakness in your arms or
  legs, difficulty speaking or slurred speech, or
  drooping muscles in your face.
• If you have atherosclerosis in the arteries in
  your arms and legs, you may have symptoms of
  peripheral arterial disease, such as leg pain
  when walking (intermittent swelling).

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Prevention of high cholesterol

• Get it checked
• Watch fats, eat healthy
• Consume less than 300 mg of cholesterol a day
• Be active
• Quit smoking
• Some may need medication
• Lipitor, Crestor, Zocor
• Vytorin

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Phytonutrients

• Soy protein may reduce risk of heart disease
• Especially when replacing foods high in saturated
  fat
• Plant sterols
• Found naturally in fruits/veggies, plant oils may
  lower LDL
• Omega-3 fatty acids
• Two weekly servings of fish may be heart healthy
• Folic Acid
• Antioxidants

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What Is Asthma?

• Asthma is a chronic lung disease that can be
  life threatening if not treated and controlled.
• The cause of asthma in unknown, but some things
  make asthma worse.

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What Is Happening During an Asthma Attach ?

• When someone is having an asthma attack the
  following is happening
• The lining of the airway is swollen and
  irritated.
• The muscles around the airway tighten and make
  it hard to breathe.
• The airway makes a thick mucus.

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What Is Happening During an Asthma Attack in the
Lungs?
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Asthma Warning Signs

• Warning signs are clues that your childs asthma
  may be getting worse.

• Runny stuffy nose
• Headache
• Tickle in throat
• Childs has a cold or flu
• Coughing
• Restless

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What Are the Symptoms of Asthma?

• Not all people with asthma have the same symptoms
• The most common symptoms are
• Coughing a cough that may not go away or may
  be worse at night
• Wheezing a whistling sound that is usually
  heard when breathing out

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More Symptoms

• Shortness of breath feels like not being able
  to catch a breath
• Tightness or pain in the chest feels like
  something heavy has been placed on the chest

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What Causes Asthma Attacks?

• AN ASTHMA TRIGGER IS
• anything that sets off asthma symptoms

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TRIGGERS
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Ways to Avoid Triggers

• Dust, dander, and house mites
• Dust the house with a damp cloth, especially in
  the childs bedroom.
• Use a damp mop to clean the floor.
• Cover pillow, mattress, and boxspring with
  special dust-miteproof covers.

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Ways to Avoid Triggers

• Smoke
• Try to make the home smoke free by
• Never allowing smoking in the home or car
• Never allowing smoking around the child
• Quitting smoking
• Avoid burning incense or candles.

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Ways to Avoid Triggers

• Pets
• If possible, remove pets from the home or limit
  the childs contact with the animal.
• Never allow pets in the childs bedroom.

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Ways to Avoid Triggers

• Strong odors and scented products
• Avoid heavy scents, like perfumes, hairsprays,
  and certain household cleaners like bleach or
  ammonia.
• Dont use room deodorizers.

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Asthma Medications and Devices
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Types of Medications

• Long-term controller medicine
• Quick-relief rescue medicine

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Long-Term Medications

• Long-term controller medicine prevents
  swelling and inflammation of the airway and
  should be used every day, even when feeling well.

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Quick-Relief Medications

• Quick-relief rescue medicine works quickly to
  open the tightened airway.
• Quick-relief medicine is usually used on an
  as-needed basis.

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Asthma Devices

• Inhaler the pump
• Delivers inhaled medication in a spray mist form

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Asthma Devices

• Inhaler with Spacer
• A spacer catches the mist and holds it so it can
  be breathed in slowly. This allows the medicine
  to reach the persons lungs.

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Asthma Devices

• Nebulizer
• A machine that delivers medication in a mist.

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Asthma Devices

• Peak Flow Meter
• A device used to measure how air flows from your
  lungs in one fast blast.

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Controlling Asthma
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Getting Asthma Under Control

• See a health-care provider for regular asthma
  checkups at least twice a year.
• Follow an Asthma Action Plan.
• Learn how to take the right medicine at the
  right time, the right way.

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Getting Asthma Under Control

• Learn about asthma triggers and how to avoid
  them.
• Talk about peak flow monitoring with your
  health-care provider.

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A Child With Well-Controlled Asthma

• Sleeps through the night
• Goes to school every day
• Is able to play, take gym, and participate in
  sports