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cardiovascular
 The cardiovascular system, also called the circulatory system, is the
system that moves blood throughout the human body. It is composed
of the heart, arteries, veins, and capillaries. It transports oxygenated
blood from the lungs and heart throughout the whole body through the
arteries. Blood goes through the capillaries - vessels situated between
the veins and arteries.
When the blood has been depleted of oxygen, it makes its way back to
the heart and lungs through the veins.
 Cardiovascular diseases (CVDs) are also popularly known as heart
diseases.
Cardiovascular disease is a term that refers to any disease of the heart or its
blood vessels (arteries, veins, capillaries) that affect the functioning of its blood
circulatory system that in turn affects another body part like brain, kidney, or
other body parts.
This disease is the most common type of illness that causes majority of deaths
around the world. According to the World Health Organization, cardiovascular
disease causes more than 17 million deaths in the world each year and is
responsible for half of all deaths in the United States.
Signs & Symptoms:
 Pale, clammy appearance
 Cyanosis (blue tinge to the skin), particularly in the extremities
 Rapid or shallow breathing
 Rapid and/or irregular heart rate
 High or low blood pressure
 Swollen veins in the neck
 Swelling in the feet and ankles
 Abnormalities in the retina (back of the eye)
 Enlarged heart (measured by placing hand on chest)
 Extra or abnormal heart sounds (via stethoscope)
 Fluid in the lungs (via stethoscope)
 Abnormal sounds of arterial blood flow throughout the body (via -
stethoscope)
 Cool extremities
 Reduced or absent pulses in the extremities
2
Major Risk Factors
1. High Blood Pressure (Hypertension).
 High blood pressure (hypertension) is by far the most important risk
factor for CVD.
 If your blood pressure is too high, it can damage your artery walls and
increase your risk of developing a blood clot.
2. High Blood Cholesterol.
 Cholesterol is a fatty substance carried in the blood by proteins. When
the two combine, they're called lipoproteins. There are harmful and
protective lipoproteins known as LDL and HDL, or "bad" and "good"
cholesterol.
 The amount of cholesterol in the blood (both LDL and HDL) can be
measured with a blood test. The recommended cholesterol level varies
depending on your overall risk of developing arterial disease.
 If you have high blood cholesterol, it can cause your arteries to narrow
and increase your risk of developing a blood clot.
3. Diabetes.
 Diabetes also increases a person's risk for heart disease. With
diabetes, the body either doesn't make enough insulin, can't use its
own insulin as well as it should, or both. This causes sugars to build up
in the blood.
 About three–quarters of people with diabetes die of some form of
heart or blood vessel disease.
4. Obesity and Overweight.
 Extra weight can lead to increased high cholesterol levels, high blood
pressure, and diabetes, all major risk factors for heart disease.
5. Smoking.
 Most people know that cigarette and tobacco smoking increases your
risk of lung cancer, but few realize that it also greatly increases the
risk of heart disease and peripheral vascular disease (disease in the
vessels that supply blood to the arms and legs).
3
6. Lack of exercise.
 People who are not active have a greater risk of heart attack than do
people who exercise regularly. Exercise burns calories to help
maintain a healthy weight, helps to control cholesterol levels and
diabetes, and may lower blood pressure. Exercise also strengthens the
heart muscle and makes the arteries more flexible.
 If you don't exercise regularly, it's more likely that you'll have high
blood pressure, higher cholesterol levels, higher stress levels and be
overweight. All of these are risk factors for CVD.
7. Gender.
 Men are more likely to develop CVD at an earlier age than women.
8. Heredity.
 Heart disease tends to run in families. For example, if your parents or
siblings had a heart or circulatory problem before age 55, then you are
at greater risk for heart disease than someone who does not have that
family history. Risk factors (including high blood pressure, diabetes,
and obesity) may also be passed from one generation to another.
9. Age.
 Older age is a risk factor for heart disease. In fact, about 4 of every 5
deaths due to heart disease occur in people older than 65. As we age,
our hearts tend not to work as well. The heart's walls may thicken and
arteries may stiffen and harden, making the heart less able to pump
blood to the muscles of the body. Because of these changes, the risk of
developing cardiovascular disease increases with age. Because of their
sex hormones, women are usually protected from heart disease until
menopause, when their risk increases.
10.Other risk factors
Other factors that affect your risk of developing CVD include:
 Diet – a high-fat diet can cause fatty deposits to build up inside your
arteries, leading to high blood cholesterol levels and high blood
pressure
 Alcohol – excessive alcohol consumption can also increase your
cholesterol and blood pressure
 Stress – not taking measures to reduce stress is thought to increase
your risk of developing CVD
4
Cardiovascular Diseases
Examples of diseases that affect the cardiovascular system:
 Cardiac diseases (Heart diseases) - examples include:
1. Angina (angina pectoris) - is chest pain, discomfort, or tightness that
occurs when an area of the heart muscle is receiving decreased blood
oxygen supply. It is not a disease itself, but rather a symptom of coronary
artery disease.
Angina may manifest itself in the form of an angina attack, pain or
discomfort in the chest that typically lasts from 1 to 15 minutes.
2. Arrhythmia - is an irregular heartbeat - the heart may beat too fast
(tachycardia), too slowly (bradycardia). occur when the electrical
impulses to the heart that coordinate heartbeats are not working
properly, making the heart beat too fast/slow or inconsistently.
3. Congenital heart disease
4. Coronary artery disease (CAD) (Ischemic)
5. Dilated cardiomyopathy
6. Heart attack (myocardial infarction) - is the death of a segment of heart
muscle caused by the loss of blood supply. The blood supply is usually lost
because a coronary artery, one that supplies blood to the heart muscle,
has a blood clot, a blockage (coronary thrombosis). If some of the heart
muscle dies, the patient experiences chest pain and electrical instability of
the heart muscle tissue.
7. Heart failure - is a serious condition in which the heart is not pumping
blood around the body efficiently.
8. Hypertrophic cardiomyopathy
9. Mitral regurgitation - is a condition in which your heart's mitral valve
doesn't close tightly, allowing blood to flow backward in your heart. As a
result, blood can't move through your heart or to the rest of your body as
efficiently, making you feel tired or out of breath.
10. Mitral valve prolapsed (MVP)
11. Pulmonary stenosis
5
 Vascular diseases - examples include:
1. Atherosclerosis - is a narrowing of the arteries caused by a buildup of
plaque. It is also called arteriosclerosis or hardening of the arteries.
Arteries are the blood vessels that carry oxygen and nutrients from the
heart to the rest of your body. As you get older, fat and cholesterol can
collect in the arteries and form plaque. The buildup of plaque makes it
difficult for blood to flow through the arteries. This buildup may occur in
any artery in the body and can result in a shortage of blood and oxygen in
various tissues of the body. Pieces of plaque can also break off, causing a
blood clot. If left untreated, atherosclerosis can lead to heart attack,
stroke, and heart failure.
2. Renal artery disease - is caused by the buildup of plaque in the arteries
that lead to the kidneys. Plaque is made up of fats and cholesterol, and as
it accumulates in the renal arteries, it causes the arteries to stiffen and
narrow, which blocks the flow of blood to the kidneys. Obstructions
(blockages) in the renal arteries, known as renal artery stenoses, can
cause poorly controlled high blood pressure, congestive heart failure, and
kidney failure.
3. Raynaud's disease - is a condition that causes some areas of the body to
feel numb and cool in response to cold temperatures or emotional stress,
caused by a problem with the blood supply to the skin.
4. Buerger's disease - is a disease that causes blockages in the blood vessels
of your feet and hands. The blood vessels become inflamed, which
reduces blood flow. Blood clots that further clog blood vessels also
develop. The disease causes pain and can lead to tissue damage and, in
severe cases tissue death (gangrene).
5. Cerebrovascular disease (Stroke) - Stroke occurs when the supply of
blood to the brain is either interrupted or reduced. When this happens,
the brain does not get enough oxygen or nutrients which causes brain
cells to die.
6. Venous blood clots 8. Blood clotting disorders
7. Peripheral venous disease 9. Peripheral artery (arterial) disease
6
Coronary heart disease (Ischaemic Heart
Disease)
Ischemic heart disease is a condition of recurring chest pain or discomfort that
occurs when a part of the heart does not receive enough blood. This condition
occurs most often during exertion or excitement, when the heart requires
greater blood flow.
Ischemic heart disease develops when cholesterol particles in the blood begin to
accumulate on the walls of the arteries that supply blood to the heart. Eventually,
deposits called plaques may form. These deposits narrow the arteries and
eventually block the flow of blood. This decrease in blood flow reduces the
amount of oxygen supplied to the heart muscle.
The signs and symptoms of ischemic heart disease may develop slowly as
arteries gradually become blocked, or they may occur quickly if an artery
suddenly becomes blocked. Some people with ischemic heart disease have no
symptoms at all, while others may have severe chest pain (angina), shortness of
breath, heart attack (myocardial infarction).
Fortunately, ischemic heart disease can be treated successfully with lifestyle
changes, medicines, and surgical procedures. Even better, you can reduce your
risk of ischemic heart disease by following heart-healthy practices, such as eating
a low-fat, low-sodium diet, being physically active, not smoking, and maintaining
a healthy body weight.
Left untreated, ischemic heart disease may lead to severe heart damage. Heart
damage can result in heart attack and shock and may be life threatening.
7
Prevention:
 Eat a healthy diet. Choosing healthful meal and snack options can help
you avoid heart disease and its complications. Be sure to eat plenty of
fresh fruits and vegetables.
 Eating foods low in saturated fat and cholesterol and high in fiber can
help prevent high blood cholesterol. Limiting salt or sodium in your
diet can also lower your blood pressure.
 Maintain a healthy weight. Being overweight or obese can increase
your risk for heart disease. To determine whether your weight is in a
healthy range, doctors often calculate a number called the body mass
index (BMI).
 Exercise regularly. Physical activity can help you maintain a healthy
weight and lower cholesterol and blood pressure. The Surgeon
General recommends adults engage in moderate-intensity exercise for
2 hours and 30 minutes every week.
 Don't smoke. Cigarette smoking greatly increases your risk for heart
disease. So, if you don't smoke, don't start. If you do smoke, quitting
will lower your risk for heart disease.
8
Medications
 Medicines are often used alone or in combination to treat or control
cardiovascular conditions.
 The followinglist provides information on medicines that your doctormay
prescribe if you have been diagnosed with cardiovascular disease.
 Antiarrhythmics:
 These drugs workto stabilize the electrical conductionsystem of the heart.
 Your doctorwill decide whichtype of medicine to prescribe depending on the
type and severity of yourarrhythmias , yoursymptoms, and your overall health.
 The different classes of antiarrhythmics include:
1. Sodium channel blockers (eg, amiodarone, propafenone)
2. Beta blockers (eg, acebutolol, propranolol)
3. Action-potential prolonging agents (eg, sotalol)
4. Calcium channel blockers (eg, verapamil)
 Antianginals:
 These medicines alleviate or prevent angina .
 Antianginals does this by helping to restore the balance between the heart’s
supply and demand of oxygen.
1. Nitrates and nitrites (eg, nitroglycerin)
2. Beta blockers (eg, acebutolol, propranolol)
3. Calcium channel blockers (eg, nifedipine, amlodipine)
 Anticoagulants:
 Anticoagulants are used to prevent stroke and heart attack in people who are at
an increased risk due to heart conditions or heart surgery.
 Anticoagulants prevent clots from forming or inhibit existing clots from growing.
But, these medicines cannot dissolve clotsthat already exist.
 Examples of anticoagulants include:
1. Warfarin (eg, Coumadin)
2. Heparin
9
 Medicationsto Treat Heart Failure:
 These medicines are designed to increase the amount of blood the heart can
eject with each beat.
 Your doctormay prescribe one or a combination of these medicines:
1. Angiotensin converting enzyme (ACE) inhibitors (eg, enalapril, ramipril)
2. Angiotensin receptor blockers (ARBs) (eg, candasartan, valsartan)
3. Beta blockers (eg, bisoprolol, metoprolol)
4. Inotropic agents (eg, digoxin, digitoxin)
5. Loop diuretics (eg, furosemide, bumetanide)
 Thrombolytic Agents:
 Thrombolytic agents are used to dissolve clots that have formed in blood vessels.
 They are administered during heart attacks to dissolve the clotand restore
blood flow to the affectedheart muscle.
 Examples of thrombolytic agents include:
1. Streptokinase
2. Anistreplase
 Other Medications:
 Most of the medicines used to reduce the risk of cardiovasculardisease are also
used in its treatment. These include:
1. High blood pressure medicine
2. Cholesterol-lowering drugs
3. Anti-diabetic medicine
4. Antiplatelet medicine

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Cardiovascular Disease

  • 1. 1 cardiovascular  The cardiovascular system, also called the circulatory system, is the system that moves blood throughout the human body. It is composed of the heart, arteries, veins, and capillaries. It transports oxygenated blood from the lungs and heart throughout the whole body through the arteries. Blood goes through the capillaries - vessels situated between the veins and arteries. When the blood has been depleted of oxygen, it makes its way back to the heart and lungs through the veins.  Cardiovascular diseases (CVDs) are also popularly known as heart diseases. Cardiovascular disease is a term that refers to any disease of the heart or its blood vessels (arteries, veins, capillaries) that affect the functioning of its blood circulatory system that in turn affects another body part like brain, kidney, or other body parts. This disease is the most common type of illness that causes majority of deaths around the world. According to the World Health Organization, cardiovascular disease causes more than 17 million deaths in the world each year and is responsible for half of all deaths in the United States. Signs & Symptoms:  Pale, clammy appearance  Cyanosis (blue tinge to the skin), particularly in the extremities  Rapid or shallow breathing  Rapid and/or irregular heart rate  High or low blood pressure  Swollen veins in the neck  Swelling in the feet and ankles  Abnormalities in the retina (back of the eye)  Enlarged heart (measured by placing hand on chest)  Extra or abnormal heart sounds (via stethoscope)  Fluid in the lungs (via stethoscope)  Abnormal sounds of arterial blood flow throughout the body (via - stethoscope)  Cool extremities  Reduced or absent pulses in the extremities
  • 2. 2 Major Risk Factors 1. High Blood Pressure (Hypertension).  High blood pressure (hypertension) is by far the most important risk factor for CVD.  If your blood pressure is too high, it can damage your artery walls and increase your risk of developing a blood clot. 2. High Blood Cholesterol.  Cholesterol is a fatty substance carried in the blood by proteins. When the two combine, they're called lipoproteins. There are harmful and protective lipoproteins known as LDL and HDL, or "bad" and "good" cholesterol.  The amount of cholesterol in the blood (both LDL and HDL) can be measured with a blood test. The recommended cholesterol level varies depending on your overall risk of developing arterial disease.  If you have high blood cholesterol, it can cause your arteries to narrow and increase your risk of developing a blood clot. 3. Diabetes.  Diabetes also increases a person's risk for heart disease. With diabetes, the body either doesn't make enough insulin, can't use its own insulin as well as it should, or both. This causes sugars to build up in the blood.  About three–quarters of people with diabetes die of some form of heart or blood vessel disease. 4. Obesity and Overweight.  Extra weight can lead to increased high cholesterol levels, high blood pressure, and diabetes, all major risk factors for heart disease. 5. Smoking.  Most people know that cigarette and tobacco smoking increases your risk of lung cancer, but few realize that it also greatly increases the risk of heart disease and peripheral vascular disease (disease in the vessels that supply blood to the arms and legs).
  • 3. 3 6. Lack of exercise.  People who are not active have a greater risk of heart attack than do people who exercise regularly. Exercise burns calories to help maintain a healthy weight, helps to control cholesterol levels and diabetes, and may lower blood pressure. Exercise also strengthens the heart muscle and makes the arteries more flexible.  If you don't exercise regularly, it's more likely that you'll have high blood pressure, higher cholesterol levels, higher stress levels and be overweight. All of these are risk factors for CVD. 7. Gender.  Men are more likely to develop CVD at an earlier age than women. 8. Heredity.  Heart disease tends to run in families. For example, if your parents or siblings had a heart or circulatory problem before age 55, then you are at greater risk for heart disease than someone who does not have that family history. Risk factors (including high blood pressure, diabetes, and obesity) may also be passed from one generation to another. 9. Age.  Older age is a risk factor for heart disease. In fact, about 4 of every 5 deaths due to heart disease occur in people older than 65. As we age, our hearts tend not to work as well. The heart's walls may thicken and arteries may stiffen and harden, making the heart less able to pump blood to the muscles of the body. Because of these changes, the risk of developing cardiovascular disease increases with age. Because of their sex hormones, women are usually protected from heart disease until menopause, when their risk increases. 10.Other risk factors Other factors that affect your risk of developing CVD include:  Diet – a high-fat diet can cause fatty deposits to build up inside your arteries, leading to high blood cholesterol levels and high blood pressure  Alcohol – excessive alcohol consumption can also increase your cholesterol and blood pressure  Stress – not taking measures to reduce stress is thought to increase your risk of developing CVD
  • 4. 4 Cardiovascular Diseases Examples of diseases that affect the cardiovascular system:  Cardiac diseases (Heart diseases) - examples include: 1. Angina (angina pectoris) - is chest pain, discomfort, or tightness that occurs when an area of the heart muscle is receiving decreased blood oxygen supply. It is not a disease itself, but rather a symptom of coronary artery disease. Angina may manifest itself in the form of an angina attack, pain or discomfort in the chest that typically lasts from 1 to 15 minutes. 2. Arrhythmia - is an irregular heartbeat - the heart may beat too fast (tachycardia), too slowly (bradycardia). occur when the electrical impulses to the heart that coordinate heartbeats are not working properly, making the heart beat too fast/slow or inconsistently. 3. Congenital heart disease 4. Coronary artery disease (CAD) (Ischemic) 5. Dilated cardiomyopathy 6. Heart attack (myocardial infarction) - is the death of a segment of heart muscle caused by the loss of blood supply. The blood supply is usually lost because a coronary artery, one that supplies blood to the heart muscle, has a blood clot, a blockage (coronary thrombosis). If some of the heart muscle dies, the patient experiences chest pain and electrical instability of the heart muscle tissue. 7. Heart failure - is a serious condition in which the heart is not pumping blood around the body efficiently. 8. Hypertrophic cardiomyopathy 9. Mitral regurgitation - is a condition in which your heart's mitral valve doesn't close tightly, allowing blood to flow backward in your heart. As a result, blood can't move through your heart or to the rest of your body as efficiently, making you feel tired or out of breath. 10. Mitral valve prolapsed (MVP) 11. Pulmonary stenosis
  • 5. 5  Vascular diseases - examples include: 1. Atherosclerosis - is a narrowing of the arteries caused by a buildup of plaque. It is also called arteriosclerosis or hardening of the arteries. Arteries are the blood vessels that carry oxygen and nutrients from the heart to the rest of your body. As you get older, fat and cholesterol can collect in the arteries and form plaque. The buildup of plaque makes it difficult for blood to flow through the arteries. This buildup may occur in any artery in the body and can result in a shortage of blood and oxygen in various tissues of the body. Pieces of plaque can also break off, causing a blood clot. If left untreated, atherosclerosis can lead to heart attack, stroke, and heart failure. 2. Renal artery disease - is caused by the buildup of plaque in the arteries that lead to the kidneys. Plaque is made up of fats and cholesterol, and as it accumulates in the renal arteries, it causes the arteries to stiffen and narrow, which blocks the flow of blood to the kidneys. Obstructions (blockages) in the renal arteries, known as renal artery stenoses, can cause poorly controlled high blood pressure, congestive heart failure, and kidney failure. 3. Raynaud's disease - is a condition that causes some areas of the body to feel numb and cool in response to cold temperatures or emotional stress, caused by a problem with the blood supply to the skin. 4. Buerger's disease - is a disease that causes blockages in the blood vessels of your feet and hands. The blood vessels become inflamed, which reduces blood flow. Blood clots that further clog blood vessels also develop. The disease causes pain and can lead to tissue damage and, in severe cases tissue death (gangrene). 5. Cerebrovascular disease (Stroke) - Stroke occurs when the supply of blood to the brain is either interrupted or reduced. When this happens, the brain does not get enough oxygen or nutrients which causes brain cells to die. 6. Venous blood clots 8. Blood clotting disorders 7. Peripheral venous disease 9. Peripheral artery (arterial) disease
  • 6. 6 Coronary heart disease (Ischaemic Heart Disease) Ischemic heart disease is a condition of recurring chest pain or discomfort that occurs when a part of the heart does not receive enough blood. This condition occurs most often during exertion or excitement, when the heart requires greater blood flow. Ischemic heart disease develops when cholesterol particles in the blood begin to accumulate on the walls of the arteries that supply blood to the heart. Eventually, deposits called plaques may form. These deposits narrow the arteries and eventually block the flow of blood. This decrease in blood flow reduces the amount of oxygen supplied to the heart muscle. The signs and symptoms of ischemic heart disease may develop slowly as arteries gradually become blocked, or they may occur quickly if an artery suddenly becomes blocked. Some people with ischemic heart disease have no symptoms at all, while others may have severe chest pain (angina), shortness of breath, heart attack (myocardial infarction). Fortunately, ischemic heart disease can be treated successfully with lifestyle changes, medicines, and surgical procedures. Even better, you can reduce your risk of ischemic heart disease by following heart-healthy practices, such as eating a low-fat, low-sodium diet, being physically active, not smoking, and maintaining a healthy body weight. Left untreated, ischemic heart disease may lead to severe heart damage. Heart damage can result in heart attack and shock and may be life threatening.
  • 7. 7 Prevention:  Eat a healthy diet. Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables.  Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting salt or sodium in your diet can also lower your blood pressure.  Maintain a healthy weight. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI).  Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends adults engage in moderate-intensity exercise for 2 hours and 30 minutes every week.  Don't smoke. Cigarette smoking greatly increases your risk for heart disease. So, if you don't smoke, don't start. If you do smoke, quitting will lower your risk for heart disease.
  • 8. 8 Medications  Medicines are often used alone or in combination to treat or control cardiovascular conditions.  The followinglist provides information on medicines that your doctormay prescribe if you have been diagnosed with cardiovascular disease.  Antiarrhythmics:  These drugs workto stabilize the electrical conductionsystem of the heart.  Your doctorwill decide whichtype of medicine to prescribe depending on the type and severity of yourarrhythmias , yoursymptoms, and your overall health.  The different classes of antiarrhythmics include: 1. Sodium channel blockers (eg, amiodarone, propafenone) 2. Beta blockers (eg, acebutolol, propranolol) 3. Action-potential prolonging agents (eg, sotalol) 4. Calcium channel blockers (eg, verapamil)  Antianginals:  These medicines alleviate or prevent angina .  Antianginals does this by helping to restore the balance between the heart’s supply and demand of oxygen. 1. Nitrates and nitrites (eg, nitroglycerin) 2. Beta blockers (eg, acebutolol, propranolol) 3. Calcium channel blockers (eg, nifedipine, amlodipine)  Anticoagulants:  Anticoagulants are used to prevent stroke and heart attack in people who are at an increased risk due to heart conditions or heart surgery.  Anticoagulants prevent clots from forming or inhibit existing clots from growing. But, these medicines cannot dissolve clotsthat already exist.  Examples of anticoagulants include: 1. Warfarin (eg, Coumadin) 2. Heparin
  • 9. 9  Medicationsto Treat Heart Failure:  These medicines are designed to increase the amount of blood the heart can eject with each beat.  Your doctormay prescribe one or a combination of these medicines: 1. Angiotensin converting enzyme (ACE) inhibitors (eg, enalapril, ramipril) 2. Angiotensin receptor blockers (ARBs) (eg, candasartan, valsartan) 3. Beta blockers (eg, bisoprolol, metoprolol) 4. Inotropic agents (eg, digoxin, digitoxin) 5. Loop diuretics (eg, furosemide, bumetanide)  Thrombolytic Agents:  Thrombolytic agents are used to dissolve clots that have formed in blood vessels.  They are administered during heart attacks to dissolve the clotand restore blood flow to the affectedheart muscle.  Examples of thrombolytic agents include: 1. Streptokinase 2. Anistreplase  Other Medications:  Most of the medicines used to reduce the risk of cardiovasculardisease are also used in its treatment. These include: 1. High blood pressure medicine 2. Cholesterol-lowering drugs 3. Anti-diabetic medicine 4. Antiplatelet medicine