Transcript Chapter10

10
CARDIOVASCULAR
DISEASE
&
CANCER
10
“You only live once…
but if you work it
right, once is
enough.”
- Joe E. Lewis -
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CARDIOVASCULAR
DISEASE
DEATH RATES FOR HEART
DISEASE OF WOMEN, AGES 45+
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THE HEART CROSS-SECTION
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PATHOPHYSIOLOGY OF THE
HEART
Categories of Cardiovascular Diseases:
Coronary Heart Disease (CHD)
Cerebrovascular Disease (Stroke)
Hypertension
Congestive Heart Failure (CHF)
Congenital Heart Disease
Rheumatic Heart Disease
Angina Pectoris
Peripheral Artery Disease (PAD)
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Coronary Heart Disease:
Arteriosclerosis - generic term describing any
disease of the arteries that leads to thickening and
hardening of artery walls
Atherosclerosis
Myocardial Infarction
Thrombus
Congestive Heart Failure:
weak heart muscles that cannot perform the pump
function with proper vigor
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Cerebrovascular Disease (Stroke):
3 Types of Stroke
Thrombus
Embolism
Aneurysm
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Congenital Heart Disease:
Babies born with a hole in septum, imperfectly formed
blood vessels, valvular damage, or left ventricular
imperfections
Rheumatic Heart Disease:
Results from bacterial infection ‘streptococcus’, which
causes damage to heart valves
Angina Pectoris:
Chest pain resulting from insufficient supply of blood
(oxygen) to heart muscle
Peripheral Artery Disease:
Disease of the extremities in which blood supply is
diminished resulting in lack of nutrients/oxygen to
arms/legs
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RISK FACTORS FOR CVD
 Age
 Hypertension
Genetics
Elevated Cholesterol
Race
Sedentary Lifestyle
Obesity
Diabetes
Smoking
Menopause
Drugs
Oral Contraceptives
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GENDER DIFFERENCES OF CVD
Prevalence of CHD higher in men
Approximately equal number of deaths
Incidence is much higher in men at earlier ages
Incidence in women increases after menopause
Symptoms and signs vary among genders
Women more likely to have a recurrent attack
Women more likely to die from heart attack
RACIAL DIFFERENCES OF CVD
CVD death rate higher in African American women than in
white women
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CANCER
MAIN GROUPS OF CANCER
Carcinoma
Sarcoma
Leukemia
Lymphoma
Hepatoma
Melanoma
Neuroblastoma
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BREAST CONDITIONS
Benign Breast Diseases:
Fibrocystic Breast Disease
Hyperplasia
Fibroadenoma
Breast Cancer:
5 Levels
Stage I: <2cm in size, localized
Stage II: 2-5cm in size, localized
Stage III: >5cm in size, grown into chest wall, skin, or lymph
nodes
Stage IV: Growth spread to other parts of body
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Risk Factors for Breast Cancer:
Gender
Age
Family history
Never had children
Had firs child after 30 yrs.
Early menarche (before 12)
Late menopause (after 55)
Oral contraceptive use
Hormone Replacement Therapy
Higher breast density
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Breast Cancer Screening:
The Mammogram
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GYNECOLOGICAL CONDITIONS
Benign Cervical Changes:
Polyps
Cervical Dysplasia
Cervical Cancer:
Stages 0-IV
Screening = Pap Smear
Risk Factors:
Human papillomavirus (HPV), smoking,
immunosuppressant drugs, early sexual intercourse, multiple
sex partners, >4 pregnancies
Treatment:
Cyrosurgery, Cone biopsy, laser cone biopsy
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Benign Uterine Conditions:
Fibroids
Adenomyosis
Endometrial Hyperplasia
Endometriosis
Malignant Uterine Tumors:
4 Stages
Screening: Pelvic exam, transvaginal ultrasound, endometrial
biopsy
Risk Factors
Age, high levels of estrogen, obesity, diabetes, failure to
ovulate, history of infertility, family history, using Tamoxifen
Treatment
Hysterectomy, surgery, radiotherapy, progesterone
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Benign Ovarian Growths:
Cysts
Polycystic Ovarian Syndrome
Ovarian Cancer:
4 Stages
Screening: Pap smear, transvaginal ultrasound, blood test
Risk Factors
Reproductive tract history, no children, early menstruation,
late menopause, pregnancy after age 30, oral contraceptives,
previous cancer, long-term use of fertility drug Clomiphene
Citrate
Treatment
Hysterectomy, surgery, radiotherapy, chemotherapy
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OTHER CANCERS
Lung Cancer
Colorectal Cancer
Skin Cancer
Comparison of Estimated New Cancer
Cases and deaths, U.S. Women, 1999
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INFORMED
DECISION MAKING
SCREENING TESTS FOR WOMEN OF
DIFFERENT AGES
Age
Recommendations
Benefit
Under 40
Breast exam by doctor
No data
40-49
Breast exam by doctor; mammogram
ever 1-2 years
 Chances of dying from
breast cancer by 17%
50-74
Breast exam by doctor; mammogram
every 1-2 years
 Chances of dying from
breast cancer by 30%
75+
Breast exam by doctor; mammogram
every 1-2 years
No data