Transcript Heart Disease

HEART DISEASECHD
Risks, facts, screenings, questions
http://www.heart.org/HEARTOR
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FACTS: WHAT IS CHD
 Coronary Heart Disease is a condition which affects the vessels which
supply the heart's muscle with blood, oxygen and nutrients.
 If vessels become partially blocked- decreased heart functioning-
experience chest pain or angina
 If vessels completely blocked- some heart muscle can die- cuase heart
attacks
 Fat, calcium, cholesterol, and other substances can block vessels
 Blocked vessels make the aterial walls narrow from plaque or form hard
fibrous caps which can erupt and cause blood clots.
FACTS- CAUSES/ INCIDENCES
 Coronary heart disease (CHD) is the leading cause of death in the
United States for men and women.
 Coronary Heart Disease (CHD) kills over 400,000 men and women
each year.
 One out of every five deaths is due to CHD. One-third of people who
have a heart attack do not survive it.
 In addition, over 12 million Americans are currently living with
coronary heart disease pain and/or heart problems.
 Stroke is the No. 4 cause of death in the United States.
FACTS CONT.
 CHD is a simple term used to describe several problems related to plaque
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buildup in the walls of the arteries, or atherosclerosis. As the plaque builds
up, the arteries narrow, making it more difficult for blood to flow and
creating a risk for heart attack or stroke. Other types of heart disease
include heart failure, an irregular heartbeat – or arrhythmia – and heart
valve problems.
Coronary heart disease is caused by the buildup of plaque in the arteries to
your heart. This may also be called hardening of the arteries.
Fatty material and other substances form a plaque build-up on the walls of
your coronary arteries. The coronary arteries bring blood and oxygen to
your heart.
This buildup causes the arteries to get narrow.
As a result, blood flow to the heart can slow down or stop.
THE RISK FACTORS FOR HEART DISEASE
THAT YOU CANNOT CHANGE ARE:
 Your age. The risk of heart disease increases with age.
 Your gender. Men have a higher risk of getting heart disease than
women who are still getting their menstrual period. After menopause,
the risk for women is closer to the risk for men. See: Heart disease and
women
 Your genes. If your parents or other close relatives had heart disease,
you are at higher risk.
 Your race. African Americans, Mexican Americans, American Indians,
Hawaiians, and some Asian Americans also have a higher risk for heart
problems.
THINGS THAT INCREASE YOUR RISK
 Diabetes is a strong risk factor for heart disease.
 High blood pressure increases your risks of heart disease and heart
failure.
 Extra cholesterol in your blood builds up inside the walls of your heart's
arteries (blood vessels).
 Smokers have a much higher risk of heart disease.
 Chronic kidney disease can increase your risk.
THINGS THAT INCREASE YOUR RISK
CONT.
 People with narrowed arteries in another part of the body (examples
are stroke and poor blood flow to the legs) are more likely to have
heart disease.
 Substance abuse (such as cocaine)
 Being overweight
 Not getting enough exercise, and feeling depressed or having excess
stress are other risk factors.
 http://www.youtube.com/watch?v=Z_uTp31Fgx8&feature=related
SYMPTOMS
 It may feel heavy or like someone is squeezing your heart. You feel it under
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your breast bone (sternum), but also in your neck, arms, stomach, or upper
back.
The pain usually occurs with activity or emotion, and goes away with rest
or a medicine called nitroglycerin.
Other symptoms include shortness of breath and fatigue with activity
(exertion).
Women, elderly people, and people with diabetes are more likely to have
symptoms other than chest pain, such as:
Fatigue
Shortness of breath
Weakness
WHAT IS BLOOD PRESSURE?
 Blood pressure measures the force pushing outwards on your
arterial walls.
 The first force occurs as blood pumps out of the heart and into the
arteries that are part of the circulatory system. The second force is
created as the heart rests between heart beats.
 Systollic vs. diastollic
 The more forcefully that blood pumps, the more the arteries stretch to
allow blood to easily flow. Over time, if the force of the blood flow is
often high, the tissue that makes up the walls of arteries gets stretched
beyond its healthy limit.
BLOOD PRESSURE
 Systollic Diastollic Healthy blood pressure:
 Normal- 120/80
 Prehypertension- 120-139/ 80-89
 High blood pressure(stage 1)- 140-159/ 90-99
 Stage 2- 160 or higher/ 100 or higher
 Stage 3 hypertensive crisis)- higher than 180/ higher than 110
LOW BLOOD PRESSURE
 Low blood pressure, or hypotension, occurs when blood pressure
during and after each heartbeat is much lower than usual. This means
the heart, brain, and other parts of the body do not get enough blood.
 Another name for it?
 Blood pressure that is borderline low for one person may be normal for
another. Most normal blood pressures fall in the range of 90/60
millimeters of mercury (mm Hg) to 130/80 mm Hg. But a significant
drop, even as little as 20 mm Hg, can cause problems for some people.
 Low bp caused by certain drugs such as:
HIGH BLOOD PRESSURE
 Can result in:
 Vascular weakness
 Scarring workload on arteries and circulatory system
 Scarring
 Plaque build up
 Organ damage
 Risk of blood clots
 Heart failure, heart attack, stroke
PREVENTION-HBP
 Eat a better diet, which may include reducing salt
 Enjoy regular physical activity
 Maintain a healthy weight
 Manage stress
 Avoid tobacco smoke
 Understand hot tub safety
 Comply with medication prescriptions
 If you drink, limit alcohol
http://www.youtube.com/watch?v=pPxnIh_WTb8&feature=endscreen&NR
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HEART ATTACK
 A coronary attack (heart attack) occurs when the blood flow that
brings oxygen to the heart muscle is severely reduced or cut off
completely.
 When a plaque in a heart artery breaks, a blood clot forms around the
plaque. This blood clot can block the artery and shut off blood flow to
the heart muscle. When the heart muscle is starved for oxygen and
nutrients, it is called ischemia. When damage or death of part of the
heart muscle occurs as a result of ischemia, it is called a heart attack or
myocardial infarction (MI). About every 34 seconds, someone in the
United States has a myocardial infarction (heart attack).
WARNING SIGNS OF HEART ATTACK
 Chest discomfort. Most heart attacks involve discomfort in the center of
the chest that lasts more than a few minutes, or that goes away and comes
back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
 Discomfort in other areas of the upper body. Symptoms can include
pain or discomfort in one or both arms, the back, neck, jaw or stomach.
 Shortness of breath with or without chest discomfort.
 Other signs may include breaking out in a cold sweat, nausea or
lightheadedness.
 Angina is a type of chest discomfort due to poor blood flow through the
blood vessels (coronary vessels) of the heart muscle (myocardium).
 Stable vs unstable angina
 Heart Attack - Warning Signs
RISKS- HEART ATTACK
 Heart Attack Risk Calculator.
 CAD is the leading cause of death and disability in women after
menopause. In fact, a 50-year-old woman faces a 46% risk of developing
CAD and a 31% risk of dying from coronary artery disease. In contrast,
her probability of contracting and dying from breast cancer is 10% and
3%, respectively
 What to do in case of heart attack?
 http://www.youtube.com/watch?v=H_VsHmoRQKk&feature=related
PREVENTION
 ABCs:
 Avoid tobacco
 Become more active
 Choose good nutrition
 Reduce blood cholesterol
 Lower high blood pressure
 Aim for healthy weight
 Manage diabetes
 Reduce stress
 Limit alcohol
ARRHYTHMIA
 The normal heart is a strong, muscular pump a little larger than a fist. It pumps blood
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continuously through the circulatory system.
Each day the average heart beats (expands and contracts) 100,000 times and pumps
about 2,000 gallons of blood.
In a 70-year lifetime, an average human heart beats more than 2.5 billion times.
Arrhythmia is refers to any change from the normal sequence of electrical impulses.
The electrical impulses may happen too fast, too slowly, or erratically – causing the
heart to beat too fast, too slowly, or erratically. When the heart doesn't beat
properly, it can't pump blood effectively. When the heart doesn't pump blood
effectively, the lungs, brain and all other organs can't work properly and may shut
down or be damaged.
http://medmovie.com/mmdatabase/mediaplayer.aspx?Message=VG9waWNpZD0wO
0NsaWVudElEPTY1O1Zlcm5hY3VsYXJJRD0x-P83bCzVaVLA%3d
CONGESTIVE HEART FAILURE
 Heart failure doesn't mean that the heart has stopped working, but that
it just isn't able to pump enough blood to meet the needs of the body.
 This may happen when the heart muscle itself is weaker than normal or
when there is a defect in the heart that prevents blood from getting out
into the circulation
 When the heart does not circulate blood normally, the kidneys receive
less blood and filter less fluid out of the circulation into the urine. The
extra fluid in the circulation builds up in the lungs, the liver, around the
eyes, and sometimes in the legs. This is called fluid "congestion" and for
this reason doctors call this "congestive heart failure".
 Fluid may also build up in the rest of the body, causing swelling of the
feet, the legs or around the eyes.
TYPES OF CHF
 Systolic Heart Failure: In this type, the heart’s ability to contract decreases leading to backing up of
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blood coming from the lungs causing the fluid to leak into the lungs. This condition is called pulmonary
congestion.
Diastolic Heart Failure: In this type, the heart cannot relax properly due to stiffening of the heart’s
muscle leading to improper filling of the heart with blood. This condition may lead to fluid
accumulation in the feet, ankles, legs and sometimes the lungs. (7)
Right-sided heart failure: The failure of the pumping action of the right side of the heart causes
swelling in the legs and abdomen.
Left-sided heart failure: In this type, the left side of the heart fails in its pumping action causing
congestion in the lungs.
Forward heart failure: Inability of the heart to pump sufficient blood to meet the oxygen needs of
the body during an exercise or rest leads to forward heart failure.
Backward heart failure: It is the inability of the heart to meet the oxygen needs when heart
pressures are very high.
High output heart failure: Though the heart pumps out the usual amount of blood, the body’s
needs may not be fulfilled (8).
CHF TREATMENT
 Medicines called diuretics ("water pills"), e.g., furosemide (Lasix), help
get rid of the extra fluid by increasing urination. To help the body rid
itself of the extra fluid, a low-salt diet may sometimes be necessary.
Blood vessel relaxing medications (captopril, enalapril) may sometimes
be used to make it easier for the heart to pump. Another medication,
digoxin, may help the heart contract with more force.
PROCEDURES
 Angioplasty procedure
CARDIAC ARREST
 Cardiac arrest is the abrupt loss of heart function in a person who may or may not
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have diagnosed heart disease.
Each year about 295,000 emergency medical services-treated out-of-hospital cardiac
arrests occur in the United States.
Heart attack vs. Cardiac Arrest
While a heart attack may cause cardiac arrest and sudden death
Cardiac arrest is caused when the heart's electrical system malfunctions. In cardiac
arrest death results when the heart suddenly stops working properly. This is caused
by abnormal, or irregular, heart rhythms (called arrhythmias). The most common
arrhythmia in cardiac arrest is ventricular fibrillation. This is when the heart's lower
chambers suddenly start beating chaotically and don't pump blood. Death occurs
within minutes after the heart stops. Cardiac arrest may be reversed if CPR
(cardiopulmonary resuscitation) is performed or a defibrillator is used to shock the
heart and restore a normal heart rhythm within a few minutes.
SYMPTOMS-CARDIAC ARREST
 Sudden loss of responsiveness
 No normal breathing
The victim does not take a normal breath when you tilt the head up
Check for at least five seconds
 What to do in case of cardiac arrest?
 http://www.youtube.com/watch?v=jcPSqe-oxPM&feature=related
 http://www.youtube.com/watch?v=kYg9e5eM9xA&feature=related
 http://www.youtube.com/watch?v=LLtzT2bXVGI&feature=related
DIABETES
 "Diabetes mellitus," more commonly referred to as "diabetes," is a condition that
causes blood sugar to rise to dangerous levels: a fasting blood glucose of 126
milligrams per deciliter (mg/dL) or more.
 Most of the food you eat is turned into glucose, or sugar, for your body to use for
energy. The pancreas, an organ near the stomach, produces a hormone called insulin.
This hormone is necessary for the body to be able to use sugar or glucose, the basic
fuel for cells in the body. Insulin's role is to take sugar from the blood into the cells.
When your body does not produce enough insulin and/or does not efficiently use
the insulin it produces, sugar levels rise and build up in the bloodstream. When this
happens, it can cause two problems: 1. Right away, the body's cells may be starved
for energy.
 2. Over time, high blood glucose levels may damage the eyes, kidneys, nerves or
heart.
 Show medmovie
DIABETES CONT.
 Type 1 diabetes is a serious condition that occurs when the pancreas makes little or no
insulin. Without insulin, the body is unable to take the glucose (blood sugar) it gets from
food into cells to fuel the body. So without daily injections of insulin, people with type 1
diabetes won't survive. For that reason, this type of diabetes is also referred to as insulindependent diabetes.
Type 1 diabetes was previously known as juvenile diabetes because it's usually diagnosed
in children and young adults. However, this chronic, lifelong disease can strike at any age,
and those with a family history of it are particularly at risk.
Health Risks for Type 1 Diabetes
During the development of type 1 diabetes, the body's immune system attacks certain
cells (called beta cells) in the pancreas. Although the reasons this occurs are still unknown,
the effects are clear. Once these cells are destroyed, the pancreas produces little or no
insulin, so the glucose stays in the blood. When there's too much glucose in the blood,
especially for prolonged periods, all the organ systems in the body suffer long-term
damage. Learn more about the health consequences of diabetes and how to treat it.
TYPE II
 Type 2 diabetes is the most common form of diabetes. Historically, type 2 diabetes
has been diagnosed primarily in middle-aged adults. Today, however, adolescents and
young adults are developing type 2 diabetes at an alarming rate. This correlates with
the increasing incidence of obesity and physical inactivity in this population, both of
which are risk factors for type 2 diabetes.
This type of diabetes can occur under two different circumstances:
The pancreas doesn't make enough insulin, or
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The body develops "insulin resistance" and can't make efficient use of the insulin it
makes
 In a mild form, this type of diabetes can go undiagnosed for many years, which is a
cause for great concern since untreated diabetes can lead to many serious medical
problems, including cardiovascular disease. Type 2 diabetes may be delayed or
controlled with diet and exercise.
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PRECURSORS TO DIABETES
 Prediabetes is a condition in which fasting blood glucose (blood sugar) levels are higher
than normal but have not quite reached the 126 milligrams/deciliter (mg/dL) threshold
considered to be full-blown diabetes.
Two prediabetic states include:
 Impaired fasting glucose (IFG): A person is considered to have IFG with a fasting blood
glucose ranging from 100 to 125 mg/dL.
 Impaired glucose tolerance (IGT): Individuals with IGT have a fasting glucose less than
126 mg/dL and a glucose level between 140 and 199 mg/dL two hours after taking an oral
glucose tolerance test.
 Health Risks for Prediabetics
The American Heart Association estimates that 59.7 million Americans 20 years and older
have prediabetes. People with IFG and IGT are at increased risk for developing type 2
diabetes, heart disease and stroke. Long-term damage to the cardiovascular system may
occur while a person has prediabetes, and a recent study indicates that prediabetes more
than doubles the risk of death due to heart attack.*
INSULIN RESISTANCE
 Both type 2 diabetes and prediabetes usually result from insulin resistance.
Insulin resistance, which is a condition that affects more than 60 million Americans, occurs
when the body can't use insulin efficiently. To compensate, the pancreas releases more and
more insulin to try to keep blood sugar levels normal. Gradually, the insulin-producing
cells in the pancreas become defective and ultimately decrease in total number. As a result,
blood sugar levels begin to rise, causing prediabetes and, eventually, type 2 diabetes to
develop.
When a fasting individual has too much glucose in the blood (hyperglycemia) or too much
insulin in the blood (hyperinsulinemia), it indicates a person may have insulin resistance.
Health Risks of Insulin Resistance
People with insulin resistance are at greater risk of developing type 2 diabetes. They also
are more likely to have too much LDL ("bad") cholesterol, not enough HDL ("good")
cholesterol, and high triglycerides, which cause atherosclerosis.
Prediabetes
Type I
Type II
No symptoms
Increased or extreme
thirst
same
Increased appetite and
fatigue
same
Increased or frequent
urination
Urination at night
Unusual weight loss
Weight loss
Blurred vision
same
Fruity odor or breath
Sores that don’t heal
Sometimes no symptoms
Sometimes none
WHO SHOULD BE TESTED
 Overweight and over age 45
 Overweight, under age 45 and have one of more additional risk factors such as:
 High blood pressure
 High cholesterol
 A family history of diabetes
 African-American, Asian-American, Latino/Hispanic-American, Native American or Pacific Islander
descent
 A history of gestational diabetes (diabetes during pregnancy) or delivering a baby over 9 lbs.
 If your blood glucose levels are in normal range, testing should be done about every
three years. If you have prediabetes, you should be checked for diabetes every one
to two years after diagnosis.
 They use a fasting glucose test or oral glucose testhow the body handles standard
glucose levels
TREATMENT
 Type I diabetes, the pancreas doesn’t produce insulin. In type II
the pancreas produces it, but doesn’t use it properly. So in both
cases, people might have to take insulin.
 Syringe: A needle connected to a hollow tube that holds the insulin
and a plunger that pushes the insulin down into and through the needle
 Insulin pen: A device that looks like a pen and holds insulin but has a
needle for its tip
 Insulin pump: A small machine (worn on a belt or kept in a pocket)
that holds insulin, pumps it through a small plastic tube and through a
tiny needle inserted under the skin where it stays for several days
STROKE
 Stroke is a disease that affects the arteries leading to and within the
brain. It is the No. 4 cause of death and a leading cause of disability in
the United States.
A stroke occurs when a blood vessel that carries oxygen and nutrients
to the brain is either blocked by a clot or bursts. When that happens,
part of the brain cannot get the blood (and oxygen) it needs, so it starts
to die.
STATISTICS ABOUT STROKES
 About 795,000 Americans each year suffer a new or recurrent stroke. That
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means, on average, a stroke occurs every 40 seconds.
Stroke kills more than 137,000 people a year. That's about 1 out of every 18
deaths. It's the No. 4 cause of death.
On average, every 4 minutes someone dies of stroke.
About 40 percent of stroke deaths occur in males, and 60 percent in
females.
The 2006 stroke death rates per 100,000 population for specific groups
were 41.7 for white males, 41.1 for white females, 67.7 for black males
and 57.0 for black females.
Americans will pay about $73.7 billion in 2010 for stroke-related medical
costs and disability.
DIVISION OF BRAIN
TYPES OF STROKE
 Ischemic( clots)
 Hemorrhagic (bleeds)
 TIA (Transient Ischemic Attack)
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 Ischemic stroke occurs as a result of an obstruction within a blood
vessel supplying blood to the brain. It accounts for 87 percent of all
stroke cases.
CONT.
 Bleeds
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TIA
WHO’S AT RISK
 Age-The chance of having a stroke approximately doubles for each
decade of life after age 55
 Race- African Americans have a much higher risk of death from a stroke
than Caucasians do.This is partly because blacks have higher risks of
high blood pressure, diabetes and obesity.
 Gender- stronger possibility in men than woman(However, more than
half of total stroke deaths occur in women.)
 Heredity- family history or prior stroke symptoms
 Symptoms- how to tell? FAST
PREVENTATIVE MEASURES/TREATMENT
 Anticoagulants/Antiplatelets
 Carotid Endarterectomy
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Angioplasty/Stents
http://www.youtube.com/watch?v=yXONEHmupy0&feature=related
http://www.youtube.com/watch?v=XkElztcWpa0
http://www.youtube.com/watch?v=VGvKUPJ7a_U
http://www.youtube.com/watch?v=Qvk9OwGh_JA