Cardiovascular System

Cardiovascular System Components

Circulatory system Pulmonary system

Purposes: Transport O2 to tissues and remove

waste Transport nutrients to tissues Regulation of body temperature

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

Cardiac Cycle Systole

Contractile phase of heart

Electrical and mechanical changes

Diastole Relaxation phase

of heart Takes twice as

long as systole

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

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

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

Autonomic Nervous System Control of Heart Rate Sympathetic

control Stimulates “fight

or flight” response Speeds up heart

rate and stroke volume

Sympathetic tone > 100 bpm

Parasympathetic control Connected to

vagus nerves Slows down heart

rate Parasympathetic

tone 60 – 100 bpm

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

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

Causes of High Blood Pressure

Age Race Heredity Diet Stress Inactivity

How to have a heart attack

Everyone’s doing it, so it must be the “in” thing to do

Be Old Relative risk of CHD increases with

age

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

Be a Man Males have 5-6 times the relative

risk of CHD of females

Why? Estrogen may be protective

Unalterable Risk Factors for CHD Age Family History Sex

Alterable Risk Factors Things you can do something

about…

Be fat Obesity increases CHD risk

How much fat is too much? Males - > 25% Females > 30%

Eat a high fat diet High fat foods increase plaque

within arteries and contribute to atherosclerosis

Have High Cholesterol Total cholesterol/HGH ratio above: Males – 4.5/1 Females – 4/1 Increases relative risk of CHD

Have High Blood Pressure High blood pressure forces the

heart to work harder

How high is too high?

> 140/90

Smoke Smokers are more likely to die of

heart attack than cancer

Smoking is the single most important alterable risk factor

Be a Type A personality Type A personalities are:

High-strung Achievement-oriented Aggressive Time-conscious

Live a stressful lifestyle No one, lying on their deathbed,

has said they wished they had spent more time at the office.

Have Other Diseases Diabetes Ulcers Obesity

Don’t Exercise If you get the urge to exercise, lie

down until the feeling passes.

Heart Disease and Stroke Statistics —

2010 Update

CVD disease mortality trends for males and femalesCVD disease mortality trends for males and females(United States: 1979-2006). United States: 1979-2006). Source: NCHS and NHLBI.Source: NCHS and NHLBI.

350

400

450

500

550

79 80 85 90 95 00 06

Years

De

ath

s in

Th

ou

sa

nd

s

Males Females

Age-adjusted death rates for CHD, stroke, lung and Age-adjusted death rates for CHD, stroke, lung and breast for white and black femalesbreast for white and black females (United States: (United States: 2006).2006).Source: NCHS. Source: NCHS.

41.1 41.122.9

57.039.0 31.6

101.5

130.0

0

50

100

150

200

Coronary HeartDisease

Stroke Lung Cancer Breast Cancer

Per

100

,000

Pop

ulat

ion

White Females Black Females

Deaths from cardiovascular diseaseDeaths from cardiovascular disease(United States: 1900–2006). (United States: 1900–2006). Source: NCHS and Source: NCHS and NHLBI. NHLBI.

0

200

400

600

800

1000

1200

00 10 20 30 40 50 60 70 80 90 00 06

Years

Dea

ths

in T

hous

ands

Percentage breakdown of deaths from cardiovascular Percentage breakdown of deaths from cardiovascular diseases diseases (United States: 2006)(United States: 2006) * - Not a true underlying cause.* - Not a true underlying cause.Source: NCHS. Source: NCHS.

51

17

7

74

14

Coronary HeartDisease

Stroke

HF*

High Blood Pressure

Diseases of theArteries

Other

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.

14.9

39.6

73.6

8.7

78.884.7

39.6

73.1

0102030405060708090

20-39 40-59 60-79 80+

Per

cent

of P

opul

atio

n

Men Women

Trends in Heart Transplants (UNOS: 1975-2008).Source: United Network for Organ Sharing (UNOS), scientific registry data.

22 57

719

2,107 2,1632,199

2,363

0

500

1,000

1,500

2,000

2,500

75 80 85 90 95 00 08

Years

Nu

mb

er

of

Tra

ns

pla

nts

Trends in Cardiovascular Operations and Trends in Cardiovascular Operations and Procedures Procedures (United States: 1979-2006).(United States: 1979-2006). Source: Source: NCHS and NHLBI.NCHS and NHLBI.Note: In-hospital procedures only.Note: In-hospital procedures only.

0

200

400

600

800

1000

1200

1400

79 80 85 90 95 00 06

Years

Pro

ce

du

res

in T

ho

us

an

ds

Catheterizations BypassPCI Carotid EndarterectomyPacemakers

Number of Surgical Procedures in the 10 Leading Number of Surgical Procedures in the 10 Leading Diagnostic Groups Diagnostic Groups (United States: 2006).(United States: 2006). Source: Source: NHDS/NCHS and NHLBI.NHDS/NCHS and NHLBI.

0.4

1

1.2

1.2

1.6

2

4.2

5.6

6.5

7.1

0 2 4 6 8

Hemic and Lymphatic 40-41

Urinary System 55-59

Nervous System 01-05

Respiratory System 30-34

Integumentary System 85-86

Female Genital Organs 65-71

Musculoskeletal 76-84

Digestive System 42-54

Cardiovascular 35-39

Obstetrical 72-75

Millions

Direct Costs of the 10 Leading Diagnostic Groups Direct Costs of the 10 Leading Diagnostic Groups (Billions of dollars)(Billions of dollars) (United States: 2010). (United States: 2010). Source: NHLBI. Source: NHLBI.

87.4

93.8

102.7

126.1

159.1

172.9

175.4

177.7

225.2

324.1

0.0 50.0 100.0 150.0 200.0 250.0 300.0 350.0

Endocrine System 240-279

Genitourinary System 580-629

Neoplasms 140-239

Musculoskeletal system 710-739

Respiratory System 460-519

Injury and Poisoning 800-999

Nervous System 320-389

Mental 290-319

Digestive System 520-579

Cardiovascular 390-459

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

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

LDL vs. HDL

LDL = “bad” Too much can clog arteries by

forming plaque Atherosclerosis can cause heart

attack or stroke

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

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

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

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

Common misconceptions Using margarine instead of butter will help

lower my cholesterol Thin people don’t have to worry about high

cholesterol If a label lists no cholesterol, it’s a “heart-

healthy” choice Eggs – good or bad? Women don’t need to worry about

cholesterol Only middle-aged people should have their

cholesterol checked

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

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

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.

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).

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

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

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.

What Is Happening During an Asthma Attach ?

When someone is having an asthma attack the following is happening:

1. The lining of the airway is swollen and irritated.

2. The muscles around the airway tighten and make it hard to breathe.

3. The airway makes a thick mucus.

What Is Happening During an Asthma Attack in the Lungs?

Asthma Warning Signs

Warning signs are clues that your child’s asthma may be getting worse.

Runny stuffy nose Headache Tickle in throat Child’s has a cold or flu Coughing Restless

Know Your Child’s Warning

Signs!

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

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

What Causes Asthma Attacks?

AN ASTHMA TRIGGER IS…anything that sets off asthma

symptoms

TRIGGERS

Ways to Avoid Triggers

Dust, dander, and house mites Dust the house with a damp cloth,

especially in the child’s bedroom. Use a damp mop to clean the floor. Cover pillow, mattress, and

boxspring with special dust-mite–proof covers.

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.

Ways to Avoid Triggers

Pets If possible, remove pets from the

home or limit the child’s contact with the animal.

Never allow pets in the child’s bedroom.

Ways to Avoid Triggers

Strong odors and scented products

Avoid heavy scents, like perfumes, hairsprays, and certain household cleaners like bleach or ammonia.

Don’t use room deodorizers.

Asthma Medications and Devices

Types of Medications Long-term “controller” medicine Quick-relief “rescue” medicine

Long-Term Medications Long-term “controller” medicine

prevents swelling and inflammation of the airway and should be used every day, even when feeling well.

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.

Inhaler “the pump”

Delivers inhaled medication in a spray mist form

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 person’s lungs.

Asthma Devices

Asthma Devices

Nebulizer

A machine that delivers medication in a mist.

Peak Flow Meter

A device used to measure how air flows from your lungs in one “fast blast.”

Asthma Devices

Controlling Asthma

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.

Getting Asthma Under Control

Learn about asthma triggers and how to avoid them.

Talk about peak flow monitoring with your health-care provider.

Sleeps through the night Goes to school every day Is able to play, take gym,

and participate in sports

A Child With Well-Controlled Asthma