Cardiovascular Disease PDF Lecture Notes

LECTURE 1 Cardiovascular Disease Cardiovascular disease is a group of diseases affecting your heart and blood vessels. These diseases can affect one or many parts of your heart and/or blood vessels. A person may be symptomatic (physically experiencing the disease) or asymptomatic (not feeling anyt...

LECTURE 1 Cardiovascular Disease Cardiovascular disease is a group of diseases affecting your heart and blood vessels. These diseases can affect one or many parts of your heart and/or blood vessels. A person may be symptomatic (physically experiencing the disease) or asymptomatic (not feeling anything at all). Cardiovascular disease includes heart or blood vessel issues, including: Narrowing of the blood vessels in your heart, other organs or throughout your body. Heart and blood vessel problems present at birth. Heart valves that aren't working right. Irregular heart rhythms. SYMPTOMS AND CAUSES causes cardiovascular disease. The causes of cardiovascular disease can vary depending on the specific type. For example, atherosclerosis (plaque buildup in your arteries) causes coronary artery disease and peripheral artery disease. Coronary artery disease, scarring of your heart muscle, genetic problems or medications can cause arrhythmias. Aging, infections and rheumatic disease can cause valve diseases. cardiovascular disease risk factors High blood pressure (hypertension). High cholesterol (hyperlipidemia). Tobacco use (including vaping). Type 2 diabetes. Family history of heart disease. Lack of physical activity. Having excess weight or obesity. Diet high in sodium, sugar and fat. Overuse of alcohol. Misuse of prescription or recreational drugs. Preeclampsia or toxemia. Gestational diabetes. Chronic inflammatory or autoimmune conditions. Chronic kidney disease. LECTURE 1 symptoms of cardiovascular disease. Cardiovascular disease symptoms can vary depending on the cause. Older adults and people assigned female at birth may have more subtle symptoms. However, they can still have serious cardiovascular disease Symptoms of heart issues Chest pain (angina). Chest pressure, heaviness or discomfort, sometimes described as a "belt around the chest" or a "weight on the chest." Shortness of breath (dyspnea). Dizziness or fainting. Fatigue or exhaustion. Symptoms of blockages in blood vessels throughout your body Pain or cramps in your legs when you walk. Leg sores that aren't healing. Cool or red skin on your legs. Swelling in your legs. Numbness in your face or a limb. This may be on only one side of your body. Difficulty with talking, seeing or walking. conditions of cardiovascular diseases. There are many different types of cardiovascular diseases, including but not limited to: Arrhythmia: Problem with your heart's electrical conduction system, which can lead to abnormal heart rhythms or heart rates. Valve disease: Tightening or leaking in your heart valves (structures that allow blood to flow from one chamber to another chamber or blood vessel). Coronary artery disease: Problem with your heart's blood vessels, such as blockages. Heart failure: Problem with heart pumping/relaxing functions, leading to fluid buildup and shortness of breath. Peripheral artery disease: Issue with the blood vessels of your arms, legs or abdominal organs, such as narrowing or blockages. Aortic disease: Problem with the large blood vessel that directs blood from your heart to your brain and the rest of your body, such as dilatation or aneurysm. Congenital heart disease: Heart issue that you're born with, which can affect different parts of your heart. Pericardial disease: Problem with the lining of your heart, including pericarditis and pericardial effusion. Cerebrovascular disease: Issue with the blood vessels that deliver blood to your brain, such as narrowing or blockages. Deep vein thrombosis (DVT): Blockage in your veins, vessels that bring blood back from your brain/body to your heart.  LECTURE 1 DIAGNOSIS AND TESTS Some common tests to diagnose cardiovascular disease include: Blood work measures substances that indicate cardiovascular health, such as cholesterol, blood sugar levels and specific proteins. A provider can use a blood test to check for blood clotting issues as well. Ankle brachial index (ABI) compares the blood pressure in your ankles and arms to diagnose peripheral artery disease. Electrocardiogram (EKG) records your heart's electrical activity. Ambulatory monitoring uses wearable devices that track your heart rhythm and rates. Echocardiogram uses sound waves to create an image of your heartbeat and blood flow. Ultrasound uses sound waves to check blood flow in your legs or neck. Cardiac computerized tomography (CT) uses X-rays and computer processing to create 3D images of your heart and blood vessels Cardiac magnetic resonance imaging (MRI) uses magnets and radio waves to create highly detailed images of your heart..MR angiogram or CT angiogram uses an MRI or CT, respectively, to see blood vessels in your legs, head and neck. Stress tests analyze how physical activity affects your heart in a controlled setting, using exercise or medications, to determine how your heart responds. This type of test can involve EKGs and/or imaging tests. Cardiac catheterization uses a catheter (thin, hollow tube) to measure pressure and blood flow in your heart. LECTURE 1 MANAGEMENT AND TREATMENT Treatment plans can vary depending on your symptoms and the type of cardiovascular disease you have. Cardiovascular disease treatment may include: Lifestyle changes: Examples include changing your diet, increasing your aerobic activity and quitting smoking or tobacco products (including vaping). Medications: Your healthcare provider may prescribe medications to help manage cardiovascular disease. Medication type will depend on what kind of cardiovascular disease you have. Procedures or surgeries: If medications aren't enough, your healthcare provider may use certain procedures or surgeries to treat your cardiovascular disease. Examples include stents in your heart or leg arteries, minimally invasive heart surgery, open-heart surgery, ablations or cardioversion. Cardiac rehabilitation: You may need a monitored exercise program to help your heart get stronger. Active surveillance: You may need careful monitoring over time without medications or procedures/surgeries.  LECTURE 2 Congenital Heart Disease Congenital heart disease (CHD) is a defect in the heart's structure that's present at birth. It can be detected before birth, soon after birth or anytime throughout life. There are many kinds of CHD. Symptoms and treatment depend on the type of defect and its severity. A person with CHD should see a cardiologist regularly throughout life. Congenital heart disease (CHD) is a defect or problem with the heart's structure that's present at birth, such as: A hole in the heart wall. Issues with the blood vessels (too many or too few, blood flowing too slowly, to the wrong place or in the wrong direction). Problems with the heart valves. types of congenital heart defects. There are two main groups of CHD: cyanotic congenital heart disease and a cyanotic congenital heart disease. Cyanotic (low oxygen in the blood) congenital heart disease. Cyanotic congenital heart disease involves heart defects that reduce the amount of oxygen delivered to the rest of the body. This is sometimes called a critical congenital heart defect. Babies born with cyanotic congenital heart disease usually have low levels of oxygen and need surgery. Examples include: left heart obstructive lesions. Right heart obstructive lesions. Mixing lesions.  LECTURE 2 Acyanotic (blood oxygen level is acceptable) congenital heart disease Acyanotic congenital heart disease involves a defect that causes blood to pump through the body abnormally. For example: Hole in the heart Problem with the aorta Problem with the pulmonary artery. SYMPTOMS AND CAUSES Symptoms may start as soon as a baby is born or may not appear until later in life. They can include: Cyanosis (blueish skin, lips or nails). Excessive sleepiness. Fast breathing or trouble breathing. Fatigue (extreme tiredness). Getting unusually tired or out of breath during exercise. Heart murmur (a swishing sound made by the heart that may indicate abnormal blood flow). Poor blood circulation. Weak pulse or pounding heartbeat. The signs and symptoms vary widely, depending on: Age. The number of heart defects (a person can be born with more than one defect). The severity of the condition. Type of defect.  LECTURE 2 causes congenital heart disease CHD happens when the fetal heart doesn't develop correctly in the uterus. Scientists don't fully understand why that happens, but it may be related to: Abnormal chromosomes or genetics. Drinking or smoking during pregnancy (or significant environmental exposures such as secondhand smoke). Illnesses in the mother during pregnancy (diabetes, drug use, phenylketonuria or viral infection). DIAGNOSIS AND TESTS Tests that can help diagnose CHD in newborns, children or adults include: Physical exam: During an exam, a healthcare provider will listen to the heart for any abnormal sounds. Chest X-ray: A chest X-ray takes pictures of the inside of your chest to reveal any structural abnormalities. Electrocardiogram: Electrocardiogram (EKG or ECG) measures the electrical activity of your heart. Echocardiogram: An echocardiogram (echo) uses ultrasound to create images of the heart's valves and chambers. Heart catheterization: A healthcare provider can tell how well your heart is pumping and circulating blood by performing a heart catheterization. It's also called cardiac catheterization or coronary angiography. Magnetic resonance imaging (MRI): MRI for heart disease can create detailed pictures of your heart.  LECTURE 2 MANAGEMENT AND TREATMENT Treatment for CHD may involve: Catheter procedure to place a plug into the defect. Medications to help your heart work more efficiently or to manage blood pressure. Nonsurgical procedure to close a defect using a closing device. Oxygen therapy, which provides higher levels of oxygen than normal room air would. Prostaglandin E1, which relaxes smooth heart muscle and can keep open the ductus arteriosus (a blood vessel normally closed after birth) helping provide needed circulation. Surgery to repair a defect, open up blood flow or redirect blood. In severe cases, a heart transplant may be necessary. PREVENTION How can I reduce the risk of a heart defect? Scientists don't have all the answers yet as to what causes heart defects other than random gene mutations. But, there are things that place you at higher risk (smoking, alcohol, certain medications, etc.) and these should be avoided during pregnancy. There are otherwise no proven strategies to prevent CHD. You should follow your healthcare provider's instructions during pregnancy, including: Don't use recreational drugs. Get all recommended screening tests during pregnancy to detect problems as early as possible. Manage any health conditions, such as diabetes and phenylketonuria.. Stop smoking and avoid secondhand smoke. Avoid alcohol.  Assist prof. Dr- Faraj Heart failure Heart failure occurs when the heart muscle doesn't pump blood as well as It should. When happens. blood often backs up and fluid can build up in the lungs. causing shortness of breath. But heart failure can be life-threatening. People with heart failure may have severe symptoms. Somo may need a heart transplant or a device to help the heart pump blood. Heart failure is sometimes called congestive heart failure. Symptoms Symptoms may develop slowly. Sometimes, heart failure symptoms start suddenly. Heart failure symptoms may include: Shortness of breath with activity or when lying down Fatigue and weakness. Swelling in the legs, ankles and feet. Rapid or irregular heartbeat. Reduced ability to exercise. Wheezing. A cough that doesn't go away or a cough that brings up White or pink mucus with spots of bloåd. Swelling of the belly area. Very rapid weight gain from fluid buildup. Nausea and lack Of appetite Difficulty concentrating or decreased alertness. Chest pain if heart failure is caused by a heart attack. Causes Heart failure can be caused by a weakened, damaged or stiff heart. If the heart is damaged or weakened. the heart chambers may stretch and get bigger. The heart can't pump out the needed amount of blood. The heart muscle can be damaged by certa If the main pumping chambers of the heart, called the ventricles. are stiff, they æn't fill with enough blood between beats.  Surgical- internal medicine The heart muscls can be damaged by certain infection. heavy alcohol use, illegal drug use and some chemotherapy therapy medicines. Your genes also can play a role. Any of the follwing conditions also can damage or weaken the heart and cause heart failure. Coronary artery disease and heart attack. Coronary artery disease Is the most common cause of heart failure. The disease results from the buildup of fatty deposits in the arteries. The deposits narrow the arteries. This reduces blood flow and can lead to heart attack. A heart attack occurs suddenly when an artery feeding the heart becomes completely blocked. Damage to the heart muscle from a heart attack may mean that the heart can no longer pump as well as should. High blood pressure. Also called hypertension, this condition forces the heart to work harder than it should to pump blood through the body. Over time, the extra work can make the heart muscle too stiff or too weak to property pump blood. Heart valve disease. The valves of the heart keep blood flowing the right way. If a valve isnt working properly, the heart must work harder to pump blood. This can weaken the heart over time. Treating some types Of heart valve problems may reverse heart failure. Inflammation of the heart muscle, also called myocarditis. Myocarditis is most commonly caused by a virus, including COVID 19virus, a can lead to left-sided heart failure. A heart problem that you're born with, also called a congenital heart defect. If the heart and its chambers or valves haven't formed correctly, the Other parts of the heart have to work harder to pump blood. This may lead to heart failure. Irregular heart rhythms, called arrhythmias. Irregular heart rhythms may cause the heart to beat too fast. creating extra work for the heart. A slow heartbeat also may lead to heart failure. Treating an irregular heart rhythm may reverse heart failure in some people. Other diseases. Some long-term diseases contribute to chronic heart failure. Examples are diabetes, HIV infection. an overactive or underactive thyroid. or a buildup of iron or protein. Causes of sudden heart failure also include: Allergic reactions. Any illness that affects the whole body. Blood clots in the lungs. Severe infections. Use of certain medicines. Viruses that attack the heart muscle. Heart failure usually begins with the lower left heart chamber. called the left ventricle. This is the heart's main pumping chamber. But heart failure also can affect the right side. The lower right heart chamber is called the right ventricle. Sometimes heart failure affects both sides of the heart.  Type of Description heart failure Right-sided This type affects the lower right heart chamber, called the right heart failure ventricle. Fluid may back up into the belly, legs and feet, causing swelling. Surgical- internal medicine Type of Description heart failure Left-sided This type affects the lower left heart chamber, called the left ventricle. Fluid may back up in the lungs, causing shortness of breath. Risk factors Diseases and conditions that increase the risk of heart failure include: Coronary artery disease. Narrowed arteries may limit the heart's supply of oxygen-rich blood, resulting in weakened heart muscle. Heart attack. A heart attack is a form of coronary artery disease that occurs suddenly. Damage to the heart muscle from a heart attack may mean the heart can no longer pump as well as it should. Heart valve disease. Having a heart valve that doesn't work properly raises the risk Of heart failure. High blood pressure. The heart works harder than it has to when blood pressure is high. Irregular heartbeats. Irregular heartbeats. especially if they are very frequent and fast. can weaken the heart muscle and cause heart failure. Congenital heart disease. Some people who develop heart failure were born with problems that affect the structure or function of their heart. Diabetes. Having diabetes increases the risk of high blood pressure and coronary artery disease. Sleep apnea. This inability to breathe properly during sleep results in low blood-oxygen levels and an increased risk of irregular heartbeats. Both Of these problems can weaken the heart. Obesity. People who have obesity have a higher risk of developing heart failure. Viral infections. Some viral infections can damage to the heart muscle. Medicines that may increase the risk of heart failure include: Some diabetes medicines. The diabetes drugs rosiglitazone (Avandia) and pioglitazone (Actos) have been found to increase the risk of heart failure in some people. Don't stop taking these medicines Without first talking to your health care provider. Some other medicines. Other medicines that may lead to heart failure or heart problems include nonsteroidal anti-inflammatory drugs (NSAIDs) and some medicines used to treat high blood pressure, cancer, blood conditions, irregular heartbeats, nervous system diseases, mental health conditions, lung and urinary problems, and infections. Other risk factors for heart failure include: Aging. The heart's ability to work decreases with age. even in healthy people. Alcohol use. Drinking too much alcohol may weaken the heart muscle and lead to heart failure. Smoking or using tobacco. If you smoke, quit. Using tobacco increases the risk of heart disease and heart failure. Surgical- internal medicine Complications Complications Of heart failure depend on your age, overall health and the severiy of heart disease. They may include: Kidney damage or failure. Heart failure can reduce the blood flow to the kidneys. Untreated. tlis can cause kidney failure. Kidney damage from heart failure can require dialysis for treatrnent. Other heart problems. Heart failure can cause changes in the heads size and function. These changes may damage heart valves and cause irregular heartbeats. Liver damage. Heart failure can cause fluid buildup that puts too much pressure on the liver. This fluid backup can lead to scarring, which makes more diffcult for the liver to vork property. Sudden cardiac death. If the heart is weak, there is a risk of dying suddenly due to a dangerous irregular heart rhythm. Prevention One way to prevent heart failure is to treat ana control the conditions that can euse it. These conditions include coronary artery disease, high blood pressure, diabetes and obesity. Some of the same lifestyle changes used to manage heart failure also may help prevent it. Try these heart-healthy tips: Don't smoke. Get plenty of exercise. Eat healthy foods.  Maintain a healthy weight. Reduce and manage stress. Take medicines as directed.