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Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
Cardio vascular diseases
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Cardio vascular diseases

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Cardio Vascular Diseases, Stroke, Treatment, Public Health threat from CVD's

Cardio Vascular Diseases, Stroke, Treatment, Public Health threat from CVD's

Published in: Education, Health & Medicine
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  • 1. CARDIOVASCULAR DISEASES
  • 2. Introduction  CVD’s comprises of a group of diseases of the heart and vascular system.  The major conditions are : IHD HT CVD (Stroke) CHD RHD Non Communicable
  • 3. PROBLEM : (No. of Deaths) Worldwide 0 5 10 15 20 25 30 35 40 Category 1 Category 2 Deaths due to Non Communicable diseases Deaths due to CVD's
  • 4. In India
  • 5. CORONARY HEART DISEASE  Impairment of heart function due to inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation to the heart.
  • 6. Manifestations of Coronary Heart Disease  Angina pectoris  Myocardial infarction  Cardiac failure
  • 7. EPIDEMICITY  In USA, 1920’s, 1930’s in Britain.  MONICA………………
  • 8. MONICA  WHO has completed a project known as MONICA.  Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases.  Is to elucidate CHD issue.  41 centres in 26 countries were participating in this issue.  Ended in 1994.
  • 9. In India INDICES URBAN RURAL Prevalence rate/1000 64.37 25.27 Death rate/1000 0.8 0.4 DALY/100,000 2703.4 986.2
  • 10. RISK FACTORS Non Modifiable Modifiable AGE SEX GENETIC HISTORY FAMILY HISTORY Cigarette Smoking High BP Elevated Serum Cholesterol Diabetes Obesity Sedentary Habits Stress
  • 11. PREVENTION OF CHD • Prevention in Whole Population • Primordial Prevention Population Strategy High Risk Strategy Secondary Prevention
  • 12. POPULATION STRATEGY
  • 13.  CHD is primarily a mass disease.  So, the strategy should be therefore mass approach.  Should focus mainly on control of risk factors. Small changes in risk factor levels In Total Population Biggest reduction in Mortality
  • 14. SPECIFIC INTERVENTIONSDietaryChanges • Limitation of consumption of fatty acids. • Reduction in dietary Cholesterol. • MUFA & PUFA. Smoking • No safer cigarette • So, smok e free society BloodPressure • Prudent Diet. • Reduced salt intake. • Avoidance of high alcohol intake. PhysicalActivity • Regular physical activity. • Encourage children to continue throughout their life.
  • 15. PRIMORDIAL PREVENTION  It involves preventing the emergence and spread of CHD risk factors and life styles that have not yet appeared or become endemic.  Prevention should be multifactorial because the aetiology is multifactorial.  The aim should be to change the community as a whole, not the individual subjects living in it.
  • 16. HIGH RISK STRATEGY
  • 17. HIGH RISK STRATEGY Identifying Risk Can be started only when those high risk individuals are identified. BP, Increased serum cholesterol levels, Family history of CHD, OCP’S. Specific Advice Bring them under preventive care. Motivate them to take positive action against all the identified factors. An elevated BP should be treated. Nicotine chewing gum to wean from smoking. Disadvantage Intervention is effective in reducing the disease only in high risk group. Might not reduce to same extent in general population. More than half of the CHD cases occurs in those who are not at high risk.
  • 18. SECONDAY PREVENTION
  • 19.  Forms an important part of an overall strategy.  Aim is to prevent the recurrence and progression of CHD.  Rapidly expanding field with much of research in progress. [ E.g. drug trials, coronary surgery, pace makers ]
  • 20. Principles Governing Secondary Prevention Cessation of Smoking Control of Hyperten sion and Diabetes Healthy Nutritio n Exercise Promoti on
  • 21. Revascularization procedures  CABG - Coronary Artery Bypass Graft  PTCA - Percutaneous Transluminal Coronary Angioplasty
  • 22. STROKE
  • 23. WHO Definition  Rapidly developed clinical signs of focal disturbance of cerebral function ; lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.  Excludes TIA.
  • 24. Causes Stenosis Occlusion Rupture of Arteries
  • 25. Signs & Symptoms Coma Multiple Paralysis Monoplegia Hemiplegia(90%) Paraplegia Sensory Impairment Speech Disturbance Nerve Paresis
  • 26. WHO’S INTERNATIONAL CLASSIFICATION  Subarachnoid Haemorrhage  Cerebral Haemorrhage  Cerebral Thrombosis or Embolism  Occlusion of Pre-Cerebral arteries  TIA ( more than 24 hrs )  Ill defined cardiovascular disease.
  • 27. In India  Prevalence rate of Stroke : 1.54/1000  Death Rate : 0.6/1000  DALY’s lost : 597.6/1,00,000
  • 28. RHEUMATIC HEART DISEASE
  • 29. RHEUMATIC HEART DISEASE  Rheumatic fever (RH) and RHD cannot be separated from an epidemiological point of view.  Lancefield Group A β Haemolytic Streptococci.  Starts as a pharyngitis.  Not a communicable disease.
  • 30. In India  RHD is prevalent in the range of 5-7/1000 in 5-15yrs age group and about 1 million cases of RHD in our country.
  • 31. Duckett Jones Criteria’s MAJOR MANIFESTATIONS MINOR MANIFESTATIONS PANCARDITIS Fever POLYARTHRITIS Previous RF SYDENHAM’s CHOREA Raised ESR/CRP ERYTHEMA MARGINATUM First degree AV block SUBCUTANEOUS NODULES Leucocytosis
  • 32. Diagnosis  ASOT  ESR  CRP  JONES criteria : 2 major criteria & 1 minor criteria
  • 33. PREVENTION Non – Medical Measures Improving living conditions, Socio- economic status etc. Breaking the poverty-disease-poverty cycle Secondary Prevention Prevention of recurrences of RF Persons with RF – IM Inj. of Benzathine Benzyl Penicillin Primary Prevention Prevent first attack of RF by identifying patients with streptococcal throat. Concentrate on high risk groups such as school children.
  • 34. NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF DIABETES, CARDIOVASCULAR DISESES AND STROKE
  • 35.  In India, 53% of deaths are due to NCD’s (2005)  Pilot programme for prevention and control of cardiovascular diseases, diabetes and stroke.  Launched on Jan 4th 2008 in 7 states with one district each.
  • 36.  Assam – Kamrup  Punjab – Jalandhar  Rajasthan – Bhilwara  Karnataka – Shimoga  Tamil Nadu – Kancheepuram  Kerala – Thiruvananthapuram  Andhra Pradesh – Nellore  Financial outlay for the pilot phase is 5 crores.
  • 37. Programme Interventions Health Promotion for the General Population • Targeted to healthy, Risk free population. • Community based, Work based and School based Interventions. Disease Prevention for the High Risk Group • Early diagnosis and appropriate management. Assessment of Prevalance of Risk Factors – through surveillance.

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