Objectives• Define the term heart disease• Discuss the common types of heart diseases• Identify risk factors of Heart disease.• Describe the signs and symptoms of heart disease .• Describe the common diagnostic measures used in heart disease.• Describe the common treatment interventions• Discuss the preventative measures .
What Is Heart Disease?• Heart disease /cardiovascular disease is a class of diseases that affects the heart and blood vessel many of which are related to a process called atherosclerosis.• Cardio –relates to the heart• Vascular –relates to the veins and arteries• Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can stop the blood flow.
Incidence and prevalence GLOBALLY• CVDs are the number one cause of death globally: more people die annually from CVDs than from any other cause.• An estimated 17.3 million people died from CVDs in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease.• Over 80% of CVD deaths take place in low- and middle-income countries and occur almost equally in men and women.• By 2030, almost 23.6 million people will die from CVDs, mainly from heart disease and stroke(WHO ,20011) GUYANA• CVD is one of the leading causes of death in Guyana• SEX -Males are more affected than females with heart disease• AGE – greater prevalence of hypertensive diseases 45 and greater age group and the 4th amongst 15 -44 yrs old .• RACE -Most common cause of death among indo and afro-Guyanese ,Chinese and Portuguese .• REGION -Major cause of death in regions 2,3,6,10(MOH ,GUYANA,2008)
COMMON TYPES OF HEART DISEASEPreventable –• Heart disease can affect the structure of the heart –valves ,muscles ,fibers and blood supply e.g. coronary heart disease – disease of the blood vessels supplying the heart muscle.• The common cause of coronary heart disease result from - Atherosclerosis –this is a condition that develops when a substance called plaque builds up in the walls of the arteries. Coronary arteries that supply the heart muscle become blocked And as a result can cause:• Hypertension (increased pressure )• Angina /Ischemic heart disease (partially blocked)• Heart attack /M.I(Fully blocked )• Heart failure (damaged valves and enlargement),arrythmias (damaged heart fibers)
COMMON TYPES OFHEART DISEASE• Heart disease can also result from infection –rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria ,and endocarditis .Non-preventable –• Heart disease can also be congenital -congenital heart disease - malformations of heart structure existing at birth
Risk FactorsModifiable risk factors-Some risk factors can be avoided or altered, potentially slowing the disease process or even reversing it. These factors include:• elevated serum lipid levels• hypertension• cigarette smoking• diabetes mellitus• sedentary lifestyle• stress• obesity—especially abdominal (waist measurement greater than 40″ [101.6 cm] in men and greater than 35″ [88.9 cm] in women)• excessive intake of saturated fats, carbohydrates, and salt.
Risk Factors Con’tNon-modifiable risk factors- there are four non-modifiable factors increase a persons risk of cardiovascular disease:• age• male gender• family history• race.
Common signs and symptomsHeart disease Signs and symptomsHypertension -A sustained blood Dizziness ,or may bepressure above 140/90mmhg . ASYMPTOMATIC Complications- Cardiac complications include CAD, angina, MI, heart failure, arrhythmias, and sudden death,stroke,blindness,kidney failureHypertrophic cardiomyopathy— shortness of breath,fatigueprimary disease of the heart dry cough atmuscle thats characterized by a night,palpitations,nauseathickened, inflexible heart muscle- Edema of the legs , chest painresults from extensively damagedmyocardial muscle fibers
Common signs and symptomsHeart disease Signs and symptomsHeart attack /MI Symptoms: chest /thumb /back pains that is not relieved by rest or medications .(nitrates) light headedness Anxiety/nervousness Paleness Increased, irregular heart rate Chest pain is relieved byAngina /ischemic heart disease medications and rest.Heart failure -When the heart Fatigue, Difficulty breathing,cant pump effectively enough dependent edema, unexplained,to meet the bodys metabolic steady weight gain,nausea,chestneeds, heart failure occurs tightness slowed mental response, anorexia
How is heart disease diagnosed?LABORATORY TESTING –measures heart enzymes/proteins and reveals the extent of damage and monitor healing. • Creatine kinase (CK)-Elevated levels indicate death to heart muscles. • Ischemia-modified albumin (IMA)-indicates lack of oxygen supply to the heart . • Myoglobin- indicates damage to the heart muscle • Troponin I and T-indicates heart damage • Cholesterol levels-detects cholesterol levels-LDL/HDLGRAPHIC RECORDING STUDIES –used to detect heart disorders . • ECG- graphically records electrical current generated by the heart. • Exercise ECG(stress test)-assess heart response to an increased workload.
How is heart diseasediagnosed?Imaging studies – • Chest X-ray-may detect enlargement or structural changes of the heart • Echo- visualize heart size and shape, heart wall thickness and motion, and cardiac valve structure and function • CT /MRI-detect changes in the structure of the heartInterventional studies – • Cardiac catheterization and coronary angiography- determines location of blockage ,pressure and oxygen levels of the heart.
How is heart disease treated ?Treatment of heart disease depends on the causative factor or the disorder present;• Pharmacological –medications may be used to reduce blood pressure(anti –hypertensives),control heart rate(ant- arrythmias) ,reduce pain(anti –anginal) ,lower cholesterol(anti –lipidemics),dissolve or prevent blood clots (anti –platelet /thrombolytics)and reduce fluid accumulation(diuretics)
How is heartdisease treated ?• Non –pharmacological -lifestyle changes-education,diet (DASH diet ),exercise• Invasive interventions (surgery)• Coronary artery with an autogenous graft-restores blood flow to the heart• Bypass grafting -bypasses the obstruction resulting from arteriosclerosis• Embolectomy- removes the blockage (blood clot) Valve repair
HOW CAN HEART DISEASE BE PREVENTED ?DIETARY MEASURES-These are based on the DASH (Dietary Approaches to Stop Hypertension) • • Limiting use of salt to less than 2.4 grams of sodium (6 gm salt) per day i.e. no added salt in cooking or at table); avoid canned foods, salted meat, etc. • • Reducing excessive dietary fat (especially saturated fat and trans-fatty acids) to no more than 30% of calories. Saturated fat should not exceed 10% of total calories. • • Ensuring intake of fibre of at least 30-40 gm/day. • • Ensuring intake of potassium between 70-80 mmol/l daily. This can be achieved by a good selection of fruits and vegetables especially bananas,tomatoes and oranges as well as coconut water. • Avoiding red meat .
HOW CAN HEART DISEASE BE PREVENTED ?Physical Exercise• This should be undertaken for 30-60 minutes at least five times each week,but preferably daily. Walking is the easiest form of exercise for most people.Weight Management• This aims at the attainment and maintenance of desirable body weight i.e.• BMI <25 or at least a significant reduction, if overweight or obese. There is a possibility of 5-20 mmHg decrease in systolic pressure for every 10kg (22lb) weight loss.
HOW CAN HEART DISEASE BE PREVENTED ?Reduction of Alcohol Intake • Alcohol use should not exceed 2 drinks/day for men and 1 drink/day for women. (1 drink = one ounce of spirits or 1 bottle of beer or 1 glass of wine)Cessation of Tobacco Use • Tobacco should be avoided.Education • Every opportunity should be taken for education of the patient, with partner and relatives. The education should include diet, exercise and other lifestyle advice(stress reduction)
References• Statistical Bulletin 2007 - Ministry of Health• www.health.gov.gy/pub/moh_stats_bulletin_07.pdf• 2.MINISTRY OF HEALTH ,GUYANA ,STATISTICAL BULLETIN ,2008• http://www.who.int/topics/cardiovascular_diseases/en/• http://www.heart.org/HEARTORG/Caregiver/Resources/WhatisCardiovasc ularDisease/What-is-Cardiovascular-Disease_UCM_301852_Article.jsp• http://www.mayoclinic.com/health/heart-disease/DS01120• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002091/• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001238/• http://www.mayoclinic.com/health/heart- disease/DS01120/DSECTION=causes