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Cardiovascular disease
Cardiovascular disease is still Australias greteast health problem 55% of women and 45% of men
It kills more people than any other and contributes to significant illness, disability, poor quality of life
and premature death.
It is the most expensive disease group in Australia in terms of health expenditure ~10% of health
budget
Overview of Cardiovascular Function
Atria > Ventricles > Arteries > Arterioles > Capillaries > Venules > Veins
Blood flows in a continuous loop through the cardiovascular system, systemic and pulmonary
circulations are in series.
Pulmonary circulation
-
Systemic circulation
-
Blood is shared between different organs and tissue (i.e. flow is parallel through different
organs)
Left heart pump
High pressure
Heart 7%
Pulmonary circulation 9%
Arteries 13%
Arterioles and capillaries 7%
Veins, venules and venous sinuses 64%
Flow =
CO = HR X SV
MAP = CO X TPR
Blood flow (F)
-
Volume of blood flowing through vessel, organ or circulation, per unit of time (ml/min)
o Blood flows from high pressure to lower pressure
Force per unit area exerted on the wall of a vessel by the blood (mean, systolic and diastolic
BP; mmHg)
o Contraction of the heart generates the pressure that drives flow of blood through
blood vessels
How difficult is it for blood to flow between two points for any given pressure difference
Resistance
o
o
1
4
Structural abnormalities
o Atherosclerotic plaques
Vasoconstriction and dilation
o Local chemical and physical factors
o Sympathetic nervous system
o Vasoactive hormones
o Factors released from the endothelium
Heart valves
Atrioventricular valves
-
Semilunar valves
-
Cardiac cycle
Cardiac Output
-
Stroke volume
-
3. Afterload
Pressure in the arterial system (aorta or pulmonary artery) that resists ventricular ejection
For ventricles to be able to eject blood, ventricular pressure must rise higher than the pressure in
the respective arterial system. (Refer to Cardiac Cycle)
High arterial pressure (high afterload) can reduce stroke volume
Heart Rate
Controlled by autonomic nervous system acting on pacemaker cells of the sinoatrial (SA) node.
DECREASED by parasympathetic stimulation.
INCREASED by sympathetic stimulation & circulating adrenaline.
Other factors incl. K. imbalance in ECF & high body temperature, but these don't play a role in
normal control of heart rate.
Definitions:
Tachycardia = INCREASED Heart Rate
Bradycardia = DECREASED Heart Rate
Average Values
Normal Resting HR: ~70 beats/min
Athlete ~40 beats/min
Upper Limit ~200 beats/min
Maximum with age 220 - Age
Arterial Blood Pressure
Normal Values
Systolic over diastolic
MAP
120/80 mmHg
~93 mmHg