CARDIOVASCULAR DISEASES

ANATOMY & PHYSIOLOGY OF

CARDIOVASCULAR SYSTEM
 Conical and hollow
Musculotendinous organ
Between the lungs
10 cm long, 300 g weight

Pericardium
Myocardium
Endocardium
Sympathetic and Vagus nerves
Arteries carry from heart
Veins carry to heart

Blood Circulation
Systemic
Pulmonary
Coronary
Electrical Activity of Heart
Electro Cardio Graph
P Contraction of atria
QRS Contraction of ventricles
T Relaxation of ventricles
Cardiac Cycle
Rhythmic contraction events in single beat
72 beats / minute
Approximately 0.8 second for one beat
Contraction of heart Systole
Relaxation of heart Diastole
Special properties of cardiac muscle
- Contractility
- Conductivity
- Rhythmicity
Impulses created and transmitted
Refractory period
4 sound Lub (long) & Dub (short) (2+2)
Measured as pulse in Radial Artery
(Every 1oF increase in temperature 10 pulse increases)
Cardiac Output ml of blood pumped / min

Stroke Volume ml of blood ejected / beat of heart (i.e.) 70 ml

Cardiac Output = Stroke volume x Heart rate

= 70 x 72 = 5040 ml/min
Approximately 5 L/min is pumped

Factors:

Amount of blood taken to heart by veins (Venous return)

Force and rate of contraction
Peripheral resistance
Blood Pressure is the lateral pressure exerted by blood on its
vessels during flow

Systolic - 100 to 120 mm Hg

Diastolic - 60 to 80 mm Hg
Pulse pressure The difference between systolic or diastolic
pressure (i.e.) 40 mm Hg

Sphigmomanometer and Stethoscope

Mercury manometer, cuff, hand pump

Factors:
Blood volume
Cardiac output
Peripheral resistance
Elasticity and diameter of blood vessels
Viscosity of blood
Cardiovascular disorders
Cardiac failure Acute / Chronic
Unable to maintain sufficient circulation of blood

Stenosis of valves Sticking & narrowing of valves

Incompetence of valves Failure of valves to close completely

Ischemic heart disease Narrowing of coronary arteries

Angina Pectoris Myocardial ischemia with severe pain

Myocardial infarction Lack of blood supply to one segment

of myocardium due to occlusion (Heart Attack)

Cardiac arrhythmia Disorder of rate & rhythm (Defective

impulse formation and conduction)
Disorders of Blood vessels
Arteriosclerosis Thickening & inelasticity of arteries

Atherosclerosis Thickening due to deposition of fat

Aneurysm Local abnormal dilatation of artery

Embolus Clot moving in circulation

Thrombus Clot obstructing at point where if formed

Phlebitis Infection of vein (inflammation or injury)

Venous thrombosis, Thrombo phlebitis

Varicose vein Dilated, tortuous superficial vein

Disorders of Blood Pressure
Hypertension Rise in b.p.
Normal 120/80 mm Hg
Above 45 yrs 150/90 mm Hg
Above 60 yrs 160/100 mm Hg
Diastole > 130 mm Hg Serious hypertension

-Changes in arteries (cerebral hemorrhage)

-Changes in eyes (retinal hemorrhage)
-Changes in kidney (renal hemorrhage impaired renal function)

Hypotension Low b.p.

During rest or in elderly
Accompanies with shock, myocardial infarction, hemorrhage
Inadequate blood supply to brain (unconsciousness, fainting,
coma, death)
 DISEASES OF THE HEART
The disorders or conditions affecting the heart are
collectively known as heart diseases.

The heart consists of a muscle that pumps blood,

arteries that supply blood to the heart muscle, and
valves that ensure that the blood within the heart is
pumped in the correct direction.

Problems can arise in any of these areas.

 Epidemiology - World
In the world: CVD deaths account for one third of all deaths
(25-50% depending on the level of economic development)
among which 50%: coronary deaths

Distribution of types of CVD in global deaths :

Global cardiovascular deaths in 2002: 16.7 million
Among which: coronary heart disease 7.2 million
stroke 6.0 million, 0.9 million hypertensive heart disease
0.4 million inflammatory heart disease
0.3 million rheumatic heart disease & 1.9 million other
CVD
 PROPORTION OF MORTALITY IN DIFFERENT AGE-GROUPS (MEN)

100% 4,7%
14,0%
14,9%
90%

80%
26,0%
61,5% 24,6%
70%

60% external
others
50% 26,9% cancer
CVD
40%

22,5% 55,8%
30%

20% 32,7%
11,4%
10%
4,6%
0%
1-24 yrs 25-64 yrs >65 yrs
 PROPORTION OF MORTALITY IN DIFFERENT AGE-GROUPS (WOMEN)

100% 4,8%
8,2%

90% 18,3%

40,0% 24,0%
80%
12,2%
70%

60% external
36,5% others
50%
35,0%
cancer
CVD
40%
64,7%

30%

20% 17,7% 31,3%

10%
7,3%

0%
1-24 yrs 25-64 yrs >65 yrs
 SEX
- Widespread idea: CVD is often thought to be a disease of
middle-aged men.
- Cardiovascular mortality (fatal cases) are more common
among men. However, CVD affect nearly as many women as
men, albeit at an older age. But high risk observed in women
Smoking
High triglyceride levels
Diabetes mellitus
Depression
Oral contraceptives
Hormone replacement therapy
Polycystic ovary disorder / syndrome (PCOD)
 World Trends

Developed countries: decreasing tendencies

(e.g, USA: 30% between 1988-98, Sweden: 42%)
- improvement of lifestyle factors, for example, a decrease
of smoking and a higher level of health consciousness in
many developed countries
- better diagnostic and therapeutic procedures
(e.g., bypass surgeries, hypertension screening,
pharmacological treatment of hypertension and
hypercholesterinaemia, access to health care)
Developing countries: increasing tendencies
- increasing longevity, urbanization, and western type
lifestyle
1. Chest pain

2. Breathlessness (dyspnoea)

3. Acute circulatory failure (cardiogenic shock)

4. Heart failure

5. Hypertension

6. Palpitation

7. Atrial fibrillation

8. Cardiac arrest

9. Sudden cardiac death