Diseases of the Heart (Cardiac)

Cardiovascular Diseases

• There are many and varied disorders of the heart and circulatory system. In some disorders, the rhythm of the heartbeats may become irregular, may enter tachycardia (abnormally fast), or may enter bradycardia (abnormally slow). Disorders of cardiac rhythm are called arrhymias or dysrhymias.

Cardiovascular Diseases Continued

• Almost one-third of all deaths in Western countries like America and Europe, are attributed to heart disease. Most of these deaths are caused by coronary artery disease and hypertension (high Blood Pressure). Cardiovascular disorders such as angina pectoris, myocardial infarction (MI), congestive heart failure (CHF), cardiac arrest, shock, and cardiac tamponade also can result in death.

Presenting Symptoms of Cardiovascular Disease:

• *Chest Pain• *Dyspnea (difficulty breathing) on exertion• *Tachypnea (rapid breathing)• *Palpitations (rapid fluttering of the heart)• *Cyanosis (slight blue coloring of skin)• *Edema (hands, feet swelling)• *Fatigue (VERY tired)• *Syncope (fainting)

Coronary Artery Disease

• Coronary artery disease (CAD) is a condition involving the arteries supplying the mycardium (heart muscle). The arteries become narrowed by atherosclerotic deposits over time, causing temporary cardiac ischemia and eventually a MI (heart attack).

Layers of Heart Muscle

Layers of Pericardium

CAD Signs and Symptoms:

• Patients are asymptomatic initially, with the first symptom being the pain of angina pectoris. In advanced disease, the severe pain of MI is described as burning, squeezing, crushing, and radiating to the arm, neck, or jaw. Nausea, vomiting, and weakness also can be experienced. Changes in the electrocardiogram (ECG) are recognized.

Etiology

• Deposits of fat-containing substances called plaque in the lumen (opening) of the coronary arteries result in arthrosclerosis and subsequent narrowing of the lumen of the arteries. The myocardium must have an adequate blood supply to function. The coronary arteries supply the cardiac muscle with blood, but become constricted by artherosclerosis.

Etiology Continued

• Arteriosclerosis, commonly called “hardening of the arteries”, is associated with the elderly and diabetic patients. The arteries eventually lose their elasticity and become hard and narrow; resulting in cardiac ischemia. The cells in the myocardium gradually weaken and die. Replacement scar tissue forms, interfering with the heart tissue’s ability to pump, resulting in heart failure.

Arterioscleriosis:

Arteriosclerosis Over Time:

Treatment for Arteriosclerosis:

• Measures to restore adequate blood flow to the myocardium. Vasodialators are prescribed. Angioplasty is attempted to open the constricted arteries. Anti-lipids drugs, and anticoagulants to prevent blood clots from breaking off lodging in the brain or cerebral arteries, causing a stroke. When the blockage is severe, a coronary artery bypass surgery (open-heart) may help open up the arteries.

Angina Pectoris• Angina Pectoris: Chest pain after exertion,

is the result of reduced oxygen supply to the myocardium.

• Signs and Symptoms:

• The patient has a sudden onset of left-sided chest pain after exertion (exercise). The pain may radiate to the left arm or back. The patient may experience dyspnea. The pain usually is relieved by ceasing, or stopping the strenuous activity

Angina Pectoris Continued

• Placing a nitroglycerin tablet sublingually under the tongue). The blood pressure may increase during the attack, and arrhythmias may occur.

• Treatment: consists of cessation of the strenuous activity or exercise and placing the nitroglycerin tablets under the tongue. Transdermal nitroglycerin patches helps in preventing angina. This is a patch worn all

Angina Pectoris Continued

• The time, usually on the chest or on the back of the arm. When angina persists more than 20 minutes, take the person to the hospital or call 911 !