Cardiovascular Diseases Overview

In the second half of the twentieth century, the main danger to public health and public health problem had came from non-communicable diseases, especially cardiovascular system, which currently are the leading cause of morbidity, disability and mortality of the adult population. There has been a "rejuvenation" of these diseases. They began to spread among the population in developing countries.

• alcohol treatment 
• heart disease diet 
• online classes 
• blood pressures 
• papillary muscle 

In most economically developed countries, diseases of the circulatory system ranked first among causes of disease morbidity and mortality, although their prevalence in different regions varies considerably. In Europe two third of all deaths each year are from cardiovascular diseases and cancer and are even higher in the U.S. These amounts accounts for half of all deaths actually it is 2.5 times more than all cancers combined, while one quarter of deaths are from cardiovascular disease comprising of people under the age of 65 years.

Diseases of the cardiovascular system are numerous. Some of them are predominantly diseases of the heart, while others – mainly the arteries (atherosclerosis) or veins, and others hit the cardiovascular system as a whole (hypertension). Diseases of the cardiovascular system may be caused by congenital defects, trauma, inflammation, and others. Congenital defects in the structure of the heart and large vessels often referred to as congenital heart disease.

There are also diseases of the cardiovascular system, an underlying inflammatory process. Occasionally, thisinflammation is bacterial. This means that the inner membrane of the heart valves or the outer membranes of heart, bacteria replicate and thus causing purulent inflammation of the heart.

The cardiovascular system consists of the heart and blood vessels with a filling of liquid tissue – blood. Blood vessels are divided into arteries, arterioles, capillaries and veins. Arteries carry blood from the heart to the tissues, they treelike branching into smaller and smaller vessels and are transformed into arterioles, which are split into a system of very thin vessels, capillaries. From the capillaries begin small veins, they merge together and become stronger. Cardiovascular system to deliver blood necessary to perform its transport functions – delivery to the tissues of nutrients and oxygen and removing metabolic products and carbon dioxide. In the center of the circulatory system is heart of it originates large and small circulation.

Systemic circulation begins large artery-aorta. It divides the large number of medium-sized arteries, and these – for thousands of small arteries. The latter in turn split into many capillaries. The wall of the capillaries has a high permeability, allowing the exchange of substances between blood and tissues: nutritional, and oxygen pass through the wall of capillaries in tissue fluid and then into the cells, in turn, give the cells in the tissue fluid carbon dioxide and other metabolic products that come in the capillaries.

Arteries are elastic tubes of different calibers. The wall consists of three layers – outer, middle and inner. The outer shell is formed by connective tissue; the average – muscle – is composed of smooth muscle cells and elastic fibers. Smooth inner shell lines the vessel from the inside and covered by its lumen flat cells (endothelium). Due to the endothelium provides unobstructed blood flow and is supported by its liquid state. Blockage or narrowing of the arteries leads to severe disorders of blood circulation.

Veins have the same structure with the arteries, but their walls are much thinner than arteries, may subside. In the lower part of body the veins muscular because these had to overcome the force of gravity and have to take the blood against the gravity. The inner shell of veins forms folds in the form of pockets – valves, which are arranged in pairs at regular intervals and prevent the back flow of blood.

Heart – the hollow muscular organ located in the thoracic cavity behind the breastbone. Most of the heart (about 2 / 3) is on the left side of chest, a smaller (approximately 1 / 3) – in the right. An adult male, weight of the heart is an average of 332g, and in the woman – 254g. Heart pumps about 4.5 liters of blood in 1 minute.

The wall of the heart consists of three layers. Inner layer – endocardium – lines the cavity of the heart from the inside, and its offshoots form the heart valves. Endocardium consists of smooth flattened endothelial cells. The middle layer – the myocardium – is formed by a special cardiac striated muscle tissue. The outer layer, epicardium – covers the outer surface of the heart and the nearest parts of the aorta, pulmonary trunk and hollow veins.

Atrio-ventricular valves close the holes that have wing structure. Valve between the left atrium and ventricle are bicuspid, or mitral, and the right side tricuspid. The edges of the valve leaflets tendon strands are connected to the papillary muscles. Around holes pulmonary trunk and aortic valves are semi lunar. Each of them has the three pockets that open in the direction of blood flow in these vessels. When reducing the pressure in the ventricles of the heart, they are filled with blood, their edges are closed by closing the lumens of the aorta and pulmonary trunk and preventing the penetration of the inverse of blood to the heart. Sometimes the heart valves, damaged in some diseases (rheumatism, atherosclerosis), can not be tightly closed, heart broken, there are heart defects.

Diseases of the cardiovascular system.

Atherosclerosis

The bases of many lesions of the cardiovascular system are atherosclerosis. The term derives from the Greek words athere – wheat paste and sclerosis – a firm and reflects the essence of the process: deposition of fat in the arterial wall masses who buy into the subsequent form slurry, and the development of connective tissue with subsequent thickening and deformation of the arterial wall. Ultimately, this leads to a narrowing of the lumen of the arteries and reduce their elasticity, which makes the flow of blood on them.

Atherosclerosis – a chronic disease of the arteries of large and medium-sized, characterized by the deposition and accumulation of plasma atherogenic apoprotein-B-containing lipoproteins, followed by a reactive growth of connective tissue and the formation of plaque. Atherosclerosis in the first place usually affects the large arteries: aorta, coronary arteries, the arteries supplying the brain (internal carotid artery). When atherosclerosisnarrows the lumen of the artery, increasing the density of the arterial wall, decreasing its tensile strength, in some cases the stretching of aneurismal wall of the artery.

Found that many external and internal, including hereditary factors are responsible for the development ofatherosclerosis or adversely affect its course. One reason for the disparity in atherosclerosis consider the content of various classes of lipoproteins in blood plasma, some of which contribute to the transport of cholesterol in the vascular wall, i.e. are atherogenic, others impede this process. Occurrence of similar violations and the development of atherosclerosis contribute to long-term consumption of foods containing an excess of animal fats that are rich in cholesterol. Factor of excess fat consumption is particularly is easy to implement when there is insufficient development of liver enzymes that deplete cholesterol. Meaning, those with high activity of these enzymes do not develop atherosclerosis, even in long-term consumption of food containing large amounts of animal fats.

Description of over 200 contributory factor to atherosclerosis, or adversely affect its course, but most important are hypertension, obesity, physical inactivity and smoking, which applies to most risk factors foratherosclerosis. According to a survey atherosclerosis significantly is more common among patients with hypertension than in those with normal blood pressure.

The earliest manifestations of atherosclerosis, lipid stains, or lipid strips, often found during childhood. This flat spots yellowish, of various sizes, which are located underneath the inner membrane of the aorta, most often in her thoracic region. Yellowish spots attached cholesterol contained in them. Over time, some lipid spots dissolve, while others, in contrast, grow, occupying an increasing area, gradually transformed into a flat spot protruding into the lumen of the artery cholesterol plaques. Later germinating plaque is compacted into connective tissue, often in delayed calcium salts. Growing plaque starts to narrow the artery and sometimes completely close it. Vessels supplying it to the ground, injured, and plaque can rupture with the formation of hemorrhage, which lifts the plaque, increasing the narrowing of the artery until complete closure. Insufficient blood supply to the plaque itself often leads to the fact that its contents are partly necrotizing forming a mushy detritus. Platelets in blood are unable to stick to intact vascular wall and are deposited in an area devoid of endothelium, giving rise to the development of thrombus.

Widespread and significant expression of aortic atherosclerosis may be the cause of its aneurysm, which is manifested symptoms of compression of the adjacent to the aortic bodies. The most dangerous complications of an aortic aneurysm is its delamination and rupture.

The basis for the prevention of atherosclerosis is a rational way of life: work and rest, reducing the likelihood of mental overstrain, with the exception inactivity, classes' recreational physical activity, and stopping smoking and drinking. Of great importance is nutrition: stability of normal body weight, elimination of excessive amounts of food of animal fats and replacing them with vegetable fats, enough content in the diet of vitamins, especially vitamin C intake of sweets. Important in the prevention of atherosclerosis is early detection of hypertension and diabetes, predisposing to the development of vascular lesions, and their systematic carefully controlled treatment.

Myocardial infarction

Myocardial infarction– an acute disease of the heart caused by the development of one or more foci of necrosis in cardiac muscle and is manifested cardiac activity, observed more often in men aged between 40 to 60 years. Usually occurs as a result of coronary heart arteries with atherosclerosis, when there is a narrowing of their lumen. Often, this blockage of blood vessels joined in his area of destruction, resulting in blood in whole or in part ceases to flow to the appropriate section of the heart muscle, and it formed foci of necrosis (necrosis). In 20% of all cases of myocardial infarction is fatal, and in 60-70% – in the first 2 hours.

In most cases, myocardial infarction is preceded by a sharp physical or mental strain. Most often it develops during exacerbation of ischemic heart disease during this period, called pre-infarction, frequent angina, become less effective action of nitroglycerin. It can last from several days to several weeks.

The main manifestation of myocardial infarction – a long bout of intense pain in my chest burning, pressing, less tearing, burning nature, which does not disappear after re-taking nitroglycerin. Attack lasts more than an hour (sometimes several hours), accompanied by severe weakness, feeling the fear of death, as well as shortness of breath and other signs of disorders of the heart.

In most cases, myocardial infarction accompanied by characteristic changes in the electrocardiogram, which can be delayed, appearing occasionally in a few hours or even days after decrease in pain intensity.

If you experience a sharp pain behind the breastbone, not disappearing after administration of nitroglycerin, an urgent need to call an ambulance is required. Based on careful examination of the patient, including electrocardiography, it is possible to recognize the disease. Before the arrival of the doctor to the patient and provide the maximum physical and mental rest: it should be laid, as far as possible to allay. When you are choking or shortness of breath the patient must give Half-upright position in bed. Although myocardial infarction nitroglycerin does not completely eliminate the pain, re-use it as appropriate and necessary. Bring noticeable relief and distraction tools: mustard on the heart and sternum, warmer to the feet, warm hands.

With the preventive point of view it is important that any sudden acute cardiovascular weakness, especially the attack of cardiac asthma in elderly and senile, should primarily cause health professional thought on the development of pain of myocardial infarction.

There is a sudden abdominal pain, vomiting, abdominal distention, and sometimes paresis of the intestine. This version of myocardial infarction is most difficult to diagnose. Localization of pain in the abdomen may lead to erroneous diagnosis of acute abdomen. Known case of mistaken gastric lavage is observed in these patients.

Sometimes myocardial infarction is clinically apparent only in cardiac rhythm disturbances.

During myocardial infarction identify the following periods:

• Pre-infarction 
• Acute (7-10 days) 
• Sub-acute (up to 3 weeks); 
• Recovery (4-7 weeks) 
• During subsequent rehabilitation (2,5-4 months); 
• Post-infarction. 

Myocardial infarction is found in lot of complications. Among the early complications of myocardial most important are the various forms of shock (collapse), often as heart failure, severe cardiac arrhythmias, external and internal ruptures of the heart muscle.

Patients with acute illness are in need of constant supervision of staff. During the first episode it is often followed by repeated, more severe. The disease may be complicated by acute heart failure, cardiac arrhythmias, etc.

Care and treatment of myocardial infarction

All recommendations, including diet and regime, gives a doctor. If the treatment is carried out at home, caring for sick relatives exercise under medical supervision.

Nutrition fractional and varied, but in the first days of illness is better to eat less, preferring the less high-calorie foods, preferably fruit and vegetable purees. Food that causes flatulence, such as peas, milk etc, excluded from the diet, because it can raise the diaphragm and presses the heart. Fatty meals smoked and salted foods, all types of alcoholic beverages are prohibited.

From the first days of treatment with no complications the doctor prescribes individually selected complex physical therapy. Care should be taken to a room where the sick, the air was always fresh.

Rehabilitative therapy aimed at preparing the patient with myocardial infarction to an active lifestyle, starting from the first days of treatment. It is conducted under the direction and supervision of a physician.

Day regime should be strictly regulated. Paste and go to bed every day is better at one time. Sleep duration of at least 7 hours. Nutrition should be a four-time, diverse, rich in vitamins and limited in calories (less than 2500 kcal / day). Stop smoking and alcohol abuse – the necessary conditions for prevention of myocardial infarction.

Cardiac arrhythmia

Cardiac arrhythmia – a variety of abnormalities in the formation or conduct of the excitation pulses to the heart, most often seen in heart rhythm disturbances, or the rate of its contractions. Some arrhythmias are detected only by ECG, and in cases of violations of rhythm or rate of heart contractions are often felt by the patient and detected by auscultation of the heart and probing pulse in the arteries.

Normal, or sinus rhythm of the heart shaped excitation pulses that occur with some frequency in special cells in the right atrium and propagating in the conduction system in the atria and ventricles of the heart. The emergence of cardiac arrhythmia can be caused by the formation of the excitation pulses outside the sinus node, their circulation or abnormal slowing of conduction along the conducting system of the heart due to congenital abnormalities of development, or in connection with disorders of the nervous regulation of the activity or heart disease.

Cardiac arrhythmia varied in its manifestations, and vary in clinical significance. Major cardiac arrhythmias are premature beats, paroxysmal tachycardia, bradycardia with heart block and atrial fibrillation. The latter, in most cases associated with heart disease, often observed in some rheumatic heart disease.

Manifested atrial fibrillation full spasmodic heart rate, often combined with their increased frequency. It can be permanent and paroxysmal in nature, with paroxysms of arrhythmia, sometimes for several years preceding its permanent form.

In elderly and senile cardiac arrhythmias commonly occur on the background cardiosclerosis, but their origins are often involved ischemic myocardium dystrophy. Organic changes in the myocardium most contribute to the emergence of arrhythmia of the heart, when they are localized in the sinus node and conducting system. Cause cardiac arrhythmias may also be congenital anomalies of these structures.

In pathogenised arrhythmia large role is played by changes in the ratio of the contents of potassium, sodium, calcium and magnesium in myocardial cells and the extra cellular environment.

Coronary heart disease

Coronary heart disease – acute and chronic heart failure caused by a decrease or cessation of delivery of blood to the myocardium due to atherosclerotic process in coronary arteries. The term was proposed in 1957. The WHO team. In most cases the reason for this is the dramatic narrowing of one or several branches of the coronary arteries feeding the heart, due to lesions of atherosclerosis. Restriction of blood flow to the myocardium reduces the delivery to him of oxygen, nutrients, and removal of waste products of metabolism, toxins.

Depending on the combination of several factors manifestations of coronary heart disease may be different. Its first manifestation may be sudden death or myocardial infarction, angina, heart failure, heart rhythm disturbances. Often, this disease affects young people (aged 30-40 years), active lifestyles, are leading to huge moral and economic losses. The annual mortality rate from coronary heart disease varies from 5, 4 to 11.3%, depending on the number of diseased arteries and the severity of coronary atherosclerosis.

Coronary heart disease can occur in both acute and chronic. Wide dissemination of the disease in most people of working age has transformed coronary heart disease into important social and medical problem. Increased the incidence of coronary heart disease is attributed, primarily, with a decrease in physical activity, family history, obesity and other risk factors. Prevalence of coronary heart disease is higher among people who are inherent in the constant striving for success in all areas; long-term overload operation. Such complex features are sometimes called "coronary personality profile."

During a prolonged period of illness, it is characterized by exacerbation, interspersed with periods of relative prosperity, when the disease may not manifest itself subjectively. Initial signs of coronary artery disease – angina occurring during exercise. In what can bind with attacks occurring at rest. Paroxysmal pain is localized in the upper or middle part of the sternum or retrosternal area on the left edge of the sternum. By the nature of pain is a pressing, rending, or nagging, less stitching.

In the diagnosis of coronary heart disease are widely used electrocardiographic methods. ECG is usually recorded in 12 leads at rest once or repeatedly.

Therapy in coronary heart disease aims at restoring the lost balance between the inflows of blood to the heart muscle. Significant role in the prevention of coronary heart disease is diet. Its basic principles: limiting the total amount and caloric intake, allowing to keep a healthy body weight, a significant restriction of animal fats and carbohydrate, excluding alcoholic beverages, food fortification with vegetable oils and vitamins C and Group B. In moderate physical activity is recommended to eat four times a day at regular intervals, with a calorie daily diet within 2500 kcal. In the diet should include foods containing large amounts of valuable protein, raw vegetables, fruits and berries.

Hypertensive heart disease

Hypertensive heart disease is a disease of the cardiovascular system, characterized by continuous or periodic high blood pressure. Unlike other forms of hypertension, this increase is not the result of another illness.

It is the most common disease in the world, effecting all sorts and races of people. In the United States in the 70′s it was about 60 million people with high blood pressure and only ¼ of the adult population registered with an "ideal" blood pressure. Cause of hypertension is not disclosed until the end. But the basic mechanisms leading to stable high blood pressure are known. Leading one among them is the nervous mechanism. Its primary link – the emotions, spiritual experiences, accompanied with healthy people different reactions, including high blood pressure.

To prevent further development of hypertension, reduce tension; relieve accumulated "charge" of emotions. This discharge is most naturally occurs in conditions of increased physical activity.

The steady progression of hypertensive disease can be halted and even reversed in a timely treatment. Medicine offers a variety of tools that enhance the excretion of renal salt excretion. Therefore, patients with hypertensive disease are often prescribed diuretics.

Reliably known that the plump man, who suffers from hypertension, is sometimes enough to get rid of excess body weight to blood pressure returned to normal without medication. Indeed with the disappearance of fat eliminated as unnecessary an extensive network of tiny blood vessels that developed in this tissue as it grows. In other words, fat deposits are forcing the heart muscle to work under high pressure in the system of blood vessels.

Thus, each person can own to prevent the development of hypertension, without resorting to drugs. This is proved by observations of large groups of patients; strictly implement the recommendations regarding physical activity, nutrition, low calorie and loss of salt in food. One-year observation period showed that most people have returned to normal blood pressure, decreased body weight, and eliminated the need for antihypertensive drugs.

Hypertensive heart disease is not one of the incurable. Arsenal of modern medicine is adequate to maintain blood pressure at the required level, and thereby inhibit the progression of the disease.

Measures for the prevention of hypertension coincide with the recommendations for patients. They are particularly necessary for people with a hereditary predisposition to the disease.

Risk factors for cardiovascular system

Smoking

Tobacco contains the alkaloid nicotine. Nicotine raises blood pressure, constricts the small blood vessels, speeds up breathing. Inhalation of smoke containing combustion products of tobacco reduces the oxygen content in arterial blood.

In the second half of the twentieth century, cigarette smoking has become a common habit. Observation period of 6 years for deaths of 45 men 49 years of age showed that overall mortality regular smokers was 2.7 times higher than non-smokers. According to American scientists in the United States, cigarette smoking contributes annually 325 thousand premature deaths.

In one study, we show that the average number of cases of cardiovascular disease per year per 1000 people aged 45-54 years for nonsmokers equals 8.1, with smoked per day to 20 cigarettes – 11.2, while smoking more than 20 Cigarettes – 16.2, i.e. twice that of nonsmokers.

Nicotine and carbon monoxide (carbon monoxide), apparently, are the main damaging factors. Cigarette smoke contains up to 26% carbon monoxide, moving into bloodstream and binds to hemoglobin (the main carrier of oxygen), thereby breaking the ability to transport oxygen to tissues.

Harm of smoking is so high that in recent years introduced measures against smoking: banned sale of tobacco products to children, smoking in public places and transport, etc.

Psychological factors

This factor has always attached, and has great importance to the development of cardiovascular diseases. Over the past few years have been particularly thorough study of human behavior. Was isolated type of behavior (type A *)

"Type A" behavior is an emotional driving range seen in humans involved in endless attempts to do more for less and less time. These people often appear elements of "freely express" hostility; easily occur at the slightest provocation. In individuals with behavioral features of type "A" has marked symptoms. These people are often simultaneously performing several tasks (reading while shaving, eating, etc.), during the conversation, they also think about other matters, not just paying attention to the interlocutor. They quickly go and eat. To convince these people to change their lifestyle, it is difficult for several reasons:

They are generally proud of their behavior and believe that success in work and society, which they achieved, is associated with this type of behavior.

Persons with the behavior of type A *, are generally pragmatic, and it is difficult to understand how their behavior can lead to heart disease.

In most cases, this energetic, hard working people that bring great benefit to society. And the challenge is to convince them to acquire such habits that will counteract the adverse effect of the characteristics of their behavior on health.

Overweight

In most economically developed countries, overweight has become widespread and poses a serious public health problem. The reason for this, in most cases seen in the discrepancy between the arrival of a large number of food calories and low power consumption due to sedentary lifestyles. The prevalence of overweight, being minimal at 20-29-year-olds (7.8%), with age has steadily increased to 11%, 30-39-year-olds. While over 40-49-year-olds it increases up to 25.7% – to 50-59-year-olds.

The link between overweight and risk of cardio-vascular system is quite complicated, since, is an independent risk factor.

Overweight attracted much attention from the fact that it is amenable to correction without using any drugs. Definition of normal body weight, because for these purposes are no uniform criteria.

Reducing excess body weight and maintain it at a normal level, the challenge is difficult. Controlling your body weight, it is necessary to monitor the quantity and composition of your food and physical activity, diet should be balanced, but the food must be low calorie.

Elevated levels of cholesterol in the blood

Cholesterol circulates in the blood in the form of a dense form of lipoprotein. A certain level of cholesterol in the blood is maintained by the cholesterol coming from the food, and its synthesis in the body. Evolved in practice the boundary of the normal blood cholesterol level is conditional. Considered normal blood levels of cholesterol is 6.72 mmol / l (260 mg). Lower levels of blood cholesterol, 5.17 mmol / l (200 mg) and below – are less dangerous.

Quite often the elevated levels of cholesterol are present blood. Blood cholesterol level 6.72 mmol / l (260 mg) and higher in men between age of 40-59 is found in 25.9% of cases.

Rapid change in the twentieth century lifestyle associated with industrialization, urbanization and mechanization, largely contributed to the illness of the cardiovascular system have become a mass phenomenon among the population of economically developed countries.

Modern principles of prevention of cardiovascular disease are based on the anti-risk factors. All over the world prevention programs have shown that it is possible to reduce the mortality from cardiovascular diseases observed in recent years in some countries, the best proof. It should be emphasized that some of these risk factors are common to a number of diseases.

Major lifestyle habits are laid in childhood and adolescence, so it becomes especially important to teach children healthy lifestyles to prevent them from developing habits that are risk factors for cardiovascular disease (smoking, overeating, etc.).

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