Chapter 10 – Cardiovascular Disease and Stroke
The American Heart Association reports that nearly half of all U. S. adults have some type of cardiovascular disease. The most recent report said 121.5 million adults in the U.S. – 48 percent based on 2016 figures – have cardiovascular disease. Heart disease was the No. 1 cause of death in the U.S. and stroke was No. 5, the same ranking as in the previous year. That information and a link to the report can be found here: https://www.heart.org/en/news/2019/01/31/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show
Coronary heart disease—often simply called heart disease—is the main form of heart disease. It is a disorder of the blood vessels of the heart that can lead to heart attack. A heart attack happens when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart. Heart disease is one of several cardiovascular diseases, which are diseases of the heart and blood vessel system. Other cardiovascular diseases include stroke, high blood pressure, angina (chest pain), and rheumatic heart disease. (NIH, 2017)
Arteriosclerosis is a form of cardiovascular disease that involves a thickening and hardening of the arteries. Arteries narrow from deposits of fat, cholesterol, and other substances. These deposits, called plaques, accumulate on arterial walls and can restrict blood flow. Coronary arteries, which supply the heart with blood, and cerebral arteries, which supply the brain with blood, are particularly susceptible to plaque build-up. The blockage of a coronary artery causes a heart attack and the blockage of a cerebral artery causes a stroke.
A Myocardial Infarction is otherwise known as a heart attack. This MI can be seen with the symptoms of Angina Pectoris: crushing chest pains, profound shortness of breath, left arm pain, radiating jaw pain or middle back pain. These signs and symptoms of heart attack are very serious and should be recognized as soon as possible and should be taken care of ASAP.
What to do if you suspect someone having a heart attack. (Mayo Clinic)
- Call 911 or your local medical emergency number. Don’t ignore or attempt to tough out the symptoms of a heart attack for more than five minutes. If you don’t have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, and realize that it places you and others at risk when you drive under these circumstances.
- Chew and swallow an aspirin. If advised to do so by 911, unless you are allergic to aspirin or have been told by your doctor never to take aspirin. Seek emergency help first, such as calling 911.
- Take nitroglycerin, if prescribed. If you think you’re having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else’s nitroglycerin, because that could put you in more danger.
- Begin CPR if the person is unconscious. If you’re with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven’t received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and performing only chest compressions (about 100 per minute). The dispatcher can instruct you in the proper procedures until help arrives.
- If an automated external defibrillator (AED) is available and the person is unconscious, begin CPR while the device is retrieved and set up. Attach the device and follow instructions that will be provided by the AED after it has evaluated the person’s condition.
A stroke, also called a cerebral vascular accident (CVA), occurs when the blood supply to the brain is cut off. When brain cells are deprived of oxygen for more than a few minutes, they die. Depending on the area of the brain affected, a stroke may cause weakness or paralysis (often on only one side of the body), speech impairment, memory loss, and changes in behavior.
Most strokes are caused by a blockage in a blood vessel and are called an ischemic stroke. There are two types of ischemic strokes: 1) thrombotic – caused by a blood clot that forms in a cerebral or carotid artery; and 2) embolic – caused by an embolus, a clot that has formed elsewhere in the body and has been carried in the blood stream and becomes wedged in a cerebral artery.
Another type of stroke is a hemorrhagic stroke. A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, leaking blood into the surrounding tissue. Brain cells are deprived of blood and accumulation of the blood from the burst vessel may put pressure on surrounding tissue, which can cause damage and even death. Only about 20% of strokes are hemorrhagic.
Using the Cincinnati Stroke Scale to identify early warning signs for stroke
F = Face: Is one side of the face drooping down?
A = Arm: Can the person raise both arms, or is one arm weak?
S = Speech: Is speech slurred or confusing?
T = Time: Time is critical!! Call 9-1-1 immediately!
High Blood Pressure
Blood pressure is the force of the blood exerted on the walls of the arteries, created by the pumping of the blood. It is expressed as two numbers – for example 120/80 – and measured in millimeters of mercury (mmHg). The first/higher number is the systolic pressure – the greatest pressure exerted as your heart beats. The second/lower number is the diastolic pressure, the lowest pressure when your heart relaxes between beats. Blood pressure is easily measured with a blood pressure cuff connected to a sphygmomanometer.
High blood pressure is a result of arterial resistance caused by the constriction of the smooth muscle surrounding the arteries or by arteriosclerosis. When someone has high blood pressure, the heart must work harder to force blood through the narrowed and/or stiffened arteries, straining both the heart and the arteries.