CORONARY HEART

DISEASE,
RHEUMATIC HEART
DISEASE, AND
HYPERTENSION
BY LEARNING TEAM 3
WHAT IS CORONARY
HEART DISEASE?
• CHD or Coronary Heart Disease is believed to start
with injury or damage to the inner layer of a
coronary artery.
• Is usually caused by a build-up of plaque or fatty
deposits (atheroma) on the walls of the arteries
around the heart (coronary arteries).
• This makes it hard for blood and oxygen to reach
your heart. It puts stress on your heart, blood
vessels, and body.
• The build-up of atheroma makes the arteries
narrower, restricting the flow of blood to the heart
muscle. This process is called atherosclerosis.
YOUR RISK OF DEVELOPING ATHEROSCLEROSIS
IS SIGNIFICANTLY INCREASED IF YOU:
• Smoke
• Have high blood pressure (hypertension)
• Have a high blood cholesterol level
• Don’t take regular exercise
• Have diabetes
OTHER RISK FACTORS FOR DEVELOPING ATHEROSCLEROSIS
INCLUDE:
• Being obese or overweight
• Having a family history of CHD – the risk is increased if you have
a male relative under the age 55, or female under 65, with CHD
SYMPTOMS OF CHD:
• Chest pain
• Indigestion
• Heartburn
• Weakness
• Sweating
• Nausea
• Cramping
• Shortness of breath
ANGINA (an-JIE-nuh)
- Is a type of chest pain caused by reduced blood flow
to the heart.
Types of angina:
• STABLE ANGINA – the discomfort may last for a short
period of time, and it may feel like gas or indigestion.
• UNSTABLE ANGINA – this is often caused by blood clots
in the coronary arteries.
• VARIANT ANGINA – it happens when there is a spasm in
an artery that causes it to tighten and narrow, disrupting
blood supply to the heart.
CURE FOR CHD:
- Lifestyle recommendations include quitting smoking, eating a
healthy diet, and exercising regularly.
MEDICATIONS INCLUDE:
• STATINS – these are the only medications demonstrated to have
a positive impact on outcomes in CHD, but if a person has
another underlying cholesterol disorder, they may not work.
• LOW-DOSE ASPIRIN – this can reduce blood clotting and lower
the chance of angina or a heart attack in people with a high
risk of cardiovascular event.
• BETA BLOCKERS – may be used to reduce blood pressure and
heart rate, especially in a person who has already had a heart
attack.
• NITROGLYCERIN PATCHES, SPRAYS, OR TABLETS -
these control chest pain by reducing the heart’s
demand for blood by widening the coronary
arteries.
• ANGIOTENSIN-CONVERTING ENZYME (ACE)
INHIBITORS – these lower blood pressure and
help to slow or stop the progression of CHD.
• CALCIUM CHANNEL BLOCKERS – this will widen
the coronary arteries, allowing greater blood
flow to the heart, and reduce hypertension.
WHAT IS RHEUMATIC HEART
DISEASE?
RHEUMATIC HEART DISEASE:
• Rheumatic heart disease is a complication of
rheumatic fever in which the heart valves are
damaged. Rheumatic fever is an inflammatory
disease that begins with strep throat. It can
affect connective tissue throughout the body,
especially in the heart, joints, brain and skin.
SYMPTOMS OF RHD:
• Fever
• Painful and tender joints – most often in the
knees, ankles, elbows and wrists.
• Pain in one joint that migrates to another joint
• Red, hot or swollen joints
• Small, painless bumps (nodules) beneath the
skin
• Chest pain
• Heart murmur
• Fatigue
• Flat or slightly raised, painless rash with a ragged
edge (erythema marginatum)
• Jerky, uncontrollable body movements – most often
in the hands, feet and face
• Outbursts of unusual behavior, such as crying or
inappropriate laughing, that accompanies
Sydenham chorea
CAUSE OF RHEUMATIC HEART
DISEASE:
• Rheumatic fever can occur after an infection
of the throat with a bacterium called group A
streptococcus.
• Group A streptococcus infections of the skin or
other parts of the body rarely trigger rheumatic
fever.
RISK FACTORS:
• Family history
• Type of step bacteria
• Environmental factors
PREVENTION FOR RHD:
• The only way to prevent Rheumatic fever is
to treat step throat infections or scarlet
fever promptly with a full course of
appropriate antibiotics.
WHAT IS HYPERTENSION?
• Hypertension is another name for high
blood pressure.
• Blood pressure is the force exerted by the
blood against the walls of the blood
vessels. The pressure depends on the work
being done by the heart and the
resistance of the blood vessels.
TYPES OF HYPERTENSION:
• PRIMARY TENSION – can result from
multiple factors, including blood
plasma volume and activity of the
hormones that regulate of blood
volume and pressure.
• SECONDARY HYPERTENSION – has
specific causes and is a
complication of another problem.
SECONDARY HYPERTENSION CAN RESULT FROM:
• Diabetes, due to both kidney problems and
nerve damage
• Kidney disease
• Pheochromocytoma, a rare cancer of an
adrenal gland
• Cushing syndrome, which can be caused by
corticosteroid drugs
• Congenital adrenal hyperplasia, a disorder of
the cortisol-secreting adrenal glands
• Hyperthyroidism, or an overactive
thyroid gland
• Hyperparathyroidism, which affects
calcium and phosphorous levels
• Pregnancy
• Sleep apnea
• Obesity
• CKD
 SYMPTOMS:
• A person with hypertension may not notice any symptoms,
and it is often called the “silent killer.”
• While undetected, it can cause damage to the
cardiovascular system and internal organs, such as the
kidneys.
• It is maintained that high blood pressure causes sweating,
anxiety, sleeping problems, and blushing. However, in most
cases, there will be no symptoms at all.
• If blood pressure reaches the level of hypertensive crisis, a
person may experience headaches and nosebleeds.
 CAUSES:
• The cause of hypertension is often not
known.
• Chronic kidney disease (CKD) is a
common cause of high blood
pressure because the kidneys do not
filter out fluid. This fluid excess leads to
hypertension.
 RISK FACTORS:
• AGE – with age, blood pressure can increase
steadily as the arteries become stiffer and
narrower due to plaque build-up.
• ETHNICITY – some ethnic groups are more
prone to hypertension.
• SIZE & WEIGHT – being overweight or obese is
a key risk factor.
• ALCOHOL & TOBACCO USE – consuming large
amounts of alcohol regularly can increase a person’s
blood pressure, as can smoking tobacco.
• SEX – the lifetime risk is the same for males and
females, but men are more prone to hypertension at
a younger age.
• EXISTING HEALTH CONDITIONS – cardiovascular
disease, diabetes, chronic kidney disease, and high
cholesterol levels can lead to hypertension,
especially as people get older.
OTHER CONTRIBUTING FACTORS
INCLUDE:
• Physical inactivity
• A salt-rich diet associated with processed
and fatty foods
• Low potassium in the diet
• Alcohol and tobacco use
• Certain diseases and medications
TREATMENT FOR HYPERTENSION:
• Lifestyle adjustment are the standard first-line
treatment for hypertension.
• REGULAR PHYSICAL EXERCISE
- People should exercise on at least 5 days of the
week. Examples of activities include walking,
jogging, cycling, or swimming.
• STRESS REDUCTION
- Avoiding stress, or developing strategies for
managing unavoidable stress, can help with blood
pressure control.
- Giving up smoking reduces the risk of hypertension,
heart conditions, and other health issues.
• MEDICATIONS
A range of drug types are available to
help lower blood pressure, including:
- diuretics, including thiazides,
chlorthalidone, and indapamide.
- Beta-blockers and alpha-blockers
- Calcium channel
- Central agonists
- Peripheral adrenergic inhibitor
- Vasodilators
- Angiotensin-converting enzyme
(ACE) inhibitors
- Angiotensin receptor blockers