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.
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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.