Chapter 14 Flashcards

1
Q

The leading cause of death for men and women in the US. Accounts for one in every three deaths. The death rate from CVD for men has decreased over the past 30 years due to lifestyle changes, improved recognition and treatment of risk factors, and improved treatment of disease, the drop in death rates for women has really just begun. This includes: heart attack, stroke, peripheral artery disease, congestive heart failure, and other conditions.

A

Cardiovascular disease (CVD)

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2
Q

A network of blood vessels (arteries, veins, and capillaries) and a pump (the heart) that circulate blood throughout the body. The heart is a fist-sized muscle with four chambers: the right and left atria and the right and left ventricles, separated by valves.

A

cardiovascular system

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3
Q

Regulates pulmonary (lung) circulation, pumping oxygen-poor blood to the lungs and oxygen-rich blood back to the heart.

A

right side of heart

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4
Q

Regulates systemic (body) circulation, pumping oxygen rich blood to the rest of the body and returning oxygen-poor blood to the heart.

A

left side of heart

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5
Q

Needs oxygen and nutrients provided by blood. The blood being pumped through this does not provide nourishment for this muscle itself.

A

heart

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6
Q

Two medium-sized arteries, supply blood to the heart muscle. When a blood vessel is narrowed, the section of the muscles it supplies does not get enough blood.

A

coronary atreries

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7
Q

Largest artery in the body; it leaves the heart and branches into smaller arteries, arterioles, and capillaries carrying oxygen-rich blood to body tissues.

A

aorta

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8
Q

The contraction and relaxation of the ventricles is what we feel and hear as this.

A

heartbeat

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9
Q

Contraction phase of the heart and represented in the upper number of blood pressure measurement.

A

systole

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10
Q

Relaxation phase of the heart and represented in the lower number in a blood pressure measurement.

A

diastole

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11
Q

group of cells in the right atrium where he electrical signal is generated that establishes the heartbeat.

A

SA node

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12
Q

Healthy arteries are strong and flexible. Arteries can harden and become stiff in a process referred to as this. It is a thickening and hardening of the arteries due to the buildup of fats, cholesterol, cellular waste products, calcium, and other substances in artery walls. It is an underlying disease process in many forms of CVD which causes damage to the blood vessels. Takes years to develop and starts at a young age. Autopsies of people aged 15-35 who died from unrelated trauma show that some young people already have the beginnings of this. Heart attacks, strokes, and peripheral vascular disease are all caused by narrowing of arteries from this.

A

Atherosclerosis

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13
Q

With white blood cells, smooth muscle cells release collagen and other proteins to form this. It is an accumulation of debris, causes the artery wall to enlarge and bulge, slowing the blood flow. This can break off and completely block the artery.

A

Plaque

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14
Q

Atherosclerosis may weaken an artery wall, causing a stretching of the artery known as this. This can rupture, tear, and bleed causing sudden death.

A

Aneurysm

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15
Q

This is often a heart attack are the result of atherosclerosis involving a coronary artery.

A

coronary heart disease (CHD)

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16
Q

What is the leading form of CVD?

A

Coronary heart disease (CHD)

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17
Q

Narrowing or blocking of a coronary artery keeps the heart from getting enough oxygen-rich blood called this.

A

ischemia

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18
Q

If the artery is completely blocked, the person has heart attack o this.

A

myocardial infarction (MI)

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19
Q

During this he area of the muscle supplied but the blocked coronary artery is completely deprived of oxygen. If blood flow is not quickly restored, that part of the heart muscle will die. The severity of this is determined by the location and the duration of the blockage. If the blockage occurs too close to the aorta where the coronary arteries are just starting to branch, a large area of heart muscle is deprived of oxygen. If the blockage is farther out in a smaller coronary artery, the area of muscle supplied is smaller. The duration of the blockage is usually determined by the time between onset of symptoms and initiation of medical or surgical treatment to reopen the artery. This can occur when the heart is stressed by extra work like exercise, emotional stress, or even light activity or even at rest. Symptoms could be chest pain, pain in back, shoulders, or arms, pressure, sensation of fullness, or squeezing in the chest.

A

Heart Attack

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20
Q

Approximately 37% of women and 27% of men in large studies did not have chest pain or discomfort with their heart attack. What is the cause for this sex difference?

A
  • women have their first heart attack older than men
  • absence of chest pain is more common with heart disease at older ages
  • there aren’t varied symptoms between men and women
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21
Q

When coronary arteries are narrowed but not completely blocked. It’s pain, pressure, heaviness, or tightness in the center of the chest that may radiate to the neck, arms, or shoulders. Half of heart attacks are preceded by this. The pain of this resolves whereas the pain of a heart attack continues.

A

angina

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22
Q

Conditions that can cause pain in the chest are irritated esophagus, arthritis, gas, stomach ulcers, gallbladder disease, chest pain from working out. Experiencing this pain can lead some people to ignore chest pain from what?

A

heart attack

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23
Q

The pumping of the heart is usually a well-coordinated event, controlled by an electrical circuit establishing a rate of 60-100 beats per minute for a normal adult heart. If the signal is disrupted, it can cause this which is the disorganized beating of the heart. This disorganized beating is not as effective at pumping blood. It is any type of irregular heartbeat. It may be an occasional skipped beat, a rapid or slow rate, or an irregular pattern. Most people have an occasional irregular heartbeat every day. Some don’t even notice it. Irregular beats may cause noticeable symptoms like palpitations, a sensation of fluttering in the chest, chest pain, light-headedness, shortness of breath, and fatigue.

A

Arrhythmias

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24
Q

An abrupt loss of heart function. Usually within an hour of symptom onset. The sudden loss of function can be due to external causes (such as trauma, drowning, electrocution, or drug overdose) but is most often due to malfunction in the hearts electrical system due to atherosclerosis or heart abnormality.

A

Sudden cardiac arrest

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25
Q

Is a particular type of arrhythmia in which the ventricles contract rapidly and erratically, causing the heart to quiver or tremor rather than beat. When the ventricles fibrillate, blood can’t be pumped by the heart. The result is sudden cardiac death, an abrupt loss of heart function. Can be reversed with an electrical shock from a defibrillator, which can restart the heart’s normal rhythm.

A

Ventricular fibrillation (VF)

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26
Q

What is the leading cause of death in high school and college athletes?

A

Ventricular fibrillation (VF)

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27
Q

When blood flow to the brain or part of the brain is blocked. The result is this and also known as a cerebrovascular accident (CVA). Third leading cause of death in the US after heart disease and cancer. Can be preventable and treatable.

A

Stroke

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28
Q

What is the leading cause of sever, long-term disability?

A

Stroke or CVA

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29
Q

Make up 87% of all strokes and occur when an artery in the brain becomes blocked in the same way that a heart attack occurs when a coronary artery is blocked and prevents the brain from receiving blood flow.

A

Ischemic strokes

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30
Q

Blockage that causes strokes can be due to this. A blood clot that develops in a narrowed artery.

A

thrombus

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31
Q

A clot that develops elsewhere, often in the heart, travels to the brain and lodges in an artery.

A

embolism

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32
Q

Occur when a brain artery ruptures, bleeds into the surrounding area, and compresses brain tissue. These may include a head injury or a ruptured aneurysm. Symptoms depend on the part of the brain involved but usually involve sudden onset of neurological problems such as headaches, numbness, weakness, or speech problems.

A

Hemorrhagic strokes

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33
Q

Stroke that account for 10% of all strokes and occur when the ruptured artery is within brain tissue.

A

Intracerebral hemorrhagic stroke

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34
Q

Account for remaining 3% of all strokes and occur when the ruptured artery is on the brain’s surface and blood accumulates between the brain and the skull.

A

Subarachnoid hemorrhagic stroke

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35
Q

Called ministrokes. Occurs before having a stroke. These are periods of ischemia or restricted blood supply that produce some symptoms of stroke but resolve within 24 hours with little or no tissue death. Isn’t taken seriously but should be viewed as a warning sign of a stroke. After this, people can have a stroke within 90 days.

A

transient ischemic attacks (TIA)

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36
Q

Pressure exerted by blood against walls of arteries. It is measured in millimeters of mercury and stated in two numbers. The upper number is systolic pressure, the pressure produced when the heart contracts. The lower number is diastolic pressure, the pressure in the arteries when the heart is relaxed between contractions. Constantly changing as more attention is being paid to pre-hypertension.

A

Blood pressure

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37
Q

High blood pressure of this occurs when the pressure is great enough to damage artery walls. A silent killer because it usually causes no symptoms. Untreated high blood pressure can weaken and scar the arteries and makes the heart work harder, weakening it, as well. Can cause heart attacks, strokes, kidney disease, peripheral artery disease, and blindness.

A

Hypertension (HTN)

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38
Q

Higher blood pressure than recommended but not meeting the requirements of hypertension. Americans aged 20 or older have pre-hypertension.

A

Pre-hypertension

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39
Q

Factors that can cause Hypertension:

A
  • Age
  • Genetics
  • High salt consumption
  • alcohol
  • not physically active
  • obesity
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40
Q

What group has the highest rates of HTN?

A

Black people

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41
Q

When the heart is not pumping blood as well as it should. Can develop after a heart attack or as a result of HTN, heart valve abnormality, or disease of the heart muscle. When the heart can’t keep up regular pumping force or rate, blood backs up into the lungs and fluid from the backed-up blood in the pulmonary veins leaks into the lungs. This leads to difficulty breathing, shortness of breath, and coughing, especially when lying down. Blood returning to the heart from the body also gets backed up, causing fluid to leak into the ankles and legs and causing swelling of the lower legs. When blood fails to reach the brain efficiently, fatigue and confusion can result. Symptoms can be treated with medications that help draw off extra fluid, decrease blood pressure, and improve the heart’s ability to pump. Other factors include cigarette smoking, high cholesterol, and diabetes.

A

Congestive Heart Failure (CHF)

42
Q

What is the most common heart valve defect?

A

mitral valve prolapse

43
Q

Billows backward, and the edges do not fully close when the left ventricle contracts to move blood into the aorta, allowing blood to leak backward into the atrium. Is common, affecting 5-10% of the population. It can occur at any age in men and women. Sometimes people with this require antibiotics before dental surgery and other procedures to reduce the risk of infection from bacteria introduced into the bloodstream by the procedure.

A

mitral valve prolapse

44
Q

More than 35 of congenital defects exist. What is the most common?

A

Septal defect

45
Q

A congenital defect in which an extra hole in the heart allows blood to flow from one atrium to the other or from one ventricle to the other. Poorly oxygenated blood from the body mixes with oxygenated blood from the lung resulting in lower oxygen supply to the body. Undetected congenital cardiac abnormalities are the leading cause of death in competitive athletes.

A

septal defect

46
Q

This causes pain, aches, or cramping in the muscles supplied by a narrowed blood vessel. It is the result of atherosclerosis in the arteries of the arms or, more likely, the legs. It is usually not fatal but causes disability because of pain with walking. If circulation is severely limited, the affected leg or arm may have to be amputated. High levels of daily physical activity are associated with better survival and a lower risk of death.

A

Peripheral vascular disease (PVD)

47
Q

Disease of the heart muscle that account for 1% of heart deaths in the US with highest rates among men and Black people. Cause is unknown, but a virus is suspected.

A

Cardiomyopathy

48
Q

Factors that can weaken the heart muscle:

A

-alcohol
- tobacco
- medications
- pregnancy
- HTN

49
Q

What is the most common form of cardiomyopathy?

A

dilated cardiomyopathy

50
Q

Enlargement of the heart muscle in response to weakening of the muscle.

A

dilated cardiomyopathy

51
Q

Is an abnormal thickening of one part of the heart, frequently the left ventricle. The thickened wall makes the heart abnormally stiff, so the heart does not fit well. Most people have no symptoms. Can cause heart failure, arrhythmia, and sudden death. 36% of cases of sudden death in young competitive athletes are due to hypertrophic cardiomyopathy. The cause of the condition is unknown in about 50% of cases. There is a genetic link in the rest.

A

Hypertrophic cardiomyopathy

52
Q

What type of disease is cardiovascular disease?

A

multifactorial disease (can be caused by a combination of genetic, environmental, and lifestyle factors interacting over the lifespan)

53
Q

A longitudinal study. This was formulated because of the increased occurrence of CVD. Every two to four years, participants undergo extensive testing to evaluate their behaviors and heart status. This study has lasted for more than 60 years and has involved more than 10,000 participants. This study has allowed researchers to identify multiple factors that alter the risk of CVD. Found 9 risk factors that account for more than 90% of the risk for initial heart attack.

A

Framingham Heart Study

54
Q

Framingham Heart Study’s 9 risk factors for initial heart attack:

A
  • smoking
  • abnormal lipid level
  • HTN
  • diabetes
  • obesity
  • lack of physical activity
  • low vegetable and fruit intake
  • excessive alcohol intake
  • phycological stress
55
Q

“Bad” cholesterol; lipoproteins that accumulate in plaque and contribute to atherosclerosis.

A

low-density lipoproteins (LDL’s)

56
Q

“good” cholesterol—consist mainly of protein and are the smallest of the lipoprotein particles. Help clear cholesterol from cells and atherosclerotic deposits and transport it back to the liver for recycling.

A

high-density lipoproteins (HDL’s)

57
Q

Controllable risk factors for CVD:

A
  • Tobacco
  • Cholesterol
  • mental well-being
  • inactive lifestyle
  • excessive weight
  • diabetes
  • blood pressure
58
Q

What is a leading risk factor for all forms of CVD?

A

Tobacco

59
Q

What increases risk of heart attack, CHF, and kidney disease. It makes the heart work harder to circulate the blood possibly causing the heart to enlarge which may lead to CHF. HTN can also cause damage to the lining of arteries, promoting atherosclerosis. In the Black community, HTN is not only more common, it also follows a different course than in other groups. It develops earlier, is more severe, and is associated with more complications such as heart attacks, strokes, and kidney failure.

A

Hypertension

60
Q

Who tend to excrete sodium at a slower rate than White people and possibly make them more sensitive to dietary salt? The difference may contribute to the higher rate of strokes among this group.

A

Black people

61
Q

Waxy, fat-like substance. The amount of this in your body is affected by what you eat and how fast your body makes and gets rid it. As this increases, so does the incidence of heart disease.

A

Cholesterol

62
Q

What is the borderline total for cholesterol? What is considered high cholesterol?

A

200-239, greater than 240

63
Q

Conditions the heart, reduces blood pressure, improves HDL’s, helps maintain weight, and helps control diabetes. Especially important for children because it is associated with lower blood pressure and better weight control. Active children tend to become active adults.

A

Physical activity

64
Q

Who reaches the highest physical activity rate?

A

College students

65
Q

Puts strain on heart and contributes to risk factors such as HTN, high LDL’s, and diabetes. Those who are apple-shaped, and have circumference of 40 inches or greater for men and greater than 35 inches for women.

A

excessive weight (obesity)

66
Q

A metabolic and endocrine disorder in which production of insulin is disrupted. Elevated levels of glucose in the bloodstream cause damage throughout the body including damaging artery walls, changes in come blood components, and damage to peripheral nerves and organs. Arteries are more susceptible to atherosclerosis which can occur at earlier ages and is more extensive. More likely to have “silent” heart attacks with this.

A

Diabetes

67
Q

The only symptoms may be nausea, vomiting, sweating, or dizziness and can easily be mistaken for another illness.

A

“silent” heart attacks

68
Q

Form of fat derived from fats eaten or produced by the body from excess carbohydrates. High levels (>150) are associated with excess body fat, diets high in saturated fat and cholesterol, alcohol use, and some medical conditions like uncontrolled diabetes. The main treatment is lifestyle change, but medications can be used.

A

Triglycerides

69
Q

What type of drinking seems to damage the heart? What type of drinking appears to protect against heart disease and stroke, increasing HDL’s?

A

heavy drinking, light to moderate drinking

70
Q

5 Psychosocial factors that contribute to CVD:

A
  • Type A personalities
  • low socioeconomic status
  • low educational attainment
  • poverty
  • discrimination
  • depression
  • lack of social support
71
Q

The anger and hostility of this personality contribute to CVD risk. Continuous circulation of stress hormones in the blood increases blood pressure, heart rate, and triggers the release of cholesterol and triglycerides into the blood.

A

Type A personality

72
Q

Limits people’s ability to obtain the basic requisites of health, such as food and shelter as well as the ability to participate in society creating psychological stress. Limits access to health-related information, health care, medications, behavior change options, and physical activity.

A

Poverty

73
Q

People with this have a more difficult time choosing healthy lifestyle options, making lifestyle changes, initiating access to health care and adhering to medication regimens.

A

Depression

74
Q

Noncontrollable risk factors for CVD:

A
  • Age
  • Gender ( death rates are higher for women and have no symptoms)
  • Genetics ( plays a role for when a relative got a disease)
  • Ethnicity ( black people have higher risk of obtaining CVD)
  • Women being postmenopausal ( estrogen drops during menopause and normal estrogen levels reduce women from obtaining CVD)
75
Q

There is a significant rise in deaths due to heart disease and stroke after what age?

A

65

76
Q

Death rates of CVD are higher for what gender because of frailer bodies when becoming older and have no symptoms?

A

Women

77
Q

True or False?
Health care providers may delay treatment because they do not recognize symptoms or are less likely to think about heart disease in women.

A

True

78
Q

Testing’s done to detect CVD:

A
  • screening for risk factors
  • electrocardiogram (EKG)
  • echocardiogram
  • exercise stress test
  • blood tests
  • visualization procedures
79
Q

Records electrical activity in the heart as it beats. It can detect abnormal rhythms, inadequate blood flow, and heart enlargement. Is an ultrasound test that uses sound waves to visualize the heart structure and motion. It can detect structural abnormalities.

A

Electrocardiogram (EKG)

80
Q

Test that evaluates how well the heart functions with exercise.

A

Exercise stress test

81
Q

Treatment options for CVD:

A
  • angioplasty
  • medications
  • stent
  • coronary artery bypass
  • pacemaker
82
Q

A surgery of which involves a balloon catheter is threaded into a blocked or narrowed artery and inflated to stretch the vessel open again.

A

angioplasty

83
Q

Supports the vessel walls and keeps the vessels open.

A

Stent

84
Q

A health blood vessel is taken from another part of the body (usually a leg) and grafted to the coronary arteries to allow a bypass of blood flow around a narrowed vessel.

A

coronary artery bypass graft or just bypass

85
Q

Tests and Treatment for Stokes:

A
  • CT scan
  • MRI
  • examine carotid arteries
  • rehabilitation
  • speech, occupational, or physical therapy
86
Q

The pancreas produces little or no insulin. Insulin must be provided from an outside source through injection by syringe or insulin pump. The onset is usually by the age of 20 which has led to it being called Juvenile Diabetes. Symptoms include extreme thirst, frequent urination, rapid weight loss, fatigue, and blurred vision. There is a genetic component. Without blood sugar control, there can be various long term complications. Treatment can include insulin replacement, dietary education, and physical activity.

A

Type 1 diabetes

87
Q

Often associated with obesity. Production of insulin was at one time normal but now the body cells have become insulin resistant. Risk factors include genetics, obesity, and age. The onset is usually gradual, and symptoms include excessive thirst, frequent urination, and fatigue. Physical activity, diet, medications, insulin injections.

A

Type 2 diabetes

88
Q

Prevention for Diabetes:

A
  • screening tests
  • physical activity
  • diet
  • maintain healthy weight
  • know side effects of medications your taking
89
Q

Treatment for Diabetes:

A
  • physical exercise
  • diet
  • insulin injections
  • obtain healthy weight
  • medications
90
Q

Public Health measures being taken to prevent diabetes:

A
  • target underlying causes of the disease
  • educational campaigns
  • programs to encourage testing
  • reduce complications of disease
91
Q

Most cost-effective and can reduce risk of more than one disease. Starts early, when lifestyle habits are being formed. Efforts are public health interventions that target the underlying causes of a disease—such as an unhealthy diet, hypertension, and tobacco use—and attempt to improve or eliminate them. Intended to stop the development of risk factors. For Type 2 diabetes, an example is a nutrition and exercise program for elementary school children.

A

Primary prevention strategies

92
Q

Are aimed at people who have developed risk factors but do not yet have symptoms. For Type 2 diabetes, an example would be an educational campaign about the benefits of weight loss and a program to encourage adults to have their blood glucose levels monitored regularly.

A

Secondary prevention strategies

93
Q

Focus on reducing complications of a disease once it has manifested, or on reversing the effects of the disease to restore function. Tends to be the most expensive and invasive level of public health intervention. It is more expensive to treat disease and prevent further complications than it is to prevent onset. For type 2 diabetes, this includes doing regular screenings for nerve damage, kidney function, eye problems, and heart disease. It can also include encouraging lifestyle changes, such as getting a membership at a gym and switching to a healthier diet.

A

Tertiary prevention strategies

94
Q

The hormonal changes of pregnancy can affect how well the body responds to insulin. Occurs in 2-18% of pregnancies. Risk factors are similar to Type 2 but also people who have this are at greater risk of developing Type 2. For most women, blood sugars return to normal after delivery. For a few, symptoms remain.

A

Gestational diabetes

95
Q

What is the most common chronic lung condition?

A

Asthma

96
Q

Symptoms can usually be controlled by avoiding triggers and using medications. The airways become inflamed and swollen, narrowing the airway passage. Also, muscles around the bronchioles spasm or tighten constricting airways. All of this leads to wheezing, coughing, chest tightness, and shortness of breath. An asthma attack is triggered by an allergen. Treatment depends upon the specific symptoms.

A

Asthma

97
Q

Develops as people experience damage to their airways and alveoli over time. The two main types of this are chronic bronchitis and emphysema. The primary cause of both is smoking. Other lung irritants can also contribute to these diseases. Symptoms usually progress slowly and include cough, shortness of breath, wheezing, and chest tightness. Inhalers can be necessary and sometimes oxygen treatments. The best way to prevent this is to never smoke or stop smoking.

A

chronic obstructive pulmonary disease (COPD)

98
Q

How to prevent chronic diseases:

A
  • healthy diet
  • exercise
  • avoid tobacco
  • control blood pressure
  • manage cholesterol
99
Q

American adults use this regularly to reduce risk of CVD. Inhibits clotting of platelets and thus reduces the risk of blood clots. However, this also increases the risk of bleeding. Is generally recommended for anyone who has a history of heart attack, unstable angina, ischemic stroke, or ischemic attack if the person is not allergic or does not have a history of bleeding ulcer.

A

Aspirin

100
Q

Spiritual ways of dealing with CVD:

A
  • meditation
  • increase social support
  • simplify schedules
  • biofeedback
  • hypnosis
101
Q

Exercise is especially important for what group? Sets for active adults.

A

Children