Lecture 11: Stress & Cardiovascular Diseases Flashcards
chronic risk factors for cardiovascular disease
age, cigarette smoking, diabetes
acute risk factors for cardiovascular disease
hemodynamic and vasoconstrictive factors
Mittleman et al. (1995)
examined how anger can be a stimulus for acute myocardial infarction
- found that when people experienced anger two hours before the heart attack, the risk of the actual heart attack was twice as high
- appears stress is involved in a heart attack
cardiovascular system
consists of the heart and blood vessels
the heart
a muscle that pumps five liters of blood through the body every minute
- left ventricle: pumps blood thoughout the body
- right ventricle: pumps blood throughout the lungs (does not have to work as hard)
- blood is pumped from the aorta through the body
blood vessels
ensure that all tissue can be supplied with oxygen and nutrients
veins
the blood vessels that carry the blood back to the heart
systemic circulation
the major system delivering oxygenated blood to tissues and organs
- blood circulation: from the left ventricle to the aorta, the arteries, then the tissues
- blood gets deoxygenated in the tissues, then flows through the veins to the right atrium
pulmonary circulation
the system responsible for oxygenating blood
- deoxygenated blood flows from the right atrium to the right ventricle of the heart into the pulmonary arteries, which then carry the deoxygenated blood into the lungs, releasing carbon dioxide and picking up oxygen
- the now oxygenated blood returns to the left atrium, and the systemic circulation starts again
coronary arteries
supply the heart muscle (myocardium) itself with oxygenated blood, enabling its proper contraction and function
- if the coronary arteries become narrowed, the heart does not receive enough blood, causing part of the heart muscle to die (heart attack)
pressure gradient
indicates the change in pressure in blood vessels
- 2 types of blood pressure can be distinguished
diastolic blood pressure/under pressure
when the heart relaxes
systolic blood pressure/overpressure
when the heart contracts
electrocardiogram
measures changes in the electrical charge of extracellular fluid due to electrical changes that occur in all cardiac muscle cells combined
coronary artery disease
the narrowing or blocking of coronary arteries which supply blood to the myocardium
- happens through the process of accumulating fatty acids like cholesterol and calcium on the inner walls of the arteries (atherosclerosis)
- leads to the formation of plaques that narrow and harden the arteries, restricting blood flow to the heart
coronary heart disease
damage to the heart muscle itself
- can be caused by not getting enough oxygen or nutrients due to reduced blood flow from the coronary arteries (atherosclerosis)
- might further present as angina (chest pain), myocardial infarction, or ischemia
heart failure
a chronic condition where the heart is unable to pump blood effectively, thus lowering cardiac output
heart valve disease
occurs when one or more of the heart’s valves don’t function properly
transient ischemic attack (TIA)/stroke
temporary disruption of blood flow
cardiac arrest
the heart suddenly stops beating due to ventricular fibrillation, which is an electrical malfunction that disrupts the heart’s normal rhythm
myocardial infarction (MI)
blockage of a blood vessel in the heart caused by narrowed arteries reducing blood flow to the heart
myocardial ischemia
insufficient blood flow through the heart (often before a heart attack)
- caused by problems with the supply of blood and problems with drainage
angioplasty
a treatment for diseases of the coronary arteries where the narrowing is stretched with some type of rubber balloon
bypass surgery
a bypass is made along the narrowing, which is done using a vein from the patient’s own body
thrombolysis
used after a cerebral infarction, where the clot blocking a blood vessel is dissolved by medicine administered intravenously (through IV)
modifiable risk factors
smoking, obesity, and diabetes
- can be altered
non-modifiable risk factors
age, gender, and genetic factors
three types of psychosocial risk factors
- chronic factors
- acute factors
- episodic factors
chronic psychosocial risk factors
type D personality and low SES
acute psychosocial risk factors
stress and anger, environmental factors (war, natural disasters, etc.)
episodic psychosocial risk factors
depression, vital exhaustion, and burnout
eustress
stress caused by positive emotions, such as being in love
distress
stress caused by negative emotions, such as loss
three components of the stress response
- time: the greater the time pressure, the worse the stress reaction
- individual differences: there is an optimal stress moment and this differs between people
- controllability: when the stressor is controllable, it is less stressful
Yerkes-Dodson law
shows that there is a relationship between stress level (arousal level) and performance
- there appears to be an optimal stress level that gives maximum performance
- if there is no stress or too little stress the performance level will be low
- when stress or arousal is too high, the graph will ‘flip’ and performance will decrease
ischemia
the insufficiency of blood flow through an organ
- usually caused by damage to the blood vessels
fast, slow, and irregular heart rhythms
- fast: tachycardia
- slow: bradycardia
- irregular: arrhythmia
perfusion imaging techniques
used to assess how well the heart muscle is being supplied with blood
- e.g. radionuclide imaging
takotsubo cardiomyopathy (TTC)
characterized by motion abnormalities of the left ventricular wall, usually without coronary artery disease
- usually affects postmenopausal women
- triggered by emotional or physical stress
- also known as apical ballooning syndrome (ABS)
interheart study
examined psychosocial factors as risk indicators for nonfatal myocardial infarction
- concluded that the odds ratio was highest for persistent stress in the home situation and persistent general stress (home, work, or both)
