Cardiovascular System

Cardiovascular system (CVS) is responsible for circulation of blood throughout the body. It is also called as circulatory system. It consists of heart, blood vessels &blood.heart

Heart
The heart is a hollow muscular organ present in the centre of the chest. An average adult heart is about the shape and size of a closed fist and weighs around 300 gms. The heart beats about 60-70 times per minute and helps in pumping the blood to all parts of the body.

Chambers of the heartchambers-of-heart
Heart is divided into 4 chambers.

1.Right atrium, 2. Left atrium

3.Right ventricle & 4. Left ventricle

Each chamber is like a separate compartment, with valves between them, which allow the blood in and out.

Heart Valves
The heart valves maintain the unidirectional flow of the blood.

The heart has four valves:heatr-valves

  1. Tricuspid valve: Present between right atrium and right ventricle
  2. Bicuspid valve: Present between left atrium and left ventricle
  3. Pulmonary valve: Present between right ventricle and pulmonary artery
  4. Aortic valve: Present between left ventricle and aorta

Circulation of the blood
De-oxygenated blood from all over the body reaches the Right Atrium through the Superior & Inferior Vena Cava.
It is then sent to the Right Ventricle from where it is pumped to both the lungs through the Pulmonary arteries.
After oxygenation in the lungs, blood is brought back to the Left Atrium via the pulmonary veins, goes to the Left Ventricle from where it is pumped to all body parts through the aorta.

BLOOD VESSELStypes-blood-vessels
They are the tubular structures of different sizes through which blood is distributed to the various parts of the body.

Types of Blood Vessels

The 3 types of blood vessels are Artery, Vein & Capillaries.
Arteries: The blood vessels taking blood away from the heart are known as arteries.
Capillaries: It connects arteries to veins. As the tiniest blood vessels, capillaries carry blood to and from every cell in the body.
Veins: The blood vessels carrying blood from the body towards the heart are known as Veins.

 

Coronary Circulationcoronary-circulation
The heart, just like any other organ, requires blood to supply it with oxygen and other nutrients so that it can do its work.
Heart gets its blood from coronary arteries that eventually carry blood within the heart muscle.

Approximately 4-5% of the blood output of the heart goes to the coronary arteries (7 ½ ounces/minute or 225 ml/min).

Blood is supplied to the heart by its own vascular system, called coronary circulation.

The aorta branches off into 2 main coronary arteries which further branch off into smaller arteries, which supply oxygen-rich blood to the entire heart muscle.

What can go wrong with heart?

Hypertensionhypertension-cvd
Blood pressure is summarised by two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole) and equate to a maximum and minimum pressure, respectively.

Sustained high blood pressure due to increased cardiac output or peripheral Resistance is referred as Hypertension

 

ANGINAangina

Refers to the presence of pain or discomfort in the chest caused by reversible myocardial ischemia.
Pain may not always occur in chest, but may radiate to left arm, back, neck, jaw….
Angina is a sign of Ischemic Heart Disease

 

Coronary Artery Disease [CAD]
Narrowing of one or more coronary arteries, usually due to atherosclerotic process or thrombosis in coronary arteriescad

Risk factors include:
Increased LDL-c, Hyperlipidemia, Hyperhomocysteinaemia, Increased C-reactive protein levels, Hypertension, diabetes, Smoking, etc.,

Major complications include:
Angina pectoris
MI, Sudden cardiac death due to arrhythmias

Ischemic heart disease
Ischemia refers to a lack of oxygen due to inadequate perfusion [ blood supply].
IHD is a condition where there is disturbance of cardiac function due to an imbalance between oxygen supply and oxygen demand.
IHD is also known as Coronary heart disease.

Myocardial infarctioncad
Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack, results from the partial interruption of blood supply to a part of the heart muscle, causing the heart cells to be damaged or die.

MI is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque

Hypercholesterolemia/Hyperlipidemia/ Dyslipidemia
High cholesterol raises your risk for heart disease, heart attack, and stroke. When there is too much cholesterol circulating in the blood, it can create sticky deposits (called plaque) along the artery walls.Dyslipidemia

Plaque can eventually narrow or block the flow of blood to the brain, heart, and other organs. Blood cells that get caught on the plaque form clots, which can break loose and completely block blood flow through an artery, causing heart attack or stroke.

Atherosclerosis
Atherosclerosis (arteriosclerotic vascular disease or ASVD) is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol and triglyceride.Atherosclerosis

Atherosclerosis is commonly referred to as a hardening or furring of the arteries that is caused by the formation of multiple plaques within the arteries.

Cardiovascular Diseases are managed by various modes of treatment.
Life style modification
Treat the underlying cause
Pharmacological management
Surgical Management

Statin induced myopathy
Statins are the drugs which are used to take care of the lipid abnormalitiesStatin induced myopathy
Statin use is often associated with a variety of muscle-related symptoms or myopathies.
Myopathy may be related in part to statin inhibition of the endogenous synthesis of CoQ10, an essential cofactor for mitochondrial energy production.

Cardiovascular surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons.
It is done to treat complications of ischemic heart disease (for example, coronary artery bypass grafting), correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart disease and atherosclerosis.
It also includes heart transplantation.

Percutaneous Transluminal Coronary Angioplasty and Stent

Percutaneous Transluminal Coronary Angioplasty and Stent

Coronary Artery Bypass Grafting (CABG)

CABG

Ischemia-reperfusion injury is a well-known phenomenon after cardiac surgery.

Myocardial reperfusion injury during cardiac operation has been the subject of intensive investigations.

Oxygen free radicals play a significant role in reperfusion injury.

Congestive heart failure

Heart failure (HF), often called congestive heart failure (CHF) or congestive cardiac failure (CCF), occurs when the heart is unable to provide sufficient pump action to maintain blood flow to meet the needs of the body.

The improved cardiac function in patients with congestive heart failure treated with CoQ10 supports the hypothesis that this condition is characterized by mitochondrial dysfunction and energy starvation, so that it may be ameliorated by CoQ10 supplementation.

Dilated CardiomyopathyDilated Cardiomyopathy
Cardiomyopathy (“heart muscle disease”) is the measurable deterioration of the function of the myocardium (the heart muscle) for any reason, usually leading to heart failure.

The most common form of cardiomyopathy is dilated cardiomyopathy.

There is myocardial deficiency of CoQ 10 in cardiomyopathy. CoQ10 is indispensable in mitochondrial bioenergetics and for human life to exist.

Care For Heart Disease patients

Diet modification:

  1. Reduce saturated fat intake (like hydrogenated fat, dalda & alike). Intake of this saturated fat should be less than 10% of the daily energy intake.
  2. Reduce excess salt intake in your daily diet.
  3. Restrict dietary cholesterol intake by limiting the dietary intake of egg yolks, liver, dairy products.

Reduce body weight

Increase in body weight have been found to be a major reason in many cases of heart disease. Thus, reduction of excess body weight should be a primary step to achieve a healthy heart status.

Modify Lifestyle

  1. Avoid heavy smoking
  2. Avoid drinking alcohol regularly & in large amounts

Increase physical activity. Indulge yourself in any form of regular physical exercise.

Foods to prefer and avoid during heart disease

Include a healthy diet to get a healthy heart. Eat ample amount of:

  1. Raw & Green leafy vegetables.
  2. Clear soups (any vegetable corn or chicken).
  3. Salads (without any dressing).
  4. Sour lime, tamarind (imli), kokam, vinegar for taste.

 

  1. Thin buttermilk.
  2. Coconut water.
  3. Garlic, onions.

 

New Concepts for patients with CVDs

Coenzyme Q10, is very much useful, in prevention and treatment of cardiovascular disease. This endogenous antioxidant, Coenzyme Q10, has potential for use in prevention and treatment of cardiovascular disease, particularly hypertension, hyperlipidemia, coronary artery disease, and heart failure. There is promising evidence of a beneficial effect of CoQ(10) when given alone or in addition to standard therapies in hypertension and in heart failure & ischemic heart disease.

Potentials of Co Q 10-1

Coenzyme Q10, also known as ubiquinone is required in adequate amount for cellular respiration and ATP production. Due to its involvement in ATP synthesis, CoQ10 affects the function of all cells in the body, making it essential for the health of all tissues and organs. Organs with the highest energy requirements—such as the heart, liver and kidney—have the highest CoQ10 concentrations.

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