Cardiovascular System Health Article

Arterial disease

Some diseases of the arteries include atherosclerosis, arterial thrombosis, aneurysm, and arteritis. The most common cause of heart attacks, coronary artery disease is the blockage of one or more of the vessels that supply blood to the heart. The arteries can be obstructed by a blood clot (thrombosis), atherosclerosis, or a coronary spasm. These problems can be treated with drugs that dissolve the clot or surgical procedures that remove or circumvent the blockages, such as coronary angioplasty or bypass surgery.

Atherosclerosis is caused by the degradation of the lining of the arteries (endothelium) and the resultant plaque, a build-up of platelets, cholesterol, and other substances such as calcium that forms at the site. Atherosclerosis occurs to some extent in everyone and can occur in any of the body's arteries. Depending on the location, the disease can lead to other cardiovascular problems such as heart attack, leg pain, stroke, and aneurysm. Arterial thrombosis is another way that arteries can be blocked, but in this case an abnormal blood clot, called an embolus, is responsible. This condition presents with very similar symptoms to atheroscloerosis. If it occurs in a coronary artery, it can cause heart attacks.

An aneurysm is an abnormally widened area of an artery. A common site for this problem is in the abdominal aorta and it is usually caused by atherosclerosis. Aneurysms can be surgically treated if detected before rupture. A final disease of the arteries is arteritis, an

inflammation of the arteries. This problem is usually a part of another general disease, such as Takayasu's disease, temporal arteritis, Buerger's disease, and polyarteritis nodosa.

Venous disease

Some diseases of the veins include venous thrombosis, thrombophlebitis, pulmonary embolism, and varicose veins. Blockages in the veins are not usually caused by atherosclerosis, but by blood clots or venous thrombi. Venous thrombosis and the resulting inflammation, thrombophlebitis, can occur in superficial veins, usually a relatively minor problem, or in deep veins, a more serious condition where the threat of the clot breaking off and traveling to the heart or lungs is present.

These conditions are generally treated with blood-thinning drugs. If the clot does travel and get lodged in the lungs the condition is called a pulmonary embolism. This is a serious problem that often requires hospitalization. If blood-thinning drugs do not resolve the problem, surgical removal of the clot can be necessary.

Varicose veins refer to a condition where the veins become abnormally dilated and most commonly appear as soft bluish bulges in the legs. Caused by elevated pressure in the veins and the resulting damage to the valves within the vessels, varicose veins, unless severe, are a cosmetic problem. They can be treated with surgery, injections (sclerotherapy), or lasers.

KEY TERMS

Adventitia—The outer layer of the arteries containing nerves and blood vessels.

Diastole—Phase of the heartbeat where the ventricles relax and fill with blood.

Endocardium—The thin, innermost layer of the heart which is infected with endocarditis.

Epicardium—The outermost layer of the heart.

Intima—The innermost layer of the arteries containing a layer of endothelial cells that are damaged with atherosclerosis.

Media—The middle layer of arteries containing the smooth muscle.

Myocardium—The middle, working layer of the heart containing the heart muscle cells.

Pulsile—Movement in waves, a characteristic of the blood when leaving the heart and in the circulation.

Regurgitation—A defect of the heart valves that interferes with its ability to close completely, allowing blood to leak in the direction opposite of circulation.

Septum—A physical divider between chambers, found between the atria and the ventricles.

Stenosis—A stiffening of the heart valves, which narrows its opening and can interfere with function.

Systole—Phase of the heartbeat where the ventricles contract and force blood from the heart.

BOOKS

Braunwald, Eugene et al. Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, PA: W.B. Saunders Company, 2001.

Gersh, Bernard J., ed. Mayo Clinic Heart Book. New York: William Morrow and Company, Inc., 2000.

PERIODICALS

Crumlish, Christine et al. "When Time is Muscle." American Journal of Nursing 100 (January 2000): 26.

Thomas, Donna Jean G. and Harrah, Barbara F. "A New Look at Heart Failure." Home Healthcare Nurse 18 (March2000).

ORGANIZATIONS

American Heart Association. 7272 Greenville Avenue, Dallas, Texas 75231. (800) AHA-USA1. <http://www.americanheart.org>.

OTHER

Anderson, Robert M. The Gross Physiology of the Cardiovascular System. 2000. <http://www.cardiovascular.cx.index.htm> (April 19, 2001).

Heart Information Network. April 4, 2001. <http://www.heartinfo.org> (April 19, 2001).

Michelle L. Johnson, M.S., J.D.