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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5536_Библиотеки_им_академика_М_И_Перельмана.pdf
Tobacco
Citation: http://images.wisegeek.com/a-brain-scan.jpg
A wide array of things can interfere with the brain’s blood supply, including venous
malformations, hardening or narrowing of the veins and arteries which supply blood
to the brain, blood clots, and obstruction of the veins. Medical imaging studies
can be used to look at the blood supply in the brain, often with the use of tracers
which illuminate the veins and arteries to make them easier to see. In people who
are more at risk for cerebrovascular disease, a doctor may recommend a periodic
screening, especially if neurological symptoms arise.
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In addition to being linked with conditions like diabetes and high blood pressure,
cerebrovascular disease can also be caused by certain medications, nutritional
deficiencies, the development of tumors, or trauma to the brain. Doctors who work
with patients who are predisposed to developing cerebrovascular problems may
suggest a number of techniques to reduce the risk. Managing conditions like high
blood pressure and diabetes is important, as is being aware of the risks involved
in taking certain medications.
It is also important to be alert to the early signs of a neurological problem. Slurred
speech, dizziness, confusion, difficulty walking, vertigo, vision problems, and memory
loss are all signs that there is something wrong with the brain, and they are grounds
for an immediate visit to the doctor. Cerebrovascular disease can emerge in people
who are perfectly healthy, so a history of generally good health and no known
illnesses is not an excuse for delaying medical evaluation of neurological symptoms.
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood
vessels. Cardiovascular disease includes coronary artery diseases (CAD) such as
angina and myocardial infarction (commonly known as a heart attack). Other
CVDs are stroke, heart failure, hypertensive heart disease, rheumatic heart disease,
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cardiomyopathy, heart arrhythmia, congenital heart disease, valvular heart disease,
carditis, aortic aneurysms, peripheral artery disease, and venous thrombosis.
Heart and blood vessel disease also called heart disease ncludes numerous problems,
many of which are related to a process called atherosclerosis. Atherosclerosis is a
condition that develops when a substance called plaque builds up in the walls of
the arteries. This buildup narrows the arteries, making it harder for blood to flow
through. If a blood clot forms, it can stop the blood flow.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Ciattion: http://images.wisegeek.com/man-looking-at-woman-in-bed.jpg
A heart attack occurs when the blood flow to a part of the heart is blocked by
a blood clot. If this clot cuts off the blood flow completely, the part of the heart
muscle supplied by that artery begins to die. Most people survive their first heart
attack and return to their normal lives to enjoy many more years of productive
activity. But having a heart attack does mean you have to make some changes. The
doctor will advise you of medications and lifestyle changes according to how badly
the heart was damaged and what degree of heart disease caused the heart attack.
Tobacco
An ischemic stroke (the most common type) happens when a blood vessel that
feeds the brain gets blocked, usually from a blood clot. When the blood supply to
a part of the brain is shut off, brain cells will die. The result will be the inability
to carry out some of the previous functions as before like walking or talking. A
hemorrhagic stroke occurs when a blood vessel within the brain bursts.
Some effects of stroke are permanent if too many brain cells die after a stroke
due to lack of blood and oxygen to the brain. These cells are never replaced. The
good news is that some brain cells don’t die — they are only temporarily out of
order. Injured cells can repair themselves. Over time, as the repair takes place,
some body functioning improves. Also, other brain cells may take control of those
areas that were injured. In this way, strength may improve, speech may get better
and memory may improve. This recovery process is what rehabilitation is all about.
Learn more about stroke.
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Other Types of Cardiovascular Disease
Heart failure: This does not mean that the heart stops beating. Heart failure, sometimes
called congestive heart failure, means the heart is not pumping blood as well as
it should. The heart keeps working, but the body’s need for blood and oxygen is
not being met. Heart failure can get worse if it’s not treated. If your loved one has
heart failure, it’s very important to follow the doctor’s orders.
Arrhythmia: This is an abnormal rhythm of the heart. There are various types of
arrhythmias. The heart can beat too slow, too fast or irregularly. Bradycardia is when
the heart rate is less than 60 beats per minute. Tachycardia is when the heart rate
is more than 100 beats per minute. An arrhythmia can affect how well the heart
works. The heart may not be able to pump enough blood to meet the body’s needs.
Heart valve problems: When heart valves do not open enough to allow the blood
to flow through as it should, it’s called stenosis. When the heart valves do not close
properly and allow blood to leak through, it’s called regurgitation. When the valve
leaflets bulge or prolapse back into the upper chamber, it’s a condition called mitral
valve prolapse. When this happens, they may not close properly.
Smoking is associated with an increased incidence of cardiovascular disease (CVD)
including:
■ coronary heart disease — angina, myocardial infarction, sudden death,
congestive heart failure
■ cerebrovascular disease — transient ischaemic attacks (TIAs), stroke
■ peripheral vascular diseases — claudication, aortic aneurysm
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Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: http://images.wisegeek.com/anatomy-of-a-heart-attack.jpg
Cardiovascular Screening
In medicine, when people are screened for disease, they undergo several tests
or examinations to help rule out or rule in factors that may suggest its presence.
Cardiovascular screening, which may vary in intensity of testing, evaluates people
for different forms of heart disease and stroke. There are differing guidelines for
who should receive this type of screening and exactly how extensive screening
needs to be.
In many cases, cardiovascular screening is performed on people beginning in their
40s or early 50s. When people are eligible for this testing, from an insurance
perspective, depends on the other risk factors they have, suggesting elevated risk
for heart disease. For those appearing relatively healthy, with no family history of
heart disease, no presence of illness like diabetes, and no markers such as obesity
or smoking, screening initially takes place for people at the age of 50. This could
all change if folks have several risk factors for heart disease, and in routine physical
examinations doctors are likely to assess present risk and determine if cardiovascular
screening is needed sooner.
Tobacco
Citation: http://images.wisegeek.com/man-on-treadmill-near-older-doctor.jpg
The simplest type of screening is a blood test that evaluates different aspects of
the blood. One of the most important measurements is cholesterol level. Higher
cholesterol might indicate development of plaque in the arteries, and this creates risk
for damage to the coronary arteries and stroke. Should cholesterol levels be high,
doctors might create a plan with patients to reduce levels using diet, medication,
or a combination of the two.
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Sometimes cardiovascular screening becomes more extensive and the need for
greater testing depends on varying factors. If a patient shows signs he or she may
already have some form of heart disease, doctors might want more concise pictures
of what is occurring. In addition to blood testing, they might have patients undergo
an electrocardiogram (EKG) to assess heart rhythm. Other scans could be suggested,
such as echocardiogram or sonogram of the heart. Exercise testing is another potential
way to view the heart’s efficiency and capability as it works harder.
Though it’s often the case that cardiovascular screening is performed on people
in middle age and older, this group is not the only one that benefits from such
evaluation. Most physician groups strongly recommend that any athletes at the middle
school, high school, college level and beyond also receive cardiovascular screening.
These screenings, when comprehensive, tend to involve EKG, echocardiogram and
blood testing. They are performed to catch any athletes at risk for sudden cardiac
death while exerting.
Screening is a means of catching disease before a lot of symptoms emerge. If people
note symptoms they think might be cardiovascular disease before they are eligible for
screenings, they still need to bring these to the attention of their physicians. Cardiac
disease can occur much earlier, in a smaller group of people. Early diagnosis and
treatment can be useful in preventing more damage to the cardiovascular system.
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Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: http://images.wisegeek.com/anatomy-of-heart.jpg
Cardiopulmonary Disease
Cardiopulmonary disease is disease which involves both the heart and lungs. It
may be known as heart-lung disease or heart and lung disease, and it can take a
number of forms. Left untreated, cardiopulmonary disease can be deadly. Treatment
of such diseases may be overseen by a medical specialist such as a cardiologist, and
can involve a team of physicians to ensure that a patient gets the most appropriate
care. It is advisable to see a specialist with experience in this area when receiving
treatment to receive the most up to date and aggressive treatments available.
The heart and lungs are closely linked, and problems which involve one organ can
also spill over into the other. For example, someone with coronary artery disease has
trouble pumping blood efficiently to the lungs for oxygenation, and someone with
asthma may not be able to fully oxygenate blood because of his or her impaired
breathing. The close connections between the heart and the lungs can also result
in cascading reactions which complicate medical issues and generate medical
emergencies quickly when a patient is having health problems.
People with cardiopulmonary disease can experience symptoms like shortness of
breath, dizziness, bluing of the extremities, chest pain, high blood pressure, and
dyspnea, in which they stop breathing altogether. Commonly people feel wheezy,
and may experience chest pain after exercising or while struggling to breathe. Over
time, the symptoms can worsen.
Cardiopulmonary disease can involve inflammation which shuts down the airways and
narrows the coronary arteries, along with infections and ongoing disease processes.
One example of cardiopulmonary disease is chronic obstructive pulmonary disease
(COPD), which makes it hard to breathe and results in subsequent heart problems
for the patient over time. The heart is strained by the extra work it has to engage
in to get blood through the lungs for oxygenation, and may eventually give out.
Tobacco
Citation: http://images.wisegeek.com/labeled-diagram-of-copd.jpg
If cardiopulmonary disease is suspected, a doctor will order lung function tests to learn
more about the status of the lungs. She or he may also order studies of the heart,
including medical imaging studies to visualize the heart, and an electrocardiograph
to record the electrical signals from the heart. These tests are used to assess current
levels of functioning and to gather information which could shed light upon the
patient’s condition. Treatment options can include medications, diet and exercise
recommendations, surgery, and recommendations for lifestyle changes which will
keep the patient more comfortable.
205
Prevalence of Cardiovascular Disease
The prevalence of cardiovascular disease represents the leading cause of death
worldwide. Heart disease leads in the number of deaths from these diseases, with
stroke the second most common cause of mortalities. The prevalence of cardiovascular
disease is greater in countries with low or moderate income residents, representing
more than 80 percent of cases. Cardiovascular disease affects men and women
equally.
The World Health Organization (WHO) expects the number of deaths from
cardiovascular disease to increase each year, with the largest increases occurring
in Southeast Asia and eastern Mediterranean countries. People with low or moderate
annual incomes typically have fewer preventative resources available. They also lack
access to quality medical care and early intervention, increasing the prevalence of
cardiovascular disease.
Residents in these areas die younger from these diseases. The very poor are most
affected, and the prevalence of cardiovascular disease in a family might lead to
increased poverty. The WHO reports one third of a family’s total yearly household
income might be spent treating cardiovascular disease after a heart attack or stroke.
In addition to poverty, stress increases the prevalence of cardiovascular disease
throughout the world. Other factors include globalization and the aging of populations.
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Health organizations aim to educate people about risks and lifestyle choices that
lead to these diseases. Tobacco control programs represent one way this is done.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: http://images.wisegeek.com/blood-flow-in-the-body.jpg
Cardiovascular disease is defined as any illness of the heart or blood vessels leading
to heart attack or stroke. Coronary heart disease affects the vessels leading to the
heart, while cerebrovascular disease involves blood vessels to the brain. Peripheral
arterial disease also affects vessels providing blood and oxygen to the brain. A
blockage typically comes from the fatty deposits that build up inside vessel walls.
These clots might cause stroke if they rupture or block blood supply. Deep vein
thrombosis creates blood clots in the legs that might travel to the heart or brain,
causing heart attack or stroke. The prevalence of cardiovascular disease might also
stem from rheumatic fever that damages the heart, or birth defects.
Cardiovascular disease might be prevented through diet, exercise, and avoiding
tobacco. A healthy diet of fruits and vegetables, combined with daily exercise,
decreases the risk of heart disease and stroke. These strategies might help keep
blood pressure and cholesterol low and keep weight at a healthy level.
Once these disorders are diagnosed, they can be treated with medication to lower
blood pressure or cholesterol. A daily low dose of aspirin typically thins the blood
to prevent blood clots. Surgery to decrease the prevalence of cardiovascular disease
includes artery bypass operations, angioplasty to clear a blocked blood vessel, and
pacemakers to restore normal heart rhythm.
Tobacco
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Respiratory
The respiratory system is a group of organs that supply the body with oxygen. The
system consists of the nose, mouth, throat, lungs, and diaphragm. These organs
work together to convert the air that is breathed in into oxygen for the blood. The
body’s cells require oxygen in order to function, so if the respiratory system does
not work properly, it can cause serious health complications or even be fatal.
The process of receiving oxygen from the respiratory system begins when a person
inhales air from the outside through his or her nose or mouth. Once the outside air
makes it way into the body, it travels into the throat. The first area of the throat the oxygen
passes through is the larynx, also known as the voice box, which is responsible for
speech. Oxygen then goes through the trachea, also known as the windpipe, which is a
thin cylinder that connects the bottom of the larynx down into the chest.
Citation: http://images.wisegeek.com/older-man-using-blue-inhaler.jpg
The chest cavity is the main location of the majority of the respiratory system organs.
The bottom of the trachea divides into two cylinders known as bronchi. Oxygen
travels through the bronchi into the alveoli, which are millions of small pockets of
air. These little pockets hold inhaled air and deliver it into the bloodstream. They
also take unneeded products from the bloodstream, such as carbon dioxide, so it
can be prepared to exit the body.
The respiratory system is also the process of ridding the body of carbon dioxide, a
chemical produced by cells that cannot be used for energy. When the alveoli bring
down the carbon dioxide from the bloodstream, it goes back up to exit through the
same organs that brought the oxygen in. The diaphragm is a muscle group located
208
in the chest and both constricts and loosens during the breathing process. It controls
the simultaneous entrance of fresh oxygen and exit of carbon dioxide. During the
diaphragm constriction, fresh oxygen enters the body, and carbon dioxide exists
during the loosening of the diaphragm.
When a part of the respiratory system fails to function correctly, it can make breathing
difficult. A common respiratory condition is bronchitis, in which the bronchial tubes
become irritated and end up making too much mucus. That extra mucus makes
a person with bronchitis cough profusely in an attempt to clear the mucus out of
the bronchi. A more serious, lifelong respiratory condition is asthma, in which the
lungs constrict in the presence of dust, smoke, or any other substances that are
inhaled. People with asthma may not be able to breathe on their own when their
lungs constrict and will have to use an inhaler, a device that helps loosen the
lungs with medication.
Respiratory agents are drugs or a combination of drugs used to prevent, relieve or
treat respiratory diseases.
Smoking:
■ is the primary cause of chronic obstructive airways disease through mucous
hypersecretion, interference with ciliary function and alveolar destruction
■ exacerbates existing hay fever and asthma
■ contributes to acute and chronic rhinitis
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Ciattion: http://images.wisegeek.com/upper-human-body-diagram.jpg