CARDIOVASCULAR

CARDIOVASCULAR
SYSTEM
SYSTEM
 INTRODUCTION
The heart is the life-giving, ever-beating
muscle in your chest. The heart for the
average human will contract about 3 billion
times; never resting, never stopping to
take a break except for a fraction of a
second between beats.
At 80 years of age, a person's heart will
continue to beat an average of 100,000
times a day.
• Many believe that the heart is the first
organ to become functional.
• Within weeks of conception the heart
starts its mission of supplying the body
with nutrients even though the embryo is
no bigger than a capital letter on this page.
• The primary function of the heart is to
pump blood through the arteries,
capillaries, and veins.
• Blood transports oxygen, nutrients,
disease causing viruses, bacteria,
hormones and has other important
functions as well.
 THE HEART
• The heart is a hollow, muscular organ
about the size of a fist .
• The heart is composed of cardiac muscle,
an involuntary muscle tissue that is found
only within this organ. The term "cardiac"
(as in cardiology) means "related to the
heart” and comes from the Greek word
kardia, for "heart." It has a four-
chambered, double pump and is located in
the thoracic cavity between the lungs.
• The cardiac muscle is self-exciting,
meaning it has its own conduction system.
This is in contrast with skeletal muscle,
which requires either conscious or reflex
nervous stimuli.
• The heart's rhythmic contractions occur
spontaneously, although the frequency or
heart rate can be changed by nervous or
hormonal influence such as exercise or the
perception of danger
 MYOCARDIUM
• The myocardium is the muscular tissue of
the heart.
• The myocardium is composed of
specialized cardiac muscle cells with an
ability not possessed by muscle tissue
elsewhere in the body. Cardiac muscle, like
other muscles, can contract, but it can also
conduct electricity, like nerves.
• The blood to the myocardium is supplied
by the coronary arteries
 PERICARDIUM
• The pericardium is the thick, membranous
sac that surrounds the heart. It protects
and lubricates the heart.
• There are two layers to the pericardium:
the fibrous pericardium and the serous
pericardium. The serous pericardium is
divided into two layers; in between these
two layers there is a space called the
pericardial cavity.
 EPICARDIUM
• The layer next to the heart is the
visceral layer, also known as the
Epicardium. This is the innermost
layer and consists of connective
tissue.
 HEART CHAMBERS
• The heart has four
chambers, two atria
and two ventricles.
• The atria are
smaller with thin
walls, while the
ventricles are larger
and much stronger
 ATRIUM
• There are two atria on either side of
the heart.
• On the right side is the atrium that
contains blood which is poor in
oxygen.
• The left atrium contains blood which
has been oxygenated and is ready to
be sent to the body.
• The right atrium
receives de-
oxygenated blood
from the
superior vena
cava and inferior
vena cava.
• The left atrium
receives
oxygenated blood
from the left and
right pulmonary
veins.
 VENTRICLES
• The ventricle is a heart chamber
which collects blood from an atrium
and pumps it out of the heart.
• There are two ventricles: the right
ventricle pumps blood into the
pulmonary circulation for the lungs,
and the left ventricle pumps blood
into the systemic circulation for the
rest of the body.
• Ventricles have thicker walls than
the atria, and thus can create the
higher blood pressure.
• Comparing the left and right
ventricle, the left ventricle has
thicker walls because it needs to
pump blood to the whole body.
• This leads to the common
misconception that the heart lies on
the left side of the body.
 SEPTUM
• The interventricular septum is the
thick wall separating the lower
chambers (the ventricles) of the
heart from one another.
• The ventricular septum is directed
backward and to the right, and is
curved toward the right ventricle.
• The greater portion of it is thick and
muscular and constitutes the
muscular ventricular septum.
• Its upper and posterior part, which
separates the aortic vestibule from
the lower part of the right atrium
and upper part of the right ventricle,
is thin and fibrous, and is termed the
membranous ventricular septum.
 VALVES
• There are two types of valves :
• Atrioventricular (AV) valves
• Semilunar (SL) valves

• The two atrioventricular (AV) valves are one-

way valves that ensure that blood flows from
the atria to the ventricles, and not the other
way.
• The two semilunar (SL) valves are present in
the arteries leaving the heart; they prevent
blood from flowing back into the ventricles.
•
• The sound heard in a heart beat is the
heart valves shutting.
There are two Atrioventricular (AV) valves
• Right Atrioventricular (AV) valve
• Left Atrioventricular (AV) valve
• The right AV valve is also called the
tricuspid valve because it has three flaps.
It is located between the right atrium and
the right ventricle. The tricuspid valve
allows blood to flow from the right atrium
into the right ventricle when the heart is
relaxed during diastole.
• When the ventricular pressure exceeds
the pressure in the atrium, the tricuspid
valve snaps shut.
• The left AV valve is also called the
bicuspid valve because it has two flaps. It
is also known as the mitral valve due to the
resemblance to a bishop's mitre (liturgical
headdress).
• This valve prevents blood in the left
ventricle from flowing into the left atrium.
• As it is on the left side of the heart, it
must withstand a great deal of strain and
pressure; this is why it is made of only two
cusps.
• There are two remaining valves called
the Semilunar Valves. They have
flaps that resemble half moons.
• The pulmonary semilunar valve lies
between the right ventricle and the
pulmonary trunk.
• The aortic semilunar valve is located
between the ventricle and the aorta.
 Passage of Blood
Through the Heart
• It is important to realize that both
atria contract at the same time and
that both ventricles contract at the
same time.
• The heart works as two pumps, one
on the right and one on the left that
works simultaneously.
• The right pump pumps the blood to the lungs or
the pulmonary circulation at the same time that
the left pump pumps blood to the rest of the
body or the systemic circulation.
• Venous blood from systemic circulation
(deoxygenated) enters the right atrium
through the superior and inferior vena
cava. The right atrium contracts and
forces the blood through the tricuspid
valve (right atrioventricular valve) and into
the right ventricles.
• The right ventricles contract and force
the blood through the pulmonary semilunar
valve into the pulmonary trunk and out the
pulmonary artery.
• This takes the blood to the lungs where
the blood releases carbon dioxide and
receives a new supply of oxygen. The new
blood is carried in the pulmonary veins
that take it to the left atrium.

• The left atrium then contracts and forces

blood through the left atrioventricular,
bicuspid, or mitral, valve into the left
ventricle.
• The left ventricle contracts forcing blood
through the aortic semilunar valve into the
ascending aorta. It then branches to arteries
carrying oxygen rich blood to all parts of the
body.
PASSAGE OF BLOOD
 Blood Flow Through
Capillaries
• From the arterioles, the blood then enters
one or more capillaries.
• The walls of capillaries are so thin and
fragile that blood cells can only pass in
single file.
• Inside the capillaries, exchange of oxygen
and carbon dioxide takes place.
• Red blood cells
inside the capillary
releases their
oxygen which
passes through the
wall and into the
surrounding tissue.
• The tissue then
releases waste,
such as carbon
dioxide, which then
passes through the
wall and into the
red blood cells.
The Circulatory System
• The circulatory system is extremely
important in sustaining life.
• It’s proper functioning is responsible for
the delivery of oxygen and nutrients to all
cells, as well as the removal of carbon
dioxide, waste products, maintenance of
optimum pH, and the mobility of the
elements, proteins and cells, of the immune
system.
 Arteries
• Arteries are muscular blood vessels that
carry blood away from the heart,
oxygenated and deoxygenated blood .

• The pulmonary arteries will carry

deoxygenated blood to the lungs and the
sytemic arteries will carry oxygenated
blood to the rest of the body
• . Arteries have a thick wall that consists of
three layers. The inside layer is called the
endothelium, the middle layer is mostly smooth
muscle and the outside layer is connective
tissue.
• The artery walls are thick so that when
blood enters under pressure the walls
can expand.
 Arterioles
• An arteriole is a small artery that
extends and leads to capillaries.
• Arterioles have thick smooth
muscular walls.
• These smooth muscles are able to
contract (causing vessel constriction)
and relax (causing vessel dilation).
• This contracting and relaxing affects
blood pressure; the higher number of
vessels dilated, the lower blood
pressure will be.

• Arterioles are just visible to the

naked eye.
 Capillaries
• Capillaries are the smallest of a body’s vessels; they
connect arteries and veins, and most closely interact with
tissues.
• They are very prevalent in the body; total surface area is
about 6,300 square meters.
• The walls of capillaries are composed of a
single layer of cells, the endothelium.

• This layer is so thin that molecules such

as oxygen, water and lipids can pass
through them by diffusion and enter the
tissues.
• Waste products such as carbon dioxide
and urea can diffuse back into the blood to
be carried away for removal from the
body.
 Veins
• Veins carry blood to the heart.
• The pulmonary veins will carry
oxygenated blood to the heart awhile the
systemic veins will carry deoxygenated to
the heart.
• Most of the blood volume is found in the
venous system; about 70% at any given
time.
• The veins outer walls have the same three
layers as the arteries, differing only
because there is a lack of smooth muscle
in the inner layer and less connective
tissue on the outer layer.
• Veins have low blood pressure compared
to arteries and need the help of skeletal
muscles to bring blood back to the heart.
• Most veins have one-way valves called
venous valves to prevent backflow caused
by gravity. They also have a thick collagen
outer layer, which helps maintain blood
pressure and stop blood pooling.
• A muscular layer allows veins to contract,
which puts more blood into circulation.
• Veins are used medically as points of
access to the blood stream, permitting
the withdrawal of blood specimens
(venipuncture) for testing purposes, and
enabling the infusion of fluid,
electrolytes, nutrition, and medications
(intravenous delivery).
 Venules
• A venule is a small vein that allows
deoxygenated blood to return from
the capillaries to the larger blood
veins, except in the pulminary circuit
were the blood is oxygenated.
• Venules have three layers; they have
the same makeup as arteries with
less smooth muscle, making them
thinner.
THE CARDIOVASCULAR
PATHWAYS
• The double circulatory system of
blood flow refers to the separate
systems of pulmonary circulation and
the systemic circulation in amphibians,
birds and mammals (including humans.)
• For instance, the adult human heart
consists of two separated pumps,
• the right side with the right atrium
and ventricle (which pumps
deoxygenated blood into the
pulmonary circulation),
• and the left side with the left atrium
and ventricle (which pumps
oxygenated blood into the systemic
circulation).
• Blood in one circuit has to go through
the heart to enter the other circuit.
Blood circulates through the body
two to three times every minute.
• In one day, the blood travels a total
of 19,000 km (12,000 miles), or four
times the distance across the U.S.
from coast to coast
 The Pulmonary Circuit
• In the pulmonary circuit, blood is pumped
to the lungs from the right ventricle of
the heart.
• It is carried to the lungs via pulmonary
arteries.
• At lungs, oxygen in the alveolae diffuses to
the capillaries surrounding the alveolae and
carbon dioxide inside the blood diffuses to
the alveolae.
• As a result, blood is oxygenated which is
then carried to the heart's left half -to
the left atrium via pulmonary veins.
• Oxygen rich blood is prepared for the
whole organs and tissues of the body.
• This is important because mitochondria
inside the cells should use oxygen to
produce energy from the organic
compounds.
 The Systemic Circuit
• The systemic circuit supplies oxygenated
blood to the organ system.
• Oxygenated blood from the lungs is
returned to the left atrium, then the
ventricle contracts and pumps blood into
the aorta.
• Systemic arteries split from the aorta and
direct blood into the capillaries.
• Cells consume the oxygen and nutrients
and add carbon dioxide, wastes, enzymes
and hormones.
• The veins drain the deoxygenated blood
from the capillaries and return the blood
to the right atrium.
 Aorta
• The aorta is the largest of the arteries in
the systemic circuit.
• The blood is pumped from the left
ventricle into the aorta and from there it
branches to all parts of the body.
• The aorta is an elastic artery, and as such
is able to distend.
• When the left ventricle contracts to
force blood into the aorta, the aorta
expands.
• This stretching gives the potential
energy that will help maintain blood
pressure during diastole, as during this
time the aorta contracts passively.
 Superior Venae Cavae
• The superior vena cava (SVC) is a large but
short vein that carries de-oxygenated
blood from the upper half of the body to
the heart's right atrium.
• It is formed by the left and right
brachiocephalic veins (also referred to as
the innominate veins) which receive blood
from the upper limbs and the head and
neck.
 Inferior Venae Cavae
• The inferior vena cava (or IVC) is a large
vein that carries de-oxygenated blood
from the lower half of the body into the
heart.
• It is formed by the left and right common
iliac veins and transports blood to the
right atrium of the heart.
• It is posterior to the abdominal cavity, and
runs along side of the vertebral column on
its right side.
 Coronary Arteries
• The coronary circulation consists of the
blood vessels that supply blood to, and
remove blood from, the heart muscle
itself.
• Although blood fills the chambers of the
heart, the muscle tissue of the heart, or
myocardium, is so thick that it requires
coronary blood vessels to deliver blood
deep into the myocardium.
• The vessels that supply blood high in
oxygen to the myocardium are known
as coronary arteries
• . The vessels that remove the
deoxygenated blood from the heart
muscle are known as cardiac veins.
 Hepatic Veins
• In human anatomy, the hepatic veins
are the blood vessels that drain de-
oxygenated blood from the liver and
blood cleaned by the liver (from the
stomach, pancreas, small intestine
and colon) into the inferior vena cava.
• They arise
from the
substance
of the
liver.
 Cardiac Cycle
 Systole
 Diastole
 "Lub-Dub"

 The Heart's Electrical Conduction System

 Control of Heartbeat

 The EKG
 Blood Pressure
 Systolic Pressure
 Diastolic Pressure
 Cardiac Cycle
• Cardiac cycle is the term used to
describe the relaxation and contraction
that occur, as a heart works to pump
blood through the body.
• Heart rate is a term used to describe
the frequency of the cardiac cycle .
 Heart Beat
• For most people, a heart rate of 70
beats a minute while at rest is
considered normal
• Heart beats approx.2.5 billion times
during a life time of 66 years.
• When resting, the adult human heart
beats at about 70 bpm (males) and 75
bpm (females), but this rate varies
between people.
• The body can increase the heart rate in
response to a wide variety of conditions
in order to increase the cardiac output
(the amount of blood ejected by the
heart per unit time).
• Exercise, environmental stressors or
psychological stress can cause the heart
rate to increase above the resting rate.
• Every single 'beat' of the heart involves
three major stages: atrial systole,
ventricular systole and complete cardiac
diastole.
• Throughout the cardiac cycle, the blood
pressure increases and decreases.
• As ventricles contract the pressure rise,
causing the AV valves to slam shut.
 Systole
• In the systolic phase
the heart contracts,
bloodpressure rises
and blood moves out
along the vessels.
• Systole,or
contraction, of the
heart is initiated by
the electrical cells of
the sinoatrial node,
which is the heart's
natural pacemaker.
 Diastole
• In the diastolic
phase the heart
relaxes, blood
pressure falls and
blood fills the
heart
 Diastole contd…
• Ventricular diastole is when the ventricles
are relaxing, while atrial diastole is when
the atria are relaxing.
• Together they are known as complete
cardiac diastole.
• During ventricular diastole, the pressure in
the (left and right) ventricles drops from
the peak that it reaches in systole. When
the pressure in the left ventricle drops to
below the pressure in the left atrium, the
mitral valve opens, and the left ventricle
fills with blood that was accumulating in the
left atrium.
• Likewise, when the pressure in the right
ventricle drops below that in the right atrium,
the tricuspid valve opens and the right ventricle
fills with blood that was in the right atrium
 Lub-Dub
• The first heart tone, "Lub" is caused
by the closure of the atrioventricular
valves, mitral and tricuspid, at the
beginning of ventricular contraction,
or systole.
• The second heart tone, "Dub" is
caused by the closure of the aortic
valve and pulmonic valve at the end of
ventricular systole.
 The Heart's Electrical
Conduction System
• The heart is primarily made up of
muscle tissue.
• A network of nerve fibers
coordinates the contraction and
relaxation of the cardiac muscle
tissue to obtain an efficient, wave-
like pumping action of the heart.
 Control of Heartbeat
• The heart contains two cardiac
pacemakers that spontaneously cause the
heart to beat. These can be controlled by
the autonomic nervous system and
circulating adrenaline.
• Pacemaker Cells: cells that create these
rhythmical impulses of the heart and
they directly control the heart rate
Artificial devices also called pacemakers can be used after
damage to the body's intrinsic conduction system to
produce these impulses synthetically.
 SA Node
• Sinoatrial Node: (abbreviated SA
node or SAN, also called the sinus
node): the impulse generating
(pacemaker) tissue located in the
right atrium of the heart near the
entrance of the superior vena cava
• Although all of the heart's cells possess
the ability to generate the electrical
impulses (or action potentials) that trigger
cardiac contraction, the sinoatrial node is
what normally initiates it, simply because it
generates impulses slightly faster than the
other areas with pacemaker potential.
• Cells in the SA node will naturally
discharge (create action potentials) at
about 70-80 times/minute.
 AV Node
• AV Node is the tissue between the atria and
the ventricles of the heart, which conducts the
normal electrical impulse from the atria to the
ventricles
• . The atrioventricular node delays impulses for
0.1 second before spreading to the ventricle
walls.
• The reason it is so important to delay the
cardiac impulse is to ensure that the atria are
empty completely before the ventricles
contract
 AV Bundle
• These specialized muscle fibers in the
heart were named after the Swiss
cardiologist Wilhelm His, Jr., who
discovered them in 1893.
• Cardiac muscle is very specialized, as it is
the only type of muscle that has an
internal rhythm; i.e., it is myogenic which
means that it can naturally contract and
relax without receiving electrical impulses
from nerves.
• The fibers of the Bundle of HIS allow
electrical conduction to occur more easily
and quickly than typical cardiac muscle.
• They are an important part of the
electrical conduction system of the heart
as they transmit the impulse from the
AV node (the ventricular pacemaker) to
the rest of the heart.
• It takes about 0.03-0.04s for the
impulse to travel from the bundle of HIS
to the ventricular muscle.
 AV Bundle contd…

• It is extremely important for these

nodes to exist as they ensure the
correct control and co-ordination of
the heart and cardiac cycle and make
sure all the contractions remain
within the correct sequence .
 Purkinje Fibers
• Purkinje fibers (or Purkyne tissue) are
located in the inner ventricular walls of
the heart, just beneath the endocardium.
• These fibers are specialized myocardial
fibers that conduct an electrical stimulus
or impulse that enables the heart to
contract in a coordinated fashion.
• Purkinje fibers work with the sinoatrial
node (SA node) and the atrioventricular
node (AV node) to control the heart rate.
• During the ventricular contraction portion of
the cardiac cycle, the Purkinje fibers carry
the contraction impulse from the left and
right bundle branches to the myocardium of
the ventricles.
• This causes the muscle tissue of the ventricles
to contract and force blood out of the heart —
either to the pulmonary circulation (from the
right ventricle) or to the systemic circulation
(from the left ventricle).
• They were discovered in 1839 by Jan
Evangelista Purkinje, who gave them his name.
 The EKG
• Cardiac electrophysiology is the science of the
mechanisms, functions, and performance of the
electrical activities of specific regions of the
heart.
• The EKG also know as the Electrocardiogram. is
the recording of the heart's electrical activity as
a graph.
• The graph can show the heart's rate and rhythm,
it can detect enlargement of the heart,
decreased blood flow, or the presence of current
or past heart attacks. EKG's are inexpensive,
Non-invasive, quick, and painless.
• Depending on the results, the patient’s
medical history, and a physical exam;
further tests or a combination of
medications and lifestyle changes may be
ordered.
• P
• P wave- indicates that
the atria are
electrically stimulated
to pump blood into the
ventricles.
• QRS
• QRS complex-
indicates that the
ventricles are
electrically stimulated • T
to pump blood out. • T wave- indicates the
recovery period of the
ventricles.
 Blood Pressure
• Blood pressure is the pressure exerted
by the blood on the walls of the blood
vessels.
• Unless indicated otherwise, blood
pressure refers to systemic arterial blood
pressure, i.e., the pressure in the large
arteries delivering blood to body parts
other than the lungs, such as the brachial
artery (in the arm).
• The pressure of the blood in other vessels
is lower than the arterial pressure.
• Blood pressure
values are
universally
stated in
millimeters of
mercury
(mmHg).
 Systolic Pressure
• The systolic pressure is defined as the
peak pressure in the arteries during the
cardiac cycle.

• Systolic Pressure is the highest when the

blood is being pumped out of the left
ventricle into the aorta during
ventricular systole. The average high
during systole is 120 mmHg.
 Diastolic Pressure
• the diastolic pressure is the lowest
pressure in the artries (at the resting
phase of the cardiac cycle).

• Diastolic blood pressure lowers steadily

to an average low of 80 mmHg during
ventricular diastole.
 Blood
• Blood is a specialized bodily fluid
(technically a tissue) that is composed of
a liquid called blood plasma and blood
cells suspended within the plasma.
• blood is considered a specialized form of
connective tissue, given its origin in the
bones .
• Plasma is predominantly water containing
dissolved proteins, salts and many other
substances; and makes up about 55% of
blood by volume.
• Mammals have red blood, which is bright
red when oxygenated, due to hemoglobin
 Blood Cells
• Human blood cells:
a - erythrocytes;
• b -leukocytes;
c - lymphocyte.
• d- Thrombocytes

• The blood cells present in blood are red blood cells (also
called RBCs or erythrocytes), white blood cells (including
both leukocytes and lymphocytes) and platelets (also
called thrombocytes).
• A scanning electron microscope (SEM)
image of normal circulating human
blood. One can see red blood cells,
several white blood cells including
knobby lymphocytes, and many small
disc-shaped platelets.

• By far the most abundant cells in blood are red

blood cells. 4.7 to 6.1 million (male), 4.2 to 5.4
million (female) erythrocytes .
• These contain hemoglobin, an iron-containing
protein, which facilitates transportation of
oxygen by reversibly binding to this respiratory
gas and greatly increasing its solubility in blood.
• In contrast, carbon dioxide is almost entirely
transported extracellularly dissolved in plasma.
• White blood cells help to resist infections and
parasites & are part of the immune system.
(4,000-11,000 leukocytes)
• Platelets are important in the clotting of blood
stops more blood from leaving the body and also
helps to prevent bacteria from entering the body.
.
 Hemoglobin
• Hemoglobin is the
principal determinant of
the color of blood in
vertebrates.

• . In vertebrates and other hemoglobin-using

creatures, arterial blood and capillary blood are
bright red as oxygen impacts a strong red color
to the heme group.
• Deoxygenated blood is a darker shade of red with
a bluish hue; this is present in veins, and can be
seen during blood donation and when venous blood
samples are taken.
 Functions of the Blood
 Blood performs many important functions
within the body including:
• Supply of oxygen to tissues (bound to
hemoglobin which is carried in red cells)
• Supply of nutrients such as glucose, amino
acids and fatty acids (dissolved in the
blood or bound to plasma proteins)
• Removal of waste such as carbon dioxide,
urea and lactic acid
• Immunological functions, including
circulation of white cells, and detection of
foreign material by antibodies
• Coagulation, which is one part of the
body's self-repair mechanism
• Messenger functions, including the
transport of hormones and the signalling
of tissue damage
• Regulation of body pH (the normal pH of
blood is in the range of 7.35 - 7.45)
• Regulation of core body temperature
 Blood Pathology
 General medical disorders  Cardiovascular Disease
 Hematological disorders  Dilated and Inflamed Vei
 Carbon monoxide poisoning ns

 Congenital Heart
 Medical treatments
 Interesting Facts
 Blood products
 Ways To A Healthy Heart
 Intravenous administratio
n

 Bloodletting
 Blood Pathologies
 Disorders of volume
 Injury can cause blood loss through
bleeding.
 Thrombocytes are important for blood
coagulation or the formation of blood
clots which can stop bleeding.
 Trauma to the internal organs or bones
can cause internal bleeding, which can
sometimes be severe.
 Hematological disorders
• Thalassemia is an
inherited blood disease.
• In thalassemia, the
genetic defect results
in the formation of
abnormal hemoglobin
molecules,
• and this in turn causes the anemia which is
the characteristic presenting symptom of
the thalassemias
• Being a carrier of the disease may confer
a degree of protection against malaria,
• This is probably by making the red blood
cells more susceptible to the less lethal
species
 Anemia

 Insufficient red cell mass (anemia) can

be the result of bleeding, blood diseases
like thalassemia, or nutritional
deficiencies; and may require blood
transfusion.
 Several countries have blood banks to
fill the demand for transfusable blood.
 A person
receiving a
blood
transfusion
must have a
blood type
compatible
with that of
the donor.
 OtherTreatments for
anemia
• There are many different treatments for
anemia and the treatment depends on
severity and the cause .
• Mild to moderate iron deficiency anemia is
treated by iron supplementation with
ferrous sulfate or ferrous gluconate.
• Vitamin C may aid in the body's ability to
absorb iron.
• Vitamin supplements given orally
(folic acid) or subcutaneously
(vitamin b-12) will replace specific
deficiencies.
Disorders of coagulation
 Coagulation is a complex process by
which blood forms solid clots.
 Hemophilia is a genetic illness that
causes dysfunction in one of the blood's
clotting mechanisms.
 This can allow otherwise inconsequential
wounds to be life-threatening.
 Ineffective or insufficient platelets
can also result in coagulopathy
(bleeding disorders).
 Hypercoagulable state (thrombophilia)

results from defects in regulation of

platelet or clotting factor function,
and can cause thrombosis.
 Sickle-cell anemia
• Sickle-cell anemia is a group
of genetic disorders caused
by sickle hemoglobin .
• In many forms of the
disease, the red blood cells
change shape.
• The hemoglobin proteins
stick to each other, causing
the cell to get a rigid
surface and sickle shape.
• This process damages the red blood cell
membrane, and can cause the cells to
become stuck in blood vessels.
• This deprives the downstream tissues of
oxygen, which may cause organ damage,
such as stroke.
• The disease is chronic and lifelong.
• Individuals are most often well, but their
lives are punctuated by periodic painful
attacks.
• Life-expectancy is shortened.
 Leukemia
• Leukemia is cancer of your body's blood-
forming tissues, including the bone
marrow.
• The word "leukemia" means "white blood"
in Greek.
• The disease usually starts in the white
blood cells.
• In leukemia, your bone marrow produces a
large number of abnormal white blood
cells.
• They look different from normal blood
cells and don't function properly.
• Eventually, they block production of
normal white blood cells, impairing your
ability to fight off infection.
• Leukemia cells also crowd out other types
of blood cells produced by the bone
marrow, including red blood cells, and
platelets.
Infectious disorders of
blood
 Blood is an important vector of
infection.
 HIV, the virus which causes AIDS, is
transmitted through contact between
blood, or the bodily secretions of an
infected person.
 Hepatitis B and C are transmitted
primarily through blood contact.
 Malaria is a blood-borne parasitic
infections.
 Carbon monoxide
poisoning
• Substances other than oxygen can bind to
hemoglobin; in some cases this can cause
irreversible damage to the body.
• Carbon monoxide, for example, is
extremely dangerous when carried to the
blood via the lungs by inhalation, because
carbon monoxide irreversibly binds to
hemoblobin to form carboxyhemoglobin,
• so that less hemoglobin is free to bind
oxygen, and less oxygen can be
transported in the blood.

• This can cause suffocation.

• A fire burning in an enclosed room with
poor ventilation presents a very dangerous
hazard since it can create a build-up of
carbon monoxide in the air.
• Some carbon monoxide binds to
hemoglobin when smoking tobacco.
 Medical Treatments for
Blood Pathologies
Blood products
• Blood for
transfusion is
obtained from
human donors by
blood donation and
stored in a blood
bank.
• Transfusion of blood of an incompatible
blood group may cause severe, often fatal,
complications, so crossmatching is done to
ensure that a compatible blood product is
transfused.
Intravenous Administration
• Other blood products administered
intravenously are platelets, blood plasma,
and specific coagulation factor
concentrates.
• Many forms of medication (from
antibiotics to chemotherapy) are
administered intravenously, as they are
not readily or adequately absorbed by
the digestive tract.
• After severe acute blood loss, liquid
preparations, generically known as plasma
expanders, can be given intravenously,
either solutions of salts (NaCl, KCl, CaCl2 etc...) at
physiological concentrations, or colloidal solutions,
such as dextrans, human serum albumin, or fresh
frozen plasma
• In these emergency situations, a plasma
expander is a more effective life saving
procedure than a blood transfusion,
• because the metabolism of transfused red
blood cells does not restart immediately
after a transfusion.
 Bloodletting
• In modern evidence-based medicine
bloodletting is used in management of a
few rare diseases.
• However, bloodletting and leeching were
common unvalidated interventions used
until the 19th century, as many diseases
were incorrectly thought to be due to an
excess of blood, according to Hippocratic
medicine.
Common Diseases
• Angina
• Atherosclerosis
• Coronary artery disease
• Heart attack
• Stroke
• High blood pressure
• Congestive heart failure
• Atrial fibrillation
• Varicose veins
• Spider veins
• Raynaud's phenomenon
 Cardiovascular Disease

• Cardiovascular disease refers to the

class of diseases that involve the heart
and/or blood vessels (arteries and veins).
 Hypertension
• Hypertension or high blood pressure is a
medical condition wherein the blood
pressure is chronically elevated.
• Persistent hypertension is one of the risk
factors for strokes, heart attacks, heart
failure and arterial aneurysm, and is a
leading cause of chronic renal failure
Blood Pressure
Desirable blood pressure

• Desirable Blood Pressure

For Healthy Adults
• 120 systolic / 80 diastolic
• Any blood pressure reading that
consistently stays at 140/90 or
higher is considered high blood
pressure.
 Causes

• It might be due to a narrowing of the arteries,

more blood than normal, or the heart beating
more forcefully or faster than it usually should.
• In most people, the specific cause
causes of high blood pressure are not known. This
is called primary or essential hypertension. In
other people, the condition is the result of
another medical problem or medication. When the
cause is known, this is called secondary high blood
pressure or secondary hypertension.
 Risk Factors

• While for most people there is no known

cause of high blood pressure, there are
factors that can increase a person's
chance of developing it. Some of these risk
factors cannot be controlled, including:
• Being a male over the age of 45 or a
female over the age of 55
• Having a family history of the condition.
• However, some risk factors can be controlled,
including:
• Being overweight or obese
• Being physically inactive
• High salt (sodium) intake
• Low potassium intake (due to not eating enough
fruits and vegetables)
• Excessive alcohol consumption
• Having diabetes
• Having prehypertension (that is, blood pressure in
the 120-139/80-89 mmHg range).
 Symptoms
• Most people with high blood pressure don't have any
symptoms. This is because the condition doesn't cause
problems over a day or weeks, or even months. It usually
takes several years for high blood pressure to cause
noticeable symptoms, and even when it does cause problems,
the symptoms are often mild and nonspecific (meaning they
could be caused by several different conditions). For this
reason, high blood pressure is often referred to as "the
silent killer." People with the condition typically don't even
realize they have it until they have blood pressure readings
that are too high
 Low blood pressure
• It is rare that a person has blood pressure
that is too low.
• For some young or small people, a blood
pressure reading of 90/70 or even 80/60
is perfectly normal and healthy.
• When their blood pressure is really too
low, people feel dizzy or light headed
every time they stand up, or they always
feel tired and lacking energy.
 Atherosclerosis
• Atherosclerosis is a
disease affecting the
arterial blood vessel.
• It is commonly
referred to as a
"hardening" or
"furring" of the
arteries.
• It is caused by the formation of multiple
plaques within the arteries
• Plaque is an abnormal inflammatory
accumulation of macrophage white blood
cells within the walls of arteries.
• Arteriosclerosis ("hardening of the
artery") results from a deposition of
tough, rigid collagen inside the vessel wall.
• This increases the stiffness, decreases
the elasticity of the artery wall.
 Understanding Plaque
• Plaque is made up of fat, cholesterol, calcium, and other
substances found in your blood. As it grows, the buildup of
plaque narrows the inside of the artery and, in time, may
restrict blood flow. Plaque can be either:
• Hard and stable
• Soft and unstable.
• Hard plaque causes the artery walls to thicken and harden.
• Soft plaque is more likely to break apart from the walls and
enter the bloodstream. This can cause a blood clot that can
partially or totally block the flow of blood in the artery.
When this happens, the organ supplied by the blocked artery
starves for blood and oxygen. The organ's cells may either
die or suffer from severe damage.
• Atherosclerosis can develop in any blood
vessel, but the most common locations
for narrowing and hardening of the
arteries include the:
• Heart
• Brain
• Legs, pelvis, or arms
• Kidneys.
• It most commonly becomes seriously
symptomatic when interfering with the
coronary circulation supplying the heart
or cerebral circulation supplying the
brain,

• Atherosclerosis is considered the most

important underlying cause of strokes,
heart attacks, various heart diseases.
 Causes
• Heart disease research doctors and scientists do not
know the exact cause or causes of atherosclerosis.
Scientists think that the buildup of plaque starts when
the lining of the artery is damaged or injured, but they
are not sure why and how the artery becomes damaged
in the first place.

• Scientists are also unsure of when atherosclerosis

begins. They do know that it is a slow and complex
disease that may start in childhood. They also think that
atherosclerosis develops faster as people grow older.
 Risk Factors
• Risk factors are conditions or behaviors that increase your
chances of getting a certain disease. For atherosclerosis, the
risk factors happen to be the same as those for
heart disease.
• Risk factors for atherosclerosis include:
• Age (risk increases with age)
• Having close relatives with heart disease at younger ages
• High cholesterol levels, also called hypercholesterolemia
• High blood pressure, also called hypertension
• Diabetes
• Being overweight or obese
• Lack of physical activity
• Cigarette smoking.
 Symptoms

• The symptoms of atherosclerosis depend

on which part of the body is not receiving
enough blood and oxygen due to the
narrowed artery or arteries.
Atherosclerosis symptoms take some time
to develop, as the disease must progress
to the point where an artery is severely
narrowed or completely blocked.
 Making a Diagnosis
• There is no single test to diagnose
atherosclerosis. Therefore, in order to help make
an atherosclerosis diagnosis, healthcare
providers ask a number of questions and perform
a physical exam, looking for signs and symptoms
of the condition.
• They also recommend certain tests and/or
procedures to identify atherosclerosis or its
complications. Doctors uses physical exam
results, risk factors, family history, and
symptoms to decide which test or tests to order
 Effects
• Atherosclerosis is a slow, progressive disease that may
start in childhood. As mentioned, it can affect the arteries
of the brain, heart, kidneys, and the arms and legs. As
plaque builds up, it can cause serious diseases and
complications. These include:
• Coronary artery disease
• Angina
• Heart attack
• Sudden death
• Cerebrovascular disease, such as a stroke or
transient ischemic attack (TIA), also known as a "mini
stroke"
• Peripheral arterial disease (PAD).
 Stroke
• A stroke is a sudden episode that may affect
consciousness, sensation, and movement, which results
from a blockage or rupture of a blood vessel in the
brain. It causes symptoms that last for at least 24
hours. A stroke (known medically as a cerebrovascular
accident or CVA) occurs when the blood supply to part
of the brain is suddenly interrupted or when a blood
vessel in the brain bursts, spilling blood into the
spaces surrounding brain cells. Brain cells die when
they no longer receive oxygen and nutrients from the
blood or there is sudden bleeding into or around the
brain.
 Types of Stroke
• There are two main types –
• ischemic and hemorrhagic.
• The ischemic type occurs when there is a lack of
oxygen- or nutrient-rich blood to a part of the brain for
a long enough period of time that brain tissue dies. This
lack of blood flow occurs because of a severely
narrowed or blocked artery in the neck or brain. The
ischemic type makes up 80 percent of all cases.
• The second type is a hemorrhagic stroke. This type
occurs because of bleeding in the brain from a broken
blood vessel. For each type -- ischemic and hemorrhagic
-- the causes can vary.
 Ischemic Stroke

 In ischemic stroke,, a blood vessel

becomes occluded and the blood
supply to part of the brain is totally
or partially blocked.
 Ischemic stroke is commonly divided
into thrombotic stroke, & embolic
stroke.
 Hemorrhagic Stroke
 A hemorrhagic stroke, or cerebral
hemorrhage, is a form of stroke that
occurs when a blood vessel in the brain
ruptures or bleeds.
 Like ischemic strokes, hemorrhagic
strokes interrupt the brain's blood
supply because the bleeding vessel can
no longer carry the blood to its target
tissue.
 In addition, blood irritates brain tissue,
disrupting the delicate chemical balance.
 In this respect, hemorrhagic strokes
are more dangerous than their more
common counterpart, ischemic
strokes.
 There are two types of hemorrhagic
stroke: intracerebral hemorrhage,
and subarachnoid hemorrhage.
 Risk Factors
• Risk factors are conditions or behaviors that increase
your chances of getting a certain disease. Some risk
factors can be treated or controlled, and some cannot.
 Risk factors for this condition that you cannot
change include:
• Age (the risk tends to increase with age)
• Gender (men are more likely to have a stroke, but
women are more likely to die of one)
• Race/ethnicity (African Americans are more likely to
have a stroke than people from other ethnic groups)
• Family history of stroke
• Personal history of a stroke, TIA, or heart attack.
 Some of the most important treatable or controllable risk
factors are:
• High blood pressure (hypertension)
• Smoking
• High cholesterol (hypercholesterolemia)
• Atrial fibrillation
• Certain heart diseases
• Diabetes
• Carotid artery disease
• Sleep apnea
• Heavy consumption of alcohol
• Drug abuse.
 Symptoms
• Symptoms of a stroke can include:
• Sudden numbness or weakness (especially on one
side of the body)
• Sudden confusion, or trouble speaking or
understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble with walking, dizziness, or loss of
balance or coordination
• Sudden severe headache with no known cause.
 How it is Diagnosed
• In order to make a diagnosis, a healthcare provider will
typically begin by asking a number of questions (such
as those concerning the patient's medical history) and
perform a physical exam. If the healthcare provider
believes that a person has had a stroke, he or she may
order additional tests. After a doctor has made a
diagnosis, he or she may recommend other tests to
help determine the cause of the stroke.
• Some tests that doctors may use for diagnosing a
stroke and/or identifying its cause include:
• CT scan
• Magnetic resonance imaging (MRI)
• Carotid Doppler ultrasound
• Carotid arteriography
• Cerebral angiography (also known as a cerebral
angiogram, cerebral arteriogram, or digital subtraction
angiography)
• Magnetic resonance angiogram (MRA) or functional
magnetic resonance imaging (fMRI)
• Transcranial Doppler
• Electrocardiogram (EKG)
• Echocardiogram
• Lumbar puncture
• Electroencephalography (EEG).
 Effects

• Generally, a stroke can cause five types of

disabilities, which include:
• Paralysis or problems controlling movement
s
• Sensory disturbances (including pain)
• Problems using or understanding language
• Problems with thinking and memory
• Emotional disturbances.
 Treatment for Stroke

• If symptoms of stroke are detected at

early on-set, special "clot busting" drugs
may be administered.
• These clot busters will dissolve clots
before they can cause tissue death and
restore normal circulation.
 Atrial Fibrillation
• Atrial fibrillation is a type of abnormal heart rhythm
-- also known as an arrhythmia. Sometimes, the
condition is called "a-fib" for short. It occurs when
something goes wrong with the heart's electrical
control system.
• Because it can be scary to experience an episode of
atrial fibrillation, a lot of people worry that they are
having a heart attack, or will have one later. But the
condition is different from a heart attack. By itself,
atrial fibrillation is rarely life-threatening, although
its complications can be, and having it doesn't mean
that you will have a heart attack in the future.
• Atrial fibrillation is the most common form of
abnormal heartbeat. Each year, more than two
million people in the United States are
diagnosed with the condition. Most of them
find that their symptoms can be controlled
with proper treatment. Atrial fibrillation is
more common in men than in women. It is also
more common in older people than in the rest
of the population.
 Types
• There are several different types of
atrial fibrillation. These include:s
• Primary atrial fibrillation
• Chronic atrial fibrillation
• Paroxysmal atrial fibrillation
• Persistent atrial fibrillation
• Permanent atrial fibrillation
• Primary Atrial Fibrillation
• One type of atrial fibrillation is
called primary, or lone, atrial
fibrillation. It's referred to this way
because the cause of primary atrial
fibrillation can't be identified. It is
usually seen in people who are
between the ages of 30 and 50.
• Chronic Atrial Fibrillation
• More frequently, atrial fibrillation is associated
with an existing heart problem and becomes an
ongoing problem. This is called chronic atrial
fibrillation. It's usually seen in older adults, and
often doesn't go away, even with treatment.
• Atrial fibrillation types can be classified even
further, according to how long the episodes of
fibrillation last and how often they happen. You
may hear your doctor use the words "paroxysmal,"
"persistent," or "permanent" to describe the type
of atrial fibrillation that you have.
• Paroxysmal Atrial Fibrillation
• In cases of paroxysmal atrial fibrillation, the
irregular rhythm occurs periodically. The human
heart returns to the normal sinus rhythm on its
own -- in a few minutes, hours, or days. People who
have this type of atrial fibrillation may have
episodes only a few times a year or every day.
When these episodes begin and end is usually
unpredictable, which can be very unsettling. About
1 in 4 people with paroxysmal atrial fibrillation
eventually develop the permanent form of the
condition
• Persistent Atrial Fibrillation
• Persistent atrial fibrillation is characterized by
an irregular rhythm that lasts for longer than 48
hours. This type of atrial fibrillation will not
return to a normal sinus rhythm on its own, but
will in response to certain types of treatment.

• Permanent Atrial Fibrillation

• Permanent atrial fibrillation occurs when the
irregular rhythm continues indefinitely and can no
longer be corrected with treatment
 Risk Factors
• Atrial fibrillation can make it hard for the heart to
pump enough blood to keep up with the body's demands.
• The condition is often associated with existing heart
problems. Other causes of atrial fibrillation may
include:
• Uncontrolled high blood pressure (hypertension)
• Thyroid problems
• Lung problems
• Diabetes
• Overuse of alcohol.
 Varicose Veins
• Varicose veins are enlarged veins that can be flesh-
colored, dark purple, or blue. They often look like
cords, and appear twisted and bulging. They are swollen
and raised above the surface of the skin. Varicose
veins are commonly found on the backs of the calves or
on the inside of the leg. During pregnancy, varicose
veins called hemorrhoids can form in the vagina or
around the anus.
• About 50 to 55 percent of American women and 40 to
45 percent of American men suffer from some form of
vein problem. Varicose veins affect 1 out of 2 people
age 50 and older.
 Causes
• The cause of varicose veins is a
weakening of one-way valves within
the veins. When these valves weaken,
blood can leak back in the vein and
collect there and enlarge the vein.
 Gravity and Varicose Veins
• The force of gravity, the pressure of body
weight, and the task of carrying blood from
the bottom of the body up to the heart make
legs the primary location for varicose and
spider veins. Compared with other veins in the
body, leg veins have the toughest job of
carrying blood back to the heart. They endure
the most pressure. This pressure can be
stronger than the veins' one-way valves.
 Risk Factors
• While not causes of varicose veins, there
are a number of factors that increase a
person's chances for developing weakened
valves. These are known as risk factors.
The more risk factors a person has, the
greater their chances for developing the
condition.
• Risk factors for varicose veins include:
• Increasing age
• Genetics
• Hormonal changes
• Pregnancy
• Obesity
• Leg injury
• Prolonged standing.
 Symptoms
• Symptoms of varicose veins include
swollen, aching legs that feel "heavy,"
numbness in the legs, and itching or a
rash on the legs. If left untreated,
varicose veins can become more severe,
which in turn, makes the symptoms more
severe -- they can even lead to other
health problems, such as blood clots
 Spider Veins
• spider veins are similar to varicose veins,
they are smaller and closer to the
surface of the skin. These veins are
often red or blue, and they can look like
tree branches or spider webs with their
short, jagged lines. Spider veins can be
found on the legs and face. They can
cover either a small or large area of skin.
 Causes
• The backing up of blood in the veins is the cause of spider
veins.
• The heart pumps blood filled with oxygen and nutrients to
the body. Arteries carry blood from the heart toward the
body parts. Veins carry oxygen-poor blood from the body
back to the heart.
• The squeezing of leg muscles pumps blood back to the
heart from the lower body. Veins have valves that act as
one-way flaps. These valves prevent the blood from flowing
backwards as it moves up the legs. If the one-way valves
become weak, blood can leak back into the vein and collect
there. This problem is called venous insufficiency.
 Risk Factors
• Risk factors are things that increase the chances of
developing a health condition. The more risk factors
you have for a particular condition, the greater your
chances of developing it. Risk factors for spider veins
include:
• Increasing age.
• Having family members with vein problems or being
born with weak vein valves.
• Hormonal changes. These occur during puberty,
pregnancy, and menopause. Taking birth control pills
and other medicines containing estrogen and
progesterone also increases the risk of varicose or
spider veins.
• Pregnancy. During pregnancy, there is a huge
increase in the amount of blood in the body,
which can cause veins to enlarge. The expanding
uterus also puts pressure on the veins. Spider
veins usually improve within three months after
delivery. A growing number of abnormal veins
usually appear with each additional pregnancy.
• Obesity, leg injury, prolonged standing, and
other things that weaken vein valves.
• Sun exposure, which can cause spider veins on
the cheeks or nose of a fair-skinned person.
 Raynaud's phenomenon
• Raynaud's phenomenon is a condition that is
characterized by the contraction of blood vessels
in the extremities (fingers and toes). Raynaud's
disease, the most common form of the disorder,
is defined by episodic attacks that cause small
blood vessels to constrict. Although there is no
cure for the condition, treatment typically
focuses on reducing the number and severity of
attacks, as well as preventing tissue damage and
loss.
 Causes

• No one knows the exact cause of

Raynaud's phenomenon and why there
is a sudden spasmodic contraction of
the small blood vessels when exposed
to cold. Finding the cause or causes of
this condition continues to be an active
area of Raynaud's research
 What Triggers it?

• For most people, an attack is usually

triggered by exposure to cold or
emotional stress. In general, attacks
affect the fingers or toes, but may
also affect the nose, lips, or ear
lobes.
 Symptoms
• During an attack, the symptoms of
Raynaud's phenomenon are caused by
reduced blood supply to the extremities.
• Once the attack begins, a person may
experience symptoms to the affected area
that includes:
• Coldness
• Changes in skin color
• Numbness
• Throbbing
• Tingling.
• During an attack, symptoms can last from less
than a minute to several hours.
• The period of exposure to the cold is
extremely critical, because it only takes about
20 to 30 minutes of exposure to the cold to
cause potentially serious problems, such as
tissue damage. This can lead to ulcers on the
fingertips and, if left untreated, even
gangrene. Bone damage may also ensue.
 Heart Attack
• Acute myocardial infarction (AMI or MI),
commonly known as a heart attack, A heart
attack occurs when the supply of blood and
oxygen to an area of heart muscle is
blocked, usually by a clot in a coronary
artery.
• Often, this blockage leads to arrhythmias
(irregular heartbeat or rhythm) that cause
a severe decrease in the pumping function
of the heart and may bring about sudden
death.
• If the blockage is not treated within a
few hours, the affected heart muscle will
die and be replaced by scar tissue.

• It is the leading cause of death for both

men and women all over the world
 Angina Pectoris

• Angina Pectoris is chest pain due to

ischemia (a lack of blood and hence
oxygen supply) of the heart muscle,
• generally due to obstruction of the
coronary arteries (the heart's blood
vessels).
 Coronary Bypass
• Coronary artery bypass graft surgery or heart
bypass are surgical procedures performed on
patients with coronary artery disease for the
relief of angina and possible improved heart
muscle function.
• Veins or arteries from elsewhere in the
patient's body are grafted from the aorta to
the coronary arteries, bypassing coronary
artery narrowing caused by atherosclerosis
and improves the blood supply to the
myocardium (heart muscle).
Congestive heart failure
• Congestive heart failure (CHF), also called
congestive cardiac failure (CCF) or just
heart failure, is a condition that can result
from any structural or functional cardiac
disorder that impairs the ability of the
heart to fill with or pump a sufficient
amount of blood throughout the body.
 Congenital Heart
Defects
• Heart defects present at birth are
called congenital heart defects.
• Slightly less than 1% of all newborn
infants have congenital heart disease.
 Interesting Facts

• Recent research suggests that taking a

small dose of aspirin daily may help
prevent a heart attack (because aspirin
inhibits platelet clumping).
• 16.7 million deaths are result forms of
cardiovascular disease, heart disease and
stroke.
• The length of all your blood vessels lined
up is about 60,000 miles long! Farther
than the distance between California and
Asia which is about 13,000 miles! Blah
• The total length of capillaries in an
average adult human is approximately
25,000 mi (42,000 km).
• Stress, foods rich in fat and alcohol are
just some risk factors of developing
heart disease.
 Ways To A Healthy
Heart
• Eating healthy,
good nutrition

• Fitness and
Exercise
• Reduce the fat,
sodium, and
calories in your
diet.
• Having a
healthy
lifestyle.

• Don't smoke
• Watch cholesterol
and blood pressure