Unmasking the Rise of Cardiovascular Diseases-MI

In recent years, with the accelerated pace of social life, work pressure, and the prevalence of bad habits, the proportion of people with high blood pressure has gradually increased, and the incidence of cardiovascular diseases in society has also gradually climbed, which myocardial infarction has become the focus of people’s concern. Cardiovascular disease (CVD) and breast cancer (BC) are significant causes of mortality globally, imposing a substantial health burden. The common risk factors for cardiovascular disease, such as hypertension, diabetes, obesity, aging, and physical inactivity, are discussed, emphasizing their modifiability. (Obeidat, O., Charles, K. R., Akhter, N., & Tong, A. 2023)

This topic will focus on the pre-symptoms, causes, and effective prevention methods of cardiovascular diseases, especially myocardial infarction, to draw attention and vigilance to heart health.

Reasons for the increase of cardiovascular diseases in society

The fast-paced life of modern society, high-pressure work, intense competition, poor dietary habits, and lack of exercise have created favorable conditions for the increase of cardiovascular diseases. Studies have shown that poor lifestyles, such as excessive stress, diets high in fats and sugar, and long-term lack of exercise, are directly and closely related to the occurrence of cardiovascular diseases. Today, there is also a gradual increase in the number of people with high blood pressure, which is usually a silent disease; as a result, people with high blood pressure may fail to recognize the severity of their condition and thus fail to follow a treatment plan. The result is usually a heart attack or stroke. Hypertension may also lead to aneurysms (swelling of blood vessels due to weak vessel walls), peripheral arterial disease (blockage of blood vessels in the body’s peripheral regions), chronic kidney disease, or heart failure.

Pre-symptoms of myocardial infarction

Pre-myocardial infarction symptoms are often the “yellow light” of the disease, reminding us to pay attention to heart health. Common symptoms include:

  • Chest pain or discomfort: The patient may feel heaviness or pressure in the chest or experience severe chest pain.
  • Shortness of breath: Difficulty breathing and shortness of breath are typical symptoms of myocardial infarction.
  • Pain or discomfort in arms or shoulders
  • Feeling weak, lightheaded, or faint
  • Pain or discomfort in the jaw, neck, or back
  • Cold sweats and nausea: Patients may experience cold sweats, nausea, and vomiting, accompanied by dizziness and lightheadedness at times.
  • Stomach or abdominal discomfort.
  • Irregular heartbeat: palpations

 (Birnbach, B., Höpner, J., & Mikolajczyk, R. 2020).

This figure traces the sequential flow of blood through the chambers of the heart and blood vessels of the body. The heart is a double pump, with each side supplying its own circuit. Each side pumps at the same time. - Pulmonary circuit: oxygen-poor blood returns from body tissues back to the heart via the superior vena cava (SVC), inferior vena cava (IVC), and coronary sinus. It enters the right atrium of the heart and moves through the tricuspid valve to the right ventricle, then through the pulmonary semilunar valve to the pulmonary trunk. Two pulmonary arteries carry the oxygen-poor blood to the lungs to be oxygenated. This is the pulmonary circuit. - Systemic circuit: in the pulmonary capillaries in the lungs, blood takes on oxygen to become oxygen-rich, then returns to the heart via the four pulmonary veins. It enters the left atrium of the heart, then travels through the mitral valve to the left ventricle, then through the aortic semilunar valve to the aorta. Arteries branch from the aorta to carry the oxygen-rich blood to body tissues where in the systemic capillaries of the body, blood gives off oxygen while taking on waste products. Oxygen-poor again, the blood enters the venules and veins to be carried back to the heart. It enters the right atrium of the heart and the cycle begins again. Know the path of blood through the heart and circulatory system(Unit11 Cardiovascular and Circulatory Systems Objectives)：

Blood enters the right atrium from the somatic circulation through the superior vena cava and inferior vena cava, then is pushed into the right ventricle, enters the pulmonary circulation through the pulmonary artery, becomes oxygenated blood after gas exchange through the pulmonary capillaries, returns to the left atrium, then is pushed into the left ventricle, and finally enters the somatic circulation through the aorta, which transports the oxygenated blood to all tissues and organs of the body. The heart plays a vital role in maintaining normal body functions.  (Lecture note: Cardiovascular and Circulatory Systems P25 see attached picture)

Causes of Heart Attack

Myocardial infarction (MI) is the official term for what is commonly referred to as a heart attack. Myocardial infarction is usually caused by a lack of blood flow and oxygen to the region of the heart, resulting in the death of heart muscle cells. Myocardial infarction usually occurs when a buildup of atherosclerotic plaque consisting of lipids, cholesterol, fatty acids, and white blood cells blocks the coronary arteries. Myocardial infarction also occurs when a portion of unstable atherosclerotic plaque crosses the coronary artery system and blocks one of the smaller vessels. The resulting blockage restricts blood and oxygen flow to the heart muscle, resulting in the death of heart muscle tissue. (Anatomy and Physiology 2e 19.1 Heart Anatomy)

What is the connection between heart disease, such as heart attack, and blood circulation pathways?

Heart disease is usually caused by impeded circulation or an inadequate blood supply. As mentioned above, blood circulates through the heart, which acts as the body’s pumping mechanism to transport blood throughout the body while delivering oxygen to all parts.

In heart attacks and other heart diseases, insufficient blood supply to the arteries leads to ischemia or necrosis of the heart muscle. This ischemia or necrosis is usually caused by coronary artery disease (e.g., atherosclerosis), which leads to narrowing or blockage of the coronary arteries, preventing the heart from receiving adequate oxygen and nutrients. Therefore, the close relationship between heart disease and blood circulation pathways means that the progression and severity of heart disease is closely related to the smoothness of blood circulation.

Ways to prevent heart disease.

  • Take beta-blockers on time: Medications prescribed by your doctor should be taken regularly to help control blood pressure and reduce the burden on your heart.
  • Reduce salt intake: Excessive salt intake is closely associated with high blood pressure, and a moderate reduction in salt intake is essential for heart health.
  • Maintain good fitness habits to stay in shape: Regular moderate aerobic exercise and weight control can help maintain a healthy cardiovascular system.
  • Eat plenty of fruits and vegetables: Fruits and vegetables rich in vitamins, minerals, and fiber can help lower cholesterol levels and maintain a healthy heart.
  • Seek medical advice if you have any discomfort: If you experience chest pain, shortness of breath, or other unusual symptoms, it is vital to seek medical advice promptly and undergo a thorough physical examination to ensure early detection and treatment.

By focusing on cardiovascular diseases, raising public awareness of heart health, and taking proactive and effective preventive measures, we can better protect our hearts, reduce the incidence of cardiovascular diseases, and embrace a healthier and more fulfilling life. Let’s work together to make heart health the bottom line of life.

Citation:

Anatomy and Physiology 2e 19.1 Heart Anatomy & 20.4 Homeostatic Regulation of the Vascular System

Birnbach, B., Höpner, J., & Mikolajczyk, R. (2020). Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review. BMC Cardiovascular Disorders, 20, 1-12.Explain the structure and function of the heart.

Obeidat, O., Charles, K. R., Akhter, N., & Tong, A. (2023). Social Risk Factors That Increase Cardiovascular and Breast Cancer Risk. Current Cardiology Reports, 25(10), 1269-1280.

Lecture note: Cardiovascular and Circulatory Systems P25

Different Part of the Brain and the functions

https://youtu.be/j3deh1O_5V8

Among the most prevalent disorders affecting the neurological system in the elder persons, epilepsy ranks 2nd only to stroke and demnetia. Old age epilepsy, which begins before the age of 60 and continues into old age, and new-onset epilepsy in the elderly are both included in geriatric epilepsy. Older adults’ quality of life is greatly diminished and societal health care resource burden is amplified by epilepsy, particularly late-onset epilepsy.The risk of acquiring epilepsy and seizures is highest among the elderly. Seizures and epilepsy are more common in those aged 60 and up compared to younger age groups. An estimated 85 per 100,000 for those aged 65–69, 159 per 100,000 for those aged 80 and more, and 80.8 per 100,000 for all age groups is the yearly incidence.According to a recent epidemiological study, there is an average of 240 cases of epilepsy per 100,000 people aged 65 and up per year. It is in the elderly that about 25% of cases of new-onset epilepsy develop. By 2020, half of all persons with new-onset epilepsy will be old, according to some researchers. (Lü et al., 2016)

Epilepsy and Seizures in Untreated Alzheimer’s Disease

Clinical seizures will emerge in a small percentage of AD patients over the course of the disease, but this has been known for decades. Between 1.5% and 64.0% of AD patients experienced an unprovoked seizure, according to both prospective and retrospective investigations [7–19]. The proportions tend to be lower, according to more recent, bigger, prospective research. There was a greater incidence of first seizure among individuals with clinically diagnosed Alzheimer’s disease compared to nondemented patients, with an odds ratio of approximately 6, in a study that examined all patients over the age of 55 in Rochester, Minnesota, who had their first unprovoked seizure between 1955 and 1984.

 

 

Seizures and epilepsy in families with AD

After taking disease duration and severity into consideration, it is unclear if the prevalence of seizures is higher in family instances compared to random cases, and not all affected individuals appear to have seizures. In a study including familial AD caused by presenilin-2 mutations, 30% of patients experienced seizures.Amyloid precursor protein (APP) duplications are associated with an increased risk of seizures; in fact, 57 percent of those affected in one research including five families had seizures.

Emergence of epilepsy in the elderly due to acquired factors

  • Among the many known causes of new-onset epilepsy in the elders, 30%-50% can be attributed to cerebrovascular disorders such as stroke.; Typically, epilepsy can happen either before or after a stroke, or it might be a first sign of a cerebrovascular disease.
  • Rather of coming from totally infarcted areas, multiple investigations have shown that partial destruction is more common as a genesis for seizures. Epilepsy risk factors include hemorrhagic transformation of ischemic stroke, which may be associated with breakdown of the blood-brain barrier.( Lü et al., 2016)
  • Epilepsy can be caused by a variety of circulatory system illnesses, including huge vessel diseases, microvascular diseases, and small vessel diseases of the central nervous system. Even in the absence of stroke, radiographic evidence confirms that risk factors of cerebrovascular diseases—including hypertension, dyslipidemia, coronary and peripheral artery disease—are linked to epilepsy.

 

 

Brain Activity and Epilepsy

Epileptiform surface Seizures and other EEG abnormalities in Alzheimer’s disease patients, are rare. Few AD seizure observational studies provided EEG results, and many patients were not tested . In these trials, some seizure patients and those without seizures had epileptiform discharges. Few research have explored epileptiform discharges in AD/dementia patients. examined 1674 memory problems clinic patients’ regular EEGs. Epileptiform discharges (spikes or sharp waves) were identified in 3%, 26% of whom had epilepsy. Most discharges were focused and temporal. On discharge, 25% of patients had no clinical indication of epilepsy. Follow-up seizures were documented in two (17%) of this small sample. In another study, severe AD patients and ApoE4-positive relatives had elevated theta and delta activity and strong waves on their EEGs . The incidence and localization of epileptiform anomalies were not reported, and the authors did not provide examples. Epileptiform discharges are rare in AD and memory clinic patients, even in those with seizures, which may be because elderly people are less likely to exhibit interictal discharges on normal EEGs . Only 36% of new-onset epilepsy patients in an elderly cohort had such discharges .

Generalized convulsions

SE is a neurological emergency characterized by seizures characterized by convulsions without full awareness recovery lasting more than 10 minutes. In practical practice, elderly SE is prevalent. In a retrospective analysis, 7.5% of 60-year-olds had SE.69 Drug use is often linked to SE. SE can develop in 15% of drug-induced seizures, especially with antibiotics.( Friedman et al., 2011)

 

Penicillins, cephalosporins, carbapenems, and quinolones can cause SE, especially when given intravenously in individuals with liver or kidney disease at high doses. Inhibitors of benzodiazepine and gamma-aminobutyric acid receptors include quinolones and beta-lactam antibiotics, respectively cause epileptogenesis from N-methyl-D-aspartate Cephalosporins including ceftriaxone, ceftazidime, cefotaxime, and cefepime can cause SE. Ipenem causes more seizures than meropenem. SE has been recorded with ciprofloxacin, ofloxacin, and gatifloxacin.

In renally impaired patients, prevent seizures when used with the appropriate dosage of an antibiotic with a low epileptogenic potential. Patients at risk of seizures due to central nervous system lesions and renal or hepatic impairment may benefit from aminoglycosides, azithromycin, vancomycin, clindamycin, or teicoplanin, since these medications have no SE reports.

 

 

Refrence:

Lü, Y., Liu, S., & Yu, W. (2016). The causes of new-onset epilepsy and seizures in the elderly. Neuropsychiatric Disease and Treatment, 12, 1425.

Friedman, D., Honig, L. S., & Scarmeas, N. (2011). Seizures and Epilepsy in Alzheimer’s Disease. CNS Neuroscience & Therapeutics, 18(4), 285–294.

 

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