DIPLOMA IN ELECTRICAL ENGINEERING (MEDICAL)

DEU30023-ANATOMY AND PHYSIOLOGY

LECTURER: PUAN WEE SOO LEE

CASE STUDY 2
(CARDIOVASCULAR SYSTEM)

PREPARED BY:
1) NUR ELYANA BINTI ZURAIWAN (08DEU21F1097)
2) NURFAZLIN BINTI MD YAMIN KHAN (08DEU21F1083)
3) HAZREEN HAZWANY BINTI HAZLEE EFFENDDY
(08DEU21F1110)
INTRODUCTION

The cardiovascular system consists of the heart, blood vessels, and blood. Its

primary function is to transport nutrients and oxygen-rich blood to all parts of the

body and to carry deoxygenated blood back to the lungs.

 The heart is the muscular organ that pumps blood through the circulatory system and the
rest of the body. It is vital for carrying oxygenated blood from the lungs to the different
tissues of the body, as well as for taking waste products and deoxygenated blood away
from the tissues. The human heart is located between the lungs in the thoracic cavity,
slightly towards the left of the sternum (breastbone). The heart also ensures that adequate
blood pressure is maintained in the body.
TYPES OF BLOOD VESSELS
1) Arteries are blood vessels that carry oxygenated blood away from the heart and the
tissue of the body, except the artery pulmonary which carries deoxygenated blood.
Because of their role, arteries contain higher pressure levels compared to veins. This is
why the arterial blood flow is one-directional and does not have valves.
2) Veins are blood vessels that bring deoxygenated blood and waste products from the
body’s tissue and back to the heart except for pulmonary veins. Veins contain valves
that keep the venous blood flow in one direction.
3) Capillaries are the smallest of a body’s blood vessels and are known as “bridges”
between arteries and veins. Capillaries have thin walls that are required to exchange the
oxygen and nutrients to sustain the cells, as well as waste products and carbon dioxide
that cells excrete.
BLOOD FLOW PATHWAY

Figure A

RIGHT-HAND SIDE OF THE HEART

The right side of the heart receives deoxygenated blood from the superior vena cava and the
inferior vena cava into the right atrium. The superior vena cava comes from the upper part of
the body, including the brain and arms, while the inferior vena cava comes from the abdominal
area and legs.

The atrium is the top two chambers of the heart that receive incoming blood from the body.
The right atrium receives deoxygenated blood through the superior and inferior vena cava from
the body and pumps it to the right ventricle through the tricuspid valve, which opens to allow
the body to flow through and closes to prevent blood backing up the atrium.

The right ventricle receives oxygen-poor blood from the right atrium and pumps it through the
pulmonic semilunar valve to the pulmonary artery and into the lungs.
LEFT-HAND SIDE OF THE HEART
Pulmonary veins bring the oxygenated blood from the lungs to the left atrium of the heart.
Then, the left atrium pumps the blood to the left ventricle via the mitral valve (bicuspid valve).
The left ventricle pumps the oxygenated blood to the aorta via the aortic valve. The aortic
valve prevents the blood to back up the left ventricle. Aorta is known as the largest artery of
the body. It pumps the oxygenated blood to the rest of the body through systemic circulation.
The aorta has thick, elastic walls in order to maintain blood pressure.

HEART SOUND
Heart sounds are the noises generated by the beating heart and the resultant flow of blood
through it. Specifically, the sound reflects the turbulence created when the heart valves snap
shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and
distinct sounds that provide important auditory data regarding the condition of the heart.

The first heart sound, or S1, forms the "lub" of "lub-dub" and is composed of components
M1 (mitral valve closure) and T1 (tricuspid valve closure). Normally M1 precedes T1 slightly. It is
caused by the closure of the atrioventricular valves : tricuspid and mitral (bicuspid), at the
beginning of ventricular contraction, or systole. When the ventricles begin to contract, so do the
papillary muscles in each ventricle. The papillary muscles are attached to the cusps or leaflets of
the tricuspid and mitral valves via chordae tendineae (heart strings). When the papillary muscles
contract, the chordae tendineae become tense and thereby prevent the backflow of blood into the
lower-pressure environment of the atria. The chordae tendineae act a bit like the strings on a
parachute, and allow the leaflets of the valve to balloon up into the atria slightly, but not so much
as to evert the cusp edges and allow backflow of blood. It is the pressure created from ventricular
contraction that closes the valve, not the papillary muscles themselves. The contraction of the
ventricle begins just prior to the AV valves closing and prior to the opening of the semilunar
valves. The sudden tensing of the chordae tendineae and the squeezing of the ventricles against
closed semilunar valves, send blood rushing back toward the atria, and the parachute-like valves
catch the rush of blood in their leaflets causing the valve to snap shut. The S1 sound results from
reverberation within the blood associated with
the sudden block of flow reversal by the
valves. The delay of T1 even more than
normally causes the split S1 which is heard in
a right bundle branch block.

The second heart sound, or S2, forms the "dub" of "lub-dub" and is composed of components
A2 (aortic valve closure) and P2 (pulmonary valve closure). Normally A2 precedes P2 , especially
during inspiration where a split of S 2 can be heard. It is caused by the closure of the semilunar
valves (the aortic valves and pulmonary valves) at the end of the ventricular systole and the
beginning of the ventricular diastole. As the left ventricle empties, its pressure falls below the
pressure in the aorta. Aortic blood flow
quickly reverses back toward the left
ventricle, catching the pocket-like cusps of
the aortic valve, and is stopped by aortic
valve closure. Similarly, as the pressure in
the right ventricle falls below the pressure in
the pulmonary artery, the pulmonary valve
closes. The S2 sound results from
reverberation within the blood associated
with the sudden block of flow reversal.
CARDIOVASCULAR DISORDERS
Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated
17.9million lives each year. CVDs are a group of disorders of the heart and blood vessels and
include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other
conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one-
third of thesedeaths occur prematurely in people under 70 years of age.
The most important behavioral risk factors of heart disease and stroke are unhealthy diet, physical
inactivity, tobacco use and harmful use of alcohol. The effects of behavioral risk factors may
show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and
overweight and obesity. These “intermediate risks factors” can be measured in primary care
facilities and indicate an increased risk of heart attack, stroke, heart failure and other
complications.
1. Abnormal Heart Rhythms
The heart is an amazing organ. It beats in a steady, even rhythm, about 60 to 100 times each minute.
That's about 100,000 times each day. Sometimes your heart gets out of rhythm. Your doctor
callsan irregular or abnormal heartbeat an arrhythmia .An arrhythmia (also called a dysrhythmia)
can bring on an uneven heartbeat or a heartbeat that is either too slow or too fast.
2. Aorta Disease and Marfan Syndrome
The aorta is the large artery that leaves your heart and brings oxygen-rich blood to the rest of
yourbody. These two conditions can cause the aorta to widen or tear. This raises the chance of
things like:
 Atherosclerosis (hardened arteries)
 High blood pressure
 Connective tissue disorders that can weaken your blood vessel walls, such as
scleroderma,osteogenesis imperfecta, Ehlers-Danlos syndrome, and polycystic kidney
disease
 Injury
3. Cardiomyopathies
This is the term for diseases of the heart muscle. They’re sometimes simply called enlarged heart.
People with these conditions have hearts that are unusually big, thick, or stiff. Their hearts can’t
pump blood as well as they should. Without treatment, cardiomyopathies get worse. They can
leadto heart failure and abnormal heart rhythms.
Cardiomyopathy may sometimes run-in families, but it can also be caused by high blood
pressure,diabetes, obesity, metabolic diseases, or infections.
4. Congenital Heart Disease
This is a problem in one or more parts of the heart or blood vessels. It happens before birth.
About 8 out of every 1,000 children get it. They may have symptoms at birth, but some people
with it don’t have symptoms until childhood or even adulthood.
In most cases, we don't know why it happens. Genes may play a role, or it can happen if a baby is
exposed to viral infections, alcohol, or drugs before it’s born.
5. Coronary Artery Disease
You may hear this called CAD. It’s when plaque builds up and hardens the arteries that give your
heart vital oxygen and nutrients. That hardening is also called atherosclerosis.
6. Deep Vein Thrombosis and Pulmonary Embolism
Blood clots can form in your deep veins, usually in your legs. This is deep vein thrombosis (DVT).
They can break loose and travel through your bloodstream to your lungs, where they can block
blood flow. This condition is called pulmonary embolism. It’s life-threatening and needs
immediate medical attention.
You might be at higher risk of DVT because of your genes or family history. Other things that can
increase risk include sitting for a long time, like in a car or on a plane; long-term bed rest;
pregnancy; and using birth control pills or hormone replacement.
7. Heart Failure
This term can be scary. It doesn’t mean your heart has "failed," or stopped working. It means your
heart doesn’t pump as strongly as it should. This will cause your body to hold in salt and water,
which will give you swelling and shortness of breath.
Heart failure is a major health problem in the United States, affecting more than 6.5 million people.
It is the leading cause of hospitalization in people older than 65.
The number of people diagnosed with heart failure is projected to rise 46% by 2030, according to
the American Heart Association.
8. Heart Valve Disease
Your valves sit at the exit of each of your four heart chambers. They keep blood flowing through
your heart.
Sometimes, there are problems with these valves. Examples of heart valve problems include:
Aortic stenosis. Your aortic valve narrows. It slows blood flow from your heart to the rest of your
body.
Mitral valve insufficiency. Your mitral valve doesn’t close tightly enough. This causes blood to
leak backward, leading to fluid backup in the lungs.
Mitral valve prolapse. The valve between your left upper and left lower chambers doesn’t close
right.
9. Pericarditis
This condition is rare and means the lining surrounding your heart is inflamed. An infection often
causes this.
10. Rheumatic Heart Disease
This happens when rheumatic fever, an inflammatory disease that’s most common in children,
damages your heart valves. Rheumatic fever starts with untreated strep throat and can affect many
parts of your child’s body. If your doctor thinks your child may have had rheumatic fever, they’ll
do a physical exam and give tests including X-rays and EKGs to look for heart damage.
11. Stroke
Strokes happen when something slows or blocks blood flow to your brain. Your brain can’t get
the oxygen and nutrients it needs, and brain cells start to die. When blood can’t get to the part of
your brain that controls a certain function, your body doesn’t work like it should.
A stroke can happen because of a blocked artery or a leaking or burst blood vessel. It needs
immediate treatment to limit brain damage and other complications.
Stroke is the leading cause of disability and one of the top causes of death in the United States.
12. Pericardial Disease
Any disease of the pericardium, the sac that surrounds your heart, is called a pericardial disease.
One of the more common diseases is pericarditis or inflammation of the pericardium.
It's usually caused by an infection with a virus, inflammatory diseases such as lupus or rheumatoid
arthritis, or injury to your pericardium. Pericarditis often follows open heart surgery.
13. Heart Arrhythmias
When you have an arrhythmia, your heart has an irregular beating pattern. Serious arrhythmias
often develop from other heart problems but may also happen on their own.
14. Peripheral arterial disease
Peripheral arterial disease, also known as peripheral vascular disease, occurs when there is a
blockage in the arteries to your limbs (usually your legs).
The most common symptom of peripheral arterial disease is pain in your legs when walking. This
is usually in one or both of your thighs, hips or calves.
The pain can feel like cramp, a dull pain or a sensation of heaviness in the muscles of your legs. It
usually comes and goes and gets worse during exercise that uses your legs, such as walking or
climbing stairs.
15. Aortic disease
The aorta is the largest blood vessel in the body. It carries blood from your heart to the rest of your
body.
The most common type of aortic disease is aortic aneurysm, which is where the wall of the aorta
becomes weakened and bulges outwards. You will usually experience pain in your chest, back or
abdomen (tummy).
16. Heart attack
Heart attack is one of several conditions that falls under the broad category of acute coronary
syndrome (ACS), a term that refers to any heart condition caused by sudden loss of blood flow to
the heart. The most frequently reported symptom of ACS, particularly heart attack, is chest pain,
often described as pressure or discomfort, and it may radiate to the jaw, shoulder, arm or upper
back. The most common co-occurring symptoms are shortness of breath, sweating or a cold sweat,
unusual fatigue, nausea and lightheadedness. These additional symptoms have often been referred
to as “atypical,” however, a recent American Association presidential advisory is label may have
been due to the lack of women included in the clinical trials from which the symptom lists were
derived. Women are more likely than men to report more symptoms in additionto chest pain.

Other Vascular Diseases

Your circulatory system is made up of the vessels that carry blood to every part of your body.
Vascular disease includes any condition that affects your circulatory system. These include
diseases of the arteries that go to your legs (peripheral vascular disease) and slow blood flow to
your brain, causing strokes.

Cardiovascular Disease Treatments

Treatments for cardiovascular diseases can differ by the type of condition. Yours may include:
 Changing parts of your lifestyle like your diet, exercise, and alcohol and tobacco use
 Medications, including ones that treat risk factors like blood pressure or cholesterol or to
break up clots
 Medical procedures like having a balloon or stent placed in your blood vessel, heart valve
surgery, or coronary artery bypass graft surgery. medication, such as to reduce low density
lipoprotein cholestrol improve blood flow, or regulate heart rhythm
 surgery, such as coronary artery bypass grafting or valve repair or replacement surgery
 cardiac rehabilitation, including exercise prescriptions and lifestyle counseling
 Treatment aims to:
 relieve symptoms
 reduce the risk of the condition or disease recurring or getting worse
 prevent complications, such as hospital admission, heart failure, stroke, heart attack, or
death
 Depending on the condition, a healthcare provider may also seek to stabilize heart rhythms,
reduce blockages, and relax the arteries to enable a better flow of blood.

Prevention
Many types of CVD are preventable. It is vital to address risk factors by taking the following steps:

 reducing the use of alcohol and tobacco

 eating fresh fruit and vegetables
 reducing salt, sugar, and saturated fat intake
 avoiding a sedentary lifestyle, particularly for children
Adopting damaging lifestyle habits, such as eating a high sugar diet and not getting much physical
activity, may not lead to CVD while a person is still young, as the effects of the condition are
cumulative.
However, continued exposure to these risk factors can contribute to the development of CVD later
in life.

Lifestyle tips
People can take the following steps to prevent some of the conditions within CVD:
 Manage body weight: The National Institute of Diabetes and Digestive and Kidney
Disorders advise that if a person loses 5-10% trusted source of their body weight, they may
reduce their risk of developing CVD.
 Get regular exercise: The American Heart Association (AHA) recommend doing 150
minutes trusted source of moderate-to-intense physical activity every week.
 Follow a heart-healthy diet: Eating foods that contain polyunsaturated fats and omega-3,
such as oily fish, alongside fruits and vegetables can support heart health and reduce the
risk of CVD. Reducing the intake of processed food, salt, saturated fat, and added sugar
has a similar effect.
 Quit smoking: Smoking is a key risk factor for almost all forms of CVD. Although quitting
can be difficult, taking steps to do so can drastically reduce its damaging effects on the
heart.



 RELATED DIAGNOSIS TECHNOLOGIES OR EQUIPMENT

1. X-ray
An image of the inside of the chest taken by an X-ray machine is usually ordered by a doctor
when a patient is experiencing symptoms that could indicate problems with the heart or lungs,
like shortness of breath.

During the process, the machine will send X-rays through a tube that pass through a patient’s
chest and are absorbed on the film behind them to create a picture.

Bones and other dense areas show up as lighter areas, while areas that don’t absorb the radiation
appear darker.

Chest X-rays are good for the detection of more obvious abnormalities, like enlargement or
atypical positioning of the heart, but aren’t so useful when doctors need a more in-depth look at
the vascular system that supports it.
2. Electrocardiogram

An electrocardiogram, or EKG, is the most frequently ordered heart test, used as part of a
generalised physical exam as well as in conjunction with an echo when a heart abnormality is
suspected.

The process involves attaching 10 small sticky pads along the chest wall that attach to the EKG
machine through wires that transmit data collected from the electrical activity of the heart.

The output is an image report of the heart’s electrical activity known as a tracing, and through
recording this information, doctors can see irregularities, like a fast or slow heart rate, which can
point to various heart disease states that may require additional detection methods to diagnose.
3. Echocardiogram (ECHO)
The above methods take a snapshot of the heart and its surrounding structures, but sometimes it’s
necessary to see it in action to detect certain abnormalities. This machine effectively performs an
ultrasound of the heart.

An image of the organ is created using sound waves produced by the echo machine that travel
out of a transducer into a conductive gel and through the chest.

The sound waves bounce off organs like the heart and return back to the transducer, which
transmits information about the timing and pattern of returning sound to the echo machine as
electricity, where it’s transformed again by the unit into an active 2D image.

A strength of the echo machine is that it can also give insight into blood flow throughout the
heart, which can help physicians on their path to diagnosing a range of conditions, like weak
heart muscles or high blood pressure.
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