HEART DISEASE

By: Nalla Sheena Daffodil C. Ariza

Anatomy of the Heart

Heart Disease
is a broad term used to describe a range of diseases that affect your heart. various diseases that fall under the umbrella of heart disease include diseases of your blood vessels, such as coronary artery disease; heart rhythm problems (arrhythmias); heart infections; and heart defects you're born with (congenital heart defects). the term "heart disease" is often used interchangeably with "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke.

Other heart conditions, such as infections and conditions that affect your heart's muscle, valves or beating rhythm, also are considered forms of heart disease. Age related changes can reduced the efficiency of the heart and contribute to the decreased compliance of the heart. This changes includes myocardial hypertrophy ,which can change the left ventricular stretch and function; fibrosis and stenosis of the valves and decreased pacemaker cells

Physiologic changes in the heart and blood vessels make the elderly more prone to certain types of cardiovascular disease.
These include isolated systolic hypertension, orthostatic hypotension, heart failure, certain valve disorders (particularly of the aortic valve), and certain rhythm abnormalities, particularly Bradycardia, or slow rhythms.

Risk Factors
Non - Modifiable Age (65 years old and Above) Race Gender( Male) Modifiable Tobacco use Elevated triglyceride Diabetes

Ethnicity

Sedentary Lifestyle
Obesity Stress

Estrogen Loss

The following cardiovascular changes result from the aging process: Cardiac output and recovery time decline. The heart requires more time to return to a normal rate after a rate increases in response to activity.
The heart rate slows. Blood flow to all organs decreases. The brain and coronary arteries continue to receive a larger volume than do other organs. Arterial elasticity decreases , causing increased peripheral resistance and, in return, arise in systolic blood pressure.

Veins dilate , and superficial vessels become more prominent.

Pathophysiology
The heart valves become thicker & stiffer
Reduced in stroke volume Calcium and fat deposit accumulate with arterial walls Veins become increasingly tortuous

The Heart muscle and arteries loss their elasticity

Increasing arterial resistance

Increased work load of the heart

Specific Assessment
Dyspnea Neurologic symptoms associated with heart disease Discomfort in an area of the upper body

Note : when the patient complaints about symptoms related to digestion and breathing and upper extremity Mental Status changes pain cardiac disease must be Report Vague symptoms such as; considered Fatigue ,nausea and syncope. May report burning or sharp pain

AGE RELATED CHANGES IN THE BODY SYSTEM AND HEALTH PROMOTION STRATEGIES Changes Subjective and Objective findings
Holds objects far away from face; complains of glare; poor night vision; confuses colors.

Health promotion strategies

Wear eye glasses, use sunglasses outdoors; avoid abrupt changes from dark to light; use adequate indoor lighting with area light and night lights; use large print books; use a magnifier for reading; avoid night driving; use contrasting colors for color coding; avoid glare of shiny surfaces and direct sunlight.

Special Senses Vision: Diminished ability to focus on close objects; inability to tolerate glare; difficulty adjusting to changes of light intensity ; decreased ability to distinguish colors.

Hearing: decreased ability to hear high- frequency sounds; tympanic membrane thinning and loss of resiliency.

Gives inappropriate responses; ask people to repeat words; strain forward to hear.

Recommend a hearing examination; reduce background noise; face person; enunciate clearly; speak with a low- pitched voice; use nonverbal cues.

Taste and smell: decreased ability to taste and smell

Uses excessive sugar and salt.

Encourage use of lemon, spices, herbs. Recommend smoking cessation.

Management
Sleeplessness Avoid daytime napping. Advise to maintain consistent bedtime routine. Limiting alcohol intake to one or two drinks. Avoiding caffeine and nicotine after noon. Social and support system and family An older adult designates one individual as a primary caregiver or decision maker, or an individual voluntarily assumes such a role. Different individuals assume responsibility for a variety of care giving tasks.(e.g. adult daughter may assist an older parent with financial matters; a son may be designated to make health care decisions.

A spouse or partner may help with activities of daily living; a grandchild may help with grocery shopping; Niece or nephew may take an older relative to religious services;
A neighbour may provide transportation to appointments.

Family care giving

Emotional, social, and spiritual support

Assistance with decision making related to health care, financial matters, and lifespan Planning Assistance with physical tasks, such as bathing, dressing, or walking

Support in navigating and negotiating health and social service systems, such as dealing with health and long-term care insurance, arranging and overseeing paid helpers ,communicating with health care professionals, or advocating for quality care and services Assistance with practical matters, such as housekeeping, processing paperwork, or going to medical and other appointments
Financial support, including direct financial assistance and help with bill-paying Shared housing

Behavioral Coping interventions for powerlessness and hopelessness

a. Referral to a falls prevention program

b. Use of a low-rise bed that measures 14 inches from floor

c. Use of floor mats if patient is at risk for serious injury, such as osteoporosis d. Easy access to call light e. Minimization and/or avoidance of physical restraints f. Use of personal or pressure sensors alarms g. Increased observation and surveillance h. Use of rubber-soled healed shoes or non-skid slippers

i. Regular toileting at set intervals and/or continence program; provide easy access to urinals and bedpans j. Observation during walking rounds or safety rounds k. Use of corrective glasses for walking l. Reduction of clutter in traffic areas

Health Education and Promotion Strategies

Exercise regularly . Pace the activity. Avoid smoking. Eat low-fat. Eat Low-salt diet Participate in stress-reduction activities. Check blood pressure regularly. Medication compliance. Weight control through exercise.

Because medication that affect the persons coordination, blood pressure, heart rate, or alertness may alter the response to exercise, people thinking medication should be ask their care provider about necessary modification in exercises. A care provider should be consulted if a person experiences dizziness, light headedness, or pain during physical activity.
Assistive devices can improve Safety and reduce energy cost during exercise for frail and every old individual. Exercise may be temporarily contraindicated during treatment for hernia, cataract, retinal bleeding and joint injury. To reduce the risk of injury, inactive older people should avoid: Activities that necessarily strain the shoulders. Jogging on hard surfaces. High Impact sports. Sports that require sudden jerky movements(e.g.., tennis) Preconditioning exercises may be prescribed, before beginning a program exercise.

Thank You For Listening