Chronic Illness-Cardiovascular Disease (CVD)

Question

Briefly describe the biological progression of CVD.

Answer 1

Cardiovascular disease (CVD) is a group of conditions that involve the heart and blood vessels. The biological progression of CVD is as follows.

1. Risk Factors: The progression of CVD often begins with various risk factors. These can include lifestyle factors like poor diet, lack of exercise, smoking, and excessive alcohol consumption, as well as underlying genetic factors.
2. Atherosclerosis: Atherosclerosis is a key step in the development of CVD. It involves the accumulation of fatty deposits, cholesterol, and other substances in the inner walls of arteries. These deposits, known as plaques, can narrow and harden the arteries, reducing blood flow and increasing the risk of clot formation.
3. Endothelial Dysfunction: Atherosclerosis is often associated with dysfunction of the endothelium, the inner lining of blood vessels. When the endothelium is damaged, it can lead to inflammation and plaque formation.
4. Hypertension (High Blood Pressure): Atherosclerosis and endothelial dysfunction can contribute to high blood pressure, which places added strain on the heart and blood vessels.
5. Ischemia: As atherosclerosis progresses, it can reduce blood flow to the heart muscle, leading to ischemia, a condition where the heart muscle doesn't receive enough oxygen and nutrients.
6. Myocardial Infarction (Heart Attack): If a plaque in a coronary artery ruptures or a blood clot forms at the site of an atherosclerotic plaque, it can block blood flow to a part of the heart, causing a heart attack.
7. Arrhythmias and Heart Failure: CVD can lead to irregular heart rhythms (arrhythmias) and weaken the heart muscle, potentially resulting in heart failure, where the heart cannot pump blood effectively.
8. Stroke: Atherosclerosis in the arteries that supply the brain can lead to stroke when blood flow to a part of the brain is blocked or when a blood vessel in the brain ruptures.
9. Peripheral Artery Disease: Atherosclerosis in the arteries outside the heart can reduce blood flow to the extremities, leading to conditions like peripheral artery disease, which can cause pain and poor wound healing in the legs.
10. Complications and Chronic Progression: Over time, CVD can lead to a range of complications, including the development of aneurysms, kidney problems, and damage to other organs. The condition can become chronic and require ongoing management and treatment

Answer 2

Hi! CVD is a group of diseases that include coronary heart disease, cerebrovascular disease, and rheumatic heart disease. It is also one of the leading causes of death in the US. The progression of CVD depends on whether we are talking about coronary, cerebrovascular, or rheumatic events. However, I believe CVD is most famously known for coronary heart disease.

In this case, the intima of the sub-endothelium layer in the heart develops an atherosclerotic plaque. In this layer, fatty streaks start to build up over time, comprising fatty deposits like cholesterol. These fatty streaks contain "lipid-laden macrophages", known as foam cells. Macrophages take up oxidized low-density lipoproteins (ox-LDL), and become foam cells (hence the term "lipid-laden"). When this starts to happen, the body tries to regulate itself by releasing inflammatory responses for damage control. All of these processes working together cause the plaque to grow in size, which then causes an obstruction in blood flow.

When the plaque becomes large in size, sometimes it can rupture. This rupture also causes an inflammatory response and a coagulative response. Thus, clotting factors release and follow an enzyme-activating pathway that causes a blood clot to form. When this happens, the chronic atherosclerotic lesion becomes an acute myocardial infarction (or heart attack).

Here is an article from Pubmed that is pretty helpful in understanding CVD. Hope this helps!

https://www.ncbi.nlm.nih.gov/books/NBK564304/