This series is going to expose the cardiovascular system and how we can care for it in order to get the best out of it always.
The cardiovascular system may be likened to the pump-and-pipe mechanism used by the Ghana Water Company Limited (GWCL) to distribute water. The pump here is the heart whereas the pipe would be the blood vessels. The heart is a muscular organ. Majority of the heart’s structure is made up of muscles which are well adapted to its herculean work throughout life.
The human heart starts pumping blood into circulation by the 6th week of foetal life. So, your heart actually starts working even before you are born. Amazing!
It must also be stated that the heart of a foetus is different from the heart of a child or an adult. When one is born, the foetal heart is amazingly transformed into an adult heart. The human adult heart beats an average of 72 times in a minute. This amounts to about 104,000 times in a day and approximately 38 million times in a year.
The statistics above is relative since it may not apply to everyone. However, if you care to know how your own heart performs, you could use this same analogy. Make sure you know your average pulse, then you multiply that by 1440 minutes to get the number of times your heart beats in a day. You can multiply the answer you get by 365 to get the number of times your heart beats in a year. It is simple and I suggest you try.
What Parents Need to Watch
Every part of our body— from the topmost tip of our hair to the lowest crease of our toe— needs blood to survive. Through the pumping action of the heart, blood is filled with oxygen and glucose from the lungs and the small intestines respectively. This same blood is then again pumped by the heart to the rest of the body for use and then, when returning to the heart, the blood brings back waste products. These waste products are taken to their various outlets such as the lungs and kidneys to be taken out of the body. The body has been designed in such a way that constant second-second supply of blood is necessary for survival even when one is asleep.
If for any reason the heart does not function for a few minutes it could result in death. Just like any other part of the body, the heart can also develop problems. Disruptions in the cardiovascular system can lead to alterations in organ function, disability, and death. Apart from congenital heart diseases (what is mostly referred to as hole in heart) which may be birth-related, most people develop heart diseases as they age in life. Some of the causes of heart diseases that are not congenital could be linked to age, gender, race, hereditary, lifestyle changes (intake of fatty foods as well as foods high in sodium, inadequate exercises and excessive stress) or the existence of co-morbid conditions such as diabetes mellitus, hyperthyroidism (overproduction of the thyroid hormones) and kidney diseases.
Congenital heart diseases may be caused by failure of the foetal heart to be transformed into an adult heart after birth or probably due to certain mishaps that occurred whilst the foetus was still growing in the womb or uterus. Congenital malformations of the heart can be treated surgically when detected very early. Parents ought to, therefore, open their eyes widely to the following which could be signs of congenital heart defects in babies and children.
Ø Bluish colouration of their skin, growth retardation and lacking energy or exercise intolerance in children and babies.
The signs above could occur immediately after birth or later in life when complications begin to appear because the heart will try to manage with the defect but will later begin to give up when it is overburdened with the increasing needs of the growing child.
What Pregnant Women Must Avoid to Protect Babies from Heart-related Problems
Congenital heart abnormalities can occur when mothers consume substances that are termed teratogenic (very harmful in pregnancy) such as alcohol, tobacco and certain drugs. It will, therefore, be wise, as a pregnant woman, to stay away from consumption of unhealthy products and, most importantly, consult your doctor anytime you suspect something you are about to take in may be harmful to you or your baby to help reduce the incidence of these malformations.
According to the Institute for Health Metrics Evaluation in a 2017 survey, stroke and ischemic heart diseases (IHD) are part of the 10 leading causes of death with stroke occupying the sixth slot and IHD following stroke in the seventh position. High blood pressure, which is the main culprit for causing these two main diseases stated above, has become very common amongst Ghanaians now largely due to lifestyle changes that have occurred over the years. Foods high in fats and sodium have dominated our diets and replaced more healthy fruit and vegetable diets. Fatty diets forms plaques inside the arteries making it narrower. This means the heart would have to work harder to pump blood through the narrow arteries and hence raising the blood pressure. Sodium naturally attracts water and so an increase in sodium consumption will increase the blood volume as more water will be drawn from the tissue spaces into the blood. For instance, the heart was dealing with 5 litres of fluids, but because of increase in sodium, it may now have to deal with 8 litres. The heart would have to increase its force of contraction to pump all this blood out, making the blood pressure rise.
Dealing with Hypertension
The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of hypertension has come out clear with new blood pressure limits. From the JNC, the limit for the normal blood pressure should now be 119/79mmHg. Any value that exceeds this is considered either as prehypertension, stage one or stage two hypertension. For instance, you find yourself within the range of 120/80 and 139/89mmHg; then, you are pre-hypertensive. Stage one hypertensive falls within the range of 140/90-159/99mmHg whereas stage two hypertensives are those who have their blood pressure readings as 160/100 mmHg and above.
According to the 12th Edition of the Brunner and Suddarth’s Textbook of Medical Surgical Nursing, dietary modifications, exercises, weight loss and careful monitoring are important strategies for managing three major cardiovascular risk factors: hyperlipidemia, hypertension and diabetes mellitus. Diets that are restricted in sodium, fat, cholesterol or calories are commonly prescribed to help curb the menace of hypertension. So, decide today to, as much as possible, reduce your fat and salt or sodium intake to keep the blood vessels patent as well as maintain a normal blood volume and in so doing you would be reducing the risk of hypertension.
Hypertension can lead to stroke, heart failure and kidney failure. One thing that makes hypertension scary is the fact that the symptoms are not so clear and may sometimes go unnoticed. You would only find out you have hypertension when some damage has been done. Regular exercises and also increasing water intake could be very beneficial to the course against hypertension. Any co-morbid condition such as diabetes or kidney disease should be well dealt with by visiting a qualified physician so as to keep the heart and blood vessels safe from the effects of these co-morbid diseases.
Warning Signs of a Heart Attack
We cannot talk about heart-related problems without talking about heart attack. It is gradually becoming one of the most common diseases in Ghana and worldwide owing to the rise in the cases of hypertension. It is usually sudden and can kill within minutes of onset. Heart attack occurs when a portion of the heart muscle is not receiving enough oxygen-rich blood to contract and pump. That part of the muscle that is being starved of blood begins to die and can stop functioning at any moment from this point. A heart attack is preventable because it gives the sufferer a distinct warning sign known as angina, although a few percentage of people may not experience it.
Angina is a choking pain that is usually felt in the chest and spreads to the shoulder, neck, jaw and then down to the left arm. This pain is felt during times of increased physical activity, heightened emotional states or cold weather. It is, therefore, important that sudden chest pain that radiates to the arm, neck, jaw, face and left arm is taken seriously and delated immediately to the hospital. If medical care is not sought, the pain could be recurring until a period where the heart muscles stops working and cannot pump blood to the vital organs (brain, kidneys, lungs and the liver) resulting in death.
The cells of the brain, for instance, cannot survive without blood for more than 5 minutes. The early stages of angina could be controlled with pain killers and rest whereas the advanced stages may warrant hospitalisation and other advanced medication to control the development. Even if it is your first experience, after taking a pain killer and resting, do well to see a doctor for further treatment. A cardiopulmonary resuscitation lesson will be on hand to educate you on how to handle someone going through an episode of heart attack before reaching the nearest health facility.
As I conclude today’s series, I would want to encourage you to get yourself a sphygmomanometer or walk to the nearest pharmacy to know your blood pressure. If it is fine, keep doing what is right to keep it normal. But if it is high, then, you seek the necessary help and follow the instructions given, religiously, to obtain a normal blood pressure. Remember that great changes come from small attitudes. Drink plenty of water, stay away from high fat and sodium diets, exercise regularly and rest well to keep a healthy heart for yourself and for your loved ones.
GLOSSARY
Sphygmomanometer: A device used for measuring blood pressure.
Teratogenic: Related to something that can cause developmental malformations
Congenital: Something existing since birth
Hypertension: High blood pressure usually of 140/90 mmHg sustained over a period of time
Hyperlipidemia: The presence of excess fat or lipids in the blood
Diabetes Mellitus: A variable disorder of carbohydrate metabolism characterised by excessive amounts of sugar in the blood and urine, thirst, hunger and weight loss.
BIBLIOGRAPHY
Smeltzer S.C, Bare B.G, Hinkle J.L and Cheever K.H (2010) Brunner and Suddarth’s Textbook of Medical Surgical Nursing, 12th Edition. Lippincott Williams & Wilkins, China.
Venes, D. (2013) Taber’s Cyclopedic Medical Dictionary, 21st Edition. F.A Davis, Philadelphia.
Adams M.P, Holland L.N, Urban C.Q (2014) Pharmacology for Nurses A Pathophysiologic Approach, 4th Edition. Pearson Education Inc. New Jersey.
By Maxwell Kpeem, a Registered General Nurse. Email contact: kpem.max@gmail.com
