Hi there, I'm Mrs. Kemp.

And welcome to today's lesson all about cardiovascular diseases.

So this lesson is part of the health and disease lesson, so let's get started then.

Today's outcome is I can describe the causes of coronary heart disease and evaluate some different treatments for cardiovascular diseases.

We'll be using a lot of these key terms today and more, and if you would like to read these over, please do pause the video and have a little look at those, but do rest assured that I will go through each one of them as we move through the learning cycles.

So we have three learning cycles today, cardiovascular diseases, damaged valves, and treatment for cardiovascular diseases.

So we'll start by explaining what cardiovascular disease is.

So, have a little think for a moment.

Why do we need a heart? What do we use our heart for? Okay, did you remember that actually what the heart does is it pumps blood all the way around the body.

That blood will travel through our vascular system and it'll go through little tiny little blood vessels called arteries, veins, and capillaries, and you can see those extending through that body there.

Why do we need that blood to go all the way round our body then? Well, what it's doing is it's actually carrying oxygen and glucose to all of our cells.

That oxygen and glucose is needed for cellular respiration.

It provides the fuel for that in order to provide energy for all of the different cellular processes that are happening in the cell.

So things like building up proteins, okay? That will require energy and cellular respiration provides that.

This all takes place then.

In the mitochondria in your cells, we can see a muscle cell there and we can see those little sausage shape organelles that are known as mitochondria, and that's where aerobic respiration takes place.

So that's where respiration using oxygen happens.

Now, cardiovascular disease or we may see it shortened to CVD is a general term that talks about all different kinds of conditions that actually affect the heart or the blood vessels or both at the same time.

It's often a result of some fatty deposit building up in your arteries, and you can see on the image there we've got a fatty deposit that's laying down on the wall of the artery there.

And then what is happening behind that is we've got an increased risk of a blood clot forming so while red blood cells are clumping up behind it.

What that would mean then is that that blood wouldn't be able to pass as easily pass through that fatty deposit because of that then any organ that is after that blood clot or that fatty deposit, then you are going to get less oxygen and you are also going to get less glucose being provided for cellular respiration.

And so any organ that is past that point could become damage or it could also impede its function.

We've got some different organs then that can be affected by cardiovascular diseases like the brain, the eyes, the heart, and also the kidneys.

Okay, onto our first check of the day then, which is the best description of cardiovascular disease? A, it is a disease that affects the eyes.

B, it is a disease that affects the heart, or C, it is a general term for conditions affecting the heart or the blood vessels.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you think that it is a general term for conditions affecting the heart or the blood vessels? Excellent, really well done.

Okay, so we're going to now have a think about a specific example of a cardiovascular disease and this is where the coronary arteries are affected.

Now the coronary arteries are actually the arteries that supply the heart with blood, we can see them there on the surface of that heart.

And just like other arteries in the body then they can actually get fatty deposits that build up inside them, therefore reducing the flow of blood to the heart.

So the heart's going to get less oxygen, it's going to get less glucose and so therefore those muscle cells that require a lot of energy to contract are not going to be able to get as much energy as is required.

This is known as coronary heart disease.

Sometimes we also shorten that to CHD.

So when we get that blockage and those muscle cells can no longer get enough energy in order to contract, they can actually die and this damage can result in what we know as being a heart attack, which can also lead to death.

Okay, onto our next check then, true or false.

The cardiac arteries supply the heart with blood.

Is that true or is that false? Can you justify your answer? The heart contains blood that it pumps around the body, it doesn't need arteries to supply blood.

B, the coronary arteries supply the heart with blood.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you realise that that was false? And that's actually because it's the coronary arteries.

Cardiac muscle is what makes up the heart, but it's the coronary arteries that then supply the heart with blood.

Excellent, well done.

Okay, onto our first task of the day then.

So if you want to get your worksheets out, you can record your answers on there.

So draw a picture of an artery that has become blocked with fatty deposits.

Label the fatty deposits and blood clot.

Number two, explain how a blocked coronary artery can lead to a heart attack.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, let's have a little look at my picture then.

So we've got there the coronary artery and we've got some fatty deposits that have built up in it.

And then behind those fatty deposits, we're getting the formation of a blood clot there with our red blood cells.

So let's think about how we can explain that then leading to a heart attack.

If the coronary arteries become blocked, it will reduce the flow of oxygen to the muscle cells of the heart for cellular respiration.

This is called a heart attack and can result in the muscle cells no longer contracting and dying.

If a large portion of the heart is damaged, this can cause death.

Okay, hope you got all of those points, but if you need to add a few more, please do that now.

Well done.

Okay, onto our second learning cycle of the day then.

This one is damaged valves.

Let's have a look inside the heart then.

And you'll notice that actually the right hand side appears to be on the left and the left hand side appears to be on the right.

That's because whenever you have a diagram of the heart, then you imagine the heart as your own heart and say this is the left and this is the right, okay? Now there's some arrows on there.

There's blue arrows and red arrows that's showing that on the right hand side we've got deoxygenated blood flowing through the heart, and on the left hand side we've got oxygenated blood flowing through the heart.

The blood always flows through the heart in one direction, that's why we can put an arrow in.

And it's really important that it only goes in that direction.

So the heart has actually got these little points to them that are a bit like a little tract door.

We call them valves and they can open and close, okay? That prevents the blood from flowing back the wrong way through the heart, so it prevents any backflow of that blood and so the blood always travels in the correct direction.

Okay, what is the function of the heart valves? A, to become leaky and allow blood to travel back the way it came.

B, to ensure blood flows in the correct direction, or C, to slow down blood flow.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you get B, to ensure blood flows in the correct direction? Excellent, well done.

Okay, so, unfortunately, sometimes these valves can actually become damaged and there's two different ways.

The first one is that actually the actual valve itself can become narrower, okay? So get closer together and also harden so it's more difficult to open and close, and so, therefore, it slows down any blood flow through the heart.

They can also become leaky.

So instead of closing completely, they actually still allow a little bit of blood through and that can actually stop it from flowing in the right direction.

And some of the blood can go back the wrong way through the heart, which we already know we don't want to happen.

Any doubt, damage valves may actually require replacing.

There isn't actually any medication to treat faulty heart valves, and so really the only thing that you can do is have surgery because actually they might get worse over time and could lead to heart failure eventually.

Now, we actually replace heart valves under general anaesthetic, so it would be in a proper operating theatre and the patient's heart has to be stopped in order to change them and then restart it again once the valves have been replaced.

That all sounds very serious, but actually they do many, many, many of these operations every year.

There's two options that you can have for different, for your valve replacement.

It could be that it's a mechanical valve, and those valves will be made from carbon and metal.

We can see a little example there.

It looks very big on the picture, but, of course, they would be tiny 'cause they're going into your heart.

It could also be that they've had tissue valves grown from pig or cow tissue in a laboratory.

Okay, how can the heart valves become damaged? A, the valve only allows blood to flow in one direction.

B, the valve becomes leaky and allows blood to flow back through the heart.

C, the valve can open and close, or D, the valve opening becomes narrower, slowing down blood flow.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you get B? The valve becomes leaky and allows blood flow back through the heart.

And also D, the valve opening becomes narrower, slowing down the blood flow.

Excellent, really well done.

Okay, onto our second task of the day then, this one is task B.

I would like you to open up your worksheets again so that you can record your answers.

All right, number one, label the valves on the diagram of the heart, you should find this on your worksheet.

Number two, state the function of the valves.

Number three, describe the treatment for damaged or faulty valves.

And number four, state the options that are for replacement valves.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, so we've labelled our valves there in the diagram and the function of those valves is to ensure blood flows in the correct direction Treatment then, heart valves can be replaced during an operation under general anaesthetic where they put you to sleep.

The options for those replacement valves can either be a mechanical valve that's made from carbon and metal, or tissue valves that would be made from pig or cow tissue.

Okay, let's move on to our third and final learning cycle of today.

This one is treatment for cardiovascular diseases.

Okay, so cardiovascular diseases are what we call non-communicable, okay? They cannot be spread from person to person, so you cannot be stood next to a person that has cardiovascular disease and contract that from them.

It's not contagious.

There are actually a number of different lifestyle factors that are associated with cardiovascular disease.

You probably know quite a few of them already, okay? So things like high blood pressure and obesity will basically increase your risk of developing cardiovascular disease or CVD.

So we need to be thinking very carefully how we can reduce those lifestyle factors in order to reduce our risk of getting cardiovascular disease.

There's also some other risk factors, so general risk factors associated with cardiovascular disease, high blood pressure.

And the reason being is that actually, if you've got a very high blood pressure and you might use a blood pressure monitor like we've got in the picture there, then it can lead to damaging the blood vessels, if we damage the blood vessels, that's cardiovascular disease.

Smoking can also lay down those fatty deposits in somebody's arteries and therefore it will narrow those blood vessels just like we saw earlier on.

High cholesterol can also narrow the blood vessels.

High cholesterol is a type of, oh sorry, cholesterol is a type of fat.

We do find it in lots of animal products.

So we should try to reduce eating lots and lots of fatty animal products.

And actually when we detect high cholesterol in people's blood, there is an increase in a risk of a blood clot and therefore cardiovascular disease.

Diabetes is where somebody isn't able to control their blood sugar levels and actually that can lead to a damage of the blood vessels as well.

And finally, an inactive lifestyle.

So not exercising regularly can lead to high blood pressure, and again, that would then lead to damaging those blood vessels.

Obesity is a really serious problem and risk factor for cardiovascular disease.

It's defined as when a person has a very high BMI, so 30 or above.

It's actually, in the UK 8% of 16 to 24-year-olds in 2021 were obese, and this number is ever increasing, okay? So it is a really big problem in the UK as well as elsewhere around the world.

Unfortunately, it does disproportionately affect people living in low income households.

So that means that people who are living in poverty or don't have quite as much money, they're much more likely to be obese.

One of the reasons that that could be is that actually ultra processed foods or UPFs are a main contributor to obesity, but actually, they tend to be the cheapest types of food and therefore people in low income families will probably rely on UPF more.

Lots of foods that we think are probably healthy such as like breakfast cereals, actually they're classed as UPF.

A really quick way of checking to see whether food is UPF is looking on the back of the packet at the ingredients list.

And if that ingredients list has got something that you don't recognise as a food such as like an emulsifier or a stabiliser, the likelihood is that food is actually UPF.

Anything that's not in a packet like an apple or a banana or a piece of broccoli, that's probably not going to be UPF, okay? It's a whole food and therefore a better thing that we should be introducing into our diets.

Okay, which of these are risk factors for cardiovascular disease? A, diabetes, B, high cholesterol, C, high blood pressure, or D, obesity? I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you actually realise it's all four of those, okay? And they're all quite linked together as well.

So when you have one, you are much more likely to have another one as well.

You know, people who are obese tend to have high blood pressure and also high cholesterol and then it can lead to type two diabetes.

So all of these risk factors do interlink with one another.

Onto the next check then, true or false.

Cardiovascular diseases are examples of communicable diseases.

Is that true or false? Can you justify your answer? CVD, which we've put as a shorthand for cardiovascular disease, can be passed from person to person, or B, CVD cannot be passed from person to person.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you realise that that was actually false? And that is because CVD cannot be passed from person to person, therefore it's non-communicable disease.

So the best treatment for cardiovascular disease is actually prevention, okay? Try to make sure that you are exercising regularly, don't start, but if you have, please stop smoking or vaping, and make sure that you increase your numbers of fruits and vegetables as part of a balanced diet.

And eating foods that are whole foods with minimal processing.

There are also medications that can help you then if you do develop cardiovascular disease or you are at high risk.

One of them is statins and that can help to lower that blood cholesterol.

Remember that cholesterol is a type of fat that will be found in your blood and if you've got very high levels it can start to lay down fatty deposits in your blood vessels.

You might also take blood thinning medication.

This is to lower your risk of that blood clot so that it can pass more easily over any fatty deposits that have laid down in those arteries.

You can also take beta-blockers, which can lower your blood pressure.

All medication though will have certain side effects.

So as a individual patient you will need to weigh up what your risk is, whether you could manage that actually by some lifestyle changes or whether or not the risk of taking that medication is low enough for you to think that that is worth it.

If the symptoms of the patient are actually not helped by any of that medication or lifestyle changes, then actually they may require surgery.

This is a an image of a stent.

A stent is a little wire mesh that can be inserted using one of those tubes at the bottom there in through a person's skin and then into one of the arteries and then they can open up the stent in the artery and essentially leave that little wire mesh there opening up the artery where before it may have been closed by those fatty deposits.

It's actually a relatively safe procedure and it is saved countless numbers of lives that people would've died maybe before by having heart attacks and things and you only need it under a general anaesthetic.

In a small number of cases it can lead to excessive bleeding and then increase your risk of having a heart attack, but on the whole, it is actually a pretty safe procedure.

So occasionally when the heart is severely damaged, actually a person may need a heart transplant and there are a couple of options for that then.

Organ donations, so this is the best kind and the most successful kind that you are waiting for another person who's got a tissue matched to you to die and then that organ is taken and transplanted into you.

For short periods of time, it might be an artificial heart could keep you alive until an organ is ready, but they're very bulky and actually they don't last for a great deal of time.

Might also be transgenic organ or organisms then.

So this is a very new part of science.

It's where they take genes from humans and put those into animals and those animal organs that grow can be then transplanted into human beings.

This has been tried.

I think the person survived for about two months, but they were very, very, very poorly at that time anyway, so they knew what the risk was and it only extended their life by a small amount, but that probably felt like a great amount to that individual.

Okay, which of these images shows a stent? Is it A, B, or C? I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, of course that's A, well done.

It's that little wire meshes, isn't it? That gets inserted into the arteries, well done.

Okay, now we're gonna have a go at evaluating a treatment for cardiovascular disease and then after that you are going to have a turn by yourself.

So we're going to be looking at organ donation from a human or potential use of an artificial heart as a heart transplant.

So here is some information about organ donation and here is information about artificial heart.

You probably want to take a little bit of time to read this over and if you do, please pause the video.

Otherwise, we're going to pick out some like for like points that are either for or against using these different kinds of donors.

So first of all, the organ donation increases lifespan for up to 12 years.

However, the artificial heart is for short term use only.

Organ donation can decrease your risk of stroke and bleeding.

Unfortunately, artificial heart increases risk of stroke and also kidney failure.

There's a risk of infection for both of them, so that is a problem on both sides.

And what I would like you to do now is try and pick one out for yourself.

So I will give you a moment to think about it, but if you need more time, please pause the video.

So you choose a like for like point.

Okay, so I chose this one, risk of rejection for the organ donation and then no risk of rejection for the artificial heart, so that's a positive for the artificial heart side.

Now whenever we evaluate something, we must also give our opinion.

Now actually you can say your opinion either way it doesn't matter as long as you back it up with some evidence.

So for example, it might be that I believe that the heart from the organ donation is a better option because donated organs last for a much longer time than the artificial hearts.

Remember they lasted for about 12 years.

I'd like you to think of which way you would like to go then it might be the same way that we've already discussed, but think of a reason why you would choose that treatment.

So I believe that because, I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, I went for the heart from the organ donation, again, but if you chose the other one, that's fine.

And that is because it decreases the risk of the patient having a stroke whereas they have an increased risk with an artificial heart.

So it doesn't matter if you chose a different reason to me just so long as it backs up your conclusion.

Okay, let's move on then.

So you are going to have a go yourself then for this task C, please open up your worksheets 'cause you can record your answers on there.

So mechanical heart valves are made from carbon and metal.

They can last a lifetime.

There is an increased risk of blood clots.

The patients will need to take blood thinning medication for the rest of their life, and they will also need regular blood tests to monitor this.

Tissue valves are made from pig or cow tissue.

They often need replacing after 10 to 20 years.

The patients will only need to take medication for a short period of time.

So I would like you to evaluate the use of the mechanical heart valves and tissue valves as a treatment for CVD.

Use the information that you can see on the slide.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, I said mechanical heart valves can last a lifetime, whereas tissue valves may only need replacing after 10 years.

A person with a mechanical valve will need to take blood thinning medication for the rest of their life.

Unlike tissue valve patients that will only need to take medication for a short period of time.

Patients with mechanical valves will have to keep going back to the doctor which could impact their wellbeing.

Now, once you have done your comparison in this way, then you need to say, I believe that, whichever one you think is best, and a reason why so.

Because, and then the reason why.

If you've done both of those things, that's correct because actually you can choose either way.

Excellent, really well done.

So we've actually come to the end of this lesson today and I just want to go through some of those key learning points with you before we finish.

Cardiovascular diseases are a group of non-communicable diseases that affect the blood vessels and heart.

Coronary heart disease is an example of CVD where the arteries that supply the heart with blood get blocked with fatty deposits.

This narrows the blood vessels and leads to restricted blood flow, which can cause a heart attack.

The heart contains valves which prevent blood flowing back through the heart.

Valves can become narrower and harden and may need replacing.

Heart disease can be prevented with lifestyle changes or treated with stents, statins, transplants, and surgery.

I've really enjoyed today's lesson, I hope you have to.

Thank you so much for learning with me, goodbye.