Heart and Cardiovascular System Anatomy
The cardiovascular system is generally defined as a system constituted of blood, heart, and vascular systems that help in blood circulation throughout the body. The central portion of the cardiovascular system is heart (a muscular pumping organ) through which all the arteries and veins originate. However, the vessels associated in the pumping system include arteries, veins and capillaries. cardiovascular system is the only organ that develops in embryo on the early stage to maintain the embryo development in fourth week of fertilization. The blood transportation process is mediated by the cardiovascular system, which is helped by the blood vessels (Mueller et al. 2015). However, certain diseases can alter the functionality of the cardiovascular system. rheumatic heart disease is one such abnormality that occurs as the inflammatory disease of heart is rheumatic heart disease that weakens the entire heart walls and valves. The further discussion will highlight the anatomy, functions and the effects of rheumatic heart disease on the cardiovascular system. Moreover, the discussion will also provide knowledge about the medications and prevention of the diseases.
Heart is situated in the thoracic cavity, present in mediastinum between lungs. The cardiovascular system consists of veins and arteries. It is surrounded by a pericardium sac consisting of fibrous and inner serous layers. Fluid-filled in the inner portion (cavity) is a pericardial fluid that nourishes the pericardium membrane. Cardiac muscles are involuntary and striated. The 4 chambers of the heart include right atrium, right ventricle, left atrium and left ventricle. Heart also contains 3 valves, called the bicuspid valve, tricuspid valve and pulmonary valve. Veins are the blood containing vessels that carry blood to heart. On the other side, arteries carry blood away from the heart to the tissue level.
The vessels can be seen in two colours; red blood vessels that carry oxygenated blood and blue vessels that carry deoxygenated blood. On the upper side of heart, a Vana cava structure is present that receives blood from upper portion of chest and send it to atrium. The other Vana cava, called inferior Vana cava, receives blood from lower lungs. Cardiovascular system is associated with the blood circulation all over the body. The pure blood reaches to tissues of body, returning the deoxygenated blood to the heart. The transportation of blood initiates from superior Vana cava, from which blood enters to right atrium and exit through tricuspid valve. Then blood enters into the right ventricle and exit through pulmonary valve to reach to pulmonary artery. Blood enters into the left lung and right lung, respectively, from the left and right pulmonary artery. Finally, blood enters into left atrium, then to left ventricle and reaches to aorta through the aortic arch. the final transportation occurs throughout the body. However, the occurrence of the disease, rheumatic heart disease, can also lead to alteration in the anatomical functions of cardiovascular system. In the disease, bicuspid valve gets affected because blood flow gets affected, resulting in the swelling or inflammation in the blood vessels near the valves, which can also cause the shortage of blood flow.
Cardiovascular System Functions
Different functions are involved in being maintained by the cardiovascular system to maintain haemostasis, regulate blood movement, and maintain the regulation of gaseous exchange. Homeostasis is a condition of maintaining the body balance to the blood pressure electrolyte balance, energy, oxygen supplies and temperatures, which are required to maintain the body on to the normal level. However, to maintain haemostasis, the supply of oxygen should be received to the brain, the control centre of homeostatic processes. Moreover, the deficiency of blood or oxygen pumping to muscles can make the body immoveable because of no energy generation. Moreover, the homeostatic imbalance can cause severe chronic hypertension, congestive heart failure or other diseases related to the cardiovascular system (Ally 2017). Filtration is another function of the cardiovascular system that tends to maintain the blood volume and another organ called the kidney that tends to filter the wastes from the body out. The elastic and muscular arterial system also reduces the pulsation and flow of the blood, which is imposed by the contraction of intermittent ventricles. The arteries and arterioles regulate the blood flow, referred to the resistance arteries. The thin-walled and distensible veins carry approximately 70% of the cardiovascular system’s blood. However, 17% of the blood volume is transported by the arteries (Aaronson et al. 2020). Gaseous exchange occurs in the heart, as CO2 gas is discarded through blood from the lungs and fixes O2. Lungs receive oxygenated blood from heart to circulate it over body through pulmonary veins. Oxygenated air from lungs is transported to circulatory system through tissues and combined with haemoglobin during blood supply. Heartbeat can be measured through the cardiac cycle (of systole/atria and diastole/ ventricles, through which cardiovascular system tends to promote the thermoregulation of the body, which can be mediated by vasoconstrictions and vasodilation (Dampney 2016).
Rheumatic heart disease, an inflammatory disease of bicuspid valve, may worsen if they are not treated on time heart valve can get complete damaged, leading to signs of strep throat and scarlet fever (Ralph et al. 2017). Rheumatic heart disease is supposed to be associated with prevalence cases of acute rheumatic fever, which is an autoimmune disease. The ARF disease caused due to streptococcal infections. The increased ARF case can lead to valvular heart disease called rheumatic heart disease. The abnormalities associated with rheumatic heart disease are joint, skin or brain inflammation, chest pain, and shortness of breath. The highly affected population from the diseases are aged between 5 to 15 and belong to the United States (de Dassel et al. 2018).
The intervention can be made after analyzing the disease outcomes, confirmed through an electrocardiogram, chest X-ray, cardiac MRI and echocardiogram (Johns Hopkins medicine. n.d.). The treatment depends on the prevalence of damage to heart valves. For example, using antibiotics medications can prevent the reoccurrence of infections associated with the disease. Moreover, aspirin and steroids/ non-steroidal medicines can be prescribed to the patients to reduce inflammation and swelling. However, in serious illness, treatment can require the replacement of the damaged valve (generally mitral or bicuspid valve). Acute rheumatic fever is generally a streptococcal infection among younger children showing rheumatologic manifestations (Sika-Paotonu et al. 2017). Acute rheumatic fever (ARF) must be treated with the application of antibiotic assessments, which can minimize the reemission of the diseases.
Signs, Symptoms, and Effects of Rheumatic Heart Disease
Benzathine penicillin-G is an example of an effective oral/injectable antimicrobial medication that acts as the first line of disease management to prevent the disease. The medication can be used for both rheumatic diseases, including streptococcal rheumatic fever and the bicuspid valve blocking rheumatic disease. The injections of the medication are given in combination with procaine penicillin to make the dosage more effective. However, it is also recommended by healthcare providers to the patients that patients should not use the medication in case of allergic symptoms or other illnesses. 10 days course of oral therapy with penicillin-G can provide effective treatment for the disease (Gerber et al. 2009). benzathine penicillin-G is generally a narrow-spectrum antibiotic used as first or second-line agents to treat the infections caused by the gram-positive cocci bacteria. The antibiotic can be prescribed intravenously as well as intramuscular.
The incidences of chronic rheumatic heart diseases have reduced to a satisfactory level because of the effective treatment and prevention technologies. The prevention technologies are being effectively adopted in developed countries, such as in United States. However, if the mitral or bicuspid valve gets damaged due to the disease, the is no cure for the damage despite replacing the damaged valve. It can reduce blood clot risks, which is aimed to repair the heart valve to prevent the disease. Furthermore, the condition of strep throat can also be reversed because of the assured and quality prevention of the disease. Thus, a better quality of life can be ensured through the primary a secondary treatment plan of the medication. A resolution has also been made by the WHO assembly to launch the global response to eliminate rheumatic heart disease. The organization has developed various strategies and clinical guidelines to care for people by providing them vaccines, health products and access to the medicine’s availability (WHO 2020).
The main functions of the heart are to purify blood, thermoregulation, gaseous exchange and filtration. The abnormality in any organs or tissues of the cardiovascular system can result in serious conditions affecting the heart pumping and blood circulation, which may be associated with other side dysfunctionalities, such as stroke, hypertension, elevated blood pressure, and rheumatic heart disease. Rheumatic heart diseases are one of the most prevalent diseases affecting the bicuspid valve of the heart, through which blood pressure elevates on the blood vessels and result in inflammation. Rheumatic heart disease is an encountering disease occurring as a side disease of rheumatic fever. Hence, to treat rheumatic heart disease, patients are given several steroid drugs, such as aspirin, in combination with penicillin G. penicillin is the most effective antibiotic drug that acts as the primary and secondary line of treatment to improve the quality of life of patients within a period of 2 weeks.
References
Aaronson, P.I., Ward, J.P. and Connolly, M.J. 2020. The Cardiovascular System at a Glance. John Wiley & Sons.
Dampney, R.A. 2016. Central neural control of the cardiovascular system: current perspectives. Advances in Physiology Education, vol. 40, no. 3, pp.283-296.
de Dassel, J.L., de Klerk, N., Carapetis, J.R. and Ralph, A.P. 2018. How many doses make a difference? An analysis of secondary prevention of rheumatic fever and rheumatic heart disease. Journal of the American Heart Association, vol. 7, no. 24, p.e010223.
Gerber, M.A., Baltimore, R.S., Eaton, C.B., Gewitz, M., Rowley, A.H., Shulman, S.T. and Taubert, K.A. 2009. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation, vol. 119, no. 11, pp.1541-1551.
- Ally. 2017. How Does the Cardiovascular System Help Maintain Homeostasis? https://healthyliving.azcentral.com/muscles-
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Johns Hopkins medicine. (n.d.). Living with rheumatic heart disease. https://www.hopkinsmedicine.org/health/conditions-and-diseases/rheumatic-heart-disease#:~:text=Key%20points,a%20person%20at%20increased%20risk.
Mueller, W.A., Hassel, M. and Grealy, M. 2015. Heart and Blood Vessels. In Development and Reproduction in Humans and Animal Model Species (pp. 499-516). Springer, Berlin, Heidelberg.
Ralph, A.P., Noonan, S., Boardman, C., Halkon, C. and Currie, B.J. 2017. Prescribing for people with acute rheumatic fever. Australian Prescriber, vol. 40, no. 2, p.70.
Sika-Paotonu, D., Beaton, A., Raghu, A., Steer, A. and Carapetis, J., 2017. Acute rheumatic fever and rheumatic heart disease. Streptococcus pyogenes: Basic Biology to Clinical Manifestations.
WHO. 2020. Rheumatic Heart Disease.
https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease#:~:text=The%20antibiotic%20treatment%20that%20is,4%20weeks%20over%20many%20years.
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