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2.Pain or discomfort in other areas of the upper body:Arms, shoulder, back, neck, jaw, or the top of the stomach. Women often have jaw or back pain.3.Shortness of breath:May occur with or without chest discomfort.4.Breaking out in a cold sweat,nausea, or light-headedness with or without chest discomfort.5.Feeling of impending doomthat does not go away. Or unusual fatigue in women.6.Chest painunrelieved by prescribed doses of nitroglycerin.7.Get help and take AspirinRisk Factors for Cardiovascular Disease1.Nonmodifiable factors1)Heredity - Children of parents with cardiovascular disease are more likely to develop the same problem.2)Race - African Americans experience high blood pressure two to three times more frequently than whites3)Sex - Males experience more heart attacks than females earlier in life. After age 65 years, the death rate from heart disease increases in women.4)Age- Four out of five people who die of a heart attack are age 65 years or older. Increasing age increases risk.2.Modifiable risk factors1)Obesity - Keep weight within normal limits by diet and exercise. Reduce abdominal obesity.2)High cholesterol >200mg/dL- Implement a low-fat diet and exercise3)HTN - Keep blood pressure less than 120/80 mm Hg.4)DM - Maintain good glycemic control by keeping blood glucose within normal limits (<100 mg/dL).5)Cigarette smoking- Quit smoking. Do not use smokeless tobacco; nicotine by any route affects blood vessels.6)Sedentary lifestyle- Maintain an exercise program of 30-min sessions three to five times a week. 7)Excessive stress- Use stress-reduction techniques regularly, such as exercise and relaxation techniques8)Excessive alcohol intake- Limit alcohol consumption to no more than recommended levels: men, 2 drinks/day; women, 1 drink/day.9)Cocaine use- Do not use cocaine, methamphetamine, or other recreational drugs.Metabolic Syndrome Components1.Elevated waist circumference indicating abdominal obesity:MEN: > 40 inches (102cm)WOMEN: >35 inches (88cm)2.Elevated triglycerides >150mg/dL3.Reduced High density lipoprotein cholesterol
MEN: < 40mg/dLWOMEN: <50mg/dL4.Elevated BP at or above 130/85 mmHg5.Elevated fasting glucose indicating insulin resistance Glucose:100mg/dLDiagnostic Test & Procedures1.Chest Radiography2.Nuclear imaging & exercise electrocardiography (Stress Test)3.Echocardiography with esophagogastroscope4.Digital subtraction angiography5.MRI6.Electro-beam computed tomography for Coronary Artery calcium scoring7.Stress echocardiogram8.Cardiac monitoringSpecific Tests for Vascular DisordersDiagnosing a vascular problem begins with a history and physical examination that includes a variety of tests for risk factors forvascular disorders.1.CBC, Urinalysis, blood lipid & cholesterol (HDL & LDL), or sequential multiple analyzer (SMA – Metabolic panel)2.Doppler flow studies - to detect a venous thrombus when one is suspected and to assess the patency of the carotid arteries3.Angiography - Determine areas of narrowing in arteries or to detect a blockage4.Nuclear medicine scans - performed to detect emboli in the lungs.