Susiana Candrawati

3-14-05

Difficult to differentiate
between age-related
changes and those
related to an inactive
lifestyle or disuse

Are the changes

normal 'wear and tear'
or cardiovascular
disease?
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Anatomical changes
 Thickening of the left
ventricular wall

  collagen,  elastin
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Anatomical changes Mitral valve

  thickness

  flexibility

 Aortic & mitral valve

calcification

Aortic valve
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Anatomical changes

  # of pacemaker cells

 Fibrous tissue infiltration of

conductive system
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Anatomical changes
 Peripheral arteries less
resilient
 Large arteries stiffer, less
elastic,  elastin
 Calcifications in artery walls,
including aorta
 Calcifications +  elastin + 
collagen = stiffer vessels =
more difficult to dilate
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Anatomical changes

 Veins dilate & stretch with 

elasticity
 Intima & muscular walls
thicken and become less
elastic
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 Coronary artery blood flow 

between ages 20 & 60

 Effect:  oxygen delivery to

the heart muscle, thus 
ability to increase activity
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 May become dilated,

elongated, rigid

 May develop calcifications

and become tortuous

  elastin,  collagen =
calcification
=  stiffness,  compliance
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Summary - changes occur in:

 heart rate
 blood pressure
 myocardial function
 cardiac output
 valvular function
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Decreased cardiac output in

response to exercise or
stress

(effects are influenced by

associated heart disease &
level of baseline physical
activity)
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Systolic and diastolic

murmurs may result from
incomplete valve closures
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  contractile strength &

efficiency

  cardiac output

  cardiac reserve
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 cardiac responsiveness
rate with exercise

Heart may take longer to

return to baseline rate
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Physiological changes

Irritability of the myocardium may

result in extra systoles, along with
sinus arrhythmias & sinus
bradycardia
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Systolic blood pressure may

rise disproportionately higher
than diastolic
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Changes in the cardiovascular system have

direct effects on other organs

Example: atherosclerotic changes in blood

vessels that occur in patients with
hypertension may result in loss of renal
function, vision impairment
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  response to stress

 Activity intolerance

 Orthostatic hypotension
 Dizziness w/position changes

*Influenced by presence of disease & lifestyle

variations
  Hypertension  Physical inactivity
 Smoking  Obesity
 Dyslipidemia  Stress
 low HDL  Post-menopausal
 elevated LDL hormone therapy
 elevated triglycerides  Excess alcohol
 Diabetes mellitus intake

3-14-05