BIOLOGY INVESTIGATORY PROJECT

CARDIOVASCULAR DISEASES

NAME: ANOUSHKA JAIN

CLASS: 12
SECTION: A
SESSION: 2021-22

DELHI PUBLIC SCHOOL R.K PURAM

 ACKNOWLEDGEMENT

I would like to express my special thanks of gratitude to

my biology teacher, Mrs. Sushma Sardana, who gave us
a golden opportunity to do this wonderful project on any
topic on biology. My topic has been cardiovascular
diseases which not only helped me in doing a lot of
Research but also helped me in learning plenty of new
things.
I would also like to thank my parents who helped me a
lot in finalizing this project within the limited time
frame.

Anoushka Jain.
 CERTIFICATE OF AUTHENTICITY

THIS IS TO CERTIFY THAT ANOUSHKA JAIN OF

CLASS XII A [SESSION 2021-22] OF DELHI PUBLIC
SCHOOL R K PURAM, NEW DELHI HAS
COMPLETED THE BIOLOGY PROJECT
“CARDIOVASCULAR DISEASES” UNDER MY
CONSTANT SUPERVISION AND GUIDANCE. HER
WORK IS GENUINE.

BIOLOGY TEACHER

MRS SUSHMA SARDANA

 INDEX

No. Topic
1. OBJECTIVE
2. THEORY
2.1 INTRODUCTION
2.2 TYPES
2.3 CAUSES
2.4 SIGNS AND SYMPTOMS
2.5 MEDICAL TREATMENT
2.6 RISK FACTORS
2.7 PREVENTION
3 CASE STUDY
4 QUESTIONNAIRE
5 BIBLIOGRAPHY
 OBJECTIVE

To study the various types of heart

diseases and their causes, symptoms,
treatment, risk factors and how can it
be prevented.
THEORY- INTRODUCTION
TYPES
CAUSES
SIGNS AND SYMPTOMS
MEDICAL TREATMENT
RISK FACTORS
PREVENTION
 CASE STUDY-1
PATIENT: A 54-year-old woman presented to the
telemetry floor with shortness of breath (SOB) for 4
months that progressed to an extent that she was
unable to perform daily activities. She also used 3
pillows to sleep and often woke up from sleep due to
difficulty catching her breath.
MEDICAL HISTORY: hypertension, dyslipidemia,
diabetes mellitus, and history of triple bypass surgery 4
years ago.
CURRENT HOME MEDICATIONS: aspirin,
atorvastatin, amlodipine, and metformin.
FAMILY HISTORY: null
VITAL SIGNS: stable.
PHYSICAL EXAMINATION: bilateral diffuse crackles
in lungs, elevated jugular venous pressure, and 2+
pitting lower extremity edema.
ECG: normal sinus rhythm with left ventricular
hypertrophy.
CHEST X-RAY: vascular congestion.
LABORATORY RESULTS: a pro-B-type natriuretic
peptide (pro-BNP) level of 874 pg/mL and troponin level
of 0.22 ng/mL.
THYROID PANEL: normal.
ECHOCARDIOGRAM: systolic dysfunction, mild mitral
regurgitation, a dilated left atrium, and an ejection
fraction (EF) of 33%.
Case Review
1.The sign and symptoms along with labs and imaging
findings point to diagnosis of heart failure with reduced
EF (HFrEF).
2.She should be treated with diuretics and guideline-
directed medical therapy for congestive heart failure
(CHF).
3.Telemetry monitoring for arrhythmia should be
performed, especially with structural heart disease.
4.Electrolyte and urine output monitoring should be
continued.
Case Discussion
In the initial evaluation of patients who present with
signs and symptoms of heart failure, pro-BNP level
measurement may be used as both a diagnostic and
prognostic tool. All patients with symptomatic heart
failure should be started on an angiotensin-converting
enzyme (ACE) inhibitor (or angiotensin receptor blocker
if ACE inhibitor is not tolerated) and β-blocker, as
appropriate. Recent recommendations also recommend
starting an angiotensin receptor-neprilysin inhibitor
(ARNI) in patients who are symptomatic on ACE
inhibitors.
Alternatively, ARNI could be started instead of ACE
inhibitors or ARBs. Loop diuretics may be added to
relieve symptoms of congestion. They help in improving
quality of life by decreasing fluid retention and thus
relieving symptoms but have shown no mortality
benefit. Medications should be started at low doses and
gradually titrated up to recommended target doses.

CASE STUDY-2
PATIENT: A 53-year-old male with blood pressure of
145/60 and a cholesterol panel as follows: total
cholesterol 189; HDL 31; LDL 141; triglycerides 87.
MEDICAL HISTORY: pre-diabetes (HgA1C 6.4); Class I
obesity (BMI 31),
FAMILY HISORY: premature CAD, daily tobacco
smoker (1/2 PPD for 35 years),
HIS RISKS:
1.The ASCVD Risk Estimator Plus places him at a 10-
year ASCVD Risk of 16.3% (intermediate).
2.His Lifetime ASCVD Risk is 50%
3.His Optimal ASCVD Risk is 2.9%
SHOULD HE START A STATIN?

• Moderate intensity statin is recommended for

patients with LDL-C 70-189 mg/dL. Presence of risk
enhancing factors (in his case, metabolic syndrome
and family history of premature ASCVD), favor
initiation of statin therapy. LDL-C should be
reduced by at least 30%.
If he is resistant to starting a statin, it is reasonable to
use a coronary artery calcium (CAC) score in the
decision to withhold, postpone or initiate statin therapy.
In which case, the following applies:

• If the coronary calcium score is zero, it is

reasonable to withhold statin therapy and reassess
in 5-10 years, as long as higher risk conditions are
absent (diabetes mellitus, family history of
premature CHD, cigarette smoking).
• If CAC score is 1 to 99, it is reasonable to initiate
statin therapy for patients ≥ 55 years of age.
• If CAC score is 100 or higher or in the 75th
percentile or higher, it is reasonable to initiate
statin therapy.
TREATMENT
COUNSELLING TO BE GIVEN

• Tobacco abstinence is recommended, and the

patient should be firmly advised to quit.
 • Offer a combination of behavioral interventions
plus pharmacotherapy.
• Avoid exposure to secondhand smoke.
• Assess tobacco use.
• Make a follow-up plan.
OTHER BEHAVIOURAL MODIFICATION

• He should be counseled on the benefits of weight

loss, and a healthy diet emphasizing intake of
vegetables, fruits, legumes, nuts, whole grains, and
fish is recommended.
• He should also be routinely counseled to optimize a
physically active lifestyle. (Engage in at least 150
minutes per week of accumulated moderate
intensity or 75 minutes per week of vigorous
intensity aerobic physical activity).
➢ NO NEED FOR MEDICAL THERAPY AND
ASPIRIN
 QUESTIONNAIRE
TARGET GROUP: 40+
1.(Have you/ Has SP) ever had any pain or discomfort in (your/her/his) chest?

• YES
• NO
• REFUSED
• DON'T KNOW

2.(Do you/Does she/Does he) get it when (you/she/he) walk uphill or hurry?
• YES
• NO
• NEVER WALKS UPHILL OR HURRIES
• REFUSED
• DON'T KNOW

3.(Do you/Does she/Does he) get it when (you/she/he) walk at an ordinary pace on
level ground?

• YES
• NO
• REFUSED
• DON'T KNOW

CHECK ITEM 3: IF 'YES' IN 2 OR 3, CONTINUE. OTHERWISE, GO TO 7.

4.What (do you/does she/does he) do if (you/she/he) get it while (you/she/he) are
walking? (Do you/Does she/Does he) stop or slow down, or continue at the same
pace?

• STOP OR SLOW DOWN

• CONTINUE AT THE SAME PACE
• REFUSED
• DON'T KNOW
5.If (you/she/he) stand still, what happens to it? Is the pain or discomfort relieved or
not relieved?

• RELIEVED
• NOT RELIEVED
• REFUSED
• DON'T KNOW

6.How soon is the pain relieved? Would you say

• 10 MINUTES OR LESS
• MORE THAN 10 MINUTES
• REFUSED
• DON'T KNOW

7.Have (you/she/he) ever had a severe pain across the front of (your/her/his) chest
lasting for half an hour or more?

• YES
• NO
• REFUSED
• DON'T KNOW

8.(Have you/ Has SP) had shortness of breath either when hurrying on the level or
walking up a slight hill?

• YES
• NO
• REFUSED
• DON'T KNOW

IF SP AGE <= 49 YEARS, CONTINUE. OTHERWISE, GO TO END OF THE

SECTION.

9.(Do you/Does SP) have to stop for breath when walking at (your/his/her) own pace
on the level?

• YES
• NO
• REFUSED
• DON'T KNOW

10.(Do you/Does SP) have to stop for breath after walking about 100 yards or after a
few minutes on the level?
 • YES
• NO
• REFUSED
• DON'T KNOW

11.(Have you/Has SP) ever been awakened by trouble breathing or shortness of

breath, other than when (you/she/he) had a cold?

• YES
• NO
• REFUSED
• DON'T KNOW

12.(Have you/Has SP) ever had to sleep on 2 or more pillows to help (you/him/her)
breathe?

• YES
• NO
• REFUSED
• DON'T KNOW
 BIBLIOGRAPHY

NCERT textbook
www.google.com
https://accessmedicine.mhmedical.com/
https://www.medicalnewstoday.com/