Cardiovascular System
Cardiovascular refers to the heart (cardio) and the blood vessels (vascular). The cardiovascular
system includes arteries, veins, arterioles, venules, and capillaries. The circulatory system
comprising the heart and blood vessels which carries nutrients and oxygen to the tissues of the
body and removes carbon dioxide and other wastes from them.
The cardiovascular system is sometimes called the blood-vascular or simply the circulatory
system. It consists of the heart, which is a muscular pumping device, and a closed system of
vessels called arteries, veins, and capillaries. As the name implies, blood contained in the
circulatory system is pumped by the heart around a closed circle or circuit of vessels as it passes
again and again through the various "circulations" of the body.
It is system of vessels that convey blood to and from tissues throughout the body, bringing
nutrients and oxygen and removing wastes and carbon dioxide. It is essentially a long, closed
tube through which blood moves in a double circuit — one through the lungs (pulmonary
circulation) and one through the rest of the body (systemic circulation). The heart pumps blood
through the arteries, which branch into smaller arterioles, which feed into microscopic
capillaries. These converge to form small venules, which join to become larger veins, generally
following the same path as the arteries back to the heart.Numerous control mechanisms help
to regulate and integrate the diverse functions and component parts of the cardiovascular
system in order to supply blood to specific body areas according to need. These mechanisms
ensure a constant internal environment surrounding each body cell regardless of differing
demands for nutrients or production of waste products.
Parts and Function
blood: consisting of liquid plasma and cells
blood vessels (vascular system): the "channels" (arteries, veins, capillaries) which carry
blood to/from all tissues. (Arteries carry blood away from the heart. Veins return blood
to the heart. Capillaries are thin-walled blood vessels in which gas/ nutrient/ waste
exchange occurs.)
heart: a muscular pump to move the blood
There are two
circulatory
"circuits":
Pulmonary
circulation,
involving the "right heart," delivers blood to and from the lungs. The pulmonary artery carries
oxygen-poor blood from the "right heart" to the lungs, where oxygenation and carbon-dioxide
removal occur. Pulmonary veins carry oxygen-rich blood from tbe lungs back to the "left heart."
Systemic circulation, driven by the "left heart," carries blood to the rest of the body. Food
products enter the sytem from the digestive organs into the portal vein. Waste products are
removed by the liver and kidneys. All systems ultimately return to the "right heart" via the
inferior and superior vena cavae.
A specialized component of the circulatory system is the lymphatic system, consisting of a
moving fluid (lymph/interstitial fluid); vessels (lymphatics); lymph nodes, and organs (bone
marrow, liver, spleen, thymus). Through the flow of blood in and out of arteries, and into the
veins, and through the lymph nodes and into the lymph, the body is able to eliminate the
products of cellular breakdown and bacterial invasion.
Blood Components
Adults have up to ten pints of blood.
Forty-five percent (45%) consists of cells -
platelets, red blood cells, and white blood
cells (neutrophils, basophils, eosinophils,
lymphocytes, monocytes). Of the white blood
cells, neutrophils and lymphocytes are the
most important.
Fifty-five percent (55%) consists of plasma,
the liquid component of blood.
Major Blood Components
Component Type Source Function
Platelets, cell fragments Bone marrow Blood clotting
life-span: 10
days
Lymphocytes (leukocytes) Bone marrow, Immunity
spleen, lymph T-cells attack cells containing
nodes viruses. B-cells produce
antibodies.
Red blood cells (erythrocytes), Filled with Bone marrow Oxygen transport
hemoglobin, a compound of iron and life-span: 120
protein days
Neutrophil (leukocyte) Bone marrow Phagocytosis
Plasma, consisting of 90% water and 1. Maintenance of pH level
10% dissolved materials -- nutrients near 7.4
(proteins, salts, glucose), wastes (urea, 2. Transport of large
creatinine), hormones, enzymes molecules
(e.g. cholesterol)
3. Immunity (globulin)
4. Blood clotting
(fibrinogen)
Vascular System - the Blood Vessels
Arteries, veins, and capillaries comprise the vascular system. Arteries and veins run parallel
throughout the body with a web-like network of capillaries connecting them. Arteries use vessel
size, controlled by the sympathetic nervous system, to move blood by pressure; veins use one-
way valves controlled by muscle contractions.
Arteries
Arteries are strong, elastic vessels adapted for carrying blood away from the heart at relatively
high pumping pressure. Arteries divide into progressively thinner tubes and eventually become
fine branches called arterioles. Blood in arteries is oxygen-rich, with the exception of the
pulmonary artery, which carries blood to the lungs to be oxygenated.
The aorta is the largest artery in the body, the main artery for systemic circulation. The major
branches of the aorta (aortic arch, ascending aorta, descending aorta) supply blood to the head,
abdomen, and extremities. Of special importance are the right and left coronary arteries, that
supply blood to the heart itself.
Major Branches of Systemic Circulation
Name Serves
Head Carotid Brain & skull
Abdomen Mesenteric Intestines
Celiac (Abdominal) Stomach, liver, spleen
Renal Kidney
Iliac Pelvis
Upper Extremity Brachial (axillary) Upper arm
Radial & Ulnar Forearm & hand
Dorsal Carpal Fingers
Lower Extremity Femoral Thigh
Popliteal Leg
Dorsal pedis Foot
Posterior tibial Foot
Capillaries
The arterioles branch into the microscopic capillaries, or capillary
beds, which lie bathed in interstitial fluid, or lymph, produced by
the lymphatic system. Capillaries are the points of exchange
between the blood and surrounding tissues. Materials cross in and
out of the capillaries by passing through or between the cells that
line the capillary. The extensive network of capillaries is estimated
at between 50,000 and 60,000 miles long.1
Veins
Blood leaving the capillary beds flows into a series of progressively larger vessels, called
venules, which in turn unite to form veins. Veins are responsible for returning blood to the
heart after the blood and the body cells exchange gases, nutrients, and wastes. Pressure in
veins is low, so veins depend on nearby muscular contractions to move blood along. Veins have
valves that prevent back-flow of blood.
Blood in veins is oxygen-poor, with the exception of the pulmonary veins, which carry
oxygenated blood from the lungs back to the heart. The major veins, like their companion
arteries, often take the name of the organ served. The exceptions are the superior vena cava
and the inferior vena cava, which collect body from all parts of the body (except from the lungs)
and channel it back to the heart.
Artery/Vein Tissues
Blood vessel anatomy Arteries and veins have the same three tissue layers, but the proportions
of these layers differ. The innermost is the intima; next comes the
media; and the outermost is the adventitia. Arteries have thick media to
absorb the pressure waves created by the heart's pumping. The smooth-muscle media walls
expand when pressure surges, then snap back to push the blood forward when the heart rests.
Valves in the arteries prevent back-flow. As blood enters the capillaries, the pressure falls off.
By the time blood reaches the veins, there is little pressure. Thus, a thick media is no longer
needed. Surrounding muscles act to squeeze the blood along veins. As with arteries, valves are
again used to ensure flow in the right direction.
Anatomy of the Heart
The heart is about the size of a man's fist. Located between the lungs, two-thirds of it lies left of
the chest midline The heart, along with the pulmonary (to and from the lungs) and systemic (to
and from the body) circuits, completely separates oxygenated from deoxygenated blood.
Internally, the heart is divided into four hollow chambers, two on the left and two on the right.
The upper chambers of the heart, the atria (singular: atrium), receive blood via veins. Passing
through valves (atrioventricular (AV) valves), blood then enters the lower chambers, the
ventricles. Ventricular contraction forces blood into the arteries.
Oxygen-poor blood empties into the right atrium via the superior and inferior vena cavae. Blood
then passes through the tricuspid valve into the right ventricle which contracts, propelling the
blood into the pulmonary artery. The pulmonary artery is the only artery that carries oxygen-
poor blood. It branches to the right and left lungs. There, gas exchange occurs -- carbon dioxide
diffuses out, oxygen diffuses in.
Pulmonary veins, the only veins that carry oxygen-rich blood, now carry the oxygenated blood
from lungs to the left atrium of the heart. Blood passes through the bicuspid (mitral) valve into
the left ventricle. The ventricle contracts, sending blood under high pressure through the aorta,
the main artery for systemic circulation. The ascending aorta carries blood to the upper body;
the descending aorta, to the lower body.
Blood Pressure and Heart Rate
The heart beats or contracts around 70 times per minute.1 The human heart will undergo over 3
billion contraction/cardiac cycles during a normal lifetime.
One heartbeat, or cardiac cycle, includes atrial contraction
and relaxation, ventricular contraction and relaxation, and a
short pause. Atria contract while ventricles relax, and vice
versa. Heart valves open and close to limit flow to a single
direction. The sound of the heart contracting and the valves
opening and closing produces a characteristic "lub-dub"
sound.
The cardiac cycle consists of two parts: systole (contraction
of the heart muscle in the ventricles) and diastole
(relaxation of the ventricular heart muscles). When the
ventricles contract, they force the blood from their Interior View Posterior View
chambers into the arteries leaving the heart. The left
ventricle empties into the aorta (systemic circuit) and the
right ventricle into the pulmonary artery (pulmonary circuit). The increased pressure on the
arteries due to the contraction of the ventricles (heart pumping) is called systolic pressure.
When the ventricles relax, blood flows in from the atria. The decreased pressure due to the
relaxation of the ventricles (heart resting) is called diastolic pressure.
Blood pressure is measured in mm of mercury, with the systole in ratio to the diastole. Healthy
young adults should have a ventricular systole of 120mm, and 80mm at ventricular diastole, or
120/80.
Receptors in the arteries and atria sense systemic pressure. Nerve messages from these sensors
communicate conditions to the medulla in the brain. Signals from the medulla regulate blood
pressure.
Electrocardiography (ECG, EKG)
An electrocardiogram measures changes in
electrical potential across the heart and detects
contraction pulses that pass over the surface of
the heart. There are three slow, negative
changes, known as P, R, and T. Positive
deflections are the Q and S waves. The P wave
represents atrial contraction ("the lub"), the T
wave the ventricular contraction ("the dub").
Diseases of the CVS
Angina
Angina, or angina pectoris, is chest pain due either to reduced blood flow to the heart or to
certain other abnormalities of heart function. Hardening (atherosclerosis) of the coronary arteries
that feed the heart is usually the underlying problem. Spasms of the coronary arteries may also
cause angina. There are three main types of angina. The first is called stable angina. This type of
chest pain comes on during exercise and is both common and predictable. Stable angina is most
often associated with atherosclerosis. A second type, called variant angina, can occur at rest or
during exercise. This type is primarily due to sudden coronary artery spasm, though
atherosclerosis may also be a component. The third, most severe type is called unstable angina.
This angina occurs with no predictability and can quickly lead to a heart attack. Anyone with
significant, new chest pain or a worsening of previously mild angina must seek medical care
immediately.
The symptoms of angina
Common symptoms of angina include a squeezing pressure, heaviness, ache, or burning pain
(like indigestion) in the chest that occur for 5 to 30 minutes at a time. These sensations are
usually felt behind the breastbone but may also be felt in the jaw, neck, arms, back, or upper
abdomen. Some people may also have difficulty in breathing or may become pale and sweaty.
Symptoms of angina usually appear during physical exertion, after heavy meals, and with
heightened emotional states, such as anger, frustration, shock, and excitement.
Atherosclerosis
Atherosclerosis is hardening of the arteries, a common disease of the major blood vessels
characterized by fatty streaks along the vessel walls and by deposits of cholesterol and calcium.
Atherosclerosis of arteries supplying the heart is called coronary artery disease. It can restrict the
flow of blood to the heart, which often triggers heart attacks¡ªthe leading cause of death in
Americans and Europeans. Atherosclerosis of arteries supplying the legs causes a condition
called intermittent claudication, which is characterized by pain in the legs after walking short
distances. People with elevated cholesterol levels are much more likely to have atherosclerosis
than people with low cholesterol levels. Many important nutritional approaches to protecting
against atherosclerosis are aimed at lowering serum cholesterol levels. People with diabetes are
also at very high risk for atherosclerosis, as are people with elevated triglycerides and high
homocysteine.
The symptoms of atherosclerosis
Atherosclerosis is typically a silent disease until one of the many late-stage vascular
manifestations intervenes. Some people with atherosclerosis may experience angina (chest pain)
or intermittent claudication (leg cramps and pain) on exertion. Symptoms such as these develop
gradually as the disease progresses.
Cardiac Arrhythmia
Cardiac arrhythmia is a term that denotes a disturbance of the heart rhythm. Cardiac arrhythmias
can range in severity from entirely benign to immediately life-threatening. If arrhythmia is
suspected, a doctor should be consulted for confirmation. In addition, the use of natural
substances for arrhythmia should always be supervised by a doctor.
The symptoms of cardiac arrhythmia
Most arrhythmia does not result in symptoms, but people may experience anxiety,
lightheadedness, dizziness, fainting, unusual awareness of the heartbeat, and sensations of
fluttering or pounding in the chest.
Cardiomyopathy
Cardiomyopathy refers to abnormalities in the structure or function of the heart muscle. There
are three major types of cardiomyopathy: dilated congestive, hypertrophic, and restrictive. The
most prevalent form is dilated congestive cardiomyopathy (DCM). In people with DCM, the
heart muscle is damaged, most commonly by coronary artery disease (atherosclerosis). People
with diabetes have been reported to be at increased risk of DCM. DCM can also be triggered by
alcohol abuse, infections, exposure to certain drugs and toxins, nutritional deficiencies,
connective tissue diseases, hereditary disorders, and pregnancy. In DCM, the heart gradually
loses its efficiency as a pump. Cardiomyopathy is a serious health condition and requires expert
medical care rather than self-treatment. However, because of the associations between
cardiomyopathy and diseases such as atherosclerosis, diabetes, hypertension, and congestive
heart failure, lifestyle recommendations for the prevention of these conditions may also help
prevent DCM. Hypertrophic cardiomyopathy is usually a hereditary disorder, although the
incidence of this form of cardiomyopathy may also be higher in people with hypertension.
Restrictive cardiomyopathy is usually due to a connective tissue disease, cancer, or an
autoimmune condition. Both hypertrophic and restrictive cardiomyopathies are relatively
uncommon.
The symptoms of cardiomyopathy
People with cardiomyopathy may have difficulty breathing during light exertion, and they may
become fatigued easily. Other chronic symptoms are swelling around the ankles and an enlarged
abdomen.
Chronic Venous Insufficiency (CVI)
Chronic venous insufficiency (CVI) is poor return of blood from feet and legs back to the heart.
CVI may occur following excessive clotting and inflammation of the leg veins, a disease known
as deep vein thrombosis. CVI also results from a simple failure of the valves in leg veins to hold
blood against gravity, leading to sluggish movement of blood out of the veins, resulting in
swollen legs.
The symptoms of chronic venous insufficiency
CVI may cause feet and calves to become swollen, often accompanied by a dull ache made
worse with prolonged standing. If CVI is allowed to progress, the skin tends to darken and ulcers
may occur. CVI often causes varicose veins.
High Blood Pressure
Blood pressure is the force in the arteries when the heart beats (systolic pressure) and when the
heart is at rest (diastolic pressure). It's measured in millimeters of mercury (mm Hg). High blood
pressure (or hypertension) is defined in an adult as a blood pressure greater than or equal to 140
mm Hg systolic pressure or greater than or equal to 90 mm Hg diastolic pressure. High blood
pressure directly increases the risk of coronary heart disease (which leads to heart attack) and
stroke, especially when it's present with other risk factors. High blood pressure can occur in
children or adults, but it's more common among people over age 35. It's particularly prevalent in
African Americans, middle-aged and elderly people, obese people, heavy drinkers and women
who are taking birth control pills. It may run in families, but many people with a strong family
history of high blood pressure never have it. People with diabetes mellitus, gout or kidney
disease are more likely to have high blood pressure, too.
American Heart Association recommended blood pressure levels
Blood Pressure Category Systolic Diastolic
(mm Hg) (mm Hg)
Normal less than 120 and less than 80
Prehypertension 120–139 or 80–89
High
Stage 1 140–159 or 90–99
Stage 2 160 or higher or 100 or higher
Common Misconceptions
Common symptoms of high blood pressure include nervousness, sweating and difficulty
sleeping. High blood pressure has NO symptoms. That often called the silent killer. The only
way to know if you have it is to have your blood pressure checked. Some people who look and
feel fit and healthy may find that they have high blood pressure. Likewise, some people who
have other risk factors for heart disease and/or stroke (such as being overweight or smoking)
may not have high blood pressure.
High Cholesterol
Although it is by no means the only major risk factor, elevated serum (blood) cholesterol is
clearly associated with a high risk of heart disease. Most doctors suggest cholesterol levels
should stay under 200 mg/dl. As levels fall below 200, the risk of heart disease continues to
decline. Many doctors consider cholesterol levels of no more than 180 to be optimal. A low
cholesterol level, however, is not a guarantee of good heart health, as some people with low
levels do suffer heart attacks. Medical laboratories now subdivide total cholesterol measurement
into several components, including LDL (¡°bad¡±) cholesterol, which is directly linked to heart
disease, and HDL (¡°good¡±) cholesterol, which is protective. The relative amount of HDL to
LDL is more important than total cholesterol. For example, it is possible for someone with very
high HDL to be at relatively low risk for heart disease even with total cholesterol above 200.
Evaluation of changes in cholesterol requires consultation with a healthcare professional and
should include measurement of total serum cholesterol, as well as HDL and LDL cholesterol.
The symptoms of high cholesterol
This condition does not produce symptoms. Therefore, it is prudent to visit a health professional
on a regular basis to have cholesterol levels measured.
High Homocysteine(Hyperhomocysteinemia)
Homocysteine, a normal breakdown product of the essential amino acidmethionine, is believed
to exert several toxic effects. A growing body of evidence suggests that an elevated
homocysteine level is a risk factor for heart disease, independent of other known risk factors,
such as elevated serum cholesterol and hypertension. The evidence is not all one-sided, however.
In some research the link has appeared only in women, and a few scientists still have doubts
about the importance of elevations in homocysteine for anyone. The clear association between
elevated homocysteine levels and heart disease reported in most studies5 does not conclusively
prove that homocysteine causes heart disease. It might only be a marker for something else that
is the real culprit.6 Nonetheless, many cardiologists take seriously the association between
elevations in homocysteine and increased risk of heart disease. Anger and hostility correlate with
the risk of heart disease. A preliminary study found a link between high homocysteine levels and
hostility and repressed anger. While anger, hostility, high homocysteine, and heart disease all
appear to be tied together, which of these is cause and which is effect remains somewhat unclear.
Increased homocysteine levels may also be a risk factor for the development of many other
conditions, including stroke, thromboembolism1 (blood clots that can dislodge and cause stroke,
heart attack, and other complications), osteoporosis, inflammatory bowel disease (Crohn¡¯s
disease and ulcerative colitis), Alzheimer¡¯s disease,14 death from diabetes, miscarriage, other
complications of pregnancy, and hypothyroidism.
The symptoms of high homocysteine
Extremely high homocysteine can cause blood clots, rapid bone loss, and, in children, mental
retardation. But in general, high homocysteine does not cause symptoms until and unless one of
the diseases with which it is associated, appears.
High Triglycerides
Triglycerides (TGs) are a group of fatty compounds that circulate in the bloodstream and are
stored in the fat tissue. Individuals who have elevated blood levels of TGs (known as
hypertriglyceridemia) appear to be at increased risk of developing heart disease. People with
diabetes often have elevated TG levels. Successfully controlling diabetes will, in some cases,
lead to normalization of TG levels.
The symptoms of high triglycerides
Very high triglycerides can cause pancreatitis, an enlarged liver and spleen, and fatty deposits in
the skin called xanthomas. Otherwise, high triglycerides may not cause symptoms until and
unless heart disease or other diseases of blood vessels develop.
Hypoglycemia
"Hypoglycemia" is the medical term for low blood sugar (glucose). Occasionally, hypoglycemia
can be dangerous (for example, from injecting too much insulin). It may also indicate a serious
underlying medical condition, such as a tumor of the pancreas or liver disease. More often,
however, when people say they have hypoglycemia, they are describing a group of symptoms
that occur when the body overreacts to the rise in blood sugar that occurs after eating, resulting
in a rapid or excessive fall in the blood sugar level. This is sometimes called ¡°reactive
hypoglycemia.¡± Many people who believe they have reactive hypoglycemia do not, in fact,
have low blood sugar levels,1 and many people who do have low blood sugar levels do not have
any symptoms of reactive hypoglycemia.2 Some evidence suggests that reactive hypoglycemia
may be partly a psychological condition.3 Consequently, some doctors believe that reactive
hypoglycemia does not exist.4 Most doctors, on the other hand, have found reactive
hypoglycemia to be a common cause of the symptoms listed below.
What are the symptoms of hypoglycemia?
Common symptoms of hypoglycemia are fatigue, anxiety, headaches, difficulty concentrating,
sweaty palms, shakiness, excessive hunger, drowsiness, abdominal pain, and depression.
Insulin Resistance Syndrome(IRS)
The insulin resistance syndrome (IRS) is a group of health risk factors that increase the
likelihood of heart disease, and perhaps other disorders, such as diabetes and some cancers. The
risk factors that make up IRS include insulin resistance, which refers to the reduced ability of the
hormone insulin to control the processing of glucose by the body. Other major risk factors often
associated with IRS include high blood sugar and high blood triglycerides, low HDL (¡°good¡±)
cholesterol, high blood pressure, and excessive body fat in the abdominal region. People with
IRS do not always have every one of these risk factors, but they usually have many of them. A
qualified doctor should make the diagnosis of IRS after a thorough examination and blood tests.
Most people with type 2 diabetes have insulin resistance, but many more people who are not
diabetic also have insulin resistance. Since insulin resistance itself often does not cause
symptoms, these people may not be aware of their problem. Some authorities believe insulin
resistance is partially inherited and partially due to lifestyle factors.
What are the symptoms of insulin resistance syndrome?
People with IRS may be overweight (especially in the trunk area), feel sluggish after eating, and
may have been told that they have high blood pressure and high cholesterol.
Mitral Valve Prolapse(MVP)
The mitral valve is one of the four valves separating chambers of the heart. Mitral valve prolapse
(MVP) is a common and occasionally serious condition in which the cusp or cusps of the mitral
valve bulge into one of the heart chambers during the heart¡¯s contraction. This bulging is
caused by abnormalities in the valve¡¯s structure. When serious, mitral valve prolapse may
progress to mitral regurgitation, where the incompetent valve can no longer keep blood from
leaking backwards into the wrong chamber of the heart.
What are the symptoms of mitral valve prolapse?
Most people with MVP experience no symptoms. Some may experience difficulty breathing
during exertion or when lying down, tremor, fatigue, lightheadedness, dizziness, and fainting.
Some develop dull chest pain, palpitations (awareness of the heartbeat), anxiety, and other
symptoms associated with the ¡°fight or flight¡± response. When MVP causes these symptoms, it
is referred to as dysautonomia syndrome.
Myocardial Infarction(MI, Heart Attack) ]
Heart attacks occur when blood flow to a portion of the heart is severely reduced or cut off. The
result is death of heart muscle cells (called an infarct). Hardening and narrowing
(atherosclerosis) of the coronary arteries that feed the heart is usually the underlying problem. In
some cases, a blood clot blocks blood flow; other times, the narrowing is caused by
atherosclerosis alone. Spasm of the coronary arteries may also cause a heart attack. Elevated
cholesterol, triglycerides, or homocysteine; angina pectoris; and diabetes are each associated
with an increased risk of heart attack. Congestive heart failure can occur in some people from
severe damage to the heart resulting from a heart attack.
What are the symptoms of a heart attack?
The first symptom of a heart attack is usually deep aching or pressure-like chest pain that may
radiate to the back, jaw, or left arm. Discomfort may be mild or severe. About 20% of heart
attacks are silent (i.e., they cause no symptoms and may therefore be missed). Older people may
experience shortness of breath. Nausea and vomiting may also occur. Restlessness,
apprehension, pallor, and sweating are common.
Sickle Cell Anemia
Anemia is a deficiency of the oxygen-carrying capacity of red blood cells. Sickle cell anemia is
an inherited chronic anemia in which the red blood cells become sickle or crescent-shaped. The
symptoms of sickle cell anemia are caused by the clogging of small blood vessels by the sickle
cells or by poor delivery of oxygen to the tissues due to the anemia itself. A sickle cell crisis is a
painful episode that occurs when the body becomes severely deprived of oxygen. The disease
and the trait occur in people of African descent, as well as in people from Mediterranean
countries, India, and the Middle East, but rarely in people of European descent.
What are the symptoms of sickle cell anemia?
Symptoms include fatigue, joint and abdominal pain, irritability, yellow discoloration of the skin
and eyes, leg sores, gum disease, frequent respiratory infections, blindness later in life, and
periods of prolonged, sometimes painful erections in males. People with sickle cell anemia can
have episodes of severe pain in the arms, legs, chest, and abdomen that may be accompanied by
fever, nausea, and difficulty breathing. These symptoms occur only in people who inherit copies
of the sickle cell gene from both parents. People who inherit a sickle cell gene from only one
parent have what is known as sickle cell trait and are without symptoms.
Leukemia
Leukemia is a cancer of the blood cells. There are several types of leukemia and these are
classified by how quickly they progress and what cell they affect. In order to understand how
leukemia affects the cells, it is helpful to first understand what normal blood cells do. In the case
of leukemia, one blood cell goes awry (in the majority of cases this cell is a white blood cell) and
the body produces large numbers of this cell. When looked at under a microscope, these
abnormally produced cells look different then the healthy cells and do not function properly. The
body continues to produce these abnormal, non-functional cells, leaving little space for healthy
cells. This imbalance of healthy and unhealthy cells is what causes the symptoms of leukemia.
What Are The Types of Leukemia?
Leukemia is classified by two factors, how quickly the disease develops and what cells are
affected. The disease is either classified as acute or chronic, referring to how quickly it develops
and progresses. In acute leukemia, the white blood cells multiple very rapidly and are very
immature, and therefore cannot function properly (immature cells are called blasts). The blood
fills with blasts quickly, causing the patient to develop symptoms and seek medical attention. In
chronic leukemia, the blasts form more slowly, allowing the body to continue to produce
functional cells, causing fewer symptoms for the patient. These cases are often diagnosed during
a routine physical. Chronic leukemia may cause the spleen to become enlarged, which can be felt
by the doctor during a physical.The types are further divided by which type of white blood cell is
affected - lymphoid cells or myeloid cells. These types are called lymphocytic leukemia and
myelogenous leukemia
The types include:
Acute myeloid leukemia (also called AML) - occurs in both children and adults.
Acute lymphocytic leukemia (ALL) - the most common type seen in children, but also seen in
adults over 65.
Chronic myelogenous leukemia (CML) - occurs mostly in adults.
Chronic lymphocytic leukemia (CLL) - most often seen in people over age 55, can affect
younger adults, but almost never seen in children.
