The Need for a Circulatory System

 The cells of all living organisms need a constant supply of reactants for
metabolism, e.g. oxygen and glucose
 Single-celled organisms can gain oxygen and glucose directly from their
surroundings and the molecules can diffuse to all parts of the cell quickly due
to short diffusion distances
 Larger organisms, however, are made up of many layers of cells, meaning that
the time taken for substances such as glucose and oxygen to diffuse to every cell
in the body would be far too long
o The diffusion distances involved are too great
o Large organisms often have high energy requirements, so the delivery
of reactants for metabolism needs to happen quickly
 To solve this problem their exchange surfaces are connected to a mass
transport system, for example
o The digestive system is connected to the circulatory system
o The lungs are connected to the circulatory system
 Mass transport is the bulk movement of gases or liquids in one direction,
usually via a system of vessels and tubes
 The circulatory system in mammals is a well-studied example of a mass
transport system; the one-way flow of blood within the blood vessels carries
essential nutrients and gases to all the cells of the body
 Mass transport systems help to
o Bring substances quickly from one exchange site to another
o Maintain diffusion gradients at exchange sites and between cells and
their fluid surroundings
o Ensure effective cell activity by supplying reactants and removing waste
products

Mammals have a circulatory system

known as a double circulatory system;
the blood travels around the body in two
separate circuits known as the
pulmonary and systemic circulation
Blood Vessels: Structure & Function
 The body contains several different types of blood vessel
o Arteries transport blood away from the heart, usually at high pressure, to
the tissues
 Remember; arteries carry blood away from the heart
o Arterioles; arteries branch into narrower blood vessels called arterioles
which transport blood into capillaries
o Veins: transport blood to the heart, usually at low pressure
 Remember; veins carry blood into the heart
o Venules; these narrower blood vessels transport blood from the
capillaries to the veins
o Capillaries are microscopic blood vessels that carry blood to the cells
 Blood flows through the lumen of a blood vessel; the size of the lumen varies
depending on the type of blood vessel
o Arteries have a narrow lumen and the veins a wider lumen
 The walls of each type of blood vessel have a structure that relates to the
function of the vessel

The blood vessels form a continuous network; the structure of each allows it to
carry out its function

Arteries

 Artery walls consist of three layers

o The endothelium, sometimes referred to as the tunica intima
  The endothelium is one cell thick and lines the lumen of all blood
vessels.
 It is very smooth and reduces friction for free blood flow
 In arteries the endothelium is highly folded, enabling it to expand
under high pressure
o Smooth muscle and elastic tissue, sometimes referred to as the tunica
media
 This layer is thick in arteries
 The layer of muscle cells strengthen the arteries so they
can withstand high pressure
 It also enables them to constrict and narrow the lumen for reduced
blood flow
 Contraction of the muscle causes constriction of the lumen
 This is useful for diverting blood flow away from certain
locations e.g. away from the digestive system during
exercise
 The elastic tissue helps to maintain blood pressure in the arteries
 It stretches and recoils to even out any fluctuations in
pressure
o The outer wall, sometimes referred to as the tunica adventitia, or tunica
externa
 Contains the structural protein collagen
 Collagen is a strong protein that protects blood vessels from
damage by over-stretching
 Arteries have a narrow lumen which helps to maintain a high blood pressure
 A pulse is present in arteries as they stretch to accommodate an increased
volume of blood with each heart beat

Veins

 Veins return blood to the heart

 They receive blood that has passed through capillary networks, so the blood
pressure is very low
 Veins contain the same layers as arteries but in different proportions
o The smooth muscle and elastic layer is much thinner in veins
 There is no need for a thick muscular layer as veins don't have to
withstand high pressure
 The lumen of the vein is much wider than that of an artery
o A larger lumen helps to ensure that blood returns to the heart at an
adequate speed
o A large lumen reduces friction between the blood and the endothelium of
the vein
 The rate of blood flow is slower in veins but a larger lumen means
the volume of blood delivered per unit of time is equal to that of
arteries
 Veins contain valves
 o These prevent the backflow of blood, helping return blood to the heart
 A pulse is absent in veins due to the increased distance from the heart

Arteries have a thick layer of elastic and muscle tissue and a narrow lumen, while
veins have a thin layer of elastic and muscle tissue and a wide lumen

Capillaries

 Capillaries have thin walls which are permeable, allowing substances to leave
the blood to reach the body’s tissues
 They can form networks called capillary beds which are very
important exchange surfaces within the circulatory system
o A large number of capillaries branch between cells
 Substances can diffuse between the blood and cells quickly as
there is a short diffusion distance
 Capillaries have a lumen that is very narrow in diameter
o Red blood cells need to pass through the capillaries in single file
o This forces the blood to travel slowly which provides more time
for diffusion to occur
 The wall of the capillary is a single layer of endothelial cells
o This layer also lines the lumen in arteries and veins
 o The wall is only one cell thick; this reduces the diffusion distance for
oxygen and carbon dioxide between the blood and the tissues of the body
o The cells of the wall have gaps called pores which allow blood plasma to
leak out and form tissue fluid
o White blood cells can combat infection in affected tissues by squeezing
through the pores in the capillary walls

Capillaries have a narrow lumen and walls that are one cell thick
Examiner Tips and Tricks

You need to know about the structure and function of arteries, veins and capillaries;
for “explain” questions remember to pair a description of a structural feature to an
explanation of how it helps the blood vessel to function. For example, “Capillary walls
are one-cell thick, which enables quick diffusion of substances due to the short diffusion
distance.”

Remember that muscle tissue contracts and elastic tissue recoils.

Remember that capillary walls are one cell thick; they do not have cell walls.
The Cardiac Cycle
 Circulatory systems are systems which transport fluids containing materials
needed by the organism, as well as waste materials that need to be removed
 Circulatory systems are described as being either open or closed
o In a closed circulatory system blood is pumped around the body and is
always contained within a network of blood vessels
o In an open circulatory system the blood, or blood equivalent, is inside the
body cavity and bathes the organs
 Circulatory systems can also be either double or single
o Double circulatory systems have two loops; one to the lungs and one to
the body
o Single circulatory systems have one loop that includes the lungs and the
body
 Humans have a closed, double circulatory system; in one complete circuit of
the body blood passes through the heart twice
o The right side of the heart pumps deoxygenated blood to the lungs for
gas exchange; this is the pulmonary circulatory system
o Blood then returns to the left side of the heart, so that oxygenated blood
can be pumped at high pressure around the body; this is the systemic
circulatory system

Heart structure

 The human heart has a mass of around 300 g and is roughly the size of a closed
fist
 The heart is a hollow, muscular organ located in the chest cavity
 It is protected in the chest cavity by the pericardium, a tough and fibrous sac
 The heart is divided into four chambers
o The two top chambers are atria
o The bottom two chambers are ventricles
 The left and right sides of the heart are separated by a wall of muscular tissue
called the septum
o The septum is very important for ensuring blood doesn’t mix between the
left and right sides of the heart
 The human heart is adapted for pumping blood around the body

The heart is a muscular organ; the muscle itself is supplied with blood by the
coronary arteries, enabling it to pump blood via a series of major blood vessels

Valves in the heart

 Valves are important for keeping blood flowing forward in the right direction and
for maintaining the correct pressure in the chambers of the heart
 o The right atrium and right ventricle are separated by an atrioventricular
(AV) valve known as the tricuspid valve
 Remember; the right side of the heart has a tricuspid valve
o The left atrium and left ventricle are separated by another AV known as
the bicuspid valve
o The right ventricle and the pulmonary artery are separated by a semilunar
(SL) valve known as the pulmonary valve
o The left ventricle and aorta are separated by another SL valve known as
the aortic valve
 Valves in the heart
o Open when the pressure of blood behind them is greater than the
pressure in front of them
o Close when the pressure of blood in front of them is greater than the
pressure behind them
 The valves are attached to the heart walls by valve tendons, or cords; these
prevent the valves from flipping inside out under high pressure

Adaptations of the Structures of the Heart Table

Blood vessels and the heart

 There are two blood vessels bringing blood into the heart; the vena
cava and pulmonary vein
o The vena cava brings blood from the body
o The pulmonary vein brings blood from the lungs
 There are two blood vessels taking blood away from the heart; the pulmonary
artery and aorta
o The pulmonary artery takes blood to the lungs
o The aorta takes blood to the body
 The muscle of the heart itself is supplied with blood by a series of blood vessels
known as the coronary arteries
o The coronary arteries can be seen running across the surface of the heart
Examiner Tips and Tricks

When looking at a diagram of a heart remember that the right side of the heart will
appear on the left of the diagram, as if you are looking at someone else's heart in front
of you

The cardiac cycle

 The cardiac cycle is the series of events that take place in one heartbeat,
including muscle contraction and relaxation
o The contraction of the heart is called systole, while the relaxation of the
heart is called diastole
 One cardiac cycle is followed by another in a continuous process
o There is no gap between cycles where blood stops flowing

Volume and pressure changes

 Contraction of the heart muscle causes a decrease in volume in the

corresponding chamber of the heart, which then increases again when the
muscle relaxes
 Volume changes lead to corresponding pressure changes
o When volume decreases, pressure increases
o When volume increases, pressure decreases
 Throughout the cardiac cycle, heart valves open and close as a result
of pressure changes in different regions of the heart
o Valves open when the pressure of blood behind them is greater than
the pressure in front of them
o They close when the pressure of blood in front of them is greater than
the pressure behind them
 Valves are an important mechanism to stop blood flowing backwards

Atrial systole

 The walls of the atria contract

o Atrial volume decreases
o Atrial pressure increases
 The pressure in the atria rises above that in the ventricles, forcing the
atrioventricular (AV) valves open
 Blood is forced into the ventricles
o There is a slight increase in ventricular pressure and chamber volume as
the ventricles receive the blood from the atria
 The ventricles are relaxed at this point; ventricular diastole coincides with atrial
systole

Ventricular systole
  The walls of the ventricles contract
o Ventricular volume decreases
o Ventricular pressure increases
 The pressure in the ventricles rises above that in the atria
o This forces the AV valves to close, preventing back flow of blood
 The pressure in the ventricles rises above that in the aorta and pulmonary artery
o This forces the semilunar (SL) valves open so blood is forced into the
arteries and out of the heart
 During this period the atria are relaxing; atrial diastole coincides with ventricular
systole
o The blood flow to the heart continues, so the relaxed atria begin to fill
with blood again

Diastole

 The ventricles and atria are both relaxed

 Pressure in the ventricles drops below that in the aorta and pulmonary artery,
forcing the SL valves to close
 The atria continue to fill with blood
o Blood returns to the heart via the vena cava and pulmonary vein
 Pressure in the atria rises above that in the ventricles, forcing the AV valves
open
 Blood flows passively into the ventricles without need of atrial systole
 The cycle then begins again with atrial systole

The events of the cardiac cycle allow the heart to pump blood to the lungs and
body
Valves during the cardiac cycle table

Stage in cardiac cycle Atrioventricular valves Semilunar valves

Atrial systole Open Closed
Ventricular systole Closed Open
Diastole Open Closed

The pressure changes in the cardiac cycle can be analysed

Analysing the cardiac cycle

  The lines on the graph represent the pressure of the left atrium, aorta, and the
left ventricle
 The points at which the lines cross each other are important because they
indicate when valves open and close

Point A - the end of diastole

 The atrium has filled with blood during the preceding diastole
 Pressure is higher in the atrium than in the ventricle, so the AV valve is open

Between points A and B - atrial systole

 Left atrium contracts, causing an increase in atrial pressure and forcing blood
into the left ventricle
 Ventricular pressure increases slightly as it fills with blood
 Pressure is higher in the atrium than in the ventricle, so the AV valve is open

Point B - beginning of ventricular systole

 Left ventricle contracts causing the ventricular pressure to increase

 Pressure in the left atrium drops as the muscle relaxes
 Pressure in the ventricle exceeds pressure in the atrium, so the AV valve shuts

Point C - ventricular systole

 The ventricle continues to contract

 Pressure in the left ventricle exceeds that in the aorta
 Aortic valve opens and blood is forced into the aorta

Point D - beginning of diastole

 Left ventricle has been emptied of blood

 Muscles in the walls of the left ventricle relax and pressure falls below that in the
newly filled aorta
 Aortic valve closes

Between points D and E - early diastole

 The ventricle remains relaxed and ventricular pressure continues to decrease

 In the meantime, blood is flowing into the relaxed atrium from the pulmonary
vein, causing an increase in pressure

Point E - diastole

 The relaxed left atrium fills with blood, causing the pressure in the atrium to
exceed that in the newly emptied ventricle
  AV valve opens

After point E - late diastole

 There is a short period of time during which the left ventricle expands due to
relaxing muscles
 This increases the internal volume of the left ventricle and decreases the
ventricular pressure
 At the same time, blood is flowing slowly through the newly opened AV valve into
the left ventricle, causing a brief decrease in pressure in the left atrium
 The pressure in both the atrium and ventricle then increases slowly as they
continue to fill with blood

Worked Example

The graph below shows the cardiac cycle.

Calculate the heart rate of this person. Give your answer in beats per minute.

Answer:

Step 1: Work out the length of one heart beat

It takes 0.7 seconds for completion of one cardiac cycle, which is one heart beat

So there is 1 cycle in 0.7 seconds

Step 2: Calculate how many heart beats occur per second

 Divide by 0.7 to find out how many cycles in 1 second

1 0.7 = 1.43 beats in 1 second

Step 3: Calculate how many heart beats occur per minute

Multiply by 60 to find out how many cycles in 60 seconds

1.43 60 = 85.71 beats in 60 seconds

So the heart rate is 85.71 beats min-1

Examiner Tips and Tricks

You might be asked to interpret the graph of the cardiac cycle so it is important you
understand it and can analyse where each stage of the cycle is happening. Common
areas of assessment are about the pressure and volume changes, where valves open
and close, and when blood starts flowing in or out of specific chambers.

Haemoglobin Structure & Function

Transport of oxygen

 The majority of oxygen transported around the body is bound to the protein
haemoglobin in red blood cells
o Red blood cells are also known as erythrocytes
 Each molecule of haemoglobin contains four haem groups, each able to bond
with one molecule of oxygen
o This means that each molecule of haemoglobin can carry four oxygen
molecules, or eight oxygen atoms in total
 Haemoglobin proteins are made up of four subunits, each of which contains a
region called a haem group to which oxygen can bind

 When oxygen binds to haemoglobin, oxyhaemoglobin is formed

Oxygen + Haemoglobin Oxyhaemoglobin

4O2 + Hb Hb4O 2

 The binding of the first oxygen molecule results in a conformational change in the
structure of the haemoglobin molecule, making it easier for each successive
oxygen molecule to bind; this is cooperative binding
 The reverse of this process happens when oxygen dissociates in the tissues

Carbon dioxide transport

 Waste carbon dioxide produced during respiration diffuses from the tissues into
the blood
 There are three main ways in which carbon dioxide is transported around the
body
o A very small percentage of carbon dioxide dissolves directly in the blood
plasma and is transported in solution
 o Carbon dioxide can bind to haemoglobin,
forming carbaminohaemoglobin
o A much larger percentage of carbon dioxide is transported in the form
of hydrogen carbonate ions (HCO3-)

Formation of hydrogen carbonate ions

 Carbon dioxide diffuses into red blood cells

 Inside red blood cells, carbon dioxide combines with water to form H2CO3

CO2 + H2O ⇌ H2CO3


o Red blood cells contain the enzyme carbonic anhydrase which catalyses
the reaction between carbon dioxide and water
o Without carbonic anhydrase this reaction proceeds very slowly
o The plasma contains very little carbonic anhydrase
hence H2CO3 forms more slowly in plasma than in the cytoplasm of red
blood cells
 Carbonic acid dissociates readily into H+ and HCO3- ions

H2CO3 ⇌ HCO3– + H+

 Hydrogen ions can combine with haemoglobin, forming haemoglobinic acid and
preventing the H+ ions from lowering the pH of the red blood cell
o Haemoglobin is said to act as a buffer in this situation
 The hydrogen carbonate ions diffuse out of the red blood cell into the blood
plasma where they are transported in solution
 Carbon dioxide can be transported in the form of hydrogen carbonate ions
Association & Dissociation of Haemoglobin
The oxygen dissociation curve

 The oxygen dissociation curve shows the rate at which oxygen associates,
and also dissociates, with haemoglobin at different partial pressures
of oxygen (pO2)
o Partial pressure of oxygen refers to the pressure exerted by oxygen
within a mixture of gases; it is a measure of oxygen concentration
o Haemoglobin is referred to as being saturated when all of its oxygen
binding sites are taken up with oxygen; so when it contains four
oxygen molecules
 The ease with which haemoglobin binds and dissociates with oxygen can be
described as its affinity for oxygen
o When haemoglobin has a high affinity it binds easily and dissociates
slowly
o When haemoglobin has a low affinity for oxygen it binds
slowly and dissociates easily
 In other liquids, such as water, we would expect oxygen to becomes associated
with water, or to dissolve, at a constant rate, providing a straight line on a
graph, but with haemoglobin oxygen binds at different rates as the
pO2 changes; hence the resulting curve
o It can be said that haemoglobin's affinity for oxygen changes at
different partial pressures of oxygen
Oxygen binds to haemoglobin at different rates as the partial pressure of oxygen
changes; the resulting curve is known as the oxygen dissociation curve

Explaining the shape of the curve

 The curved shape of the oxygen dissociation curve for haemoglobin can be
explained as follows
o Due to the shape of the haemoglobin molecule, it is difficult for the first
oxygen molecule to bind to haemoglobin; this means that binding of the
first oxygen occurs slowly, explaining the relatively shallow curve at the
bottom left corner of the graph
o After the first oxygen molecule binds to haemoglobin, the haemoglobin
protein changes shape, or conformation, making it easier for the next
oxygen molecules to bind; this speeds up binding of the remaining
oxygen molecules and explains the steeper part of the curve in the
middle of the graph
 The shape changes of haemoglobin leading to easier oxygen
binding is known as cooperative binding
o As the haemoglobin molecule approaches saturation it takes longer for the
fourth oxygen molecule to bind due to the shortage of remaining binding
sites, explaining the levelling off of the curve in the top right corner of
the graph

Interpreting the curve

 When the curve is read from left to right, it provides information about the rate at
which haemoglobin binds to oxygen at different partial pressures of oxygen
o At low pO2, in the bottom left corner of the graph, oxygen binds slowly
to haemoglobin; this means that haemoglobin cannot pick up oxygen and
become saturated as blood passes through the body's oxygen-depleted
tissues
 Haemoglobin has a low affinity for oxygen at low pO2, so
saturation percentage is low
o At medium pO2, in the central region of the graph, oxygen binds more
easily to haemoglobin and saturation increases quickly; at this point
on the graph a small increase in pO2 causes a large increase in
haemoglobin saturation
o At high pO2, in the top right corner of the graph, oxygen binds easily to
haemoglobin; this means that haemoglobin can pick up oxygen and
become saturated as blood passes through the lungs
 Haemoglobin has a high affinity for oxygen at high pO 2, so
saturation percentage is high
 Note that at this point on the graph increasing the pO2 by a large
amount only has a small effect on the percentage saturation of
haemoglobin; this is because most oxygen binding sites on
haemoglobin are already occupied
  When read from right to left, the curve provides information about the rate at
which haemoglobin dissociates with oxygen at different partial pressures of
oxygen
o In the lungs, where pO2 is high, there is very little dissociation of
oxygen from haemoglobin
o At medium pO2, oxygen dissociates readily from haemoglobin, as
shown by the steep region of the curve; this region corresponds with
the partial pressures of oxygen present in the respiring tissues of the
body, so ready release of oxygen is important for cellular respiration
 At this point on the graph a small decrease in pO2 causes a large
decrease in percentage saturation of haemoglobin, leading to
easy release of plenty of oxygen to the cells
o At low pO2 dissociation slows again; there are few oxygen molecules
left on the binding sites, and the release of the final oxygen molecule
becomes more difficult, in a similar way to the slow binding of the first
oxygen molecule

The Bohr effect

 Changes in the oxygen dissociation curve as a result of carbon dioxide

levels are known as the Bohr effect, or Bohr shift
 When the partial pressure of carbon dioxide in the blood is high,
haemoglobin’s affinity for oxygen is reduced
o This is the case in respiring tissues, where cells are producing carbon
dioxide as a waste product of respiration
o This occurs because CO2 lowers the pH of the blood
 CO2 combines with water to form carbonic acid
 Carbonic acid dissociates into hydrogen carbonate ions and
hydrogen ions
 Hydrogen ions bind to haemoglobin, causing the release of oxygen
 This is a helpful change because it means that haemoglobin gives up its
oxygen more readily in the respiring tissues where it is needed
 On a graph showing the dissociation curve, the curve shifts to the right when
CO2 levels increase
o This means that at any given partial pressure of oxygen, the
percentage saturation of haemoglobin is lower at higher levels of CO 2
 The dissociation curve shifts to the right as a result of the Bohr effect. This
means that at any given partial pressure of oxygen, the percentage saturation of
haemoglobin is lower at higher CO2 levels

Foetal haemoglobin

 The haemoglobin of a developing foetus has a higher affinity for oxygen than
adult haemoglobin
 This is vital as it allows a foetus to obtain oxygen from its mother's blood at
the placenta
o Foetal haemoglobin can bind to oxygen at low pO2
o At this low pO2 the mother's haemoglobin is dissociating with oxygen
 On a dissociation curve graph, the curve for foetal haemoglobin shifts to the
left of that for adult haemoglobin
o This means that at any given partial pressure of oxygen, foetal
haemoglobin has a higher percentage saturation than adult
haemoglobin
 After birth, a baby begins to produce adult haemoglobin which gradually
replaces foetal haemoglobin
o This is important for the easy release of oxygen in the respiring
tissues of a more metabolically active individual
Foetal haemoglobin has a higher affinity for oxygen than adult haemoglobin. This
means that at any given pO2, foetal haemoglobin will have a higher percentage
saturation than adult haemoglobin

Atherosclerosis
 There are a number of diseases of the heart, or cardiovascular diseases, that
can affect blood vessels in different ways
 Atherosclerosis, also known as hardening of the arteries, is caused primarily by
damage to the delicate endothelium of an artery followed by an inflammatory
response
o It is a progressive disease, meaning that it can worsen over time
 In a healthy artery the endothelium is smooth and unbroken to reduce friction
between blood and the inside if the artery
 The steps involved in atherosclerosis are
o Damage, e.g. by high blood pressure, is caused to the endothelium
 Damage can also occur as a result of high levels of certain types of
cholesterol, smoking, diabetes, obesity, and old age
o An inflammatory response occurs and white blood cells, such as
macrophages, accumulate in the damaged area
o Lipids and cholesterol clump together with the macrophages under the
endothelium and form fatty streaks
 This is one of the first signs of atherosclerosis
o Platelets can also add to the fatty deposit
  Platelets are fragments of red blood cells involved in the blood
clotting process
o The collection of cholesterol, lipids, macrophages and platelets
accumulate under the endothelium
 The structure forms a plaque known as an atheroma
o The atheroma narrows the lumen of the artery, reducing and restricting
blood flow and thereby raising blood pressure
o Over time the plaque can calcify and harden, reducing elasticity of the
artery wall and further increasing blood pressure

Blood Clotting
 Blood clotting is an important process; it prevents excess blood loss, the entry of
pathogens, and provides a barrier, or scab, under which wound healing can
occur
  A break in the mucous membranes or skin membranes causes the release of
molecules that trigger a chemical cascade which results in blood clotting
o The process of blood clotting is known as thrombosis
 The chemical cascade involves a large number of steps and several plasma
proteins

 The process of thrombosis involves

o The damaged blood vessel releases thromboplastin, which acts as an
enzyme
o Calcium ions from the plasma, along with thromboplastin, trigger the
conversion of soluble prothrombin protein into the enzyme thrombin
o Thrombin catalyses the conversion of the soluble protein fibrinogen to
the insoluble protein fibrin
o Fibrin fibres mesh and tangle together, trapping platelets and red blood
cells
o A blood clot is formed

Blood clotting, or thrombosis, is brought about by a cascade of chemical

reactions

Blood clots and atheromas

 Atheromas can increase the risk of blood clotting

 o The plaque deposit of an atheroma can rupture through the
endothelium of the artery, damaging the endothelium and forming a
rough surface
o The damage to the endothelium triggers the process of thrombosis
 The combination of atheromas and blood clotting can be dangerous to the health
of an individual
o The blood clot that forms can completely block the artery
 Blood clots reduce blood flow which restricts the movement of
oxygen in the blood, therefore reducing respiration of the
surrounding cells, tissues and organs
o The blood clots can dislodge and travel to different blood vessels in the
body; if they reach the brain this can cause a stroke to occur
 Blood clotting can also lead to
o Heart attack
o Deep vein thrombosis

Stroke

 A stroke is a sudden loss of brain function in a localised area due

to disruption of blood flow to the brain
o A blood clot leads to a blockage of the arteries supplying the brain
o This leads to reduced blood flow and delivery of oxygen to the cells of
the brain, reducing respiration
o Cells in the affected part of the brain cannot produce ATP and their
function is reduced
 A stroke caused by a blood clot is called an ischemic stroke

Heart attack

 Coronary heart disease (CHD) is caused by the formation of atheromas and

blood clots in the coronary arteries
o The coronary arteries flow over the surface of the heart, supplying the
heart muscle itself with blood
 Blood flow to certain areas of the heart is restricted and delivery of oxygen to
the affected cells decreases, thereby reducing respiration in these cells
o The cells can no longer produce ATP
o The cells can no longer contract, reducing the force generated by the
heart when it beats
o The cells can die, causing permanent damage to heart tissue
 This leads to a myocardial infarction, also known as a heart attack
 Complete heart failure may occur if large areas of the heart are affected by
blood clots; this can be fatal
 Symptoms of a heat attack include
o Chest pain
o Shortness of breath
o Sweating
 Atheroma and blood clots in the coronary arteries can restrict blood flow to the
heart muscle, leading to a heart attack

Deep vein thrombosis

 If a blood clot forms in a vein deep inside the body it is known as deep vein
thrombosis (DVT)
 This is most common in the veins of the legs
 Causes include
o Prolonged inactivity
o Old age
o Some medications