The next day at work, Denise was having a hard time focusing. Maybe the stress of her job was finally catching up with her. Managing a catering business was no easy task. On top of that, her only daughter,
Emily, had left for college this fall and, being the overprotective parent that she was, Denise found
herself constantly worrying about how her daughter was faring in a different city, away from the
comforts of home. Also, Denise was starting to go through the early stages of menopause. The
hormonal changes, combined with fatigue, stress, and her general worrisome nature, were catching up to
her. Not only that, she couldn't get last night's scary episode out of her thoughts. Was it just part of the
whole perimenopause thing or was it more? Her body was trying to tell her something, but Denise
wasn't sure she was ready to hear.
"I wonder if Denise realizes how all those years of second-hand smoke have taken a toll on
her lungs and on ME, her heart! All that tobacco inhalation has constricted her coronary
arteries. Sure, Denise tries to stay physically active but genetics and her food choices have
brought her blood cholesterol up pretty high to 245 mg/dl. She could be headed for heart
disease. A person's total cholesterol level shouldn't get above 200 mg/dl. That's right. I
ought to know! Denise has hypercholesterolemia, a major contributor to heart disease.
Geesh. Get with it, Denise.
That was a major warning last night. I'm oxygen-starved! Luckily, only a small area of my
left ventricle had a big decrease in blood flow and oxygen supply (cardiac ischemia).
Thank goodness. If nothing else happens, my body will start growing some new collateral
vessels (bypass channels) and I can get some repair work done. Denise didn't experience
chest pain (angina pectoris). But her rapid heart beat and shortness of breath sure got her
attention. She had better shape up because I don't know if I can handle much more oxygen
deprivation. And, hey, all this unstable plaque lurking around is not a good sign either. No
indeed Who knows when it may rupture? I don't like the looks of this at all."
Questions:
1. Draw a sketch of the heart and show where the coronary blood vessels lie.
2. List in order the blood vessels that a drop of blood would follow as it makes a complete journey
around the body starting as it enters the right atrium until it returns to the right atrium.
3. What are the characteristics of Denise's lifestyle that might lead to a heart problem?
4. Has Denise suffered a heart attack?
5. Define these terms: cholesterol, hypercholesterolemia, cardiac ischemia, collateral vessels,