02 Understanding and Reducing Cardiovascular Disease... Flashcards

1
Q

Sudden cardiac events are the #1 cause of LODDs in the fire service. They account for approximately ______ of all FF duty-related deaths.

A

45%

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2
Q

Additionally, for every duty-related fatal cardiac event, approximately ______ duty-related nonfatal events are reported.

A

25

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3
Q

32% of deaths occurred during fire suppression despite firefighting accounting for only ________ of annual time on the job.

A

1-5%

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4
Q

In terms of risk, this translates to an estimated _______ higher risk of death from heart disease during fire suppression than during non-emergency duties.

A

10 to 100 times

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5
Q

Contributing factors to the cardiovascular strain of firefighting:

A
  1. Activation of the sympathetic nervous system
  2. Heavy muscular work
  3. Heat stress
  4. Dehydration
  5. Severe envinronmental conditions
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6
Q

Physiological Disruptions that may or may not be noticable

A
  1. Cardiovascular
    • Increase in HR, BP, Arterial stiffness, and a decrease in stroke volume
  2. Hematological
    • Increase in clotting potential (thrombus) and decrease in plasma volume
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7
Q

Stroke volume decreased by ____ after firefighting,

A

13%

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8
Q

Other bad cardiovascular things that happen after firefighting:

A
  1. reduction in left ventricular diastolic size and volume
  2. left ventricular shortening fraction
  3. Shortening of ejection time
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9
Q

Cardiovascular Strain of firefighting

A
  1. Maximal or near maximal heart rates (~190 bpm)
  2. Decreased stroke volume (decreased by 13-30%)
  3. Increased arterial stiffness
  4. Reduced plasma volume (decreased 15%)
  5. Increased blood clotting potential
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10
Q

Who is at risk of sudden cardiac death?

A

Firefighters with
1. An excess of cardiovascular disease risk factors
2. A previous diagnosis of CVD
3. Undetected structural heart disease
4. Any combo

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11
Q

Risk of On-duty Coronary Heart Disease Death by Risk Factor

A

Risk Factor - Odds Ratio
Age > 45 - 18.0
Current Smoking - 8.6
Hypertension - 12.0
Obesity (BMI > 30) - 3.1
Cholesterol (> 200mg/dL) - 4.4
Diabetes Mellitus - 10.2
Prior diagnosis of coronary heart disease - 35.0

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12
Q

Coronary Heart Disease (CHD) accounts for approximately ______ of all CVD.

A

50%

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13
Q

CHD results from damage to the coronary arteries supply the heart muscle (myocardium).

A
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14
Q

Steps to Prevent Cardiovascular Events

A
  1. Get an appropriate medical evaluation
  2. Maintain a high level of physical fitness
  3. Eat a healthy diet and avoid excess body fat
  4. Get adequate sleep
  5. Embrace a wellness-related lifestyle
  6. Minimize smoke exposure
  7. Follow FD guidelines for rehab during emergency ops and training
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15
Q

NFPA 1582 requires a minimum aerobic capacity of

A

12 METS

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16
Q

Aerobic fitness is also associated with many health benefits (for each 1 MET increase in aerobic capacity)

A
  1. 13% reduction in risk of all-cause mortality
  2. 15% reduction in risk of coronary heart disease and cardiovascular disease
17
Q

Benefits of Fitness

A

Increase in
- Work capacity
- Cardiac efficiency
- Muscular strength and endurance
- Thermal tolerance
- Plasma volume
- Clotting potential
- Metabolism
- Sleep quality

Decrease in cardiovascular risk

18
Q

Studies support the Mediterranean diet in reducing

A
  1. All-cause mortality
  2. CVD morbidity and mortality
  3. Cancer mortality
  4. Diabetes
  5. Obesity
  6. Risk of dementia
  7. Risk of other chronic diseases
19
Q

Recommended Practices for Obtaining Proper Rest

A
  1. Get at least 8 hours of sleep on nights you are not on shift
  2. Consider day time naps
  3. Keep sleeping quarters as quiet as possible to permit sleep
20
Q

Minimize Smoke Exposure: Particulate matter is associated with

A
  1. Increased BP
  2. May promote arrhythmias
  3. Promote the progression of atherosclerosis
  4. Increased coagulatory potential
    • Which increases risk of myocardial infarction
  5. Cellular reactions leading to tissue hypoxemia and myocardial ischemia
21
Q

Rehab provides time for

A
  1. rest
  2. rehydration
  3. cooling
  4. medical monitoring