How does the cardiovascular system work, and what happens when coronary heart disease develops?
The structure and function of the cardiovascular system: the heart, blood vessels and the cardiac cycle, and a physiological disorder of the system (coronary heart disease) including its causes, risk factors, effects and management.
A CCEA A2 2 answer on the cardiovascular system: the structure of the heart and blood vessels, the cardiac cycle and circulation, and coronary heart disease as a physiological disorder, including its causes, risk factors, signs and symptoms, and management.
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What this dot point is asking
CCEA wants you to describe the structure and function of the cardiovascular system (the heart, blood vessels and the cardiac cycle) and to explain a physiological disorder of the system. The most commonly taught disorder is coronary heart disease: its causes, risk factors, effects, and how it is monitored and managed.
Structure and function of the cardiovascular system
The heart has four chambers: the right and left atria (upper) and the right and left ventricles (lower), divided by the septum. Valves (atrioventricular and semilunar) keep blood flowing one way. Arteries have thick, muscular, elastic walls to withstand high pressure; veins have thinner walls and valves to prevent backflow; capillaries have walls one cell thick to allow the exchange of oxygen, nutrients and waste. The circulation is double: blood passes through the heart twice, once to the lungs (pulmonary) and once to the body (systemic).
The cardiac cycle
The ordered flow is essential to learn: vena cava, right atrium, right ventricle, pulmonary artery, lungs, pulmonary vein, left atrium, left ventricle, aorta, body. The left ventricle has the thickest wall because it pumps blood at high pressure all the way around the body.
Coronary heart disease
Reduced flow causes angina (chest pain on exertion). If a coronary artery becomes completely blocked, the heart muscle beyond it is starved of oxygen and part of it dies, which is a heart attack (myocardial infarction). Risk factors include a high-fat diet, smoking, physical inactivity, obesity, high blood pressure, high cholesterol, diabetes and stress (controllable), and age, sex and family history (not controllable). This links directly to the AS 3 idea of controllable and uncontrollable factors.
Management
Coronary heart disease is managed at three levels. Lifestyle change (stopping smoking, a healthier diet, exercise, weight loss) reduces risk and slows progression. Medication includes statins (to lower cholesterol), drugs to lower blood pressure, and aspirin (to reduce clotting). Surgery in severe cases includes angioplasty (widening the artery and inserting a stent) or a coronary bypass. Management therefore combines the individual's own changes with medical and surgical care, the same partnership idea that runs through the qualification.
Try this
Q1. Name the four chambers of the heart. [4 marks]
- Cue. Right atrium, left atrium, right ventricle, left ventricle.
Q2. State what happens during ventricular systole. [1 mark]
- Cue. The ventricles contract and pump blood out through the pulmonary artery and aorta.
Q3. Explain how atherosclerosis leads to a heart attack. [3 marks]
- Cue. Fatty deposits narrow a coronary artery; a clot blocks it; the heart muscle beyond is starved of oxygen and dies.
Exam-style practice questions
Practice questions written in the style of CCEA exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
CCEA A2 2 20196 marksDescribe the structure of the heart and explain how blood flows through it during the cardiac cycle.Show worked answer →
A 6-mark answer needs the four chambers, the valves, and the ordered flow.
Structure: the heart has four chambers, two atria (top) and two ventricles (bottom), separated into right and left sides by the septum. Valves (the atrioventricular valves and the semilunar valves) prevent backflow.
Flow: deoxygenated blood returns from the body via the vena cava into the right atrium, passes through the right atrioventricular valve into the right ventricle, and is pumped through the pulmonary artery to the lungs. Oxygenated blood returns via the pulmonary vein into the left atrium, passes into the left ventricle, and is pumped out through the aorta to the body.
Cardiac cycle: atria contract (atrial systole) filling the ventricles, then ventricles contract (ventricular systole) pushing blood out, then the heart relaxes (diastole) and refills.
Markers reward the chambers and valves, the correct ordered flow, and the systole and diastole stages.
CCEA A2 2 20218 marksExplain the causes and risk factors of coronary heart disease and describe how it can be managed.Show worked answer →
An 8-mark answer needs the disease mechanism, the risk factors, and management.
Cause: coronary heart disease develops when the coronary arteries that supply the heart muscle become narrowed by a build-up of fatty deposits (atherosclerosis, atheroma or plaques). This reduces blood flow and oxygen to the heart muscle, causing chest pain (angina); if an artery is blocked completely, part of the heart muscle dies (a heart attack, myocardial infarction).
Risk factors: a high-fat diet, smoking, physical inactivity, obesity, high blood pressure, high cholesterol, diabetes, stress, age, sex and family history. Some are controllable (lifestyle) and some are not (age, family history).
Management: lifestyle change (stopping smoking, healthier diet, exercise, weight loss), medication (statins to lower cholesterol, drugs to lower blood pressure, aspirin), and surgical treatment (angioplasty with a stent, or coronary bypass) in severe cases.
Markers reward the atherosclerosis mechanism, a range of controllable and uncontrollable risk factors, and lifestyle, medical and surgical management.
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Sources & how we know this
- CCEA GCE Health and Social Care specification — CCEA (2016)