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Flashcards in 2. BAMS Cardiology Deck (17):
1

6 modifiable CVD risk factors

4 irreversible CVD risk factors

CVD prevention involves what two things

Smoking, obesity, stress, diabetes, exercise, hypertension

Sex, age, family history, genes

Lifestyle changes (exercise, weight, stop smoking, drugs)
Medical intervention

2

Give an example of an antiplatelet and how it works

What do anticoagulants do

Give an example of an anticoagulant and how it works

Aspirin - reduces platelet aggregation, preventing blood clot formation

Prevent/slow down clotting, preventing thrombosis or pulmonary embolism formation

Warfarin - inhibits vitamin K-dependent clotting factor synthesis, inhibiting the coagulation cascade, preventing blood clot formation

3

What are the 2 ways statins can work

Lower lipid content or inhibit cholesterol synthesis in the liver

4

2 functions of beta-blockers

2 side effects of beta-blockers

Stop arrhythmias, lower heart rate

Block beta-receptors in the lungs (non-selective), prevent heart rate rise (postural hypotension)

5

2 functions of diuretics

1 side effect of diuretics

Increase salt and water loss, reduce cardiac workload

Xerostomia (dry mouth)

6

3 functions of nitrates

1 side effect of nitrates

Venodilators, reduce peripheral resistance, dilate coronary arteries

Headaches

7

Function of Ca-channel blockers and how do they do this

1 side effect of Ca-channel blockers

Lower blood pressure by blocking smooth muscle calcium channels

Gingival hyperplasia

8

3 functions of ACE inhibitors

2 side effects of ACE inhibitors

2 oral reactions to ACE inhibitors

Block ACE (block Ang I into Ang II), lower blood pressure, reduce salt and water retention

Hypotension, cough

Angio-oedema, lichenoid reactions

9

Definition of ischaemia

Definition of infarction

Narrowing of BVs, causing inadequate oxygen delivery for tissue needs

Occlusion of BVs, causing no oxygen delivery to tissues, resulting in tissue death

10

Angina and PVD

What is angina

5 symptoms of angina

3 investigations for angina

Which drug used to treat angina during acute episode in a dental situation

What is involved in angina therapy (4)

Name at least 3 drugs involved in angina therapy/treatment

How is PVD described

What 3 things can PVD cause

Narrowing of one or more coronary arteries, reducing oxygen delivery to the heart

Chest pain, shortness of breath, dizziness, nausea, unusual tiredness

ECG, angiography, echocardiography

GTN - nitrate

Modifying risk factors, aspirin, other drugs

ACE inhibitors, aspirin, beta-blockers, nitrates, Ca-channel blockers, diuretics

Angina of the (lower) limbs

Poor wound infection, tissue necrosis and gangrene

11

Myocardial Infarction (MI)

5 ways an MI can occur

2 ECG types of MI

4 symptoms of an MI

2 investigations for an MI

4 things you would do if a patient had an MI in your practice

4 components to MI treatment in a hospital

List 4 contraindications to thrombolysis treatment - why is this contraindicated

Name 3 drugs used in secondary prevention of an MI

List 3 complications of an MI

Spontaneous, secondary to ischaemia, sudden death with ischaemia symptoms, MI from PCI, MI from CABG

STEMI, NSTEMI

Chest pain, pain radiates down arm, nausea, shortness of breath, pale, sweaty

ECG, cardiac enzyme (troponin leaks from dead cardiac muscle/tissue)

Call 999, give aspirin (dispersible tablet), give oxygen/loosen clothing, administer analgesia, BLS if required

PCI (stenting/angioplasty), thrombolysis, surgical (CABG), prevent recurrence

Recent surgery, recent injury, severe hypertension, PUD. tPA, involved in thrombolysis, dissolves all blood clots systemically, not just local clots

Beta-blockers, aspirin, ACE inhibitors

Death, arrhythmia, heart failure

12

Hypertension

What is hypertension

List 5 risk factors associated with hypertension

List 2 symptoms of hypertension

List 3 hypertension investigations

Name 2 things involved in hypertension treatment

List 4 drugs involved in hypertension treatment

A blood pressure greater than 140mmHg systolic over 90mmHg diastolic (140/90)

Age, alcohol, stress, race, obesity

Headaches, TIAs

BP measurement (sphygmomanometer), urinalysis, ultrasound

Modify risk factors, drug treatment (reduce BP to < 140/90)

ACE inhibitors, B-blockers, Ca-channel blockers, (thiazide) diuretics

13

Heart Failure

Why does heart failure occur

Name two causes of heart failure with diseases associated with each type

Name three types of heart failure

List three symptoms associated with 2 types of heart failure

List 3 drugs used to treat heart failure

List 3 consequences of congestive heart failure

Output of the heart is incapable of meeting tissue demands

High output failure (anaemia, thyrotoxicosis), low output failure (cardiac defect)

Left, right and congestive

Left - lung and systolic effects - shortness of breath, increased HR (tachycardia), hypotension
Right - elevated venous pressure (raised JVP, ascites, swollen ankles)

Diuretics, ACE inhibitors, nitrates

Hypertrophy, oedema, CVC of lungs and liver

14

Valve disease and Infective Endocarditis

List 3 causes of valve disease

Name one investigation for valve disease

How is valve disease treated

What is infective endocarditis

What two pathogens are commonly associated with infective endocarditis

Congenital abnormality, MI, rheumatic fever

Ultrasound (of heart chambers and valves)

Replacement valve (mechanical or porcine)

Infection of the endocardium, usually valves, caused by microbial colonisation of the thrombi on the endocardial surface

S. aureus and S, viridans

15

Cyanosis

What is cyanosis

When does cyanosis occur clinically

Name the two types of cyanosis, what tissues they effect, and associated causes

List 5 symptoms of cyanosis

Blue/purple discolouration of the skin/mucous membranes due to low oxygen saturation to surface tissues

When there is > 5g/dl of deoxygenated haemoglobin in the blood

Central (core, lips, tongue - congenital heart disease) and peripheral (extremities - cold environment)

Finger clubbing, blue lips, blue gums, blue skin, blue mucous membranes

16

Atherosclerosis

What is atherosclerosis

What are the two stages of atherosclerosis formation

Describe stage 1 (2)

Describe stage 2 (2)

Changes in blood vessel walls due to atheroma formation in the tunica intima

Chronic inflammation followed by healing

Modifiable risk factors damage endothelial cells, causing a change in cell surface receptor, increasing lipid permeability. This causes a change in cell adhesion molecules, allowing monocytes to attach and move into the blood vessel wall

This involves proliferation of smooth muscle cells and fibrous tissue growth. Growth factors are produced and a fibrous fatty plaque, with a central mass of lipid, is formed

17

Arrhythmias

What is VF

What 4 things can cause VF

2 ways VF is treated

What is asystole

What is AF

List 4 (uncommon) symptoms of AF

List 3 diseases that AF can increase the risk of developing

Ventricular fibrillation - disorganised ventricular electrical activity

MI, electrocution, long QT syndrome, Wolf-Parkinson-White syndrome

Defibrillation, CPR

Absence of ventricular contractions lasting longer than the maximum time for sustainable life (2s)

Atrial fibrillation - rapid, irregular beating of the atria. May be brief or constant

Shortness of breath, palpitations, chest pain, lightheadedness

CVA (Stroke), heart failure, dementia