Cardiovascular Disease Flashcards

1
Q

What is the main function of the cardiovascular system?

A

transport gases, nutrients, wastes, hormones

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2
Q

What are the 3 that make up the cardiovascular system?

A

heart, vessels, blood

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3
Q

What are the 4 main types of CVD?

A
  • Coronary Heart Disease (CHD)
  • Stroke/ Cerebrovascular accident (CVA)
  • Peripheral artery disease (PAD)
  • Aortic disease (aneurysm)
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4
Q

What other ways can cause CVD?

A
  • hypertension
  • heart valve disease
  • cardiomyopathy
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5
Q

What is cardiovascular disease?

A

general term
for diseases of the heart
or blood vessels/ circulatory system
(includes all the diseases of the heart and circulation
including coronary heart disease, angina, heart attack, congenital heart disease and stroke)

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6
Q

How can blood flow be reduced to the heart, brain or body?

A
  • blood clot (thrombosis)

- build-up of fatty deposits inside artery (artery hardens, narrows = atherosclerosis)

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7
Q

What is angina?

A

pain which occurs in areas of the body when heart muscles don’t get enough oxygen-rich blood

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8
Q

What is myocardial infarction?

A

dead cardiac muscle tissue

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9
Q

What do the coronary arteries do?

A

supply blood and oxygen to heart muscles

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10
Q

When does thrombosis start?

A

when plaque becomes unstable and ruptures, clotting process starts

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11
Q

Why do the muscle tissues die in thrombosis?

A

blood supply to heart muscle is reduced

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12
Q

What are the types of diagnostic tests for the heart?

A
  1. EKG (electrocardiogram)
  2. Stress testing
  3. Echocardiography
  4. Chest X ray
  5. Blood tests
  6. Coronary Angiography
  7. Cardiac Catheterization
  8. Angiogram
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13
Q

What is a transient ischaemic attack?

A

When the atherosclerotic plaque ruptures, the tiny pieces of plaque travel into bloodstream to the brain

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14
Q

What method is used to remember warning signs of stroke (cerebrovascular disease)?

A

FAST

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15
Q

What does FAST stand for?

A
  1. Face - ask them to smile, does one side droop?
  2. Arms - ask to raise both arms, does one arm drift downward?
  3. Speech - Repeat simple phrase, is speech slurred/strange?
  4. Time - observed the signs? Call 911 immediately
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16
Q

What is the difference with ischaemic and haemorrhage stroke?

A
ischaemic = 85% blockage
bleed = 15% bleed
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17
Q

What same problem causes coronary heart disease and stroke?

A

atherosclerosis

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18
Q

What is atherosclerosis?

A

A progressive inflammatory disorder of the artery wall: when your arteries become narrowed by a gradual build-up of fatty material (called atheroma) within their walls. Plaque forms.

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19
Q

What initiates thrombosis?

A

platelet aggregation

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20
Q

What controls platelet aggregation?

A

balance in pro-thrombotic compounds (TXA2) and anti-thrombotic compounds (PGI2)

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21
Q

Describe the 3 layers of the arteries:

A
  1. Tunica adventitia - collagen fibres
  2. Tunica Media - smooth muscle cell + elastic fibres
  3. Tunica intima - endothelium lining
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22
Q

In atherosclerosis, what does the gradual build-up of fatty material cause?

A
  • injury of endothelium
  • inflammation
  • fatty deposits in vessels (atheroma)
  • thrombosis
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23
Q

What is the pathogenesis of atherosclerosis? (11 steps though)

A
  1. Response to injury hypothesis
  2. Begin with injury to endothelium (smoking, oxidised
  3. Endothelium becomes permeable
  4. Triggers an immune response - macrophages & monocytes
  5. Macrophages migrate through endothelium & situate themselves in subendothelial layer and vascular wall
  6. Macrophages accumulate lipid = large foam cells
  7. Foam cells release growth factors/cytokines - smooth muscle cells migration/proliferation
  8. Platelets adhere
  9. Foam cells and smooth muscle cells eventually form fatty streak
  10. Fatty streaks progress = fibrous cap
  11. Rupture of fibrous cap = thrombosis
24
Q

What are 3 traditional primary risk factors of atherosclerosis?

A
  • hyperlipidemia
  • hypertension
  • smoking
25
Q

What secondary pathologies does obesity promote in CVD?

A
  • diabetes
  • insulin resistance
  • Dyslipidemia
  • Inflammation
  • Thrombosis
  • Hypertension
  • Metabolic syndrome
    (all heighten the CVD risk)
26
Q

What forms the core of all lipoproteins?

A

cholesterol and triglycerides

27
Q

What are triglycerides?

A

stored in fat cells and used as energy source of body

28
Q

Who has high levels of blood triglycerides?

A
  • those with high cholesterol levels
  • heart problems
  • overweight
  • diabetes
29
Q

What is a marker of hypofibrinolysis?

A

PAI-1

30
Q

When does atherosclerosis usually start?

A

frequently present in 20s and 30s

31
Q

What is the total number of deaths due to CVD worldwide?

A

17.3 million

32
Q

What are the top 10 global causes of death (in order, highest to lowest)?

A
  1. Coronary heart disease
  2. Stroke
  3. Chronic obstructive pulmonary disease
  4. Alzheimer’s/Dementia
  5. Trachea, bronchus, lung cancers
  6. Diabetes mellitus
  7. Road injury
33
Q

How many people die of CVD in EU and what’s the percentage?

A

1.9million

42%

34
Q

What is the ratio of men who die from coronary heart disease?

A

1 in 7 men

35
Q

What is the ratio of women who die from coronary heart disease?

A

1 in 12 women

36
Q

Is CVD a multifactorial disease?

A

YES

37
Q

What are the lifestyle risk factors of CVD?

A
  • Diet

- Exercise

38
Q

What is the fastest heart attack call to ambulance for balloon time?

A

42 mins

39
Q

What is given to heart attack patients within those few minutes?

A
  • primary angioplasty (restores blood flow to the heart)

- statins

40
Q

What are the risk factors targeted in CVD?

A
  • smoking
  • diet
  • physical activity
  • body weight
  • blood pressure
  • lipids
  • diabetes
41
Q

What are the evaluated reasons for the declining CHD mortality in UK?

A
  • reduction in smoking/blood lipids
  • improved physical activity levels
  • reduced BP in those not on antihypertensives
  • better medical treatment of lipids, angina, secondary prevention
42
Q

Hyperlipidaemia is a term to denote raised serum levels of?

A
  • Total cholesterol
  • low-density-lipoprotein cholesterol (LDL-C)
  • triglycerides (TG)
43
Q

What is dyslipidaemia?

A

wider term that includes abnormal amount of lipids in blod + low levels of HDL-C

44
Q

What are the cholesterol levels the population can’t exceed for high risk of CVD?

A

<4.0

45
Q

What are the LDL-C levels the population can’t exceed for high risk of CVD?

A

<2.0

46
Q

How do you calculate total serum cholesterol levels (TSC)?

A

TSC = VLDL-C + LDL-C = HDL-C

47
Q

What are the classifications for biomarkers of CVD?

A
  1. Inflammatory (high-sensitivity C-reactive protein = hsCRP)
  2. Thrombotic (homocysteine)
  3. Glucose and lipid-related markers (apolipoproteings)
48
Q

What does HRV indicate?

A

Heart variability

49
Q

What are the risk factor interventions (clinical management) of CVD?

A
  1. Behavior change
  2. Psychosocial factors
  3. Physical activity
  4. Smoking intervention (most cost-effective stratefy)
  5. Nutrition (healthy diet)
  6. Body weight
  7. Lipids control
  8. Hypertension
50
Q

How much salt can you eat a day?

A

<5g

51
Q

How much more fruits and vege each, should you eat a day?

A

> 200g

52
Q

What does the mediterranean diet comprise?

A
  • nutrients, foods
  • high intake of fruits, vege., legumes, wholegrain produces, fish, unsaturated fatty acids
  • moderate alcohol (wine)
  • low red meat, dairy and saturated fatty acids
53
Q

What is well documented in the DASH diet?

A

BP-lowering effect of increased potassium

54
Q

What diet are patients with hypertension generally advised to have?

A

more fruits and vege (reduce intake of saturated fat and cholesterol)

55
Q

What does DASH stand for?

A

Dietary Approaches to Stop Hypertension

56
Q

How much sodium is advised for consumption in the DASH diet?

A

2400mg/dy (6g table salt)