Lecture 16 Flashcards
1
Q
What are the types of cardiovascular disease due to atherosclerosis?
A
- Ischaemic heart disease or coronary artery disease (e.g. heart attack)
- Cerebrovascular disease (e.g. stroke)
- Diseases of the aorta and arteries, including hypertension and peripheral
vascular disease.
2
Q
What are other types of cardiovascular disease?
A
- Congenital heart disease
- Rheumatic heart disease
- Cardiomyopathies
- Cardiac arrhythmias
3
Q
what is CVD in Austrlia
A
schemic heart diseases (IHD) are our leading cause of death - No. 1 in males - No. 2 in females - 18,591 total IHD deaths in 2017 - Down 40% since 2008 Effects aboriginal and Torres Strait islanders more
4
Q
what is angina
A
Spasmodic bouts of intense discomfort in upper chest - Pain often radiates to left arm - Sense of suffocation and impending death - can be stable or unstable
5
Q
what causes angina
A
- low blood flow limits 02 delivery to heart muscle during exertion
- involves fatty deposits in blood vessel
6
Q
who invented nitroglycerin
A
- Ascanio Sobrero
- Invented nitroglycerin using
glycerol and mineral acids
7
Q
Who tamed nitroglycerin?
A
Alfred Nobel - after his brother and 64 others were killed in a mining plant using nitroglycerin - Alfred finds nitroglycerin is stable if blended with porous silica gel (dynamite)
8
Q
what was the monday disease
A
- Munitions factory workers
exposed to large quantities of nitroglycerin - Strong headaches &
facial flushing on return to
work after weekend break - solved by wearing work clothes on the weekend
9
Q
who started using nitroglycerin on patients ?
A
- William Murell
- used BP monitoring device to confirm beneficial effects in 3 angina patients
10
Q
how is nitroglycerin used in mordern medicine ?
A
- used to relieve angina pain in vulenerable patients
- acts by dilating veins in the periphery
- Peripheral “pooling” reduces effort needed by ventricles to pump blood into circulation
11
Q
how is nitroglycerin consumed
A
- Breaks down rapidly in stomach contents
- Used via various topical routes (oral cavity in acute attack)
- under tongue or against cheek
Other routes: sticking patches (for skin application), oral sprays, oral pastes, intradermal implants - Tablet, patches removed once pain subsides (avoid headaches)
12
Q
how does nitroglycerin work?
A
vascular smooth muscle relaxation
13
Q
what are cardiovascular medicines used today?
A
- vasodilators
- calcium channel blockeres
- beta blockers
- statins
- diuretics
- ACE inhibitors
14
Q
what are ongoing challenges regarding cardiovascualr diease
A
1- The Global Problem & Promise of Polypills
2-Variability in Patient Response
15
Q
what was the polylran study ?
A
- Roshandel first results from large population polypill ‘cardioprotection’ study
- findings: decrease in major CVD events over 5 years
