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Flashcards in Cardiovascular Deck (77)
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1
Q

define atherosclerosis

A

a build up of lipid rich ‘plaques’ on the inner walls of arteries

2
Q

what are the 4 types of ischemic heart disease?

A
  1. angina
  2. heart attacks (unstable angina & acute coronary syndrome)
  3. arrhythmia
    4 heart failure
3
Q

what are the 2 consequences for atherosclerosis?

A
  1. ischemia (progressive narrowing)

2. infarction (due to plaque rupture)

4
Q

what are the ‘big 5’ risk factors for atherosclerosis?

A
  1. smoking
  2. high cholesterol
  3. high blood pressure
  4. diabetes
  5. genes
5
Q

who are at high risk of familial hypercholesterolaemia?

A

the young

6
Q

what is the max % reduction in choesterol due to diet?

A

15%

7
Q

types of food to reduce high cholesterol are…

A
fruit and veg 
nuts 
soya food 
oats and barley 
food with unsaturated fats
8
Q

what medication is given to patients with high cholesterol?

A

statins

9
Q

what are statins classfication?

A

lipid regulating drugs

10
Q

what are 2 relevant side effects of statins?

A
  • GI disturbance

- nasopharyngitis

11
Q

what is the normal blood pressure?

A

120/80 (systolic/diastolic)

12
Q

high blood pressure is diagnosed when the systolic pressure is >? or the diastolic pressure is >?

A

> 160 or >90

13
Q

what is the incidence of hypertension in western society?

A

15-20%

14
Q

what are the two types of hypertension?

A

primary (essential) and secondary

15
Q

primary hypertension is less/more common than secondary hypertension?

A

more

16
Q

what are 4 factors relating to primary hypertension?

A
  • obesity
  • alcohol
  • high salt diet
  • genetic
17
Q

what are the 2 factors that cause secondary hypertension?

A
  1. kidneys not working

2. hormone excess

18
Q

when are you likely to get symptoms from hypertension?

A

if it is very very high eg 240/130

19
Q

what symptoms of hypertension can you get?

A
  • fits
  • confusion
  • headache
  • breathlessness
  • chest pain
20
Q

what are 5 drugs in management of hypertension?

A
  • ACE inhibitors
  • B-blockers
  • Calcium channel blockers
  • Diuretics
  • angiotension II antagonist
21
Q

4 lifestyle changes required in patients who have hypertension

A
  1. cut out alcohol
  2. low salt diet
  3. lose weight
  4. take exercise
22
Q

what is the normal total cholesterol?

A
23
Q

define peripheral vascular disease.

A
  • atherosclerosis affecting the peripheral vessels esp lower limbs and abdominal aorta
24
Q

what are the symptoms of chronic peripheral vascular disease?

A

leg pain when walking a long distance especially in calf

25
Q

what are they symptoms of acute peripheral vascular disease?

A
leg pain at rest 
no sensation (numb)
cannot move 
pale, cold 
(a medical emergency)
26
Q

3 ways to manage peripheral vascular disease

A
  1. risk factor management
  2. exercise program
  3. surgery
27
Q

what are the 2 surgery options for peripheral vascular disease?

A

stent

bypass graft

28
Q

what category of people are at high risk of an abdominal aortic aneurysm?

A

men >65

29
Q

what are the symptoms of an abdominal aortic aneurysm?

A

nil or vague abdominal pain

(on rupture) severe abdominal pain & collapse

30
Q

what is the mortality rate for an abdominal aortic aneurysm?

A

50-90%

31
Q

define angina

A

the narrowing of the coronary arteries = ischemia

32
Q

what are the typical signs of angina?

A
  • crushing central chest pain which may radiate down left arm
  • may also have breathlessness
33
Q

what is an atypical sign of angina?

A
  • jaw
  • back
  • upper abdomen pain
34
Q

when would angina be classified as unstable?

A
  • pain at rest
  • unpredictable onset
  • increased frequency with reduced effort
35
Q

angina is closely related with…

A

physical stress

36
Q

3 investigations to diagnose angina

A
  • ECG
  • ECG & radiological investigation with exersice
  • coronary angiogram
37
Q

symptoms of a myocardial infarction

A
  • central crushing chest pain that is usually worse than angina
  • breathlessness
  • nausea
  • sweating
  • feeling of imminent death
  • cardiac arrest
38
Q

what are the 2 types of structural heart disease?

A
  1. heart failure

2. vascular disease

39
Q

what investigations do you carry out to test for structural heart disease?

A
  • ECG
  • Chest X-ray
  • echocardiogram (chest ultrasound)
40
Q

5 causes of structural heart failure?

A
  1. ischaemic heart disease
  2. hypertension
  3. valvular heart disease
  4. alcohol excess
  5. many rare condition
41
Q

pump failure leads to oedema which causes what 2 things?

A

breathlessness on exertion or at rest

and

swelling at the peripheries

42
Q

what are the treatment stages of heart failure?

A
  1. address underlying cause
  2. medication
  3. surgical
43
Q

what are the 4 medications that would be given for heart failure?

A
  • ACE inhibitors
  • Beta-blockers
  • Diuretics
  • digoxin
44
Q

what are the 3 surgical options for heart failure?

A
  • CABG/PTCA (percutaneous transluminal coronary angioplasty) ONLY if pre-existing angina/valvular disease
  • rarely transplant
  • pacemaker
45
Q

what are the dental aspects of heart failure?

A
  • avoid tx if unstable condition
  • polypharmacy common with these patients (drug side effect and interactions)
  • avoid NSAIDs as they can cause fluid retention
  • caution when lying patient flat
  • acute heart failure presenting in dental chair (ABCDE)
46
Q

what is the pathophysiology of VALVULAR heart failure?

  • what is the side most affected?
  • what valves can be affected?
  • what can cause heart failure?
  • can it be congenital?
  • can it be age related?
A
  • left side most affected
  • aortic/mitral valves affected
  • causes = infective endocarditis & rheumatic fever
  • can be congenital
  • often age related
47
Q

what is rheumatic fever?

A
  • complication of strep infection (often in childhood)

- increasingly rare

48
Q

what is regurgitation in the cardiac sense?

A

loss of valve integrity
- leaky
- becomes ‘floppy’
(HEART FAILURE)

49
Q

what is stenosis?

A

the narrowing of valve that obstructs the flow

INADEQUATE PUMP OUTPUT FAILURE

50
Q

what are the treatment options for valvular heart disease?

A
  • medication (ACE inhibitors/Beta-blockers/diuretic/digoxin)

- surgery = Valve replacement (porcelain/metal) - have the potential to thrombose if inadequate anti-coagulation

51
Q

what is the ideal INR for patients who have a metal heart valves?

A

> 3

52
Q

what is a normal cardiac rhythm called?

A

sinus rhythm

53
Q

what is an abnormal cardiac rhythm called?

A

arrhythmia

54
Q

name the 4 arrhythmias

A
  1. irregular
  2. tachyarrhythmia (too fast)
  3. bradyarrhythmia (too slow)
  4. abnormal beat conduction
55
Q

give 5 symptoms of cardiac arrhythmias

A
  • nil
  • palpitations
  • chest pain
  • heart failure
  • syncope (temporary loss in BP causing unconsciousness)
56
Q

what is the other name for irregular cardiac arrhythmias?

A

atrial fibrillation

57
Q

what is the incidence of atrial fibrillation?

A

common (10% of elderly)

58
Q

is atrial fibrillation symptomatic?

A

often not

59
Q

what is atrial fibrillation associated with?

A

CVD - angina, hypertension, heart failure

60
Q

what is the treatment for atrial fibrillation?

A

medication and rarely surgery

61
Q

what is the worry with atrial fibrillation?

A

it comes with an increased risk of stroke so anticoagulants should be prescribed

62
Q

name a type of tachyarrhythmia

A

supraventricular tachycardia (SVT)

63
Q

what is the incidence of SVT?

A

common ( in otherwise well people )

64
Q

is SVT dangerous?

A

Benign unless wolff-parkinson white syndrome

65
Q

what is wolff parkinson white syndrome?

A

a congenital condition where an extra electrical connection is present

66
Q

what symptoms can you get from SVT? and when are they commonly present?

A
  • palpitations
  • breathlessness
  • chest pain

caffeine, injections, anxiety

67
Q

what is the the treatment of SVT?

A

drugs and surgery to prevent

vagal manouveres, carotid sinus massage, and drugs (adenosine) at time

68
Q

when is a resting heart rate considered too fast?

A

> 100bpm

69
Q

when is a resting heart rate considered too slow?

A
70
Q

at what heart rate would a patient experience blackout/dizziness?

A
71
Q

what are 4 causes of bradycardia?

A
  • ischaemia
  • age
  • drugs
  • physiological (ie fit athletes)
72
Q

what is the treatment for bradycardia?

A
  1. remove underlying cause

2. may require pacemaker

73
Q

abnormal conduction is also known as?

A

ventricular arrhythmia/vantricular tachycardia

74
Q

is abnormal conduction serious?

A

always a medical emergency (peri-arrest rhythm)

75
Q

what are the 4 causes of abnormal conduction (ventricular arrhythmia)?

A
  • ischaemic heart disease (incl heart attack)
  • drugs
  • congenital
  • electrolyte disturbance
76
Q

what are the symptoms of abnormal conduction?

A
  • breathlessness
  • dizzy
  • chest pain
  • palpitations
  • cardiorespiratory arrest
77
Q

what is ventricular fibrillation always?

A

cardiorespiratory arrest