Cardiovascular disease Flashcards Preview

Phase 4 cardiology > Cardiovascular disease > Flashcards

Flashcards in Cardiovascular disease Deck (15)
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1
Q

What are atheroma?

A

fatty deposits in the artery walls

2
Q

What is sclerosis?

A

The process of hardening or stiffening of the blood vessel walls

3
Q

What arteries does atherosclerosis affect?

A

The medium and large arteries

4
Q

What causes atherosclerosis?

A

chronic inflammation and activation of the immune system in the artery wall

5
Q

What do plaques cause?

A

Stiffening of the artery walls leading to hypertension
Stenosis leading to reduced blood flow (e.g. angina)
Plaque rupture giving off a thrombus that blocks a distal vessel leading to ischaemia

6
Q

What are the non-modifiable risk factors for atherosclerosis?

A

older age
family history
male

7
Q

What are the modifiable risk factors for atherosclerosis?

A
smoking
alcohol consumption
poor diet
low exercise 
obesity
poor sleep
stress
8
Q

What medical co-morbidities increase the risk of atherosclerosis?

A
diabetes
hypertension
chronic kidney disease
inflammatory conditions such as RA
atypical antipsychotic medications
9
Q

What are the end results of atherosclerosis?

A
angina
MI
TIA
Strokes
Peripheral vascular disease
chronic mesenteric ischaemia
10
Q

How can modifiable risk factors be optimised?

A

advise of diet, exercise and weight loss
stop smoking
stop drinking alcohol
tightly treat co-morbidities

11
Q

What score can be used to assess the risk of MI (primary prevention)?

A

QRISK score

If risk is >10% start a statin (atorvastatin 20mg at night)

12
Q

Who should always be offered a statin?

A

all patients with chronic kidney disease or type 1 diabetes (atorvastatin 20mg at night)

13
Q

What should be checked 3 months after commencing a statin?

A

lipids (aim for >40% reduction in non-HDL cholesterol)

LFTs - can cause transient and mil d raise in ALT and AST in the first dew weeks

14
Q

Describe the secondary prevention of cardiovascular disease

A

Aspirin (and anti-platelet for 12 months)
Atorvastatin 80mg
Atenolol (or other) to maximum tolerated dose
ACE inhibitor (ramipril) to max tolerated dose

15
Q

What are the notable side effects of statins?

A

myopathy (check creatine kinase)
Type 2 diabetes
Haemorrhagic strokes (rare)