Lecture 11: Cardiovascular Disease Flashcards
What is cardiovascular disease?
Involves all disease that involve the heart and the blood vessels.
What is atherosclerosis?
the buildup of plaque inside the arteries
What are the risk factors for CVD?
Modifiable
- High blood pressure
- Cigarette smoking
- Diabetes
- Inactivity
- Obesity
- High cholesterol
Non-modifiable
- Age
- Gender
- Family history
What is the progression of heart disease?
High blood pressure/cholesterol levels –> atherosclerosis –> ischemia –> heart attack (to heart failure) or directly to heart failure
What is stenosis?
Narrowing of the artery diameter, leading to a decrease in blood flow
What is thrombus?
Is a blood clot created due to unstable plaques. Can completely block blood flow due to an embolism.
How does a thrombus develop?
A tear in the artery wall allows to fatty material to be deposited in the cell wall. The narrowed artery then becomes blocked by a blood clot.
What is myocardial perfusion?
Decrease blood flow to the heart
What is angina?
Chest pain or discomfort that occurs if an area of your heart doesn’t get enough oxygen-rich blood.
What does stable angina consist of?
Heaviness, pressure, squeezing, smothering or choking.
The pain is usually localized to chest but can radiate to left shoulder or arms.
Last about 1-5 minutes
What does unstable angina consist of?
Patient will suffer from severe and frequent, accelerating angina at times even at rest.
How is atherosclerosis diagnoses?
- History
- Physical exam
- Testing (blood test, EKG, electrocardiogram, stress testing, coronary angiography)
What is an angiography?
A medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body. Enter the body goes up the body to the aortic valve.
Can see if there is a decrease in artery/vein diameters.
How is Ischemic heart disease treated?
- Medical management (various drugs)
- Thrombolysis
- Percutaneous Transluminal Coronary Angioplasty
- Stents
- Coronary Artery Bypass Grafting
What are the drugs that can be used to treat ischemic heart disease?
- Aspiring - anti-inflammatory, inhibits thromboxane
- Nitrates
- Warfarin
- B-blockers (reduce response of sympathetic stimulation, reduces hypertension)
- Ca2+ blockers (lower heart rate, reduce BP, decrease angina)
- ACE (decrease the tension of blood vessels and blood volume, thus lower BP)
- Statins (inhibit cholesterol production in liver)
How does PTCA work?
- The balloon catheter with uninflated balloon approaches obstructed area in artery
- When balloon is inflated, it breaks up atherosclerotic plaque
- After lumen widened, balloon catheter with deflated balloon is withdrawn.
How effective is PTCA?
- Cannot always successfully perform procedure
- Restenosis
How do stents work?
- A catheter with a closed balloon and closed stent enters the artery and finds the approaches obstructed area in artery.
- The balloon inflates, expanding the stent.
- The stent will widen the artery and compress the plaque, increasing blood flow.
How do drug-eluting stents work?
- They slowly release drugs hindering cell proliferation around and over the stent, therefore they slow restenosis, but can increase thrombosis.
What is thrombus?
The thin layer or “cap” covering a plaque can burst or rupture. This inside of the plaque is then exposed to blood. Send chemical signals to blood.
- Plates aggregate to form a clot, can block blood flow and decrease oxygen delivered (ischemia) and tissues began to die (infraction)
What is embolus?
When a thrombus is displaced from its origin and begins to travel to another location.
Because vessels shrink in diameter away from the heart, it can block blood flow in healthy vessels.
Describe the pathophysiology of cerebrovascular disease.
There is an abrupt onset with usually mini-event or warning signs such as transient ischemic attacks (last 24 hours, tissue damage but no tissue death)
- Can also cause a complete stroke due to a maximal decrease in blood flow (oxygen)
How is cerebrovascular disease diagnosed?
- History
- Disease
- Imaging (CT Scan, MRI, CT/MR angiography)
How is a stroke treated?
- Thrombolysis (tissue plasminogen activator), given within 3 hours of onset
- Mechanical thrombectomy
- Induces hypothermia (expe.)
- Rehabilitation therapies (physical, occupational, speech)
