Cardiac A

Question 1

Atherosclerosis
Patho:
Clinical manifestations:

Answer 1

Patho:
- Thickening of lumen walls of arterial vessels due to accumulation of lipids
- Eventually narrows arterial vessel and may result in complete blockage.
Clinical Manifestations:
- Chest pain
Atypical: Nausea, fatigue, back pain

Question 2

Diagnosis, Treatment and mgt of: 
Atherosclerosis
Angina
Acute coronary syndrome 
Coronary heart disease

Answer 2

Diagnostics:

• U&Es
• Liver function
• FBE
• Troponin
• Relieve pain and stress
• Improve coronary blood flow
• Restore heart function
• Medication, surgical procedures and life style changes

Question 3

Hypertension
Patho:
Clinical Manifestations:

Primary:
Secondary:
Urgencies:
Emergencies:

Answer 3

Patho:

• Genetics and environmental factors causing neural and hormonal effects
• Mechanisms include RAAS, SNS
• increased SNS activity causes increase HR and vasoconstriction, raises the BP.
• Vascular remodelling results in permanent increases in peripheral resistance

Clinical manifestations: 
- Asymptomatic
- Headache, dizziness, fatigue
- Stroke
- Retinal changes
Secondary: Sleep apnoea, headaches, sweating

Primary: No known cause
Secondary: Cause can be identified
Urgency: Severe BP >180/110. Not immediately life threatening. Headach as symptom
Emergency: >220/140. Associated acute organ failure

Question 4

Angina
Patho:
Clinical Manifesations:

Stable:
Unstable:

Answer 4

• Pain caused by myocardial ischemia
• Demand for myocardial oxygen exceeds the supply of oxygen from coronary arteries, causing myocardial ischemia
• Caused by physical exertion or emotional stress. Also by atherosclerosis

Clinical Manifestations

• Chest pain/discomfort
• Radiating pain to arms, jaw, neck
• SOB

Stable:

• Symptom of coronary heart disease. Brief episode fixed with meds or rest.
• Predictable, from physical exertion

Unstable:

• New or onset
• occurs at rest
• Small fissure or erosion of place

Question 5

Acute coronary syndrome & AMI
Patho:
Clinical Manifestation:

Answer 5

• Acumulation of of atherosclerosis and angina overtime
• Acute process of myocardial ischemia after long term, chronic conditions
• When blood flow is reduced to the myocardium it becomes damaged wth myocardial cell death

Acute Myocardial Infarction:

• Plaque is disrupted and there is clot formation, results in reduction of coronary blood flow
• Results in cell injury and death and structural changes

Clinical Manifestations:

• Similar to angina but more intense
• Sudden death

Question 6

Coronary Heart Disease
Patho:
Clinical Manifestations

Answer 6

• Coronary arteries clog and narrow due to a build up of plaque and are unable to deliver enough O2 to heart muscles
• Long term chronic conditions, such as atherosclerosis, hypertension

Clinical Manifestations:
- As per previously mentioned conditions