cardiac disease

Question 1

what is CVD

Answer 1

cardiovascular disease is a general term for conditions affecting the heart and blood vessels. it is also associated with damage to the arteries of the brain, kidneys and eyes

Question 2

types of CVD

Answer 2

coronary heart disease (CHD), CVA/TIA, peripheral vascular disease (PVD), aortic disease

Question 3

coronary heart disease

Answer 3

sometimes called ischaemic heart disease or coronary artery disease. a disease where the coronary arteries are blocked and narrowed. includes the following diseases- angina, MI, heart failure

Question 4

CHD incidence and prevalence

Answer 4

most common cause of death in UK, 1/7 men and 1/12 women die, causes 66K deaths per year

Question 5

CHD risk factors- cause

Answer 5

multifactorial and a result if infection between genetic, lifestyle and environmental factors

Question 6

CHD risk factors

Answer 6

age- increased, gender- male, social deprivation, smoking- mortality 60% higher, diet- not a lot of fruit and veg, exercise- less activity, alcohol 1-2 units per day reduces risk as it increases HDL, psychosocial well being- depression/ anxiety, personality, blood pressure- hypertension, cholesterol, obesity, diabetes, family history

Question 7

when do CHD symptoms occur

Answer 7

only appear when a coronary artery is 70/75% occluded

Question 8

CHD symptoms- pain etc.

Answer 8

pain/ discomfort, pressure, tightness, numbness or burning sensation in chest, arms, shoulders, back, upper abdomen or jaw

Question 9

CHD symptoms- other

Answer 9

dizziness, SOB, fatigue and weakness, nausea or vomiting, indigestion or heartburn, sweating or clammy skin, rapid heart rate, palpitations, swollen ankles or legs, feeling of something wrong

Question 10

what is angina

Answer 10

angina is a chest pain due to an inadequate supply of oxygen to the heart muscles, tends to be transient

Question 11

types of angina

Answer 11

stable (angina pectoris) happens at predictable times- stress or exercise, unstable happens when no particular demand is placed on heart, variant (prinzmetal) when a coronary artery goes into spasm, microvascular (cardiac syndrome X) affects small vessels

Question 12

treatment for angina

Answer 12

medication- nitrates, anticoagulants- affects all arteries, not just those affected, lifestyle changes, surgery- angioplasty and CABG

Question 13

what is myocardial infarction

Answer 13

MI is when the blood supplying the oxygen to the heart is severely reduced o cut off. the result is ischaemia of the heart muscle and scar formation

Question 14

diagnosis of myocardial infarction

Answer 14

cardiac enzymes- troponin- appears 3-6 hours, peaks 24-48 hours, lasts 7-10 days, creatine kinase
ECG- ST elevation, inversion of T wave, enlarged Q wave

Question 15

symptoms of MI

Answer 15

sweating/ cold clammy skin, feeling dizzy, SOB, pain/ pressure discomfort, tingling or discomfort, nausea/ vomiting/ heartburn, a fast or uneven heartbeat

Question 16

prognosis/ consequence- MI

Answer 16

depends on the site of infarction and degree of damage, sudden death, arrhythmias, heart failure, cardiogenic shock, thrombus formation, rupture

Question 17

CHD MI prognosis/ consequence

Answer 17

MI- sudden death (20%) or survival (80%)= adequate compensation (=uncomplicated recovery 12%) or inadequate compensation= complications 66%= delayed recovery (55%) or delayed death (13%)

Question 18

treatment of MI

Answer 18

depends on severity of MI, drugs= beta blockers and vasodilators, cardiac catheterization/angiography, stenting, CABG

Question 19

physio involved in cardiac rehabilitation

Answer 19

MI rehabilitation- in patient or outpatient, CABG surgery from critical care, post discharge rehabilitation

Question 20

MI and coronary arteries

Answer 20

left ventricle has higher demand and is most common site of ischaemia, 50-70% of coronary artery obstruction involves left

Question 21

CHD- heart failure and causes

Answer 21

the heart is unable to adequately pump the blood around the body usually because the heart has become stiff or weak. a common cause is MI, other causes- HYTN, cardiomyopathy, damaged valves, congenital conditions, viral infections, chemotherapy, excessive alcohol, anaemia, thyroid disease. there is no cure and treatments aim to control symptoms

Question 22

symptoms of heart failure

Answer 22

SOBOE or at rest, swollen feet/ ankles/ stomach/lower back, fatigue or feeling weak

Question 23

treatment of heart failure

Answer 23

treatments include diuretics, some patients benefit from pacemaker or an implantable cardioverter defibrillator to help improve the pumping action of the heart

Question 24

heart valve disease and causes

Answer 24

can affect any of the 4 valves, causes- CHD, rheumatic fever, cardiomyopathy, MI, endocarditis, aging

Question 25

heart valve disease- symptoms

Answer 25

SOB, ankle/feet swelling, fatigue

Question 26

how can a diseased or damaged valve affect blood flow- 2 ways

Answer 26

if the valve doesn’t fully open it obstructs or restriction the flow of blood- stenosis or narrowing= extra strain on heart, if the valve doesn’t close properly- blood leaking backwards- valve incompetence or regurgitation or a leaky valve= extra strain on heart