Cardiac Disease Flashcards
What is cardiovascular disease?
CVD is a general term for conditions affecting the heart and blood vessels
Also associated with damage to the arteries of the brain, kidneys and eyes
Types of CVD -
Coronary heart disease (CHD)
Cerebral vascular accidents (CVA) and transient ischaemic attacks (TIA’s)
Peripheral vascular disease (PVD)
Aortic disease
Types of CVD
Coronary heart disease -
Sometimes cause ischaemic heart disease or coronary artery
Disease whereby coronary arteries are blocked or narrowed
Includes the following:
Angina, myocardial infarction and heart failure
Types of CVD
CHD, prevalence and incidence -
It is the most common cause of death and premature death in the UK
Also leading cause of death worldwide
1 in 7 men and 1 in 12 woman die from it in UK
66,000 deaths per year
Death rates highest in Scotland and lowest in south of England
2.3 million people living with it in the UK Also leading
Types of CVD
CHD, risk factors -
Multifactorial and result of interaction between genetic, lifestyle and environmental factors:
Age, gender, social deprivation
Smoking, diet, exercise, alcohol
Psych well being, BP, cholesterol, obesity
Ethnicity and fam history
SUGGESTIONS!!!!
Look at -
- hypertension in blood vessels lecture patho 1
- pathologies of arterial walls in blood vessels lecture patho 1
- diabetes in homeo and endocrine seminar and from patho 2 as well
- obesity from patho 2
- all directly link!
Types of CVD
CHD, symptoms -
Only appear when coronary artery is 70-75% occluded
Can include:
Pain, discomfort, pressure, tightness, numbness or burning sensation in chest, arms, shoulders, upper abdomen or jaw
Dizziness
Shortness of breath
Fatigue or weakness
Nausea or vomitting
Indigestion or heartburn
Sweating or clammy skin
Rapid heart rate
Palpitations
Swollen ankles or legs
Feeling of something being wrong
Types of CVD
CHD, angina - what is it, types and treatment
Angina is a chest pain due to an inadequate supply of oxygen to the heart muscle
Tends to be transient
Types:
- stable (angina pectoris) happens at predicable times eg, stress or exercise
- unstable happens when no particular demand is being placed on the heart
- variant (prinzmetal) when a coronary artery goes into spasm
- microvascular (cardiac syndrome X) affects the very smallest of the vessels
Treatment - medications = nitrates and anticoagulants
Lifestyle changes
Surgery - angioplasty, CABG
Types of CVD
CHD, what is a myocardial infarction?
MI is when the blood supplying the oxygen to the heart is severely reduced or cut off.
The result is ischaemic of the heart muscle and scar formation
CHD, myocardial infarction - diagnosis
- cardiac enzymes
Top on in
Appears after 3-6 hours
Peaks 24-48 hours
Lasts 7-10 days
Creatinine kinase (CK) - ECG (typically)
ST elevation
Inversion of T wave
Enlarged Q wave
CHD, symptoms of myocardial infarction -
(Heart attack/MI)
Sweating or cold, clammy skin Rapid
Feeling out of breath
Feeling dizzy or like you are going to pass out
Pain, tingling or discomfort in other parts of the upper body, including the arms, back, neck, jaw or stomach
Pain, pressure or discomfort
Nausea, vomitting, burping or heartburn
Fast or uneven heartbeat
CHD, MI prognosis/consequence -
Depends on site of infarction and degree of damage
Sudden death
Arrhythmias
Heart failure
Cardiogenic shock
Thrombus formation
Rupture
Survival - 80% and sudden death 20%
Complications - 68%
CHD, treatment of MI -
Depends on symptoms severity
- drugs beta blockers and vasodilators
Cardiac catheterisation/angiography
CABG
Physio involvement - cardiac rehab and perioperative care
CHD. MI physio, where?
Cardiac rehab can take place inpatient or outpatient
CHD, MI and Coronary arteries -
Left ventricle was highest demand and is most common site of ischaemia
50-70% of coronary artery obstruction involves left coronary territory
CHD - heart failure, what is it and what causes it?
Heart is unable to adequately pump the blood around the body usually because the heart has become too stiff or week
A common cause is MI
Other causes:
Pulmonary HTN
Cardiomyopathy
Damaged valves
Arrhythmias
Congenital disorders
Viral infections
Chemotherapy
Excessive alcohol
Anaemia
Thyroid disease
CHD - heart failures, cure, symptoms and treatments -
There is no cure and treatments aim to control the symptoms
Symptoms - SOB on exertion and sometimes rest
Swollen feet, ankles, stomach and lower back
Fatigue or feeling weak
Treatments often include diuretics
Some will benefit from a pacemaker or an implantable cardioverter defibrillator (ICD) to help improve the pumping action of the heart.
Heart valve disease - causes and symptoms
Can affect any of the four valves
Causes: congenital heart disease
Rheumatic fever
Cardiomyopathy
MI
Endocarditis
Aging
Symptoms - SOB, ankle/feet swelling and fatigue
Heart valve disease - in what two ways can a diseased or damaged valve affect blood flow?
If valve does not fully open, obstruct/restrict the flow of blood = stenosis or narrowing
If the valve does not close properly, blood to leaking backwards = valve incompetence or regurgitation or a leaky valve
What are other common cardiac problems?
Congenital heart disease
Rhythm issues - AF, atrial flutter, arrhythmia, AV heart blocks, bundle branch blocks
Sudden death - brugada syndrome, sudden arrhythmic death syndrome (SADS)
Aortic disease - aneurysm, dissection, stenosis
Out of hospital cardiac arrest (OHCA)
What is angina -
Heaviness tightness or dull ache
Four types of angina, symptoms and cause
1) stable -
2) unstable -
1) stable angina
Symptoms, predictable time and most common type
Cause - arteriosclerosis
2) unstable
Symptoms, no particular demand placed on and will occur anyways
Cause - result from rupture of an atherosclerotic plaque in coronary artery to a blood clot
Four types angina, cause and symptoms
3) variant -
4) microvascular -
3) variant
Symptoms, severe pain for a few minutes
Cause - temporary spasm in coronary arteries and decrease in blood to heart
4) microvascular
Symptoms - shortness of breath with minimal exertion and chest pain
Cause - small blood vessels in heat may constrict or spasm or not function properly, reduced blood flow.
