Cardiac Diseases Flashcards
Define Cardiovascular disease (CVD)
Cardiovascular disease (CVD) 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.
Types of CVD
There are 4 types of CVD:
- Coronary Heart Disease (CHD)
- Cerebral Vascular Accidents (CVA) or Transient Ischaemic Attacks
- Peripheral Vascular Disease (PVD)
- Aortic Disease
Define Coronary Heart Disease (CHD)
Sometimes called ischaemic heart disease or coronary artery disease and is a disease where the coronary arteries are blocked or narrowed.
It includes the following diseases: angina, myocardial infarction (MI), heart failure
Risk factors of CHD
Multifactorial & a result of interaction between genetic, lifestyle and environmental factors including:
–Age – increasing
–Gender - males
–Social deprivation - lower socio-economic groups; related to diet, smoking, exercise levels
–Diet - high sat fat diet, high salt, low complex carbs
–Exercise - physical activity shown to reduce risk
–Smoking – mortality CHD 60% higher
–Alcohol - 1-2 units per day reduces risk (increases ability to intake High Density Lipoproteins & reduce cholesterol), higher levels will increase risk due to impact on other organs
–Psychosocial well being - high work stress levels, depression, a lack of social support, anxiety, personality (that show hostility or alpha-male type)
–Blood pressure - hypertension (140:90 mmHg); for every 20 mmHg rise in systolic and 10 mmHg rise in diastolic will double risk
–Cholesterol - high risk factor; 45% of MI due to abnormal lipids
–Obesity - independent risk but also increases risk of hypertension and diabetes (other risk factors)
–Diabetes - 2-4X risk in males, 3-5X risk in females
–Ethnicity - South Asians 46% increased mortality rate from CHD in males, 51% in females (India, Pakistan, Bangladesh, Sri Lanka)
–Family history - genetics, shared lifestyle changes learned from family
Symptoms of CHD
Only appear when a coronary artery is 70-75% occluded. Can include: –Pain*, discomfort*, pressure, tightness, numbness or burning sensation in chest, arms, shoulders, back, upper abdomen or jaw –Dizziness –Shortness of breath* –Fatigue* or weakness –Nausea or vomiting –Indigestion or heartburn –Sweating or clammy skin –Rapid heart rate –Palpitations –Swollen ankles or legs –Feeling of something being wrong
Define angina
Angina is chest pain due to an inadequate supply of oxygen to the heart muscle. It tends to be transient – lasting 10 mins normally
Types of angina
There are 4 types:
- Stable (angina pectoris) - happens at predictable times e.g. stress or exercise
- Unstable - happens when no particular demand is being placed on the heart
- Variant (Prinzmetal) - when muscle within a coronary artery goes into spasm
- Microvascular (Cardiac Syndrome X) - affects the very smallest of the blood vessels; symptoms tend to last longest (up to 30 mins)
Treatment for angina
–Medications to vasodilate arteries = nitrates, anticoagulants; global affect causing complaint of intense headaches – due to arteries in brain dilating
–Lifestyle changes
–Surgery = angioplasty, CABG
Define MI
MI is when the blood supplying the oxygen to the heart is severely reduced or cut off. The result is ischaemia of the heart muscle and scar formation
Symptoms of MI
A person having an MI may present with a range of symptoms: Any symptoms of CHD: –Pain*, discomfort*, pressure, tightness, numbness or burning sensation in chest, arms, shoulders, back, upper abdomen or jaw –Dizziness –Shortness of breath* –Fatigue* or weakness –Nausea or vomiting –Indigestion or heartburn –Sweating or clammy skin –Rapid heart rate –Palpitations –Swollen ankles or legs –Feeling of something being wrong PLUS •Heart attack symptoms: –sweating or cold, clammy skin –Feeling dizzy or like you are going to pass out –Feeling out of breath –Pain, tingling or discomfort in other parts of the upper body including the arms, backs, neck, jay or stomach –Pain, pressure or discomfort in left chest –Nausea, vomiting, burping or heartburn
Diagnosis of MI
An MI is diagnosed via an ECG and blood tests looking at cardiac enzymes
Define heart failure
Heart failure is when the heart is unable to adequately pump the blood around the body usually because the heart has become too stiff or weak
Causes of heart failure
A common cause is MI but other causes include: –HTN, particularly pulmonary HTN (damage to lungs and pulmonary system associated with the lungs) –Cardiomyopathy –Damaged valves –Arrhythmias (chronic) –Congenital conditions –Viral infections –Chemotherapy –Excessive alcohol –Anaemia –Thyroid disease
Symptoms of heart failure
– SOB on exertion +/- at rest
–Swollen feet, ankles, stomach and lower back
–Fatigue or feeling weak
Treatment of MI
Treatments often include diuretics with some patients benefiting from a pacemaker or an Implantable Cardioverter Defibrillator (ICD) to help improve the pumping action of the heart.
Define Heart Valve Disease
Heart valve disease can affect any of the 4 valves in the heart and can be caused by: –Congenital heart disease –Rheumatic fever –Cardiomyopathy –MI –Endocarditis (infection) –Aging
Symptoms of Heart Valve Disease
–SOB
–Ankle/feet swelling
–Fatigue
Types of Heart Valve Disease
A diseased or damaged valve can affect the flow of blood in two ways:
- If the valve does not open fully → obstruct or 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
Types of Heart Valve Replacement
Valves can be replaced using 5 different types:
- Mechanical – long lasting (15-25 years), require long-term anticoagulants as patients become at risk of blood clot formation around new valve
- Tissue (bioprosthetic) – lasts 10-20 years, created from animal donors (pigs or cows) valves or other animal tissue; usually used if patients cannot have long-term anticoagulants required of mechanical valve replacement
- Donor – lasts 10-20 years, least common
- Ross procedure – aortic valve replaces with pulmonary valve, which is subsequently replaced. Pulmonary valve is under less pressure and will last longer; often used in children with congenital heart defects as the valve will grow and handle high BP and less likely for long-term medication
- Transcatheter aortic valve implantation or replacement (TAVI/TAVR) – similar to stenting arteries; a fully collapsible replacement valve is forced into valve site and once the new valve is in it expands pushing the old valve leaflets out of the way so the tissue of the replacement valve takes over job of regulating blood flow
