Cardiology Flashcards
Define cardiovascular disease
Diseases of the heart and circulation
Why is cardiovascular disease more common in children and adults in the developed world?
Due to a high prevalence of obesity
What is considered a good blood pressure?
120/80 mmHg
What is considered a high blood pressure?
140/90 mmHg
What is type hypertension is the most common?
What causes this disease?
Is it hereditary?
- Primary hypertension most common
- Multiple factors so direct cause unknown
- Can be hereditary
How can secondary hypertension occur? (4)
- Result of renal diseases
- Result of endocrine diseases (hyperthyroidism)
- Coarctation of the aorta (narrowing)
- Excessive drug/alcohol intake
Is hypertension symptomatic?
Usually asymptomatic until complications develop in target organs
Severe or prolonged hypertension increases the risk of? (4)
- Coronary artery disease
- Heart failure
- Stroke (particularly haemorrhagic)
- Renal failure
What are some complications linked with hypertension? (5)
- Arteriolosclerosis
- Narrowing of arteriolar lumen in kidney
- Increased after load leading to heart failure
- Thoracic aortic dissection
- Abdominal aortic aneurysms
How would you investigate hypertension? (4)
- BP measurements with sphygmomanometers
- Urinalysis
- Blood tests
- Electrocardiogram (ECG)
Dental Relevance of hypertension
- Patients with stable hypertension can be treated
- Hypertensive drugs can impact oral health
What Atherosclerosis?
Atherosclerosis is a disease in which plaque builds up inside your arteries
What does plaque contain? (4)
- Lipids
- Inflammatory cells
- Smooth muscle cells
- Connective tissue
What is stable plaque
Plaque that may:
- Regress
- Remain static
- Grow slowly
What is unstable plaque
Plaque which is vulnerable to spontaneous rupture, erosion or fissuring
Stable exertional angina, transient ischaemic attacks and intermittent claudication can all result due to which plaque build up?
Stable Plaque
Unstable angina, myocardial infarction and ischaemic stroke can all result due to which plaque build up?
Unstable Plaque
How would you investigate Atherosclerosis? (3)
- CT angiography
- Blood tests
- Catether-based imaging tests
What is Angina?
Chest pains due to the heart not getting enough oxygen (ischemia) due to narrowed arteries
Describe stable angina
- Predictable
- Increased workload leads to ischaemia
Where can symptoms of angina radiate to? (6)
- Left shoulder
- Inside left arm
- Back
- Throat
- Jaw
- Teeth
How would you investigate Angina? (3)
- ECG
- Coronary artery angiography
- Intravascular ultrasonography
What is a myocardial infarction
Myocardial necrosis (tissue death) resulting from acute obstruction of a coronary artery
How can you temporarily relieve a myocardial infarction?
Rest or glyceryl trinitrate
What is infective endocarditis?
Rare condition associated with microbial infection of the endocardial surface of the heart (heart valves)
What increases the risk of infective endocarditis? (4)
- Prosthetic valves
- Previous Infective endocarditis
- Acquired valvular heart disease
- Congenital heart defect
How long does acute bacterial endocarditis take to occur?
Within 7 days of infection
How long does sub-acute bacterial endocarditis take to occur?
Within 2-3 weeks of infection
Which bacteria most commonly causes acute bacterial endocarditis?
Staphylococcus aureus
Which bacteria most commonly causes sub-acute bacterial endocarditis?
Streptococcus viridans
List some symptoms of infective endocarditis
- Flu-like symptoms
- Fever
- Anorexia
- Malaise (discomfort)
- Night sweats
- Haematuria (blood in urine)
Why isn’t infective endocarditis treated?
- Very rare
- Increased resistant bacteria
- High costs
Where does the the bacteria for infective endocarditis arise from?
Tooth brushing and chewing
How can patients at risk of infective endocarditis reduce chance of infection? (4)
- Maintain good oral health
- Receive intensive preventative oral healthcare
- Informed of risks
- Made aware of symptoms
What is heart failure?
Syndrome of left and/or right ventricular dysfunction
What are the causes of left ventricular heart failure? (7)
- Coronary artery disease
- Diabetes mellitus
- Hypertension
- Obesity
- Valvular heart disease
- Hyperthyroid disease
- Substance abuse
What are the causes of right ventricular heart failure? (3)
- Previous left ventricular failure
- Severe lung disorder
- Multiple pulmonary emboli
How many people with CVD live in the UK?
7.4 million people
What % of deaths/year in the UK are CVD related?
27%
How would you manage hypertension? (4)
- Weight loss
- Smoking cessation
- Dietary changes
- Medication
What is atherosclerosis initiated by?
Initiated by endothelial injury
How would you investigate heart failure?
- Full blood count
- Electrolyte and urea
- Thyroid function test
- ECG
- Chest radiography
- Echocardiography
- Coronary angiography
- Cardiac MRI
