Cardiology Flashcards
What is atherosclerosis?
A progressive inflammatory disorder of the arterial walls characterized by lipid rich deposits (atheromas)
What risk factors contribute to Atherosclerosis?
Modifiable: HTN, DM, Hyperlipidemia, Smoking, Alcohol consumption, obesity (esp truncal), Exercise
Non-modifiable: Age, Sex, FH (HTN, DM, Hyperlipidemia)
Preventative measures for atherosclerosis?
Primary prevention:
a) Modify the risk of the entire population through diet and lifestyle advice (Balanced diet, regular exercise, avoid smoking, maintain ideal BMI)
b) Targeted strategy: High risk groups
Secondary prevention: Pts who already have evidence of atheromatous plaques & have high risk of cardiovascular events
Preventative measures for atherosclerosis?
Primary prevention:
a) Modify the risk of the entire population through diet and lifestyle advice (Balanced diet, regular exercise, avoid smoking, maintain ideal BMI)
b) Targeted strategy: High risk groups
Secondary prevention: Pts who already have evidence of atheromatous plaques & have high risk of cardiovascular events
Unstable vs Stable atheromatous plaques?
Unstable plaque: Thin fibrous cap, large lipid core, increased inflammation
Stable plaque: Thick fibrous cap, negligible atheromatous core, minimal inflammation
Clinical consequences of Atherosclerosis include:
- Ischemia distal to plaque–> MI, stroke, PAOD
- Plaque erosion/rupture–> Thrombosis, Embolus, Haemorrhage into plaque
- Weakening of media of vessel wall–> aneurysm formation
- Critical stenosis–> angina, claudication
Arteriolosclerosis (characteristics)
This is a type of arterosclerosis. Affects small arteries & arterioles. May cause ischaemic injury distally. Hyaline or Hyperplastic. Associated with HTN & DM
Monckeburg medial sclerosis (characteristics)
This is a type of arterosclerosis. Char by calcific deposits in muscular arteries. Lesions don’t encroach the vessel lumen. Usually not clinically significant
What is HTN?
Elevated blood Pressure of >/= 140/90mmHg on at least two readings on at least two separate visits
Predisposing Factors for developing HTN?
NON-MODIFIABLE o Ethnicity (African Americans >Asians or Whites) o Family History o Age >30 o Male
MODIFIABLE
o Diet (excessive salt intake/fatty diet)
o Exercise –Sedentary Lifestyle; Obesity (especially abdominal)
o Alcohol consumption
o Smoking
o DM (suspected that insulin resistance in hyperinsulinemia leads to renal sodium retention and proliferation of vascular muscle cells; both lead to increased BP)
o Dyslipidemia
o Psychological Stress
Causes of HTN?
- Essential HTN (90%, undetermined cause)
- Secondary HTN (10%, known cause)
“RECENT”
o Renal: Renal artery stenosis, PKD, Renal failure, Glomerulonephritis, SLE, Renal tumours
o Endocrine: Acromegaly; Hyperthyroidism; Primary Hyperparathyroidism; Primary hyperaldosteronism [Conn Syndrome] (most common); Hypercortisolism [Cushing syndrome]; Phaeochromocytoma; CAH
o Coarctation of the Aorta
o Estrogen: OCPs
o Neurologic: Incr ICP, Psychostimulant use
o Treatment: NSAIDs, Steroids
What is HTN Urgency?
SBP>210 or DBP >120 with minimal or no target organ damage
What is Accelerated HTN?
significant recent increase in BP over previous Hypertensive levels associated with evidence of vascular damage on fundoscopy but without papilledema
What is Malignant HTN?
Sufficient elevation in BP to cause papilledema and other manifestations of vascular damage (retinal haemorrhages, bulging discs, mental status changes, increasing creatinine)
What is HTN Emergency?
Severe HTN (DBP >120) + acute target organ damage
