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Cardiovascular Flashcards

1
Q

What is the main cause of vascular disease in the developed world?

A

Atherosclerosis

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2
Q

What is Atherosclerosis?

A

Atherosclerosis is the buildup of fats, cholesterol and other substances in and on the artery walls

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3
Q

Non modifiable risk factors of atherosclerosis

A

older age
family history
male > female

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4
Q

Modifiable risk factors of atherosclerosis

A

smoking
alcohol
poor diet
obesity
stress
diabetes mellitus

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5
Q

Systolic

A

Heart pumping

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6
Q

Diastolic

A

Heart relaxing

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7
Q

HBP reading

A

> 140/90 or 150/90 if >80yrs old

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8
Q

Normal blood pressure reading

A

<120/80

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9
Q

Diseases caused by atherosclerosis

A

Cerebrovascular disease (brain)
Ischaemic heart disease (heart)
Mesenteric ischaemia (gut)
Renovascular disease (kidney)
Abdominal aortic aneurysm (aorta)
Peripheral vascular disease (legs)

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10
Q

Primary prevention

A

for patients that have never had cardiovascular disease in the past.
QRISK3 score calculates the percentage risk of the patient having a stroke in the next 10 yrs. If >10% risk offer a statin. If patient has chronic kidney disease or type 1 diabetes for >10 yrs offer atorvastatin.

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11
Q

Secondary prevention

A

for patients that have had angina, myocardial infarction, TIA, stroke or peripheral vascular disease.
4 As:
A - Aspirin (plus a second antiplatelet such as clopidogrel for 12 months)
A - Atorvastatin
A - Atenolol (or other beta-blocker – commonly bisoprolol) titrated to maximum tolerated dose
A - ACE inhibitor (commonly ramipril) titrated to maximum tolerated dose

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12
Q

How long should you avoid dental treatment post myocardial infarction

A

4 weeks - check with GP before treating

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13
Q

Drug impact on oral cavity - ACE inhibitors

A

Oral lichen planus

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14
Q

Drug impact on oral cavity - Nicorandil

A

Chronic painful ulcers

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15
Q

Drug impact on oral cavity - Calcium channel blockers

A

Gingival hyperplasia

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16
Q

Sinus rhythm

A

Normal cardiac rhythm

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17
Q

On an ECG: P WAVE

A

Atrial depolarisation

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18
Q

On an ECG: QRS WAVE

A

Ventricular depolarisation

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19
Q

On an ECG: T WAVE

A

Ventricular repolarisation

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20
Q

Arrhythmia

A

Abnormal cardiac rhythm

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21
Q

What is classed as too fast a heart beat?

A

> 100/minute

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22
Q

What is classed as too slow a heart beat?

A

<60/minute

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23
Q

Atrial fibrillation

A

Irregular

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24
Q

Tachyarrhythmia

A

Too fast

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25
Bradyarrhythmia
Too slow
26
Ventricular arrhythmia
1. Ventricular tachycardia 2. Ventricular fibrillation
27
Peripheral vascular disease
Atherosclerosis effecting peripheral vessels - lower limbs - abdominal aorta
28
Critical limb ischaemia
Serious form of PVD. Embolus or atherosclerotic plaque rupture
29
Claudication
Pain in the legs or arms that occurs while walking or using the arms. Usually a symptom of PVD
30
Management of PVD
- Risk factor modification - Exercise programme - Surgery > Bypass grafts > Stents > Amputation
31
Abdominal aortic aneurysm
Damage to vessel wall from atherosclerosis causing a dilated aorta
32
What is the UK screening age for men
>65 yrs old
33
Medical management of Ischaemic heart disease
- Pericutaneous coronary intervention (stents) - Coronary artery bypass grafting - open heart surgery
34
GTN dosage
2 sprays, sublingually, 5 mins apart, up to 3 doses
35
What side of the heart is most commonly effected by valvular heart disease?
Left - Aortic valve - Mitral valve
36
Pathophysiology of valvular heart disease: regurgitation
- Loss of valve integrity - Becomes floppy - Leaks - Can cause heart failure
37
Pathophysiology of valvular heart disease: Stenosis
- Narrowing of valve - Obstruction of flow - Inadequate output - Can cause heart failure
38
Treatment for VHD
Medication Surgery - valve replacement
39
Dental aspects of VHD
Anticoagulation due to warfarin etc Risk of infective endocarditis due to invasive procedures
40
Congenital Heart Disease
term used to describe a range of birth defects that affect the normal way the heart works. The term "congenital" means the condition is present from birth.
41
Types of congenital heart disease
- Atrial septal defect - Ventricular septal defect - Patent ductus arteriosus - Coarctation of the aorta - Tetralogy of Fallot
42
Atrial septal defect
- hole in atrial septum - not at increased of endocarditis
43
Ventricular septal defect
- hole in ventricular septum - at increased risk of endocarditis
44
Patent ductus arteriosus
- duct arteriosus is part of foetal circulation - usually closes at birth - at increased risk of endocarditis
45
Coarctation of the aorta
- narrowing of the aorta at the site of the ductus - at increased risk of endocarditis
46
Tetralogy of Fallot
- VSD - Pulmonary stenosis - RV hypertrophy - over riding aorta - at increased risk of endocarditis
47
Dental aspects of CHD
- risk of infective endocarditis unless it is an isolated - if severe can have problems lying flat
48
Infective endocarditis
Usually occurs on diseased or prosthetic valves An infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel
49
Infarction
No blood is getting through at all - tissue death
50
thrombus
a blood clot that forms in a vessel and stays there
51
example of an ACE inhibitor
rampipril
52
example of an Angiotensin II antagonist
valsartan
53
example of Diuretics
Bedroflumethiazide
54
example of a calcium channel blocker
amlodipine
55
example of a beta blocker
bisoprolol
56
The American Society of Anaesthesiologists patient classification states; "globally assess the degree of .... or .... prior to selecting anaesthetic or performing surgery"
sickness physical state
57
how is atrial fibrillation controlled
drugs - anticoagulants
58
where in the body may you find a pacemaker?
left upper chest wall, below the clavicle
59
Supraventricular tachycardia (SVT)
An arrhythmia originating above the ventricles (either atria or AV node)
60
Emergency treatment for tachyarrhythmias
vagal manoeuvres, carotid sinus massage, drugs
61
Prevention treatment for tachyarrhythmias
drugs surgery
62
treatment for ventricular arrhythmias
start CPR rapid defibrillation phone 999 longer term treatment - drugs and ICD (Implantable Cardioverter Defibrillator
63
5 Ps of critical limb ischaemia
Pale Pulseless Perishing cold Paralysis Paraesthesia of limb (pins and needles)
64
What is intermittent claudication
muscle pain that happens when you're active and stops when you rest

Human Disease (17 decks)

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