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Human Disease > Cardiovascular > Flashcards

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
Q

Bradyarrhythmia

A

Too slow

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26
Q

Ventricular arrhythmia

A
  1. Ventricular tachycardia
  2. Ventricular fibrillation
27
Q

Peripheral vascular disease

A

Atherosclerosis effecting peripheral vessels
- lower limbs
- abdominal aorta

28
Q

Critical limb ischaemia

A

Serious form of PVD.
Embolus or atherosclerotic plaque rupture

29
Q

Claudication

A

Pain in the legs or arms that occurs while walking or using the arms. Usually a symptom of PVD

30
Q

Management of PVD

A
  • Risk factor modification
  • Exercise programme
  • Surgery
    > Bypass grafts
    > Stents
    > Amputation
31
Q

Abdominal aortic aneurysm

A

Damage to vessel wall from atherosclerosis causing a dilated aorta

32
Q

What is the UK screening age for men

A

> 65 yrs old

33
Q

Medical management of Ischaemic heart disease

A
  • Pericutaneous coronary intervention (stents)
  • Coronary artery bypass grafting - open heart surgery
34
Q

GTN dosage

A

2 sprays, sublingually, 5 mins apart, up to 3 doses

35
Q

What side of the heart is most commonly effected by valvular heart disease?

A

Left
- Aortic valve
- Mitral valve

36
Q

Pathophysiology of valvular heart disease: regurgitation

A
  • Loss of valve integrity
  • Becomes floppy
  • Leaks
  • Can cause heart failure
37
Q

Pathophysiology of valvular heart disease: Stenosis

A
  • Narrowing of valve
  • Obstruction of flow
  • Inadequate output
  • Can cause heart failure
38
Q

Treatment for VHD

A

Medication
Surgery - valve replacement

39
Q

Dental aspects of VHD

A

Anticoagulation due to warfarin etc
Risk of infective endocarditis due to invasive procedures

40
Q

Congenital Heart Disease

A

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
Q

Types of congenital heart disease

A
  • Atrial septal defect
  • Ventricular septal defect
  • Patent ductus arteriosus
  • Coarctation of the aorta
  • Tetralogy of Fallot
42
Q

Atrial septal defect

A
  • hole in atrial septum
  • not at increased of endocarditis
43
Q

Ventricular septal defect

A
  • hole in ventricular septum
  • at increased risk of endocarditis
44
Q

Patent ductus arteriosus

A
  • duct arteriosus is part of foetal circulation
  • usually closes at birth
  • at increased risk of endocarditis
45
Q

Coarctation of the aorta

A
  • narrowing of the aorta at the site of the ductus
  • at increased risk of endocarditis
46
Q

Tetralogy of Fallot

A
  • VSD
  • Pulmonary stenosis
  • RV hypertrophy
  • over riding aorta
  • at increased risk of endocarditis
47
Q

Dental aspects of CHD

A
  • risk of infective endocarditis unless it is an isolated
  • if severe can have problems lying flat
48
Q

Infective endocarditis

A

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
Q

Infarction

A

No blood is getting through at all - tissue death

50
Q

thrombus

A

a blood clot that forms in a vessel and stays there

51
Q

example of an ACE inhibitor

A

rampipril

52
Q

example of an Angiotensin II antagonist

A

valsartan

53
Q

example of Diuretics

A

Bedroflumethiazide

54
Q

example of a calcium channel blocker

A

amlodipine

55
Q

example of a beta blocker

A

bisoprolol

56
Q

The American Society of Anaesthesiologists patient classification states;

“globally assess the degree of …. or …. prior to selecting anaesthetic or performing surgery”

A

sickness
physical state

57
Q

how is atrial fibrillation controlled

A

drugs - anticoagulants

58
Q

where in the body may you find a pacemaker?

A

left upper chest wall, below the clavicle

59
Q

Supraventricular tachycardia (SVT)

A

An arrhythmia originating above the ventricles (either atria or AV node)

60
Q

Emergency treatment for tachyarrhythmias

A

vagal manoeuvres, carotid sinus massage, drugs

61
Q

Prevention treatment for tachyarrhythmias

A

drugs
surgery

62
Q

treatment for ventricular arrhythmias

A

start CPR
rapid defibrillation
phone 999
longer term treatment - drugs and ICD (Implantable Cardioverter Defibrillator

63
Q

5 Ps of critical limb ischaemia

A

Pale
Pulseless
Perishing cold
Paralysis
Paraesthesia of limb (pins and needles)

64
Q

What is intermittent claudication

A

muscle pain that happens when you’re active and stops when you rest

Human Disease (17 decks)

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