Cardiovascular Conditions

Question 1

Non-Modifiable causes of cardiovascular disease

Answer 1

• increasing age
• male gender (until female menopause)
• genetics
• race
• congenital conditions

Question 2

Modifiable causes for cardiovascular disease

Answer 2

• diet
• lack of exercise
• obesity
• type 2 diabetes mellitus
• tobacco smoking
• stress
• excess alcohol & drug use
• hypertension

Question 3

What is Atherosclerosis

Answer 3

• progressive, degenerative disease of the coronary arterial system denotes the formation of fibrosis-fatty lesions in intimate lining of arteries.

Question 4

What are plaques

Answer 4

Fatty deposits (lipids) under the lining of the arteries often near branches of vessels causing reduced blood flow

Question 5

In atherosclerosis, what do localized plaques do

Answer 5

Protrude into the lumen of the artery and reduces blood flow

Question 6

How does atherosclerosis begin

Answer 6

As a result of damage, or “insult” to the endothelium

Question 7

What is Ischemia

Answer 7

Decreased blood supply to an organ or part

Question 8

What is infarction

Answer 8

Necrosis or death of tissues due to ischemia

Question 9

When blood vessels rupture, what are the most affected arteries?

Answer 9

• Coronary arteries
• arteries supplying brain, kidneys, lower extremities, small intestine

Question 10

What is the most common cause for myocardial ischemia

Answer 10

Atherosclerosis of the coronary artery

Question 11

What is myocardial ischemia associated with

Answer 11

Increased concentrations of blood lactic acid produced by anaerobic respiration of the ischemic tissue

Question 12

Ischemic heart disease often causes

Answer 12

Substernal pain, (left shoulder and arm), this pain is referred to as angina pectoris

Question 13

A sudden, irreversible injury of Ischemic heart disease is

Answer 13

Myocardial infarction (MI)

Question 14

What is hypertension

Answer 14

An intermittent or sustained elevation of diastolic or systolic BP

Question 15

What BP would be classed as hypertension

Answer 15

140/90

Question 16

What are the two major types of hypertension

Answer 16

• Essential (aka primary or idiopathic)
• Secondary

Question 17

Irrespective of cause, hypertension often affects the

Answer 17

Kidneys

Question 18

Essential hypertensions cause is

Answer 18

Unknown

Question 19

Symptoms of essential hypertension and diagnosis

Answer 19

Hypertension is symptomless and only discovered through routine examination

Question 20

First indications of hypertension are

Answer 20

• Heart failure
• cerebrovascular accident
• MI

Question 21

Causes of Secondary Hypertension

Answer 21

• kidney disease
• adrenal gland disorders
• hyperthyroidism
• structure of the aorta
• nervous system
• alcohol
• obesity
• pregnancy
• drug treatment

Question 22

Effects of longstanding and rising blood pressure on the heart:

Answer 22

• rate & force of contraction are increased against high arterial pressure
• LV hypertrophied
• back pressure & accumulation of blood in lungs
• predisposes to ischaemic heart disease & aneurysm formation

Question 23

Effects of longstanding and rising blood pressure on the brain:

Answer 23

• stroke caused by cerebral haemorrhage (ruptured vessel)

Question 24

Effects of longstanding and rising blood pressure on the kidneys:

Answer 24

• causes direct damage to kidneys

Question 25

Effects of longstanding and rising blood pressure on the blood vessels:

Answer 25

• small arteries become hardened.
• in large arteries, atheroma is accelerated.
• vessels become less elastic and hypertension worsens.

Question 26

What is pulmonary hypertension?

Answer 26

• increased blood pressure in lung vasculature.

Question 27

Clinical manifestations of pulmonary hypertension

Answer 27

• shortness of breath
• fatigue
• non-productive cough
• angina
• cyanosis
• peripheral oedema, ascites
• syncope
• jugular vein dilation
• wide split S2 (second heart sound) and loud P2 (pulmonary valve closure) upon auscultation

Question 28

Heart failure signs and symptoms

Answer 28

• shortness of breath (at rest or exertion)
• orthopnoea
• paroxysmal nocturnal dyspnoea
• fluid
• chest pain
• difficulty focusing and confusion
• lowered exercise ability and/or fatigue
• heart palpitations
• oedema
• fatigue

Question 29

Chronic heart failure is caused by:

Answer 29

• an imbalance in the pump function where the heart fails to maintain circulation - affecting preload, after load and contractility

Question 30

Risk factors for Congestive heart failure:

Answer 30

• poorly controlled high blood pressure
• high cholesterol
• diabetes
• smoking
• family history
• sleep apnoea
• alcohol and drug abuse
• infections
• connective tissue disorders (lupus erythematosus, sarcoidosis and anyloidosis)

Question 31

Symptoms of left sided heart failure

Answer 31

• restlessness
• confusion
•orthopnoea
• tachycardia
• exertional dyspnoea
• fatigue
• cyanosis
• tachypnoea
• blood-tinged sputum
• wheezes
• crackles
• cough
• elevated pulmonary capillary wedge pressure
• paroxysmal nocturnal dyspnoea

Question 32

Right sided heart failure symptoms

Answer 32

• secondary to chronic pulmonary problems
• distended jugular veins
• anorexia & complaints of GI distress
• weight gain
• dependent edema
• enlarged liver & spleen
• ascites
• peripheral venous pressure
• fatigue

Question 33

What is left ventricular failure

Answer 33

• The inability of the left ventricle to function effectively as a forward pump causing excessive volume of fluid to accumulate in the pulmonary circulation.
• inability to pump out the blood returned from the lungs

Question 34

Clinical manifestations of left ventricular failure

Answer 34

• severe respiratory distress
• severe apprehension, agitation, confusion and feeling of being smothered
• cyanosis
• white frothy sputum (pink frothy in severe disease)
• jugular vein distention
• tachycardia and raised BP
• level of consciousness may very depending on hypoxia
• diaphoresis
• chest pain, usually in the presence of an MI

Question 35

What is right ventricular failure

Answer 35

• failure of the right ventricle to function effectively enough to act as a pump, causing excessive volume of fluid to accumulate the systemic circulation.
• blood engorges, causing a rise in pressure in the right atrium, RV and systemic veins causing peripheral oedema.

Question 36

Possible causes for Right Ventricular Failure

Answer 36

• acute right ventricular infarct - inferior MI
• pulmonary disease (COPD, fibrosis, pulmonary hypertension)
• cardiac disease involving left or both ventricles
• results from left ventricular failure
• tricuspid or pulmonary valve disease
• cardiomyopathy
• pneumonia / TB
• pulmonary embolism

Question 37

Clinical manifestations for right ventricular failure

Answer 37

• weakness or fatigue
• tachycardia
• venous congestion (neck veins)
• engorged liver and/or spleen
• peripheral oedema
• weight gain
• congestion of GI tract can compromise digestion (causes anorexia, nausea, bloating & vomiting)
• arrhythmias
• hypotension
• previous history of MI or CCF
• poor exercise tolerance

Question 38

Types of cardiomyopathy

Answer 38

• dilated cardiomyopathy
• hypertrophic cardiomyopathy
• arrhythmogenic right ventricular dysplasia (ARVD)
• restrictive cardiomyopathy

Question 39

What is dilated cardiomyopathy

Answer 39

When the heart muscle is too weak to pump blood efficiently. Muscles stretch and become thinner which causes chambers of the heart to expand. Can be inherited, or due to coronary artery disease

Question 40

What is hypertrophic cardiomyopathy

Answer 40

• believed to be genetic
• occurs when heart walls thicken and prevent blood flow.
• can be caused by long-term high blood pressure or aging
• diabetes or thyroid disease can cause cardiomyopathy

Question 41

What is arrhythmogenic right ventricular dysplasia (ARVD)

Answer 41

• leading cause in death in young athletes
• fat and extra fibrous tissue replace the muscle of the right ventricle causing abnormal heart rhythms

Question 42

What is restrictive cardiomyopathy

Answer 42

• ventricles stiffen and can’t relax enough to fill up with blood.
• scarring of the heart which happens frequently after a heart transplant may be a cause, as well as heart disease

Question 43

Risk factors of cardiomyopathy

Answer 43

• family history
• coronary heart disease
• diabetes
• severe obesity
• sarcoidosis
• hemocheomatosis
• amyloidosis
• heart attack
• long term high blood pressure
• alcoholism

Question 44

Signs & symptoms of cardiomyopathy

Answer 44

• general weakness and fatigue
• shortness of breaths
• light headedness and dizziness
• chest pain
• heart palpitations
• fainting attacks
• high blood pressure
• oedema of the feet,ankles and legs

Question 45

Name the 3 types of aneurysms

Answer 45

• fusiform
• dissecting
• saccular/berry

Question 46

What is fusiform (type of aneurysm)

Answer 46

Wall of the arty expands until it bursts. Repairable using a mesh applied to the artery to stop it expanding further

Question 47

What is dissecting (type of aneurysm)

Answer 47

• usually found in the highest-pressure areas (aorta)
• split in the inner lining, blood will push out and strip the layers apart.
• blood will end up around the aorta instead of inside.

Question 48

What is saccular/berry (type of aneurysm)

Answer 48

• a particular part of the arty wall that has failed and forms a berry shape.
• can be repaired with a clip at the bottom where it joins the main artery.

Question 49

Complications of aneurysms

Answer 49

• potential for unequal blood pressures varying by 20mmHg
• thromboembolism
• stroke
• severe chest and/or back pain if aortic aneurysm in chest ruptures
• angina
• sudden, extreme headache
• low BP
• tachycardia
• light headedness

Question 50

Clinical signs of abdominal aortic aneurysm

Answer 50

• commonly asymptomatic
• pulsating mass
• mid and or lumbar pain
• large aneurysm might compress lumbar nerves and sciatic pain
•

Question 51

Effects of hypertension on blood vessels

Answer 51

Small arteries become hardened

Atheroma accelerated in large arteries

Question 52

Which layer of the heart is affected during a heart attack

Answer 52

Myocardium