cardiovascular disease 1

Question 1

what is atherosclerosis?

Answer 1

accumulation of lipid rich plaques in arterial walls

Question 2

what ischaemia?

Answer 2

the progressive narrowing of blood vessels with reduced blood supply and oxygen

Question 3

what happens when plaque ruptures?

Answer 3

thrombus formation and occlusion of blood supply = infarction

Question 4

risk factors of cardiovascular disease?

Answer 4

diabetes, smoking, high cholesterol, high bp, genes

Question 5

what causes high cholesterol?

Answer 5

lifestyle, genes - hypercholesterolaemia

Question 6

management of high cholesterol?

Answer 6

dietary modication, use of drugs - statins

Question 7

in hypertension what are the systolic and diastolic values?

Answer 7

systolic > 160, diastolic >90

Question 8

what is the incidence of hypertension?

Answer 8

15-20% in the western world, increase risk with age

Question 9

what is primary hypertension?

Answer 9

no single underlying cause but related to obesity/alcohol/high salt/genetic

Question 10

what is secondary hypertension?

Answer 10

endocrine - excess hormones

renal - kidneys failing

Question 11

symptoms of very high bp?

Answer 11

firs, breathless, confusion, headaches, chest pain

Question 12

if hypertension is untreated how to treat dentally?

Answer 12

postpone LA until controlled

Question 13

drugs used in hypertension?

Answer 13

beta blockers, diuretics, ace inhibitors, angiotensin II antagonists, Ca channel blockers

Question 14

how is diabetes relevant to hypertension?

Answer 14

increased blood sugar,

Question 15

if diabetes is well controlled what happens to artherosclorosis risk?

Answer 15

reduced risk

Question 16

how to handle hypertension pt’s with genetic factors?

Answer 16

indentify those most at risk and try prevent

Question 17

what is peripheral vascular disease?

Answer 17

artherosclorosis affecting peripheral vessels

Question 18

where does peripheral vascular disease occur?

Answer 18

abdominal aorta, lower limbs

Question 19

what is experienced in chronic peripeheral vascular disease?

Answer 19

intermittent claudication - leg pain in calf when walking

Question 20

what is experiences in acute peripheral vascular disease?

Answer 20

ischaemic limb - pain at rest, pale, cold, numb limb - no sensation cant move

Question 21

management of peripheral vascular disease?

Answer 21

risk factor modification, exercise programme, surgery - bypass grafts and stents

Question 22

what is an abdominal aortic aneurysm

Answer 22

damage to the vessel wall from artherosclerosis = dilated aorta

Question 23

what is there a risk of in abdominal aortic aneurysm?

Answer 23

risk of catastrophic rupture

Question 24

what are the symptoms of abdomical aortic aneurysms?

Answer 24

mild abdomical pain, collapses with rupture

Question 25

who is screened for abdominal aortic aneurysms?

Answer 25

men > 65 years

Question 26

clinical manifestations of ischaemic heart disease?

Answer 26

angina, heart failure, acute coronary syndrome, heart attack, unstable angina, arrythmias

Question 27

what is angina?

Answer 27

the narrowing of coronary arteries

Question 28

what causes visceral pain in angina?

Answer 28

lack of blood to heart = ischaemia

Question 29

where is visceral pain felt?

Answer 29

at central chest, down the left arm, atypical - jaw, back , upper abdomen

Question 30

what is unstable angina?

Answer 30

angina felt at rest, unpredictable arrest, increased frequency with reduced amount of exertion

Question 31

investigations for angina?

Answer 31

ECG, ECG under exercise,

coronary angiography

Question 32

what is a coronary angiography?

Answer 32

accessed via femoral/ radial arteries

visualises blood vessels at heart

Question 33

management of stable angina?

Answer 33

antiplatelets - aspirin +/- copidogrel
cholesterol - statins
symptom relief - b blockers, nitrates, ca antagonists

Question 34

surgical interventions of angina?

Answer 34

coronary angioplasty, coronary artery bypass grafting

Question 35

what are acute coronary syndromes?

Answer 35

MI, unstable angina,