cardiovascular disease 1 Flashcards
what is atherosclerosis?
accumulation of lipid rich plaques in arterial walls
what ischaemia?
the progressive narrowing of blood vessels with reduced blood supply and oxygen
what happens when plaque ruptures?
thrombus formation and occlusion of blood supply = infarction
risk factors of cardiovascular disease?
diabetes, smoking, high cholesterol, high bp, genes
what causes high cholesterol?
lifestyle, genes - hypercholesterolaemia
management of high cholesterol?
dietary modication, use of drugs - statins
in hypertension what are the systolic and diastolic values?
systolic > 160, diastolic >90
what is the incidence of hypertension?
15-20% in the western world, increase risk with age
what is primary hypertension?
no single underlying cause but related to obesity/alcohol/high salt/genetic
what is secondary hypertension?
endocrine - excess hormones
renal - kidneys failing
symptoms of very high bp?
firs, breathless, confusion, headaches, chest pain
if hypertension is untreated how to treat dentally?
postpone LA until controlled
drugs used in hypertension?
beta blockers, diuretics, ace inhibitors, angiotensin II antagonists, Ca channel blockers
how is diabetes relevant to hypertension?
increased blood sugar,
if diabetes is well controlled what happens to artherosclorosis risk?
reduced risk
how to handle hypertension pt’s with genetic factors?
indentify those most at risk and try prevent
what is peripheral vascular disease?
artherosclorosis affecting peripheral vessels
where does peripheral vascular disease occur?
abdominal aorta, lower limbs
what is experienced in chronic peripeheral vascular disease?
intermittent claudication - leg pain in calf when walking
what is experiences in acute peripheral vascular disease?
ischaemic limb - pain at rest, pale, cold, numb limb - no sensation cant move
management of peripheral vascular disease?
risk factor modification, exercise programme, surgery - bypass grafts and stents
what is an abdominal aortic aneurysm
damage to the vessel wall from artherosclerosis = dilated aorta
what is there a risk of in abdominal aortic aneurysm?
risk of catastrophic rupture
what are the symptoms of abdomical aortic aneurysms?
mild abdomical pain, collapses with rupture
who is screened for abdominal aortic aneurysms?
men > 65 years
clinical manifestations of ischaemic heart disease?
angina, heart failure, acute coronary syndrome, heart attack, unstable angina, arrythmias
what is angina?
the narrowing of coronary arteries
what causes visceral pain in angina?
lack of blood to heart = ischaemia
where is visceral pain felt?
at central chest, down the left arm, atypical - jaw, back , upper abdomen
what is unstable angina?
angina felt at rest, unpredictable arrest, increased frequency with reduced amount of exertion
investigations for angina?
ECG, ECG under exercise,
coronary angiography
what is a coronary angiography?
accessed via femoral/ radial arteries
visualises blood vessels at heart
management of stable angina?
antiplatelets - aspirin +/- copidogrel
cholesterol - statins
symptom relief - b blockers, nitrates, ca antagonists
surgical interventions of angina?
coronary angioplasty, coronary artery bypass grafting
what are acute coronary syndromes?
MI, unstable angina,
