Cardiovascular Disease

Question 1

Risk Factors

Answer 1

smoking 
inactivity
excessive alcohol consumption
mental stress and tension
poor diet 
increased weight and obesity 
HTN 
dyslipidaemia/increased cholesterol 
age >70
male 
family history 
diabetes

Question 2

Clinical Significance

Answer 2

decreased exercise tolerance 
dyspnoea 
pain 
decreased lung volumes 
impaired gas exchange

Question 3

Acute Coronary Syndrome

Answer 3

Any condition attributed to obstruction of the coronary arteries which reduces blood flow to the heart, and includes unstable angina and myocardial infarction

Any condition that obstructs blood flow to the heart - causes ischaemia and cell death, result of atherosclerosis in coronary arteries

Question 4

Types of Lesions ACS

Answer 4

Stenotic Lesion - fibrous plaques containing collagen and calcium

• more stable
• results in thickening of the vessel wall causing occluded blood flow
• results in myocardial ischaemia

Non-Stenotic Lesions - plaque has a thin fibrous cap and lipid laden core

• unstable
• tend to cause more damage
• don’t cause vessel wall thickening
• prone to rupture - leads to thrombus
• causes sudden onset of cardiac symptoms - likely to cause myocardial infarction

Question 5

ACS Clinical Features

Answer 5

pain or discomfort - chest, jaw, neck, back, UL, epigastric area
can occur at rest or only with exertion
symptoms typically last for at least 20mins
may also have breathlessness, syncope, diaphoresis, nausea and/or vomiting
may have little to no symptoms

Question 6

Heart Failure

Answer 6

heart unable to pump sufficient amount of blood to meet the demands of the body

Question 7

Causes of heart failure

Answer 7

repeated myocardial insult 
HTN 
lung disease
diabetes
valvular disease, malformation or dysfunction

Question 8

Heart Failure Pathophysiology

Answer 8

myocardial infarction - causes ventricular dysfunction and resultant reduced cardiac output
reduced cardiac output results in reduced renal perfusion, triggering the RAAS
results in
- systemic vascoconstriction
- increased sodium and water reabsorption to increase blood volume
results in increased blood pressure
increased pre load and after load on the heart

Question 9

Classifications of CVD

Answer 9

1. no limitation of physical activity - ordinary physical activity doesn’t cause an onset of symptoms
2. slight limitation of physical activity - patient comfortable at rest but ordinary physical activity causes fatigue, palpitations and dyspnoea
3. marked limitation of physical activity - comfortable at rest, less than ordinary physical activity causes fatigue, palpitations and dyspnoea
4. unable to carry out any physical activity without symptoms