Cardiovascular Disease Flashcards
what may breathlessness at rest indicate in a pt?
heart failure
respiratory problem
what can an apprehensive, sweaty, pained expression indicate in a pt?
angina
myocardial infarction
what CV disease can be indicted by finger clubbing?
congenital heart defect
what can a pale nail bed indicate?
anaemia
what is cyanosis?
blue discolouration of the lips or palate
what medication can cause gingival hypertrophy?
nifedipine antihypertensive medication
what is xanthelasma and what does it indicate?
-yellow plaques around eyes
-elevated cholesterol
what is the most common cardiac rhythm abnormality?
atrial fibrillation
what is the name given to a heart rate >100bpm?
tachycardia
what is the name given to a heart rate <60bpm?
bradycardia
what is hypertension?
persistently raised blood pressure >140/90mmHg
where should a blood pressure cuffed be placed whilst taking a reading?
3cm above the anticubital fossa
what is the name given to hypertension with no known cause?
primary hypertension
what % of the population suffers from primary hypertension?
5-10%
what are the known aetiologies of hypertension?
-renal disease
-pregnancy
-coarctation of the aorta
-endocrine tumours
-drugs e.g. steroids
how does hypertension cause arteriolar sclerosis?
the vessels adapt to the raised pressure by increasing smooth muscle and hyaline content of the media
what does it mean if an artery is aneurysmal?
it is abnormally dilated
what is classified as severe hypertension?
> 180/110mmHg
what are the symptoms of severe hypertension?
-dizziness
-headache
-epistaxis
what are the risks of untreated hypertension?
-left ventricular failure (enlarges to cope with the extra pressure but eventually dilates and fails)
-MI
-stroke
-renal failure
what is the most important predisposing factor for stroke?
hypertension
how is hypertension diagnosed?
by accurate measurement of the blood pressure on at least 3 occasions over a 3-month period in a relaxed atmosphere
what lifestyle modifications can a person with hypertension make in an effort to try reduce their blood pressure?
-weight reduction
-Increased exercise
-decreased alcohol consumption
-stop smoking
-low salt diet
name 6 classes of antihypertensive medication
-diuretic
-B-blocker
-Ca antagonist
-ACE inhibitor
-angiotensin II receptor blocker
-adrenergic inhibitors
what 3 groups should you split hypertension patients into?
-controlled hypertensive on treatment
-high blood pressure detected in practice
-malignant hypertensive
how would you manage a pt with high blood pressure detected in practice?
refer to GP for further investigation
elective treatment deferred
how do you manage a malignant hypertensive pt?
bp>185/110mmHg
high risk fo acute complications- refer urgently to GP/hospital
name an oral side effect of nifedipine
gingival hyperplasia
name an oral side effect of clonidine
salivary gland swelling
name an oral side effect of diuretics
xerostomia
name a dental complication of hypertension
increased post operative bleeding
when is a pt’s blood pressure too high for treatment in general practice?
160/110
What organs are commonly affected by hypertension and how does this present?
Brain-stroke
Eyes- retinal haemorrhages
Aorta-aneurysm
Kidney-renal failure
Heart- MI, failure, left ventricular hypertrophy
What is ischaemic heart disease?
An imbalance between supply of blood to the heart muscle and demand
What % of males under the age of 60 have ischaemic heart disease?
> 20
What is the most common cause of IHD?
coronary atheroma
Name 3 fixed risk factors of IHD
-age
-male
-family history
Name 6 modifiable risk factors for IHD
-smoking
-hypertension
-diabetes
-obesity / lack of exercise
-alcohol
-oral contraceptive
Describe the pathogenesis of IHD
-formation of an atheromatous plaque within coronary arteries
-this produces fixed constriction to blood flow
-Endothelial lining is disrupted
-thrombus formation occurs due to platelet adhesion
-vessel lumen becomes narrowed
What happens when an atheromatous plaque within an artery fissures?
An acute thrombus may form which can completely occlude the vessel leading to myocardial infarction
Describe the composition of an atheromatous plaque which may form within an artery
Consists of a necrotic core containing cholesterol Surrounded by increased smooth muscle and fibrous tissue
What are the clinical features of IHD?
-angina
-breathlessness
-nausea
-sweating
-pain in arm, neck or jaw
How is diagnosis of IHD made?
-the patients history
-ECG
-coronary angiography
-nuclear medicine scans of the myocardium
What are the main aims when treating a pt with IHD?
