Cardiovascular Disease Flashcards
What are the risk factors for Cardiovascular Disease?
Age:
– Males 45 and up
– Females 55 and up, or premature menopause with no HRT
Family History
Smoking
Hypertension
Diabetes
Abdominal Obesity
Ethnicity
Hyperlipidemia
Sedentary lifestyle
Dietary Choices
What is coronary artery disease?
Irregular thickening of the inner layer of the coronary artery walls, narrowing of the internal channel and reducing blood supply to the heart
Frequently leads to myocardial infarction
What is coronary heart disease and how is it different from coronary artery disease?
Direct damage to the heart muscle of a degree sufficient to interfere with the function of the heart
May result in reduced blood flow as a result of narrowing due to coronary artery disease or from complete blockage during a heart attack
Victim may have CAD but not CHD because of the development of collateral vessels around the narrowed coronary artery
Describe the formation of atherosclerosis.
The narrowing and progressive occlusion of arteries, of which a major contributor is hyperlipidemia
Fatty streaks form on the arterial wall - could be due to smoking, hypertension, viruses etc. that cause oxidative damage to the arterial walls which develop streaks
When the body tries to heal itself from the small damages, it creates scarring which then leads to more and more serious damage
What factors increase cholesterol synthesis?
Hyperinsulinemia
Insulin resistance
Diets high in simple sugars
What is homocysteine a marker for?
Considered an indirect marker of CVD risk but elevations may be reflective of genetic defects
What are the unmodifiable and modifiable determinants of plasma Hcy?
Unmodifiable:
Age
Sex - higher in males than females
Genetics
Modifiable:
Dietary intake of Folate, B12, and B6
Physical activity
Smoking
Coffee
What conditions can contribute to hyperhomocysteinemia?
Renal Failure
Diabetes
Malignancies
Hypothyroidism
Lupus
IBD
Medications
What are the classifications of homocysteinemia
Normal:
5-15 µmol/L normal
15-30 µmol/L moderate
30-100 µmol/L intermediate
>100µmol/L severe
What are the two types of cardiac surgery?
CABG - coronary artery bypass graft
Meant for coronary arteries - reactive
Percutaneous coronary angioplasty - dilation
Can be in the neck or other areas, often has to be repeated
Proactive
What should you keep in mind for patients undergoing cardiac surgery?
Maintain protein reserves - support anabolism and healing during post operative period and prevent weight loss
Prevent fluid overload
Immediately post operative period, patients will be hypermetabolic
Restrict sodium
Protein 1-1.2g/kg
BEE x 1.2-1.3
What is Digitalis/Digoxin? What are its side effects?
Used in heart patients to promote strength and efficiency
Side effects include Hypokalemia, Hypomagnesemia, Hypercalcemia
What is Lasix? What are its side effects?
Diuretic, brings blood pressure down
Can cause severe hypokalemia, decreased zing, decreased gut motility
Can contribute to hypercholesteremia and hyperglycemia
What is amiodarone? What are its side effects?
Anti-arrhythmic/vasodilator
Nausea, change in appetite, constipation, metallic taste in the mouth
What are considerations that need to be made when giving patients anticoagulants?
Require consistent intake of Vitamin K because the drug is dosed according to clotting time
May need to limit the intake of green leafy vegetables
