Cardiovascular Disease Flashcards
What is ischemic heart disease?
It is a condition caused by inadequate blood flow to the heart muscle.
What are the non-modifiable risk factors for cardiovascular disease?
Age, gender, family history, and race.
Modifiable risk factors for cardiovascular disease?
- Hypertension = ?
- Hypercholesterolemia = ?
- Physical Inactivity = ?
- Diabetes = ?
- Obesity = ?
-) Cigarette Smoking
- Current smoker or quit within last 6 months
- Hypertension
- > 130 and/or >80
- 2 readings/2 separate occasion
-) Hypercholesterolemia
- Total >200
- LDL > 130
- HDL < 40 men / < 50 women
-) Physical Inactivity
- < 75-150 min/week moderate to vigorous a week
- MET min/week = 500-1000 MET min/week
-) Diabetes
- Fasting >100mg/dL
- 2-hour glucose > 140mg
- HbA1c >5.7%
-) Obesity
- BMI >30; Waist circumference >40” (men), 35” (women)
-) On medications for HTN, HLD, Diabetes is also a risk factor
What are the Life’s Simple 7 recommended by AHA?
- avoid smoking
- engage in physical activity
- maintain ideal body weight
- eat a healthy diet
- manage blood pressure
- manage cholesterol
- manage fasting glucose
What is….
- hypertension = ?
- hypertensive heart disease = ?
Hypertension:
- A condition with systolic blood pressure >130 mmHg or diastolic >80 mmHg on two separate occasions.
Hypertensive heart disease:
- A condition where hypertension causes left ventricular hypertrophy, leading to decreased stroke volume.
What are the main goals of treating hypertension?
a) Goals
- normalize blood pressure,
- reverse left ventricular hypertrophy
- manage myocardial dysfunction
b) Pharmacologic treatment is the most common
- Diuretics, vasodilators, ACE inhibitors, beta-blockers, and calcium-channel blockers.
What are beta-blockers used for?
They compete with epinephrine to reduce heart rate, decrease contractility, decrease cardiac output, and decrease blood pressure.
What are calcium-channel blockers used for?
They block calcium entry, reducing muscular contraction and promoting vasodilation.
What are the 2017 BP guidelines for normal, elevated, and hypertensive values?
- Normal: < 120 and < 80
- Elevated: 120-129 and < 80
- HTN Stage 1: 130-139 or 80-89
- HTN Stage 2: ≥ 140 or ≥ 90
What is the impact of exercise on hypertension?
a) Aerobic exercise training: somewhat strong evidence for reducing blood pressure
- By atleast 10mmHg systolic and/or diastolic
b) Resistance training: data considered to be lacking in strength and consistency
c) Must stay consistent with exercise program
What is coronary artery disease (CAD)?
CAD occurs when fatty deposits (plaque) build up in the arteries, leading to reduced blood flow.
What is the clinical course of atherosclerosis?
It can result in sudden cardiac death, stable or unstable angina, myocardial infarction, and cardiac muscle dysfunction.
- clear
- partial
- total
What is angina?
Chest pain caused by inadequate oxygen supply to the heart, relieved by rest or nitroglycerin.
What are the types of angina?
a) stable angina (predictable)
b) unstable angina (unpredictable)
c) Prinzmetal’s (variant) angina
- Angina caused by coronary artery vasospasm, occurring at rest and usually in the morning.
What are the symptoms of unstable angina?
Unpredictable chest pain, poor response to rest or nitroglycerin, and increased risk of myocardial infarction.
What is…
- myocardial infarction = ?
- cardiac markers elevated during a myocardial infarction = ?
- Myocardial infarction: It is the death of heart muscle due to prolonged lack of oxygen, typically caused by a blocked coronary artery.
- Troponin, creatine kinase (CK-MB), and lactate dehydrogenase (LDH).
What is the role of troponin in diagnosing MI?
Troponin is a cardiac marker that increases 4-6 hours after a heart attack and remains elevated for up to 7 days.
What is…
- Percutaneous coronary intervention (PCI) = ?
- Precautions = ?
- PCI: A non-surgical procedure using a balloon or stent to open blocked coronary arteries.
- Monitor for bleeding at the insertion site, avoid strenuous activity, and follow physician’s guidelines.
What is
- coronary artery bypass graft (CABG) = ?
- sternal precautions after CABG = ?
CABG:
- A surgical procedure to bypass blocked coronary arteries and restore blood flow to the heart.
Pracautions:
- No lifting >5-10 lbs, no pushing/pulling, avoid driving, and splint the chest when coughing.
What are the effects of atherosclerosis?
It leads to the hardening and narrowing of arteries, reducing blood flow and causing ischemia.
What are the implications of hypertension on left ventricular function?
- hypertension causes left ventricular hypertrophy
- reducing stroke volume, and
- increasing heart rate
What is the Valsalva maneuver and its effects on the heart?
The Valsalva maneuver increases intrathoracic pressure, reducing venous return and preload, affecting cardiac output.
What are the main treatment goals for cardiovascular disease?
- reduce risk factors
- improve cardiac output
- promote heart health through lifestyle modifications
What is the significance of LDL in coronary artery disease?
High LDL levels contribute to plaque buildup in arteries, leading to atherosclerosis and heart disease.
What is the difference between STEMI and NSTEMI?
- STEMI is a full-thickness myocardial infarction with ST elevation.
- NSTEMI is a partial-thickness infarction without ST elevation.
What is the role of nitrates in managing angina?
Nitrates promote vasodilation, reducing oxygen demand and relieving chest pain.
What is the main purpose of an angiogram?
To visualize the coronary arteries and assess the location and severity of blockages.
What is heart failure?
A condition where the heart is unable to pump enough blood to meet the body’s needs.
What is peripheral artery disease (PAD)?
PAD is a condition where narrowed arteries reduce blood flow to the limbs, causing pain and discomfort during activity.
What is the role of diuretics in managing hypertension?
Diuretics help reduce blood pressure by removing excess fluid from the body, decreasing blood volume.
What are anticoagulants used for in cardiovascular treatment?
Anticoagulants prevent blood clots from forming, reducing the risk of stroke and heart attack.
Angina Scale = ?
1 = Mild, barely noticeable
2 = Somewhat Strong, Moderate, Bothersome
3 = Moderately severe, very uncomfortable
4 = Very Severe, most intense pain ever experienced
Balloon angioplasty vs. Balloon Valvuloplasty
Balloon angioplasty:
- Widen the opening and increaseblood flow in the heart
- Catheter with tiny balloon tip isinserted and inflated at side ofblockage
Balloon Valvuloplasty:
- Utilized for valve stiffness orregurgitation
- Inflates at the valve
- Typicallybed rest for a few hoursafter
IABP = ?
Intra-Aortic BalloonCounterpulsation(IABP)
Right vs Left Catheterization
Right:
- Performed through vein to get to right side of heart
- Assess pressure in right side of heart and can diagnose pulmonary HTN
- Assess R atrium, ventricle, tricuspid and pulmonic valve
Left:
- Through artery (brachial, radial, or femoral) to assess left side of heart
- Can assess coronary arteries through aorta
- Primary test for CAD, MI
MPI = ?
Myocardial Perfusion Imaging
