Cardiovascular Disease

Question 1

What are the non-modifiable risk factors for cardiovascular disease?

Answer 1

Sex: Males at greater risk
Age: With old age prevalence of hypertension increases
Genetics: Heart disease runs in families

Question 2

What are the modifiable risk factors for cardiovascular disease?

Answer 2

Hypertension
Diet
High blood cholesterol (LDL)
Smoking
Inactivity

Question 3

What is the treatment for hypertension?

Answer 3

Change of lifestyle
ACE inhibitors
Calcium channel blockers
Beta blockers

Question 4

What is the treatment for high LDL?

Answer 4

Dietary modification and exercise

Statin therapy

Question 5

What is the framingham heart study?

Answer 5

An ongoing study with 5200 participants that began in 1948 and is the reason for much of the current knowledge of CV risk

Question 6

What are the main stages of atherosclerosis plaque development?

Answer 6

Endothelial injury
Lymphocyte adherence and transmigration
Smooth muscle cell migration
Macrophages ingest LDL

Question 7

What are the main stages of atherosclerosis plaque development?

Answer 7

Endothelial injury
Lymphocyte adherence and transmigration
Smooth muscle cell migration
Macrophages ingest LDL

Question 8

What is angioplasty?

Answer 8

Treatment for coronary artery disease
Catheter is inserted through the groin towards CA and dye is injected
Once segment is found a balloon is inflated to compress plaque and a stent remains in place to stabilise CA

Question 9

What is a heart bypass?

Answer 9

Grafting a vessel from another part of the body to bypass the CA blockage
Increased blood flow to the heart reduces chance of myocardial infarction

Question 10

What are the consequences of acute myocardial infarction?

Answer 10

Occurs when CA is occluded by an embolus leading to heart muscle ischaemia
Chest pain, shortness of breath, weakness & anxiety

Question 11

What are the consequences of ischaemic heart disease?

Answer 11

Many small clots and ruptures occur in CA that produce no symptoms
Results in eventual MI or congestive heart failure
(CHF)

Question 12

What is CHF?

Answer 12

A physiological state where the cardiac output is insufficient to meet the needs of the body
Can lead to hypertrophy and fluid retention due to kidney insufficiency

Question 13

What are the consequences of ischaemic stroke?

Answer 13

Occurs when blood supply to part of the brain is compromised
Can be due to a thrombus or a plaque rupture
Symptoms depend on area affected

Question 14

What are the consequences of aortic aneurysms?

Answer 14

Stiffening of the aorta
Weakening and bulging of the wall
No symptoms other than pulsating in abdomen
Rupture is serious and usually fatal

Question 15

What are the consequences of peripheral vascular disease?

Answer 15

Obstruction of large arteries 
Often due to atherosclerosis blockages
Leads to acute and chronic ischaemia
Symptoms include claudication, colour changes in limb and slow-non healing wounds and ulcers
Can result in loss of limb

Question 16

What are the consequences of mesenteric infarction

Answer 16

Occurs when one or more mesenteric vessels become occluded
Early diagnosis of bowel ischaemia is difficult as few symptoms
Once infarction has occured mortality is between 70-90%

Question 17

What are the pathological consequences of vascular calcification?

Answer 17

Leads to life-threatening aortic stenosis
Increased arterial stiffness, bp, cardiac hypertrophy and risk of MI and stroke
Occlusion of artery resulting in lower limb ischaemia

Question 18

Why does obesity cause type 2 diabetes?

Answer 18

Insulin resistance

B cell failure

Question 19

What are the current treatment strategies for type 2 diabetes?

Answer 19

Improved lifestyle
Single oral medications
Combinational regimes
Insulin therapy
Islet transplantation (?)

Question 20

What are the current treatment strategies for type 2 diabetes?

Answer 20

Improved lifestyle
Single oral medications
Combinational regimes
Insulin therapy
Islet transplantation (?)

Question 21

What is familial hypercholesterolemia?

Answer 21

Caused by mutations in the genes associated with lipid metabolism
Autosomal dominant disorder
Clinical features = very high levels of LDL, early onset CV disease
Symptoms = yellow cholesterol deposits around eyes & tendons
(Xanthomas)
Treatment = Statins

Question 22

What is atrial fibrillation?

Answer 22

Affects young, low risk individuals
Disruption in atrial blood flow
Blood pooling and clots
TIA or stroke

Question 23

What is a heart block?

Answer 23

An electrical disturbance between SA and AV node that causes arrhythmia

Question 24

What is cardiomyopathy?

Answer 24

A primary disorder of the heart muscle

Question 25

What is rheumatic heart disease?

Answer 25

Inflammatory disorder that occurs following untreated infection with Streptococcus

Question 26

What are epigenetics?

Answer 26

Genetic changes that are not caused by mutations in DNA sequences