Cardiovascular Disease Flashcards
Cardiovascular disease (CVD) includes…
> Atherosclerosis and associated conditions
Infections
Electrical impulse generation and conduction defects
Congenital Heart Disease
Atherosclerosis and associated conditions of CVD?
> Raised BP (hypertension) > Coronary Heart Disease (CHD) > Chronic Heart Failure (CHF) > Cerebrovascular Disease (stroke) > Peripheral Artery Disease (DVT)
Infections of CVD?
> Endocarditis
> Rheumatic Heart Disease
Prevention of CVD
- Primary prevention
2. Secondary prevention
Primary prevention of CVD…
> when the patient has NO cardiovascular disease (otherwise healthy)
using drugs to PREVENT developing any CVD
Secondary prevention of CVD…
> when the patient HAVE cardiovascular disease
> using drugs to TREAT/STOP them from having another one
CV Risk Assessment
In adults with NO KNOWN CVD, a comprehensive assessment of CVD risk includes consideration of the following: modifiable and non-modifiable risk factors, related conditions
Non-modifiable risk factors..
> Gender and Age
Family history of premature CVD
Social history including cultural ethnicity, and socioeconomic status
Age and Gender
> Risk increases with increasing age.
> CVD risk is higher in male than female (starts at 40)
Family history: relative risk?
Significant family history: Clinically proven CVD in a first-degree relative before the age of 55 (male) and 65 (female).
Ethnicity: Indigenous & Non-Indigenous
Prevalence among Indigenous = non-Indigenous Australians who are 10 years older.
May influence risk by multiple mechanism:
>Genetics
>Lifestyle: smoking, poor nutrition & overweight, diabetes
>Psychosocial
Psychosocial?
>Stress & CVD
> no confirmed relationship btwn stress and CVD
but there is CONFIRMED increased risk for CVD in people who live with: social isolation, depression, lack of social support
Socioeconomic status: Low-Middle socioeconomic groups
Why?
>increased incidence of major risk factors: including psychosocial risk factors
>Low nutrition
>Low education
Modifiable risk factors…
Smoking, BP, serum lipids, waist circumference & BMI, nutrition, physical activity level, alcohol intake
Smoking risk of CVD..
2-6 times higher and risk of stroke is 3 times higher!
BP & serum lipids..
use drugs like ACE-inhibitors and HMGCoA reductase inhibitors (statins)
Physical activity…
at least 30 minutes on days of a week
>more intense and frequent activity does confer greater protection
>but be careful on counselling for doing physical activity in ppl who hv angina for ex. so refer to specialist.
Related conditions to CVD
Diabetes, Chronic Kidney Disease (CKD), Familial Hypercholesterolaemia, Evidence of Atrial FIbrillations (AF)
Absolute CVD Risk is……?
> based on Framingham heart study.
>a CV Risk Calculator to predict the likelihood of someone to experience a CV event
Infectionsss of the heartt
ENDOCARDITIS
> infection of the endocardial surface of the heart
HOWW can endocarditis happen?
bacteria enter bloodstream -> lodge on abnormal heart valve/other damaged heart tissue (minor surgery, valve replacement, IV drug use)
Symptoms of endocarditis (commonly vague)
> fever and chills
heart murmurs
congestive heart failure
secondary embolic phenomena
Causative organisms?
dependant upon site –> bacteria in the blood
Gram+ : Staphylococcus, Streptococcus, Enterococcus
Gram - : HACEK group
Fungal : Candida
Steps to treat endocarditis..
- Take blood to do blood cultures –> BEFORE any antibiotic given!
- Give empirical treatment
Endocarditis empirical treatment
>to cover all relevant G+ and G- organisms
REFER TG FOR COMPLETE NOTE Benzylpenicillin 1.8g IV, 4-hourly and Di/Flucoxacillin 2g IV, 4-hourly and Gentamicin 4-6mg/kg IV for 1st dose, then determine dosing interval if needed for subsequent doses based on renal fx
