Cardiovascular Disease Flashcards
What is the main function of the cardiovascular system?
transport gases, nutrients, wastes, hormones
What are the 3 that make up the cardiovascular system?
heart, vessels, blood
What are the 4 main types of CVD?
- Coronary Heart Disease (CHD)
- Stroke/ Cerebrovascular accident (CVA)
- Peripheral artery disease (PAD)
- Aortic disease (aneurysm)
What other ways can cause CVD?
- hypertension
- heart valve disease
- cardiomyopathy
What is cardiovascular disease?
general term
for diseases of the heart
or blood vessels/ circulatory system
(includes all the diseases of the heart and circulation
including coronary heart disease, angina, heart attack, congenital heart disease and stroke)
How can blood flow be reduced to the heart, brain or body?
- blood clot (thrombosis)
- build-up of fatty deposits inside artery (artery hardens, narrows = atherosclerosis)
What is angina?
pain which occurs in areas of the body when heart muscles don’t get enough oxygen-rich blood
What is myocardial infarction?
dead cardiac muscle tissue
What do the coronary arteries do?
supply blood and oxygen to heart muscles
When does thrombosis start?
when plaque becomes unstable and ruptures, clotting process starts
Why do the muscle tissues die in thrombosis?
blood supply to heart muscle is reduced
What are the types of diagnostic tests for the heart?
- EKG (electrocardiogram)
- Stress testing
- Echocardiography
- Chest X ray
- Blood tests
- Coronary Angiography
- Cardiac Catheterization
- Angiogram
What is a transient ischaemic attack?
When the atherosclerotic plaque ruptures, the tiny pieces of plaque travel into bloodstream to the brain
What method is used to remember warning signs of stroke (cerebrovascular disease)?
FAST
What does FAST stand for?
- Face - ask them to smile, does one side droop?
- Arms - ask to raise both arms, does one arm drift downward?
- Speech - Repeat simple phrase, is speech slurred/strange?
- Time - observed the signs? Call 911 immediately
What is the difference with ischaemic and haemorrhage stroke?
ischaemic = 85% blockage bleed = 15% bleed
What same problem causes coronary heart disease and stroke?
atherosclerosis
What is atherosclerosis?
A progressive inflammatory disorder of the artery wall: when your arteries become narrowed by a gradual build-up of fatty material (called atheroma) within their walls. Plaque forms.
What initiates thrombosis?
platelet aggregation
What controls platelet aggregation?
balance in pro-thrombotic compounds (TXA2) and anti-thrombotic compounds (PGI2)
Describe the 3 layers of the arteries:
- Tunica adventitia - collagen fibres
- Tunica Media - smooth muscle cell + elastic fibres
- Tunica intima - endothelium lining
In atherosclerosis, what does the gradual build-up of fatty material cause?
- injury of endothelium
- inflammation
- fatty deposits in vessels (atheroma)
- thrombosis
What is the pathogenesis of atherosclerosis? (11 steps though)
- Response to injury hypothesis
- Begin with injury to endothelium (smoking, oxidised
- Endothelium becomes permeable
- Triggers an immune response - macrophages & monocytes
- Macrophages migrate through endothelium & situate themselves in subendothelial layer and vascular wall
- Macrophages accumulate lipid = large foam cells
- Foam cells release growth factors/cytokines - smooth muscle cells migration/proliferation
- Platelets adhere
- Foam cells and smooth muscle cells eventually form fatty streak
- Fatty streaks progress = fibrous cap
- Rupture of fibrous cap = thrombosis
What are 3 traditional primary risk factors of atherosclerosis?
- hyperlipidemia
- hypertension
- smoking
What secondary pathologies does obesity promote in CVD?
- diabetes
- insulin resistance
- Dyslipidemia
- Inflammation
- Thrombosis
- Hypertension
- Metabolic syndrome
(all heighten the CVD risk)
What forms the core of all lipoproteins?
cholesterol and triglycerides
What are triglycerides?
stored in fat cells and used as energy source of body
Who has high levels of blood triglycerides?
- those with high cholesterol levels
- heart problems
- overweight
- diabetes
What is a marker of hypofibrinolysis?
PAI-1
When does atherosclerosis usually start?
frequently present in 20s and 30s
What is the total number of deaths due to CVD worldwide?
17.3 million
What are the top 10 global causes of death (in order, highest to lowest)?
- Coronary heart disease
- Stroke
- Chronic obstructive pulmonary disease
- Alzheimer’s/Dementia
- Trachea, bronchus, lung cancers
- Diabetes mellitus
- Road injury
How many people die of CVD in EU and what’s the percentage?
1.9million
42%
What is the ratio of men who die from coronary heart disease?
1 in 7 men
What is the ratio of women who die from coronary heart disease?
1 in 12 women
Is CVD a multifactorial disease?
YES
What are the lifestyle risk factors of CVD?
- Diet
- Exercise
What is the fastest heart attack call to ambulance for balloon time?
42 mins
What is given to heart attack patients within those few minutes?
- primary angioplasty (restores blood flow to the heart)
- statins
What are the risk factors targeted in CVD?
- smoking
- diet
- physical activity
- body weight
- blood pressure
- lipids
- diabetes
What are the evaluated reasons for the declining CHD mortality in UK?
- reduction in smoking/blood lipids
- improved physical activity levels
- reduced BP in those not on antihypertensives
- better medical treatment of lipids, angina, secondary prevention
Hyperlipidaemia is a term to denote raised serum levels of?
- Total cholesterol
- low-density-lipoprotein cholesterol (LDL-C)
- triglycerides (TG)
What is dyslipidaemia?
wider term that includes abnormal amount of lipids in blod + low levels of HDL-C
What are the cholesterol levels the population can’t exceed for high risk of CVD?
<4.0
What are the LDL-C levels the population can’t exceed for high risk of CVD?
<2.0
How do you calculate total serum cholesterol levels (TSC)?
TSC = VLDL-C + LDL-C = HDL-C
What are the classifications for biomarkers of CVD?
- Inflammatory (high-sensitivity C-reactive protein = hsCRP)
- Thrombotic (homocysteine)
- Glucose and lipid-related markers (apolipoproteings)
What does HRV indicate?
Heart variability
What are the risk factor interventions (clinical management) of CVD?
- Behavior change
- Psychosocial factors
- Physical activity
- Smoking intervention (most cost-effective stratefy)
- Nutrition (healthy diet)
- Body weight
- Lipids control
- Hypertension
How much salt can you eat a day?
<5g
How much more fruits and vege each, should you eat a day?
> 200g
What does the mediterranean diet comprise?
- nutrients, foods
- high intake of fruits, vege., legumes, wholegrain produces, fish, unsaturated fatty acids
- moderate alcohol (wine)
- low red meat, dairy and saturated fatty acids
What is well documented in the DASH diet?
BP-lowering effect of increased potassium
What diet are patients with hypertension generally advised to have?
more fruits and vege (reduce intake of saturated fat and cholesterol)
What does DASH stand for?
Dietary Approaches to Stop Hypertension
How much sodium is advised for consumption in the DASH diet?
2400mg/dy (6g table salt)
