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Clinical health midterm2 > Cardiovascular disorder > Flashcards

Cardiovascular disorder Flashcards

1
Q

Artherosclerosis

A

Is a disease in which the inside of an artery narrows due to the build up of plaque.

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2
Q

Traditional view of Artherosclerosis

A
  • Lipid accumulation and calcification
  • Artery wall damages (smoking, high blood pressure, stress, LDL)
  • Lipids and salta accumulates on the damages artery wall –> plaque is formed
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3
Q

Modern view of artherosclerosis

A

inflammatory processes are present in each stage -> the important of immune system

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4
Q

Hypertension

A

Pressure on the artery walls during contraction and relaxation of the heart

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5
Q

Types of hypertension

A
  • Essential
  • Secondary (consequence of renal disease or hormonal problems)
  • “white coat”
  • During pregnancy
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6
Q

Blood pressure values (normal)

A

SBP < 120

DBP < 80

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7
Q

Blood pressure values (high)

A

SBP <140

DBP > 90

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8
Q

Hypertension; main problem

A

Non-adherence, about 50% of patient do not take their medicine as prescribed

  • Lack of treatment is the main cause of the CV-consequences of hypertension
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9
Q

Hypertension; psychological focus

A
  1. enhancing complience
  2. exercies
    - lowers blood pressure 3-5 a week, 30 minutes is enough (more is not better)
    - exercise may serve as the only therapy requires in some mild hypertensive subjects
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10
Q

Types of cerebrovascular disease (stroke)

A
  • Ischaemic stroke: the blood vessels is blocked, and not sufficient blood supply
  • Haemorrhagic stroke: bleeding
  • Transient ischemic attach: symptoms resolved within 24 h.
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11
Q

Symptoms of stroke

A

FAST (Facial weakness, Arm weakness, Speech problems, Time to call 999)

  • Unilateral symptoms in most cases
  • Hemiplegia
  • Inability to produce speech
  • Altered vision
  • Altered movement coordination
  • Loss of consciousness
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12
Q

Consequences of stroke

A
  • The main cause of long-term disability
  • Depend on the brain area affected and the size of the damage
  • Also depend on time between the onset of symptoms and the treatment
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13
Q

Types of heart diseases

A

Ischaemic heart disease:

  • Angina pectoris
  • Myocardial infarction

Acute coronary syndrome

  • Unstable angina
  • Myocardial infarction

Arrtyhmia

Heart failure

Sudden cardiac death

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14
Q

Symptom and diagnostic criteria of heart disease

A

Chest pain radiating into the shoulders, arms, neck or lower jaws

May be atypical (especially in woman)

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15
Q

Criteria of myocardial infarction

A

Two out of the following:

  • chest pain
  • elecated enzyme levels
  • changes in ECG
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16
Q

Risk factors for CVD

A

Modifiable and non-modifiable

Behavioral risk factors account for 80% of coronary disease and stroke

Risk factors tend to co-occur, especially in people with low SES

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17
Q

Non-modifiable risk factors of CVD

A

age
sex
genetics (family history of CVD, ethnicity)

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18
Q

Modifiable risk factors of CVD

A 
smoking
high cholesterol level
high blood pressure
diabetes
sedentary life style
overweight, obesity
stress (psychosocial risk factor)
alcohol consumption
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19
Q

Psychosocial risk factors of CVD

A 
hostility
anger
type a behavior pattern
depression and related concepts (hopelessness, fatigue, exhaustion)
anxiety
low social support
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20
Q

Coronary heart disease (psychosocial factors)

A

Two major topics

  1. hostility, anger, type A behavior pattern
  2. Negative emotionality: depression, anxiety and related notions (vital exhaustion, hopelessness, fatigue)
21
Q

Type A behavior pattern (TABP)

A

Rosenman and Friedman = at the end of 1950 (cardiologists)

“combination of certain personality traits such as excessive competitive drive, persistent desire for recognition, advancement and achievement, and peristent inclination on one hand and of chronic immersion in “deadlines” on the other hand”

Charcateristics:

  • time urgency, impatience
  • free-floating hostility
  • competiviteness
22
Q

Measuring type A behavior

A

Self-assessment:
Time urgency:
- symptoms: hurrying while walking, eating, extreme punctuality, intense aversion to having to wait in a due

  • psychomotor signs: chronic facial tension, tense posture, quick speech, excessive facial sweat

Fluctuating hostility:
- Symptoms: frequently getting angry while driving, grinding of teeth, irritability easily provoked, discomfort when having to face pretty mistake

  • psychomotor signs: facial hostility, tightening the hand during a conversation, hostile laughter
23
Q

ARIC study on anger and CVD

A

high trait anger -> significant higher rate of cardiac death

24
Q

Framinghan heart study and CVD

A

suppressed hostility is an independent risk factor of CHD in both sexes

25
Q

Rosenman and Friedman

A

Type A behavior

26
Q

Physiological mechanisms of hostility and anger + CVD

A

Cardiovascular reactivity changes in response to physical or psychological stressors.

27
Q

Hostile person and psychological mechanisms

A

exaggerate cardiovascular reactivity. SNS activity increase lead to higher blood pressure and heart rate.

28
Q

Why does anger episode trigger infarction?

A

When anger –> arteries contract, higher blood pressure which leads to changes in the blood flow which then leads to plaque may rupture.

29
Q

Social support and hostility

A

Increased hostility leads to increased interpersonal conflicts which again leads to difficulties in their close relationship as well.

So, hostility = low social support.

30
Q

Health behavior and hostility

A

Perceived importance of health behavior may be lower; does not care about the harmful consequences of health damaging behaviors.

Non-adherence is more frequent.

31
Q

Depression and the development of CHD

A

Meta analysis: found a connection between depression and later CHD.
Depressive people have 64% change of getting CHD.

32
Q

Hopelessness increases the risk of..?

A

ischemic heart disease or cardiac death

33
Q

How does heart patient express depression?

A

They complain less directly, and they tend to normalize depression by regarding their symptoms as a consequence of their heart disease.

Less typical symptoms: anxiety, irritability

34
Q

Anxiety in CHD

A

Anxiety is the earliest and most intensive psychological reaction to MI.

High anxiety after infarction is an independent predictor of complication in the hospital.

35
Q

psychological mechanisms of depression and anxiety

A
  • Both HPA axis and SNS are over-stimulated
  • higher level of catecholamines and cortisol leads the wall of the blood vessels to be damaged.
  • High anxiety: high level of coagulation markers.
36
Q

Anxiety as trigger of acute events

A

Acute anxiety leads to catecholamines to suddenly rise which again leads to:

  • heart rate and blood pressure increase, the oxygen need of the heart muscle increases too.
  • Excitability of the heart muscle is high which leads to that arrhythmia develops easier.
37
Q

Acute coronary syndrome (ACS)

A

Is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies.

Most cases are caused by the rupture of an atherosclerotic plaque. The degree of arterial blockage determines the amount of myocardial damage.

38
Q

Most common cause of death in both developing and developed countries?

A

Acut coronary syndrome

39
Q

Acute coronary syndrome secondary prevention

A

Mediterranean diet
Alcohol consumption
Physical activity status
Smoking status

40
Q

Mediterranean diet

A

Increased intake of fruit, vegetables, fish.

50-70% lower risk of recurrent heart disease event

41
Q

Alcohol consumption (ACS prevention)

A

Moderate consumption of wine during meals could reduce mortality, while wine drinking outside meals increased mortality rates.

42
Q

Physical activity status (ACS prevention)

A

The most important non-pharmaceutical mean for secondary CVD prevention

43
Q

Smoking (ACS secondary prevention)

A

CVD patient who quit smoking reduce their CVD death rate by about 40%.

cognitive behavioral methods intend to explain and predict healthy behaviors and can ultimately contribute to implementation of more effective health promotion strategies.

44
Q

Motivation and behavioral change in CVD patients

A

only intrinsic motivation was a significant predictor of the maintenance of long-term physical activity.

CVD patient need to feel motivated, but also effective, toward physical activity for the initiation of it.

45
Q

Intervention for motivation and self-efficiency on behavioral change in CVD patient

A

Should be based on supporting autonomy and competence.

  • improve patients perception about their abilities to adopt healthy eating habits
  • help them take small steps
  • encourage them and support their achievements and attribute their accomplishments to their abilties
46
Q

Psychological interventions on CVD (linden et al.)

A

Intervention focusing only on psychological factors lowered long-term mortality by 43%.

Focus must be on psychological distress: lowers heart rate, rate of cholesterol, raise social support and QoL.

47
Q

psycholgoical internvetions (CVD) - relaxation

A

lower HR

the prevalence of cardiac event lowered to half > even long term effect.

48
Q

psychological intervention (CVD) - treating type A behavior

A

Very effective: combined interventions; education, relaxation, cognitive restructuring, behavior modifications.

Clinical health midterm2 (8 decks)

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