Cardiovascular Pathologies Flashcards
What is coronary heart disease?
Astheroma formation in coronary arteries
What is Myocardial ischaemia?
Stroke - caused by plaque rupture or ulceration of coronary artery
What are the risk factors for CHD?
Non modifiable
- Age 40-60
- cellular celesence
- Plaque maturation
- genetics
- Family Hx - hyper cholesterol diabetes - Gender - oestregon, willingness to change
Modifiable
- Dyslipidemia - high cholesterol
- Smoking - Nicotine stress vessel, predispose to injury
- Hypertension - stress vessels
- Diabetes - Inc. cholesterol, Hyperlipidemia, insulin resistance
- Obesity
- Physical inactivity
Metabolic syndrome - 3/5 criteria
Obesity, diabetes, Dyslipidemia, Hypertension, Low HLD
Discuss the management for CHD risk factors?
Diet change increase exercise 150-300 a week stop smoking Take meds to regulate cholesterol and hypertension Diabetes meds
What are a mature atheroma and its structure?
Artheroma is a plaque = Fibrous caps of cells and connective tissue
How does atheroma develop?
1) Endothelial damage
2) Increase permeability of the wall and allow passage of ADL to Tunica intima
3) Chronic inflammation + add immune cells
4) gradual accumulation of lipid over time
What are some complications of atherosclerotic plaque formation.
Chronic ischaemia - narrowing of lumina
Thrombus formation
Aneurysm
Plaque calcification
- coronary artery - angina - chest pain
- peripheral artery - leg pain
- cerebral artery - dyspnea, numbness weakness in arms, loss of vision
What are the difference and clinical features between stable angina, unstable angina and myocardial infarction?
Stable Angina
- Dyspnea - Tachycardia
- Pallor - Nausea - Fatigue
Unstable Angina
- Same as angina but more intense and S&S mya present at rest
AMI
- Same as unAngina plus
- Diaphoresis
- tachycardia and tachyphonea
- Psychological stress
- loss of consciousness
What is cardiac arrhythmia?
A variation from a normal heart rhythm
What is the classification of arrhythmias?
- Regular irregular heartbeat
- Irregular irregular heartbeat
What are the risk factors for atrial fibrillation?
Hx Obesity sleep apnea Alcohol caffeine High-intensity exercise
Whats the clinical presentation for atrial fibrillation?
Palpitation dyspnea dizziness weakness hypotension Angina
What are pericarditis and endocarditis and their clinical features?
Pericarditis - Inflammation of the pericardium
- Chest P - Back shoulder referral - dysphagia - restlessness - anxiety - fatigue
Endocarditis - inflammation of endocardium due to infection
- Arythmia, chest pain, valvular dysfunction,
- fever, fatigue, loss of appetite, malaise
How to diagnose hypertension?
Hypertension is diagnosed by taking BP measurement patients with BP > 90/140
What are the risk factors for hypertension?
Primary Hx Inc. salt Age Gender Alcohol Obesity Physical inactivity smoking
Differentiate between the terms “primary hypertension” and “secondary hypertension”
Primary: Caused directly by patient habits
Secondary: Caused by other disease
List some potential causes of secondary hypertension
Pregnancy Stress renal disease medications endocrine disease atheroma
Define the terms “isolated systolic hypertension” and “malignant hypertension”?
isolated systolic hypertension: when the systolic pressure is > 140 but the diastolic remains normal <90
Malignant hypertension: BP> 180/120 medical emergency
Summarise the possible clinical features and complications of hypertension
Clinical Severe headache Fatigue or confusion Vision problems Chest pain Difficulty breathing Irregular heartbeat Blood in the urine
Complications AMI Heart Failure Haemorrage aortic aneurism
What is the management of hypertension
Lifestyle changes
Meds - diuretics, beta blockers, ace inhibitors
What is aortic dissection and how are they classified?
Tear in tunic intimate of aorta
classified by
Type A: dissection of ascending aorta aortic root
Type B: dissection of descending aorta
Describe risk factors and clinical features of aortic dissection
Risk
- HBP - Age, Male, genetic -Smoking
- Hx - drugs - Trauma
clinical
- Sudden onset, severe chest and upper back pain, sharp
- Shortness of breath (Dyspnea)
What causes common heart failure and what are the clinical features
Failure of the heart to maintain CO, despite normal volume
Clinical
Fatigue, weakness, chest P, dizziness, displaced apical beat, Tachycardia, thready pulse
How is chronic heart failure classified
Lt sided = systolic failure
Rt side = diastolic failure
How does right-hearted heart failure develop compared to AMI (left ventricular failure)
Rt side
- Lung disease
- pulmonary valve disease
- Lt heart failure
- congenital Heart disease
Lt side
- AMI
- HBP
- Aortic/ mitral valve disease
- inc. CO
What is anaemia and what are the different types
Anaemia is decrease in RBC
- Iron deficiency anaemia - loss of iron
- B12 folliate anemia
- Thalassaemia- haemolytic anemia
What is Iron deficiency anemia, and the difference between occult bleeding and Frank bleeding?
Loss of iron through loss of blood
Frank = external bleeding
Occult = internal bleeding
What role do Vitamin B12 and folate play in haemopoiesis?
B12 is needed to produce RBC without it the cells are large and malformed. Deficiency of RBC leads to demyelination in CNS and ANS
List the patient groups that are most likely to develop Vitamin B12 Deficiency Anaemia or Folate Deficiency Anaemia.
Pregnancy vegans alcoholics poor diet (elderly) contraceptive medicine
Describe the possible clinical features of anemia
parasthesia depression delirium ataxia reduced reproduction irritability paranoia
What is Thalassaemia and what types are there?
Haemolytic anemia = early cell death
Inherited disease resulting in early RBC death
Classified as:
- mayor = can’t produce beta and alpha
- minor = can’t produce either beta or alpha
What is the importance of identifying the thalassaemia gene?
- Increase life span
- Genetic planning
What is haemochromatosis and what are the types
Iron overload
- Primary = genetic bad production of hepcidin which limits iron storage
- Secondary = result of Thalassaemia major
Clinical presentation for haemochromatosis?
male
>40
joint pain
bronze pigmentation
What is Aortic regurgitation
The inability of aortic valve to close properly and allowing backflow.
Diastolic murmur
Lt Ventricular hypertrophy - dilation
What is aortic stenosis?
narrowing of valve to restrict blood flow from lt ventricle to aorta.
Systolic murmur
Lt ventricle hypertrophy
Fatigue, dyspnea, angina, arrhythmia
What is mitral stenosis?
Narrowing of the mitral valve restricting blood flow from Lt ventricle to Lt atrium
Diastolic murmur
Lt ventricle hypertrophy
atrial fibrillation and thrombus
What is mitral regurgitation
mitral valve doesn’t shut and allows backflow to from Lt atrium to Lt ventricle.
systolic murmur
Lt hearted failure
fatigue palpitation dyspnea
