Cardiovascular Pathology Flashcards by Aisha Mohammed

What cardiovascular problem is finger clubbing linked to?

Congenital heart defect

How well did you know this?

Not at all

Perfectly

What cardiovascular problem is a pale nail bed associated with?

Anaemia

How well did you know this?

Not at all

Perfectly

What cardiovascular problem are splinter haemorrhages associated with?

Bacterial endocarditis

How well did you know this?

Not at all

Perfectly

What is the cause of gingival hypertrophic?

Nifedipine antihypertensive medication

How well did you know this?

Not at all

Perfectly

What is the cause of xanthelasma - yellow plaque around eyes?

Elevated cholesterol

How well did you know this?

Not at all

Perfectly

What is the normal range of heart rate?

60-100 bpm

How well did you know this?

Not at all

Perfectly

What are the possible causes of chest pain?

Respiratory
Cardiac disease
Trauma
Psychological

How well did you know this?

Not at all

Perfectly

What are the differential diagnosis of chest pain?

Unstable angina: pain at rest
Myocardial infarction: pain at rest >15 mins
Aortic dissection: sever sudden pain, asymmetric pulse
Pericarditis: pain worse on inspiration
Pneumothorax: sudden pleuritic pain, SOB
Pulmonary embolism: pleuritic pain, SOB
Oesophageal rupture: pain after vomit, pain swallowing
Da Costas syndrome: left stabbing pain, anxiety

How well did you know this?

Not at all

Perfectly

What is the blood pressure threshold for hypertension?

> 140/90 mmHg

How well did you know this?

Not at all

Perfectly

What are the two types of hypertension?

Primary: no specific cause, genetic, environmental, African
Secondary: narrowing of aorta, drugs (steroids), pregnancy, renal disease

How well did you know this?

Not at all

Perfectly

What are the pathological changes of hypertension?

Arteriolar sclerosis
Left ventricle enlarges
Atheroma formation, arteries narrow - ischaemic HD
Aneurysms

How well did you know this?

Not at all

Perfectly

What are the clinical features of hypertension?

Asymptomatic until target organs affected
Dizziness, epistaxis
Predisposes stroke

How well did you know this?

Not at all

Perfectly

What is the treatment for hypertension?

Primary: lifestyle modifications
Secondary: treatment of cause
Antihypertensive drugs: vasodilation, low cardiac output ABCD: ACE, beta blocker, ca channel, diuretic

How well did you know this?

Not at all

Perfectly

What are the four types of hypertensive patient?

Normotensive
Controlled - be aware, treat as normal
High BP in practice - defer treatment and refer
Malignant - referred urgently to hospital

How well did you know this?

Not at all

Perfectly

What is the dental relevance of hypertension?

Stressful environment
Postoperative bleeding
Oral side effects of medication
Do not carry out treatment on >160/10
Breathless laid flat

How well did you know this?

Not at all

Perfectly

What are the oral side effects of hypertension drugs?

ACE: lichenoid, loss of taste, burning
Beta: xerostomia, lichenoid
Ca: salivation, gingival hyperplasia
Diuretic: xerostomia, altered taste

How well did you know this?

Not at all

Perfectly

What is the most common cause of ischaemic heart disease?

Coronary atheroma (plaques)

How well did you know this?

Not at all

Perfectly

What are the pathological effects of IHD?

Atheromatous plaque restricts blood flow
Formation of thrombus
Narrowed lumen
Myocardial infarction

How well did you know this?

Not at all

Perfectly

What are the clinical features of IHD?

Angina - crushing chest pain
Radiates to neck, jaw, teeth, left arm
Resolves with rest

How well did you know this?

Not at all

Perfectly

What are the two classifications of angina?

Stable - responds to rest and medication
Unstable - gets progressively worse and occur at rest

How well did you know this?

Not at all

Perfectly

What is the treatment of IHD?

Lifestyle, underlying abnormalities, surgical stents
Nitrates
Aspirin
GTN spray - use before
Beta blocker
Ca channel
Nicorandil - unstable angina, ulcers

How well did you know this?

Not at all

Perfectly

What is the dental relevance of IHD?

Emergency: GTN 0.5mg sublingually, 300 mg chewed aspirin
Presents with tooth ache, jaw pain

What are the oral side effects of angina medication?

Aspirin - bleeding
Beta - mucosal
Ca - gingival hyperplasia
Nicorandil - mucosal, ulcers

When should you consider myocardial infarction?

Crushing chest pain lasting more than 15 mins

What are the signs and symptoms of MI?

SOB Radiates to neck teeth left arm Nausea Sweating, pale Tachycardia Manage same as angina

What is a thrombus made up of?

Platelets RBC Fibrin

What are the causes of deep vein thrombosis?

Virchows triad: Stasis of normal blood flow Damage to blood vessel wall Composition change of blood

What are the pathological effects of DVT?

Blood clot obstructs venous blood flow Break off into emboli

What are the clinical features of DVT?

One lower limb Swelling Tenderness and pain Erythema

What is the treatment for DVT?

Anticoagulant - warfarin Resorbes clot

What is the dental relevance of DVT?

Can lead to pulmonary embolism Anticoagulant drugs require local haem measures

How much blockage of arteries is considered atheroma/atherosclerosis?

More than 70% lumen occlusion

What are the 3 stages of pathogenesis for an atheroma?

Initiation - influx cholesterol, plaque formation Progression - oxidised LDL, fatty streaks, monocytes Destabilisation - sclerosis, fibrous cap, rupture

What are the three common causes of heart failure?

Due to problem with systole or diastole Hypertension - LV fails Valvular heart disease Ischaemic heart disease - lack of blood and O2

What is the pathology following heart failure?

Left ventricle - decreased blood to body, fluid builds up in the lungs Right ventricle - fluid builds up in periphery of body Congestive - left failure leads to right and then both

What are the symptoms of heart failure?

Depends on which ventricle SOB Weight gain - left Swelling in ankles, legs, abdomen - right

What is the treatment for heart failure?

Lifestyle, surgical - valves/heart transplant ACE - decrease cardiac workload Diuretics - reduce fluid overload Inotropic - increase contractility

What is the dental relevance of heart failure?

Breathless if laid flat Keep treatment short Unstable refer to doctor

What is the cause of congenital heart defect?

Diseases in first trimester Familial

What is the pathology following congenital heart defect?

Obstructive defects - narrowing of flow Septal defects - hole in the heart, abnormal flow Cyanotic defects - less oxygen than normal Shunts - diverted blood

What are the clinical effects of congenital heart defect?

Cyanosis - blue Heart failure Heart murmur Chest infections

What is the treatment for congenital heart defect?

Surgery

What is the dental relevance of congenital heart disease?

Supine position makes them breathless

What are the 4 requirements for rheumatic fever to occur?

Group A beta haemolytic streptococcal infection Susceptible host Pharyngeal site Persistence of infection

When does rheumatic fever occur?

2-3 weeks after strep sore throat Cross reacting antibodies attack tissues

Which parts of the heart does rheumatic fever affect?

Connective tissues Valves - mitral

What are the clinical features of rheumatic fever?

Fever Poly arthritis Murmur or endocarditis Subcutaneous nodules Chorea

What is the treatment for rheumatic fever?

Bed rest Analgesia Treat strep infection Aspirin Corticosteroids if carditis

What is the dental relevance of rheumatic fever?

Increased risk of endocarditis after treatment No more antibiotic prophylaxis

What are 50% of infective endocarditis caused by?

Streptococcus viridans From dental treatment

What is the pathology causing infective endocarditis?

Damaged/prosthetic heart valves Congenial heart defect Mitral valve affected

What are the clinical features of infective endocarditis?

Local valvular damage - narrowing and murmur Septic emboli Finger clubbing Flu, weight loss

What is the treatment of infective endocarditis?

Antibiotic therapy