Coronary Heart Disease Flashcards
What is coronary heart disease also known as?
Ischaemic heart disease or coronary artery disease.
How is the heart muscle constantly supplied with glucose and oxygen?
It requires glucose and oxygen as it continuously contracts.
Blood flowing through the heart does not supply the cardiac muscle with glucose and oxygen. Instead, a series of branching coronary arteries spread over the surface of the heart, with smaller vessels penetrating the heart muscle.
This means that all parts of the heart muscle are close to a blood supply, which allows glucose and oxygen to diffuse into the muscle cells.
What is CHD?
Any narrowing or blockage of the coronary arteries, causing the supply of glucose and oxygen to reduce or cut off completely.
What is ischaemia?
Lack of oxygen in a a tissue, seeding the term ‘ischaemic heart disease’.
Consequences differ as different areas cause more of less serious complications.
What causes narrowing or blockages in the coronary arteries?
This occurs due to a build up of fatty substances in the walls of the arteries.
This process is called atherosclerosis, and fatty deposits are called atheroma.
What can start to form in the narrowed arteries?
Blood clots, also known as thrombosis.
What happens if a blood clot completely blocks an artery?
The heart muscle supplied by that artery becomes starved of oxygen and glucose and starts to die.
This is called myocardial infarction, or a heart attack.
What are the risk factors for CHD?
• Hypertension
• Smoking
• Excessive alcohol consumption
• High cholesterol
• Diabtetes
• Age and sex
• Genetics
• Ethnicity
How is hypertension a risk factor for CHD?
This is high blood pressure, which thickens the walls of the arteries, reducing the diameter of the lumen.
This narrowing increased blood pressure further, and an increased in blood pressure can damage the lining of the arteries.
This increases the likelihood of atheroma developing.
How is smoking a risk for CHD?
Smoking mostly affects the lungs, but it is possible that nicotine constricts the arteries, raising blood pressure.
How is high cholesterol a risk factor for CHD?
This is due to high concentrations of low-density lipoprotein (LDL) in the blood.
LDL transports cholesterol from the liver to the tissues, where it is used to make cell membranes.
If the diet is high in fat, particularly saturated fat, the conc. of LDL increases, so more cholesterol is delivered to the tissue and this increases the risk of atherosclerosis.
How is diabetes a risk factor for CHD?
It increases the risk of atherosclerosis.
How is age and sex a risk factor for CHD?
This risk of CHD increases with age as damage to the arteries developed slowly.
Males are more likely to get it in middle age.
How is genetics a risk factor for CHD?
The risk of identical twins dying for CHD is about 4x greater than the risk for non identical twins.
How is ethnicity a risk factor for CHD?
In the UK, people of African Caribbean, Black African or south Asian background have a great risk of CHD.
This is because they’re more likely to have other risk factors, like hypertension and diabetes.
What are the symptoms of CHD?
Symptoms depend on the degree of and location of the narrowing coronary arteries.
• Chest pain (angina) as the heart muscles become starved of blood.
• Shortness of breath as the heart is less able to pump blood around the body.
• Pain throughout body
• Feeling faint
• Feeling sick (nausea)
What can happen if CHD is undetected or untreated?
It can lead to myocardial infarction (a heart attack), when a whole segment of the heart muscle is starved of oxygen (ischaemia) and begins to die.
Blockages of one of the larger coronary arteries can be fatal.
How does CHD affect mental health?
It can cause a decline in mental health as a result of the symptoms, concern over the risk of a heart attack and the need to make lifestyle changes may be stressful.
What lifestyle change can be made to improve CHD?
• Healthy diet
• Exercise
• Quit smoking
• Maintain a healthy weight
• Manage stress
• Lower cholesterol and blood pressure
What are the treatments for CHD?
It can’t be cured but the symptoms can be managed, and the risk of a heart attack can be reduced.
• Blood thinning medication
• Statins
• Beta blockers
• Angioplasty & stent
• Coronary artery bypass graft
• Heart transplant
How does blood thinning medication treat CHD?
These are also known as anticoagulants, and can prevent the formation of blood clots by reducing platelet aggregation or targeting specific clotting factors.
Therefore reducing the risk of thrombosis.
However, blood clotting is important for the protective mechanism during injury, so they can cause the person to bleed easily.
What are 3 types of blood thinning medication?
• Aspirin is an anti platelet that prevents platelets from sticking together, reducing clots.
• Warfarin inhibits the production of certain clotting factors in the liver, making blood less likely to clot.
• Direct-oral anticoagulants (DOACS) target specific clotting factors in the blood.
What are the side effects of blood thinning medication?
• Possible blood in urine
• Bleed easily
• Bruising
• Nose bleeds
• Vomiting blood
• Heavy periods
How do statins treat CHD?
They lower the concentration of LDL cholesterol, reducing the risk of atherosclerosis.
They reduce the production of cholesterol in the liver, therefore lowering the bad LDL cholesterol levels in the blood.
This protects against heart disease as lowering cholesterol levels reduces the plaque build up in the arteries, improving blood flow.
These are taken in tablet for once a day.
