CVD Flashcards
these are a group of disorders of the heart and blood vessels
CVD
What happens in CVD
there is a blockage that prevents blood from flowing to the top heart or brain
Caused by bleeding from a blood vessel in the brain or from blood clots
CVD
An estimated _____ people died from CVDs in 2019, which is ~32% of global deaths
17.9 million
CVDs in the philippines are the cause of _____ of total deaths of Filipinos and Filipino-Americans from 1994-2018
20%
a disease of the blood vessels
supplying the heart muscle
Coronary Heart Disease
a disease of the blood vessels supplying the brain
Cerebrovascular Disease
a disease of the blood vessels
supplying the arms and legs
Peripheral Arterial Disease
damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria
Rheumatic Heart Disease
birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth
Congenital Heart Disease
blood clots in the leg veins, which can dislodge and move to the heart and lungs
Deep Vein Thrombosis and Pulmonary Embolism
Differentiate CVD from CVA
CVD:
Umbrella term for everything
Involves problems with heart and blood vessels
Can develop overtime
CVA:
Specifically refers to a stroke that affects the brain
Sudden that needs immediate treatment
what is a CVA?
a disorder that affects the blood flow in the brain or this is more commonly known as the stroke
what is a stroke?
abrupt interruption of a constant blood flow to the brain that causes loss of neurological function.
2 types of stroke
ischemic and hemorrhagic
differentiate the 2 types of stroke
Blockage -> ischemic (cerebral infarction)
Bleeding -> hemorrhagic
Controllable risk factors for stroke:
smoking
high BP
carotid or other artery disease
diabetes
high boood cholesterol
excessive alcohol drinking
physical inactivity/obesity
HRT (hormone replacement therapy)
uncontrollable risk factors for stroke
age
gender
heredity and race
prior stroke or heart stroke
80% of all strokes
ischemic stroke
what is a ischemic troke
Meron blockage or occlusion sa blood vessel
Most common type of stroke
what are the 2 types of ischemic stroke
thrombotic and embolic
what is a thrombotic stroke?
a blood clot, called a thrombus, blocks an artery to the brain and stops blood flow.
what is an embolic stroke
occurs when a piece of plaque or thrombus travels from its original site and blocks an artery downstream.
what causes a hemorrhagic stroke
caused by hypertension, rupture of an aneurysm or vascular malformation or as a complication of anticoagulation medications
what is a ICH
occurs when there is bleeding directly into the brain tissue, which often forms a clot within the brain
what is a SAH
occurs when the bleeding fills the cerebrospinal fluid spaces around the brain
“mini-stroke”, “warning stroke” aka mild stroke
TRANSIENT ISCHEMIC ATTACK
temporary cerebrovascular event that leaves no permanent damage lasting less than 24 hrs
TIA
what is a TIA
Most likely an artery to the brain is temporarily blocked, causing stroke-like symptoms, but the blockage dislodges before any permanent damage occurs.
a mini stroke or mild stroke or warning stroke
True or False:
50 percent of all people who suffer a major stroke experience a prior TIA
false
30 percent of all people who suffer a major stroke experience a prior TIA
true or false
15 percent of all TIA victims suffer a stroke within 2 weeks
false
10 percent of all TIA victims suffer a stroke within 2 weeks
temporal profile of embolic stroke
peaks at once
temporal profile of thrombotic stroke
evolve more slowly
Abrupt onset; deficit may be static or steadily progressive over minutes or hours
ICH
Almost instantaneous
SAH
Warning signs of stroke
Dizziness, nausea, or vomiting
Unusually severe headache
Confusion, disorientation or memory loss
Numbness, weakness in an arm, leg or the face, especially on one side
Abnormal or slurred speech speech
Difficulty with comprehension
Loss of vision or difficulty seeing
Loss of balance, coordination or the ability to walk
what is BEFAST
Balance, Eyes, Face, Arms, Speech, Time
what are the stroke scales?
NIHSS Stroke Scale, ABCD2 Score for TIA, Modified Rankin Scale for Neurologic Disability
what are stroke scales for
Predict patient outcomes
Helps determine appropriate treatment
NIHSS severities
Very Severe: >25
Severe: 15 - 24
Mild to Moderately severe 5 -14
Mild: 1 - 5
True or False
For NIHSS, the higher the score is, the less severe the stroke is.
For NIHSS, the higher the score is, the more severe the stroke is.
usually conducted by asking the person to perform several physical and mental tests.
NIHSS
designed to be a simple clinical prediction to previous triaging patients presenting with acute transient ischemic attacks.
ABCD2`
optimized to predict the two day stroke risk.
ABCD2
the patient is rated zero (0), if there are no symptoms at all, and as high as six (6) to indicate the mortality or severity of the stroke
Modified Rankin Scale
Ultrasound is used to help detect plaque, blood clots or other problems with blood flow in the carotid arteries
No known risks and this test is noninvasive and painless
CAROTID DUPLEX
Contrast dye is utilized
This procedure is monitored by a fluoroscope
Cerebral angiography (vertebral angiogram, carotid angiogram)
A useful diagnostic test for hemorrhagic strokes because blood can easily be seen
CT or CAT scan
allows clinicians to see blood vessels in the head and neck and is increasingly being used instead of an invasive angiogram
CT or CAT scan
what is the limitation of a CAT scan?
Limitations: harder to interpret for ischemic strokes. You would only see an impression of it.
Both the superficial and deep venous systems are evaluated.
No known risks and this test is noninvasive and painless
Doppler Ultrasound
A diagnostic test using small metal discs (electrodes) placed on a person’ s scalp to pick up electrical impulses
These electrical signals are printed out as brain waves
EEG
An invasive diagnostic test that uses a needle to remove a sample of cerebrospinal fluid from the space surrounding the spinal cord
Can be helpful in detecting bleeding caused by a cerebral hemorrhage
Lumbar Puncture (spinal tap)
A noninvasive study which conducted in a Magnetic Resonance Imager (MRI)
Shows the actual blood vessels in the neck and brain and can help detect blockage and aneurysms
MRA
Can clearly show various types of nerve tissue and clear pictures of the brainstem and posterior brain
Can help determine whether there are signs of prior mini-strokes
MRI
General Management for All Acute Stroke
Ascertain clinical diagnosis of TIA or stroke
Identify comorbidities
Provide basis emergent supportive care
Monitor neuro-vital signs
Perform stroke scales
Ensure appropriate hydration
Treatment of permissive hypertension
PREVENTION (phramacologic)
Hypertension: antihypertensive medications
Diabetes Mellitus: oral hypoglycemic agents
Dyslipidemia: lifestyle modification, dietary changes, pharmacologic treatments
CHALLENGES (effects of the stroke)
Physical challenges/impairments
Communication challenges
Emotional and behavioral challenges
Cognitive challenges
Swallowing problems
SLP ROLES IN STROKE
Screening
Formal Assessment
Management of different conditions arising from the Stroke
Management of different conditions arising from the Stroke; like:
Dysphagia
Communication Impairments
Aphasia
Motor Speech Disorders
RHD
Cognitive-Communication Impairments
