CVD: Angina, DVT

Question 1

What is Angina?

Answer 1

• Chest pain as a result of myocardial ischemia (=when the blood flow to the heart is restricted/reduced)

Question 2

By what is Angina (often) caused?

Answer 2

• Causes = atherosclerosis of coronary artery or thickened wall (hypertrophic cardiomyopathy)/aortic stenosis/hypertension/need more oxygen for muscle

Question 3

What are symptoms of angina?

Answer 3

• Without enough nutrients/oxygen in a muscle = pain
• Lightheaded
• Short of breath

Question 4

What is ‘unstable’ Angina?

Answer 4

An emergency which may lead to a myocardial infarction, but without necrosis of the muscle tissue yet.

Pain on chest is also during rest

Question 5

What is the difference between angina and a myocardial infarction?

Answer 5

 Angina is reversible (cardiomyocytes do not die). This is how it differs from myocardial infarction.

Question 6

• how coronary artery blood is distributed across the myocardial wall

Answer 6

Start up in the epicardium, then spreads through myocardium.
If the muscle becomes thicker, the blood has a harder time reaching the deepest layer of the endocardium, which is the deeper layer under the myocardium.

Question 7

he difference between unstable angina (although an emergency) and a myocardial infarction?

Answer 7

Unstable: pain during exercise, stress and rest. Always. Usually caused by rupture of atherosclerotic plaque: thrombosis, even less room for blood.

However, Heart tissue is alive, but ischemic. Myocardial infarction: area of heart tissue have begun to necrose/die.

Question 8

What are symptoms of a heart attack?

Answer 8

• Chest pain, radiating to left arm/jaw
• Sweating
• Nausea
• Fatigue
• Dyspnea (shortness breath)
• 65> age

Question 9

What happens in the emergency room with a heart attack?

Answer 9

In emergency room: oxygen supply + nitro-glycerine (dilates blood vessels). Morphine (pain). Possibly stent is needed: to open up artery.

Question 10

What is deep vein thrombosis and what are its three main causes?

Answer 10

= formation of a blood clot in veins deep within the body
Three main causes (‘virchow’s triad’):

1. Stasis
2. Hypercoagulation
3. Damage to endothelial lining vein

Question 11

Symptoms of thrombosis?

Answer 11

• Pain (begin like cramp, may intensify)
• Swelling (asymmetrical), warm

Question 12

Risk factors thrombosis?

Answer 12

Risk factors:

• Genes (family history)
• Sitting for long time
• Long-term bed rest
• Pregnancy
• Using birth control pills

Question 13

Diagnosis thrombosis?

Answer 13

• Presence D-dimers (clot degradation products) in the blood
• US
• Other imaging techniques

Question 14

• Explain how a thromboembolism may end up in the lungs (pulmonary embolism) or the brain (embolic stroke)

Answer 14

Embolism: thrombus dislodges, travels up to the heart, which will pump it to the lungs = pulmonary embolism.

Question 15

• recall what medication is used in DVT

Answer 15

Anticoagulation medicine, such as warfarin. Compression stockings for prevention