CVD: Diagnosis and Treatment

Question 1

What are some common CVD diseases?

Answer 1

• congestive heart failure
• coronery artery disease (ex. myocardial infarction)
• cerebrovascular disease (ex. stroke)
• peripheral vascular disease (leads to swelling and non-healing ulcers)

Question 2

Describe congestive heart failure

Answer 2

Progressive reduction of the heart muscle function. The heart becomes weak and congested
* Blood is not pumped effectively and backs up, leading to edema (stalls in certain areas)
* Fluid can build up in the lungs causing shortness of breath

Question 3

Describe coronary heart disease

Answer 3

Results form plaque buildup in the coronary arteries which irrigate the heart muscles. May be due to narrowing from plaque build up or a blood clot. Myocytes dependent on the effected arteries die because they are no longer receiving oxygen or nutrients.
* Causes chest pain (angina) and shortness of breath
* Complete blockage can cause an infarction/heart attack
* Symptoms may include: Pressure, pain, paleness, irregular heart rate, dizziness, sweating
* Women may experience a sharper chest pain, abdominal pain, back pain, nausea and shortness of breath

Question 4

Describe cerobrovascular disease

Answer 4

Stroke → When the blood supply to part of the brain is interrupted or reduced. Restriction of blood flow is called “ischemia”. Deprived of oxygen, brain cells die in minutes.
* Symptoms include: numbness of the face, arm or leg on one side of the body; confusion; trouble speaking; dizziness; loss of balance or coordination

Question 5

What is a hemorrhagic stroke?

Answer 5

blood leaks into brain tissue vessel rupture (weakened/ diseased vessel)

Question 6

Diagnostic tools for cardiac/ cardiovascular imaging

Answer 6

• Electrocardiogram
• Echocardiogram / Doppler ultrasound
• Coronary angiogram
• Computed Tomography (CT) scan
• Positron Emission Tomography (PET)
• Cardiac MRI

Question 7

ECG as a diagnostic tool for cardiac imaging

Answer 7

Can detect abnormalities in the heart beat
* fast heartbeat: tachycardia
* slow heartbeat: bradycardia
* irregular heartbeat: arrhythmia

Question 8

Echocardiogram/ doppler ultrasound as a diagnostic tool for CVD

Answer 8

Uses high frequency waves to create images and videos. Doppler echo can measure the flow of blood as ultrasounds bounce off red blood cells
* can measure speed at which they are travelling and some might be going backwards as you see decrease in heart function.

Question 9

Coronary angiogram as a diagnostic tool for CVD

Answer 9

X-ray imaging performed during cardiac catheterization with injection of a dye.
* A series of images can be taken rapidly to create a video of the dye moving through blood vessels and if one is plugged would be able to see where it stops and would not be able to see lower capilleries since they would be blocked.
* can help doctors with planning bypass surgery

Question 10

Positron emission tomography as a diagnostic tool for CVD

Answer 10

A non-invasive nuclear imaging test where patient drinks isotope substance and through a series of images can see the heart beating and where places are not getting properly irrigated
* Traces a radioactive substance

Question 11

MRI as a diagnostic tool for CVD

Answer 11

Uses radio waves and magnets to scan the heart and create very detailed images.
* darker regions show necrosis

Question 12

Treatment goals for patients at risk of CVD

Answer 12

Done first through lifestyle modification and if cannot acheive than consider medications
* People with diabetes and hypertension should be treated to a systolic blood pressure goal of <140 mmHg
* Individuals with diabetes should be treated to a diastolic blood pressure goal of <90 mmHg
* Lower targets such as 130/80 may be appropriate if they can be achieved without burden
* Patients should be advised on lifestyle changes and blood pressure >140/90 should prompt initiation of pharmacological therapy

Question 13

What does lifestyle therapy consist of?

Answer 13

• weight loss
• diet patterns including reduced sodium intake (reduce strain on the heart)
• moderation of alcohol intake
• physical activity (make the heart stronger)

Question 14

Heart disease medications

Answer 14

• Anticoagulants (blood thinners) and antiplatelet agents (Aspirin)
• Angiotensin converting enzyme (ACE) inhibitors / Angiotensin 2 receptor blockers (work on BP, RAAS)
• b-adrenergic blocking agents (beta-blockers)
• Diuretics (reduce liquid volume the heart has to pump)
• Vasodilators
• Statins and other cholesterol drugs

Question 15

Surgical treatments

Answer 15

• Coronary artery bypass surgery → cut off areas and reattach
• Balloon angioplasty (with stent) → increase diameter of the vessel
• lifestyle/rehab