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SYSTEMIC CONDITIONS > CVS CONDITIONS > Flashcards

CVS CONDITIONS Flashcards

1
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - DEFINITION

A
  • VBI is when blood flow to the back of your brain reduces or stops
  • VBI affects the parts of the brain that controls balance and movement
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2
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - RARE TYPE

A

A rare type of VBI is transient vertebral artery insufficiency (also called Bow Hunter syndrome) and it is caused by turning/rotating the head

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3
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - CAUSE

A
  • Atherosclerosis commonly causes VBI
    o Atherosclerosis occurs when plaque forms from calcium and cholesterol build up in the arteries
  • Other common causes
    o Penetrating artery disease
    o Pulmonary embolism
    o Vertebral artery dissection
  • Less common causes
    o Blood disorders (coagulopathies)
    o Drug addiction
    o Fibromuscular dysplasia
    o Migraine headaches
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4
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - POPULATION AFFECTED

A

Men over 50

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5
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - RISK FACTORS

A
  • Coronary artery disease
  • Peripheral artery disease
  • Diabetes
  • Family history
  • Hypertension
  • High cholesterol
  • History of smoking
  • Obesity
  • Atherosclerosis
  • Hyperlipidemia
  • Heart conditions that cause a blocked artery also increase the risk of VBI
    o Arterial fibrillation
    o Blood clotting disorders
    o Infective endocarditis
    o Vertebral artery dissection
  • Men
  • Black people
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6
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - CLINICAL PRESENTATION

A
  • Balance problems - Dizziness, Vertigo
  • Confusion
  • Dysphagia
  • Ataxia
  • Double vision/loss of vision
  • Syncope
  • Loss of balance
  • Nausea and vomiting
  • Numbness in part of the body
  • Dysarthria
  • Drop attacks
  • Urinary incontinence
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7
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - DIAGNOSIS

A
  • Imaging – CT or MRI
  • Angiography
  • CTA or MRA
  • Echocardiogram
  • Electrocardiogram
  • Holter monitor
  • Prothrombin time (PT) and partial thromboplastin tine (PTT) blood tests
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8
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - TREATMENT - LIFESTYLE CHANGES

A

o Achieving a healthy weight
o Controlling cholesterol by changing diet
o Increasing exercise
o Quitting smoking

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9
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - TREATMENT - MEDICATIONS

A
  • Medications to help manage health problems
    o Blood clots
    o Blood pressure
    o Cholesterol
    o Diabetes
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10
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - TREATMENT - SURGERY

A

o Carotid endarterectomy – removing plaque from the carotid artery
o Coronary angioplasty and stent – inserts a small balloon with a stent into an artery in the heart to open it up
o Coronary artery bypass – replace a damaged blood vessel in the heart with a healthy one
o Vertebral artery reconstruction – fix the damage to the arterys that carry blood to that brain

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11
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - TREATMENT FOR TRANSIENT VBI

A

o Brace/collar
o Medication
o Surgery, including minimally invasive spine surgery

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12
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - PREVENTION

A
  • You can reduce the risk by
    o Eating a healthy diet
    o Exercising regularly
    o Keeping cholesterol under control
    o Managing other health conditions – hypertension and diabetes
    o Quite smoking
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13
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - PROGNOSIS

A
  • Prognosis depends on
    o Severity of brain function issues
    o Whether you have had a stroke
    o Age
    o Other health conditions
  • Serious causes may lead to disability or death
  • Most people are able to manage symptoms with medications and lifestyle changes
  • VBI has a recurrence rate of 10% to 15%
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14
Q

VERTEBRAL ARTERY INSUFFICIENCY (VBI) - LONGTERM EFFECTS

A

o DVT
o Pulmonary embolism
o Dehydration/swallowing problems
o Difficulty breathing
o Paralysis or numbness
o Gastritis
o Myocardial infarction
o Lung infections
o Bedsores
o Stroke/TIA
o Vision loss

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15
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - DEFINITION

A
  • AAA is a potentially life-threatening condition
  • It’s a bulge in the main artery that supplies blood to the belly, pelvis and legs
  • The aneurysm is a weak spot in the blood vessel wall, at risk of rupturing and causing a haemorrhage
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16
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - CAUSE

A
  • The following diseases can damage the blood vessel walls or cause weak spots
    o Atherosclerosis
    o Cardiovascular disease
    o Peripheral artery disease (PAD)
    o Traumatic injuries that cause tears in the artery wall
    o Smoking
    o Vasculitis
    o Genetic diseases that affect connective tissues – Marfan syndrome, Ehlers Danlos type IV
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17
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - POPULATION AFFECTED

A

Men over 65

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18
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - RISK FACTORS

A
  • Smoking
  • Being a woman over 70
  • Personal history of an aneurysm in another site, especially in the lower extremities
  • Family history
  • High blood pressure
  • High cholesterol
  • Obesity
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19
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - CLINICAL PRESENTATION

A
  • Most people don’t have symptoms until the aneurysm is close to rupturing
  • You may experience
    o Back, leg or abdominal pain that doesn’t go away
    o Pulsing sensation in the belly
  • Signs of a ruptured AAA
    o Clammy, sweaty skin
    o Dizziness
    o Fainting
    o Fast heartbeat
    o Nausea and vomiting
    o Shortness of breath
    o Sudden, severe pain in the belly, lower back or legs
  • This is a medical emergency
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20
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - DIAGNOSIS

A
  • They don’t have symptoms so healthcare providers often diagnose unruptured AAAs when performing screening exams or tests
  • These include
    o Abdominal ultrasound
    o Computed tomography angiography (CTA)
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21
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - TREATMENT

A
  • Treatment depends on the size of the aneurysm
  • Aneurysms less than 5cm have a low risk of rupturing and may not need treatment right away
  • “Watchful waiting” is recommended
    o Getting ultrasounds every few months to make sure the aneurysm isn’t getting bigger
    o Making lifestyle adjustments
     Exercising
     Not smoking
     Eating a healthy diet
     Avoiding alcohol
     Maintaining a healthy weight
     Taking medication to lower blood pressure
  • Surgery
    o Open surgery – incision in the belly and a graft is sewn onto the bulging section of the aorta
    o Endovascular aneurysm repair (EVAR) – minimally invasive aneurysm repair surgery. Uses a small incision in the groin and the use of a catheter into an artery with an expandable stent to reinforce the aneurysm and prevent rupture
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22
Q

ABDOMINAL AORTIC ANEURYSM (AAA) - PREVENTION

A
  • Can’t always prevent AAA, especially is there is a family history of the condition
  • Screening is available to spot it early
  • Early detection and the right treatment may prevent the aneurysm from getting larger or rupturing
  • Can control risk factors
    o Stopping smoking
    o Exercising
    o Eating a healthy diet
    o Managing weight, blood pressure and cholesterol
    o Avoiding drinking too much alcohol
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23
Q

ABDOMINAL AROTIC ANEURYSM (AAA) - PROGNOSIS

A
  • Outlook is poor for people with an AAA that ruptures – 80% mortality rate
  • About 70% of people who have surgery before their aneurysm reptures live at least another 5 years
  • Prognosis is good for people with small AAAs detected during screening, especially if they improve their cardiovascular health risk factors
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24
Q

CERVICAL ARTERY DISSECTION (CAD) - DEFINITION

A
  • CAD happens when there is a tear in one or more layers of blood vessel tissue
  • It is a common cause of stroke in young and middle-aged adults
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25
Q

CERVICAL ARTERY DISSECTION (CAD) - CAUSE

A
  • Injury to your head or neck is the most common cause of dissection
  • Non-traumatic dissections can occur due to straining or heavy lifting in some people
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26
Q

CERVICAL ARTERY DISSECTION (CAD) - POPULATION AFFECTED

A

People ages 40 – 60

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27
Q

CERVICAL ARTERY DISSECTION (CAD) - RISK FACTORS

A
  • Connective tissue disorders
    o Ehlers-Danlos syndrome
    o Fibromuscular dysplasia
    o Marfan syndrome
    o Osteogenesis imperfecta
  • Recent illnesses
    o Gastrointestinal upset that causes frequent vomiting
    o Upper respiratory infection with persistent coughing
  • Atherosclerosis
  • Hypertension
  • Smoking
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28
Q

CERVICAL ARTERY DISSECTION (CAD) - CLINICAL PRESENTATION

A
  • Many people start noticing symptoms up to a month before receiving a CAD diagnosis
  • There are 3 main types
  • Head or neck pain
  • Horner’s syndrome
  • Stroke-like symptoms
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29
Q

CERVICAL ARTERY DISSECTION (CAD) - CLINICAL PRESENTATION - HEAD OR NECK PAIN

A

 May experience head or neck pain not related to an existing health issue
 Discomfort typically comes on suddenly and doesn’t go away
 Pain is on one side of the head (especially behind one eye) or neck and often resembles a cluster, migraine or thunderclap headache

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30
Q

CERVICAL ARTERY DISSECTION (CAD) - CLINICAL PRESENTATION - HORNER’S SYNDROME

A

 Condition that affects the involuntary function of the eyes and face
 Symptoms include:
 Drooping eyelids
 Smaller pupil in one eye
 Lack of sweating
 Typically only impacts one side of the head

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31
Q

CERVICAL ARTERY DISSECTION (CAD) - CLINICAL PRESENTATION - STROKE-LIKE SYMPTOMS

A

 CAD symptoms occur when part of the brain isn’t getting enough blood
 Ataxia
 Balance problems
 Blurred vision
 Dizziness
 Diplopia
 Limb weakness
 Dysarthria or aphasia
 Vertigo

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32
Q

CERVICAL ARTERY DISSECTION (CAD) - DIAGNOSIS

A
  • CTA
  • MRA
  • Any technique that takes specific pictures of the blood vessels
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33
Q

CERVICAL ARTERY DISSECTION (CAD) - TREATMENT

A
  • They often heal on their own
  • Medical therapies can lower the risk of blood clots that can lead to stroke
  • Antiplatelet therapy – aspirin and clopidogrel
  • Anticoagulant medications – heparin infusion or warfarin tablets
  • Rarely, stenting is necessary
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34
Q

CERVICAL ARTERY DISSECTION (CAD) - PREVENTION

A
  • Important to have monitoring from a vascular specialist
  • All people at risk for CAD should optimise their health by
    o Avoiding prolonged extreme neck positions
    o Avoiding rapid head and neck movements
    o Avoiding heavy lifting
    o Eating a heart-healthy diet
    o Exercise regularly
    o Maintaining blood pressure
    o Quitting smoking
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35
Q

CERVICAL ARTERY DISSECTION (CAD) - PROGNOSIS

A
  • They often heal on their own
  • Typically heals very well, returning the vessel to normal
  • Process usually occurs within the first 3 to 6 months
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36
Q

DEEP VEIN THROMBOSIS (DVT) - DEFINITION

A
  • Deep vein thrombosis occurs when a thrombus (blood clot) develops in veins deep in the body because the veins are injured or the blood flowing through them is too sluggish
  • The blood clots may partially or completely block blood flow through the vein
  • Most DVTs happen in the lower leg, thigh or pelvis but can also occur in other parts of the body including the arm, brain, intestines, liver or kidneys
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37
Q

DEEP VEIN THROMBOSIS (DVT) - CAUSE

A
  • Anything that prevents the blood from flowing or properly clotting can cause a blood clot
  • The main causes of DVT are damage to a vein from surgery or inflammation and damage due to infection or injury
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38
Q

DEEP VEIN THROMBOSIS (DVT) - POPULATION AFFECTED

A
  • Can occur at any age
  • Less common in children and adolescents
  • More common in those over 60
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39
Q

DEEP VEIN THROMBOSIS (DVT) - RISK FACTORS

A
  • Having an inherited condition increases the risk of blood clots
  • Having cancer and some of its treatments
  • Having a history of DVT in yourself or your family
  • Having limited blood flow in a deep vein because of an injury, surgery or immobilisation
  • Not moving for long periods of time
  • Being pregnant or recently having a baby
  • Over 40
  • Being obese
  • Autoimmune disease
    o Lupus
    o Vasculitis
    o IBD
  • Smoking
  • Having varicose veins
  • Taking birth control
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40
Q

DEEP VEIN THROMBOSIS (DVT) - CLINICAL PRESENTATION

A
  • Usually forms in the veins of your legs or arms
  • Up to 30 % of people with DVT don’t have any symptoms but sometimes the symptoms are very mild and don’t raise concern
  • Symptoms of acute DVT include
    o Swelling of the leg or arm
    o Pain or tenderness in your leg or arm
    o The area of your leg or arm that’s swollen or hurts may be warmer than usual
    o Skin that’s red or discoloured
    o The veins near your skins surface may be larger than normal
    o Abdominal pain or flank pain
    o Severe headache and/or seizures (when blood clots affect the veins of your brain)
  • Some people don’t know they have a DVT until the clot moves from their leg or arm and travels to their lung
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41
Q

DEEP VEIN THROMBOSIS (DVT) - DIAGNOSIS

A
  • Duplex venous ultrasound
  • Venography
  • MRI or MRV
  • CT
  • If someone thinks the patient may have a genetic or acquired clotting disorder you may need special blood tests
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42
Q

DEEP VEIN THROMBOSIS (DVT) - TREATMENT

A
  • Anticoagulants
  • Compression stockings
  • Elevating the affected limb at different times throughout the day
  • Sometimes more invasive treatments are requires – these are catheter based procedures
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43
Q

DEEP VEIN THROMBOSIS (DVT) - PREVENTION

A
  • After you have a DVT you will have to reduce your risk of future DVT clots by
    o Taking blood thinning medications
    o Keeping follow-up appointments
    o Making lifestyle changes such as eating healthier foods, being more active and avoiding smoking
  • If you have never had a DVT but have an increased risk of developing one you should
    o Exercise the calf muscles if you sit for a long time - stand up and walk around every 30 mins
    o Get out of bed as soon as you can if you’re sick or have had surgery
    o Take medications or use compression socks after surgery
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44
Q

DEEP VEIN THROMBOSIS (DVT) - PROGNOSIS

A
  • A DVT can take several months to a year to come apart
  • You will need blood thinner medications and keep wearing compression stockings until you are told to stop
  • May need blood tests to make sure you’re getting the right dose of blood thinners
  • You may need continued ultrasounds to make sure the clot hasn’t moved or got bigger
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45
Q

PULMONARY EMBOLISM (PE) - DEFINITION

A
  • A pulmonary embolism is a blood clot in the blood vessels of your lungs
  • This happens when a clot in another part of the body moves through the veins to your lung
  • A PE restricts blood flow tp your lungs, lowers oxygen levels in the lungs and increases blood pressure in the pulmonary arteries
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46
Q

PULMONARY EMBOLISM (PE) - CAUSE

A
  • Blood pooling in a certain part of the body, usually arm or leg
  • Injury to a vein
  • Another medical condition – congestive heart failure, atrial fibrillation, heart attack, stroke
  • Increase or decrease in the bloods clotting factors
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47
Q

PULMONARY EMBOLISM (PE) - POPULATION AFFECTED

A

Adults aged 70-80

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48
Q

PULMONARY EMBOLISM (PE) - RISK FACTORS

A
  • Having a blood clot in the leg or DVT
  • Being inactive for long periods of time
  • Having recently had trauma or injury to a vein
  • Taking birth control pills
  • Currently smoking
  • History of heart failure or stroke
  • Being overweight
  • Are pregnant or have given birth in the previous 6 weeks
  • Received a central venous catheter through the arm or leg
  • Having cancer or receiving cancer treatments
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49
Q

PULMONARY EMBOLISM (PE) - CLINICAL PRESENTATION

A
  • Symptoms vary depending on the severity of the clot
  • Some people don’t experience symptoms with a pulmonary embolism but most do
  • Sudden shortness of breath – whether you are active or at rest
  • Unexplained sharp pain in the chest, arm, shoulder, neck or jaw – pain may also be similar to the symptoms of a heart attack
  • Cough with or without bloody mucus
  • Pale, clammy or bluish skin
  • Rapid heartbeat
  • Excessive sweating
  • Feeling anxious, light headed, faint or passing out
  • Wheezing
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50
Q

PULMONARY EMBOLISM (PE) - DIAGNOSIS

A
  • Blood tests – D-dimer test
  • CT angiogram
  • Ultrasound of the leg
  • A ventilation/perfusion (V/Q) scan
  • Pulmonary angiogram
  • Chest x-ray
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51
Q

PULMONARY EMBOLISM (PE) - TREATMENT

A
  • Hospital stay and treatment length will vary depending on the severity of the clot
  • Main treatment is anticoagulants
  • Compression stockings
  • Thrombolytic therapy – “clot busters”
  • Surgery
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52
Q

PULMONARY EMBOLISM (PE) - PREVENTION

A
  • Exercise regularly
  • Drink plenty of fluids, but limit alcohol and caffeine
  • Don’t use tobacco products
  • Avoid crossing legs
  • Don’t wear tight fitting clothing
  • Lose weight if you have overweight
  • Elevate your feet for 30 minutes twice a day
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53
Q

PULMONARY EMBOLISM (PE) - PROGNOSIS

A
  • Without treatment, a PE is a very serious condition that can lead to permanent illness or death
  • With treatment, your prognosis depends on the size of the blood clot and blockages as well as overall health and how well your heart can pump blood
  • It can take months or years for a PE to go away completely
  • Repeated PE or a very large PE can lead to pulmonary hypertension in some people
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54
Q

STROKE - DEFINITION

A
  • A stroke is a life-threatening condition that happens when a part of the brain doesn’t have enough blood flow
  • This most commonly happens because of a blocked artery or bleeding in the brain
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55
Q

STROKE - TYPES

A
  • 2 main ways strokes can happen – ischemia and haemorrhage
  • Ischemia
    o When cells don’t get enough blood flow to supply them with oxygen.
    o This usually happens because something blocks blood vessels in the brain, cutting off blood flow.
    o This type is most common and account for about 80% of all strokes
    o Usually happens due to thrombosis, an embolism, lacunar stroke (small vessel blockage) or cryptogenic stroke (an unknown reason)
  • Haemorrhagic
    o Cause bleeding in and around the brain
    o Usually happens due to bleeding inside the brain (intracerebral) or because of bleeding into the subarachnoid space (the space between the brain and its outer covering
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56
Q

STROKE - CAUSE

A
  • Ischemic
    o Atherosclerosis
    o Clotting disorders
    o Atrial fibrillation
    o Heart defects
    o Microvascular ischemic disease
  • Haemorrhagic
    o High blood pressure
    o Brain aneurysms
    o Brain tumours
    o Diseases that weaken or cause unusual changes in blood vessels in the brain, such as moyamoya disease
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57
Q

STROKE - POPULATION AFFECTED

A
  • Anyone can have a stroke
  • Most common in people over 65
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58
Q

STROKE - RISK FACTORS

A
  • Alcohol use disorder
  • High blood pressure
  • Hyperlipidaemia
  • Migraine headaches
  • Type 2 diabetes
  • Smoking
  • Drug misuse
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59
Q

STROKE - CLINICAL PRESENTATION

A
  • Stroke symptoms often depend on the area of the brain that is affected
  • Symptoms of stroke can lead to one or more of the following:
    o One-sided weakness or paralysis
    o Difficulty with or loss of speaking ability (aphasia)
    o Slurred or garbled speaking (dysarthria)
    o Loss of muscle control on one side of the face
    o Sudden loss – partial or total – of one or more senses (vision, hearing, taste, smell and touch)
    o Diplopia
    o Ataxia
    o Dizziness or vertigo
    o Nausea and vomiting
    o Neck stiffness
    o Emotional instability and personality changes
    o Confusion or agitation
    o Seizures
    o Memory loss (amnesia)
    o Headaches (usually sudden and severe)
    o Passing out or fainting
    o Coma
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60
Q

STROKE - DIAGNOSIS

A
  • Diagnosis involves a combo of neurological examination, diagnostic imaging and other tests
  • CT scan
  • Lab blood tests
  • ECG
  • MRI scan
  • EEG
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61
Q

STROKE - TREATMENT

A
  • Treatment depends on many factors, the most important factor in determining treatment is what kind of stroke a person has
  • Ischemic
    o Top priority is restoring circulation to affected brain areas
    o Restoring circulation usually involves a certain medication type called thrombolytics but may also involve a catheterization procedure
    o Thrombolytic drugs (within 3 to 4.5 hours)
    o Thrombectomy (within 24 hours if there is no significant brain damage)
    o Blood pressure management
  • Haemorrhagic
    o Treatment depends on the location and severity of the bleeding
    o Reducing blood pressure is often the top priority because this will reduce the amount of bleeding and keep it from getting worse
    o Another treatment option is to improve clotting so the bleeding will stop
    o Surgery is sometimes necessary to relieve pressure on the brain from accumulated blood
  • Rehabilitation
    o Speech therapy
    o Physical therapy
    o Occupational therapy
    o Cognitive therapy
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62
Q

STROKE - PREVENTION

A
  • Improve your lifestyle
  • Avoid risky lifestyle choices or make changes to your behaviours
  • Manage health conditions and risk factors
  • Reduce caffeine, alcohol, fried foods and recreational drugs
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63
Q

STROKE - PROGNOSIS

A
  • Ischemic
    o The more severe an ischemic stroke is, the worse the damage
    o You are more likely to lose certain abilities, at least temporarily
    o The faster you get medical attention the effects or more likely to be temporary or less severe
  • Haemorrhagic
    o These usually cause much worse symptoms, especially when bleeding is more severe
    o Symptoms tend to get worse quickly
  • Strokes have the potential to cause death when they are severe or if they go too long without treatment
  • Outlook does depend a lot on how severe the initial stroke is
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64
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - DEFINITION

A
  • A TIA starts like a stroke but only lasts from several minutes up to 24 hours
  • A TIA does not kill the brain cells so there is no lasting damage to the brain
  • Also called a mini-stroke
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65
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - CAUSE

A
  • Happens when one of the blood vessels that supply the brain with oxygen-rich blood becomes blocked
  • In TIAs the blockage quickly resolves and the brain’s blood supply returns to normal before there is any significant damage
  • The blockage in the blood vessels responsible for most TIAs is usually caused by a blood clot that’s formed elsewhere in the body and travelled to the blood vessels supplying the brain
  • It can also be caused by pieces of fatty material or air bubbles
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66
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - POPULATION AFFECTED

A

Adults over 55

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67
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - RISK FACTORS

A
  • Older age – the risk of a stroke doubles with each decade after the age of 55 in both men and women
  • Family history
  • Being male
  • Race – black and Hispanic have a higher risk than white people
  • Hypertension
  • Physical inactivity
  • Diabetes
  • Heart disease
  • Atrial fibrillation
  • Smoking
  • High blood cholesterol levels
  • Drug abuse
  • Obesity
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68
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - CLINICAL PRESENTATION

A
  • Symptoms of a TIA and stroke do not differ
  • Symptoms come on suddenly
  • Difficulty seeing from one or both eyes
  • Numbness or weakness in the face, arms or legs, especially on one side
  • Severe headache
  • Difficulty walking
  • Dizziness, loss or coordination and balance
  • Difficulty speaking or understanding words
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69
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - DIAGNOSIS

A
  • Simple tests to check vision, muscle strength and ability to think and speak
  • CT scan
  • MRI scan
  • ECG
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70
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - TREATMENT

A
  • General approach to treating and preventing TIAs is the same as that used to treat and prevent strokes
  • Aspirin and clopidogrel
  • Anticoagulant drugs
  • Carotid endarterectomy – surgical removal or the plaque withing the carotid artery
  • Carotid angioplasty and stenting procedure
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71
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - PREVENTION

A
  • Stopping smoking
  • Monitor blood pressure
  • Monitor cholesterol
  • Eat a Mediterranean-style diet
  • Maintain a healthy weight
  • Stop drinking alcohol
  • Exercise
  • Wear your CPAP
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72
Q

TRANSIENT ISCHEMIC ATTACK (TIA) - PROGNOSIS

A
  • Prognosis is good
  • A TIA usually lasts only a few minutes and doesn’t cause permeant damage
  • However a TIA is often a warning of a stroke so it is important to look at lifestyle factors to reduce risk factors
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73
Q

HYPERTENSION - DEFINITION

A
  • High blood pressure
  • Blood pressure is the measurement of the pressure of blood pushing against blood vessel walls
  • Hypertension means that the pressure against the blood vessel walls in the body is consistently too high
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74
Q

HYPERTENSION - BLOOD PRESSURE READINGS

A
  • Normal – under 130/80 mmHg
  • Stage 1 hypertension (mild) – 130-139 OR diastolic between 80-89 mmHg
  • Stage 2 hypertension (moderate) – 140/90 mmHg or higher
  • Hypertensive crisis (get emergency care) – 180/120 mmHg or higher
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75
Q

HYPERTENSION - CAUSE

A
  • 2 types of high blood pressure
  • Primary
    o Most common
    o Aging
    o Unhealthy habits – not getting enough exercise
  • Secondary
    o Different medical problems
    o A medication you are taking
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76
Q

HYPERTENSION - POPULATION AFFECTED

A

Black adults over 55

77
Q

HYPERTENSION - RISK FACTORS

A
  • Have family members who have high blood pressure, cardiovascular disease or diabetes
  • Are of African descent
  • Older than 55
  • Overweight
  • Don’t get enough exercise
  • Eat foods high in sodium
  • Smoke
  • Are a heavy drinker
78
Q

HYPERTENSION - PREGNANCY

A
  • High blood pressure complicates about 10 % of all pregnancies
  • Several different types of high blood pressure during pregnancy
  • Chronic hypertension – high blood pressure that is present before pregnancy
  • Gestational hypertension – high blood pressure in the latter part of pregnancy
  • Preeclampsia – dangerous condition that typically develops in the latter half of pregnancy and results in hypertension, protein in the urine and generalised swelling in the pregnant person. It can affect other organs in the body and cause seizures (eclampsia)
  • Chronic hypertension with superimposed preeclampsia – pregnant people who have chronic hypertension are at an increased risk for developing preeclampsia
79
Q

HYPERTENSION - CLINICAL PRESENTATION

A
  • Called the ‘silent killer’
  • Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms
  • Most people have no symptoms at all
  • When symptoms do occur they can include
    o Early morning headaches
    o Nosebleeds
    o Irregular heart rhythms
    o Vision changes
    o Buzzing in ears
  • Severe hypertension can cause
    o Fatigue
    o Nausea
    o Vomiting
    o Confusion
    o Anxiety
    o Chest pain
    o Muscle tremors
80
Q

HYPERTENSION - DIAGNOSIS

A
  • Taking blood pressure with a blood pressure cuff
81
Q

HYPERTENSION - TREATMENT

A
  • Diet
    o Eat foods that are lower in fat, salt and calories
    o Use flavourings, spices and herbs to make foods tasty without using salt
    o Avoid or cut down on foods high in fat or salt
    o Increase potassium in your diet
  • Medications
    o Angiotensin-converting enzyme (ACE) inhibitors
    o Angiotensin II receptor blockers (ARBs)
    o Calcium channel blockers
    o Diuretics
82
Q

HYPERTENSION - PREVENTION

A
  • Eating a healthy diet
  • Keeping a healthy weight
  • Cutting down on salt
  • Keeping active
  • Drinking alcohol in moderation
83
Q

HYPERTENSION - PROGNOSIS

A
  • If you have primary hypertension, you will need to manage it for the rest of your life
  • If you have secondary hypertension, your blood pressure will most likely come down after you receive treatment for the medical problem that has caused it
  • You can get seriously ill of you don’t treat high blood pressure
  • You can manage blood pressure by taking certain medications
  • Exercising and eating healthy foods helps lower blood pressure
84
Q

PERIPHERAL VASCULAR DISEASE (PVD) - DEFINITION

A
  • Peripheral vascular disease is an accumulation of plaque in the arteries in the legs or arms
  • This makes it harder for the blood to carry oxygen and nutrients to the tissues in these areas
85
Q

PERIPHERAL VASCULAR DISEASE (PVD) - CAUSE

A
  • Most common cause of PVD is atherosclerosis that develops in the arteries of the legs or arms
  • A collection of fatty plaque in the blood vessel walls caused peripheral vascular disease
  • As plaque builds up, the blood vessels get narrower and narrower, until they become blocked
86
Q

PERIPHERAL VASCULAR DISEASE (PVD) - POPULATION AFFECTED

A

Adults over 50 who smoke

87
Q

PERIPHERAL VASCULAR DISEASE (PVD) - RISK FACTORS

A
  • Using tobacco products
  • Diabetes
  • Being 50 or older
  • Being of African descent
  • Having a personal or family history of heart or blood vessel disease
  • Hypertension
  • Hyperlipidaemia
  • Obesity
  • Having a blood clotting disorder
  • Having kidney disease
88
Q

PERIPHERAL VASCULAR DISEASE (PVD) - CLINICAL PRESENTATION

A
  • Half of the people who have PVD don’t have any symptoms
  • Symptoms may not become obvious until later in life
  • Symptoms wont appear until their artery narrows by 60% or more
  • The first symptom of PVD is usually intermittent claudication
    o Pain, cramping or discomfort in your legs or buttocks
  • Burning or aching pain in the feet and toes while resting, especially at night while lying flat
  • Cool skin on your feet
  • Redness or other changes of the skin
  • More frequent skin and soft tissue infections (usually in feet or legs)
  • Toe and foot sores that don’t heal
89
Q

PERIPHERAL VASCULAR DISEASE (PVD) 0 DIAGNOSIS

A
  • Ankle-brachial index (ABI)
  • Pulse volume recording (PVR)
  • Vascular ultrasound
  • Angiogram
90
Q

PERIPHERAL VASCULAR DISEASE (PVD) - TREATMENT

A
  • There is some evidence that PVD can be reversed but it is incurable
  • Lifestyle changes, medications and procedures can treat PVD
  • 2 main goals of treatment are
    o Reducing the risk of cardiovascular events
    o Improving quality of life by easing the pain that occurs when walking
  • Lifestyle changes
    o Quitting tobacco products
    o Eat a balanced diet that is high in fibre and low in cholesterol, fat and sodium
    o Exercise
    o Manage other health conditions
    o Keep stress to a low level
    o Practice food foot and skin care
  • Medications
    o Antihypertensive medications
    o Statin medications
    o Diabetes medications
    o Antiplatelet medication – aspirin, clopidogrel
  • Surgical treatments
    o Angioplasty
    o Stents
    o Peripheral artery bypass surgery
    o Atherectomy
91
Q

PERIPHERAL VASCULAR DISEASE (PVD) - PREVENTION

A
  • Manage weight
  • Eat a low-fat, low-sugar diet that includes at least 5 servings of fresh fruits and vegetables every day
  • Don’t use tobacco products
  • Exercise for at least 30 mins a day on most days of the week
92
Q

PERIPHERAL VASCULAR DISEASE (PVD) - PROGNOSIS

A
  • PVD is most treatable when it is found early
  • Progression depends on may factors including where the plaque formed in the body and the patients overall health
  • No cure
  • It is a condition that you will have for the rest of your life
  • You can slow its progression by
    o Not using tobacco products
    o Exercising regularly
    o Limiting fat and following a healthy diet
    o Managing risk factors such as – diabetes, high cholesterol and high blood pressure
93
Q

ALZHEIMER’S DISEASE - DEFINITION

A
  • Alzheimer’s disease is a brain disorder that gets worse over time
  • It is a form of dementia
  • It is characterised by changes in the brain that lead to deposits of certain proteins
  • Alzheimer’s disease causes the brain to shrink and brain cells to eventually die
94
Q

ALZHEIMER’S DISEASE - CAUSE

A
  • Exact cause is unknown
  • Caused by a combo of genetic, lifestyle and environmental factors
  • Brain proteins fail to function as usual – this disrupts the work of the neurons and triggers a series of events. The neurons become damaged and lose connections to each other, eventually making them die
95
Q

ALZHEIMER’S DISEASE - POPULATION AFFECTED

A
  • 70 and older
96
Q

ALZHEIMER’S DISEASE - RISK FACTORS

A
  • Increasing age
  • Family history
  • Genetics
  • Down syndrome
  • Sex - Women more than men
  • Mild cognitive impairment
  • Head trauma
  • Air pollution
  • Excessive alcohol consumption
  • Poor sleep patterns
  • Poor lifestyle and heart health
97
Q

ALZHEIMER’S DISEASE - CLINICAL PRESENTATION

A
  • Memory loss is the key symptom
  • Early signs include difficulty remembering recent events or conversations
  • Brain changes associated with Alzheimer’s disease lead to growing trouble with
    • Memory
      • Repeating themselves over and over, Forget conversations, appointments or events, Misplace items, Getting lost in places they used to know well, Forget names of family or every day objects, Have trouble finding the right words or expressing thoughts
    • Thinking and reasoning
    • Making judgments and decisions
    • Planning and performing familiar tasks
    • Changes in personality and behaviour
      • Depression, Loss of interest in activities, Social withdrawal, Mood swings, Distrust in others, Anger or aggression, Changes in sleeping habits, Wandering, Loss of inhibitions, Delusions
    • Preserved skills
98
Q

DEMENTIA - DEFINITION

A
  • Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily life
  • It is not a specific disease but several diseases can cause dementia
  • Alzheimer’s disease is the most common cause of progressive dementia in older adults
99
Q

DEMENTIA - CAUSES

A
  • Dementia is caused by damage to or loss of nerve cells and their connections in the brain
  • Depending on the area of the brain that is damaged, symptoms can be different
  • Dementias are often grouped by what they have in common such as the protein or proteins deposited in the brain or part of the brain that is affected
100
Q

DEMENTIA - POPULATION AFFECTED

A
  • Over 65s
101
Q

DEMENTIA - RISK FACTORS

A
  • Risk factors that can’t be changed
    • Age, Family history, Down syndrome
  • Risk factors that can be changed
    • Diet and exercise, Excessive alcohol use, Cardiovascular risk factors, Depression, Diabetes, Smoking, Air pollution, Head trauma, Sleep disturbances, Vitamin and nutritional deficiencies, Medications that can worsen memory
102
Q

DEMENTIA - CLINICAL PRESENTATION

A
  • Dementia symptoms vary depending on the cause
  • Cognitive changes
    • Memory loss, which is usually noticed by someone else
    • Difficulty communicating or finding the right words
    • Difficulty with visual and spatial abilities such as getting lost
    • Difficulty reasoning or problem-solving
    • Difficulty handling complex tasks
    • Difficulty with planning and organisation
    • Difficulty with coordination and motor functions
    • Confusion and disorientation
  • Psychological changes
    • Personality changes
    • Depression
    • Anxiety
    • Inappropriate behaviour
    • Paranoia
    • Agitation
    • Hallucinations
103
Q

ANGINA - DEFINITION

A
  • Condition marked by a severe px in the chest, often also spreading to the shoulders, arms and neck, owing to an inadequate blood supply to the heart
104
Q

ANGINA - CAUSE

A
  • Usually caused by the arteries supplying blood to the heart muscles becoming narrowed by atherosclerosis (a build-up of fatty substances)
105
Q

ANGINA - POPULATION AFFECTED

A
  • Adults over 60
106
Q

ANGINA - RISK FACTORS

A
  • Unhealthy diet, Lack of exercise
  • Smoking
  • Increasing age
  • Family history of atherosclerosis or heart problems
107
Q

ANGINA - CLINICAL PRESENTATION

A
  • Chest px and discomfort
  • Px may also be felt in arms, neck, jaw, shoulder or back
  • Dizziness
  • Fatigue
  • Nausea
  • Shortness of breath
  • Sweating
108
Q

ANGINA - PROGNOSIS

A
  • Will probably have to take several medications for the rest of life
109
Q

MYOCARDIAL INFARCTION - DEFINITION

A
  • Heart attack
110
Q

MYOCARDIAL INFARCTION - CAUSE

A
  • Blockage in one of the blood vessels that supplies the heart - Occurs when the blood flow through one or more of the coronary arteries is decreases
111
Q

MYOCARDIAL INFARCTION - POPULATION AFFECTED

A
  • Obese people most affected
112
Q

MYOCARDIAL INFARCTION - RISK FACTORS

A
  • Smoking
  • Diabetes
  • High blood pressure
  • High blood cholesterol levels
  • High blood triglyceride level
  • Obesity
  • Lack of physical activity
113
Q

MYOCARDIAL INFARCTION - CLINICAL PRESENTATION

A
  • Most common symptom is chest pressure or px, typically on the left side of the body
  • Shortness of breath or trouble breathing
  • Fatigue
  • Insomnia
  • Nausea or stomach discomfort
  • Heart palpitations
  • Anxiety or feeling of impending doom
  • Sweating
  • Feeling light headed, dizzy or passing out
  • Women are less likely to experience chest px or discomfort that feels like indigestion
  • Women are more likely to have shortness of breath, fatigue and insomnia that started before the heart attack
114
Q

AORTIC DISSECTION - DEFINITION

A
  • Serious condition in which a tear occurs in the inner layer of the aorta. Blood rushes through the tear, causing the inner and middle layers of the aorta to dissect (split)
115
Q

AORTIC DISSECTION - CAUSE

A
  • Caused by a weakened area of the aortas wall
116
Q

AORTIC DISSECTION - POPULATION AFFECTED

A
  • Men over 60
117
Q

AORTIC DISSECTION - RISK FACTORS

A
  • Hypertension
  • Atherosclerosis
  • Aortic aneurysm
  • Aortic valve defect
  • Narrowing of the aorta at birth
  • Certain genetic diseases
  • Cocaine use
  • Pregnancy
  • High-intensity weightlifting
118
Q

AORTIC DISSECTION - CLINICAL PRESENTATION

A
  • Sudden severe chest or upper back pain
  • Sudden severe stomach pain
  • Loss of consciousness
  • Shortness of breath
  • Symptoms similar to those of a stroke - Sudden vision problems, Difficulty speaking, Weakness or loss of movement on one side of your body
  • Weak pulse in one arm or thigh compared to the other
  • Leg pain
  • Difficulty walking
119
Q

AORTIC DISSECTION - PROGNOSIS

A
  • Around 20% of pt die before getting to hospital
120
Q

VALVULAR HEART DISEASE - DEFINITION

A
  • When any valve in the heart has damage or is diseased
121
Q

VALVULAR HEART DISEASE - POPULATION AFFECTED

A
  • Older adults
122
Q

VALVULAR HEART DISEASE - RISK FACTORS

A
  • Older age
  • History of certain infections that can affect the heart and forms of heart disease or heart attack
  • High blood pressure, high cholesterol, diabetes and other heart disease risk factors
  • Heart conditions present at birth
123
Q

VALVULAR HEART DISEASE - CLINICAL PRESENTATION

A
  • May not have symptoms for many years
  • Whooshing sound (heart murmur) when a doctor is listening to the heart
  • Chest pain
  • Abdominal swelling
  • Fatigue
  • Shortness of breath - Esp when lying down or active
  • Swelling of ankles or feet
  • Dizziness
  • Fainting
  • Irregular heartbeat
124
Q

ANEURYSM - DEFINITION

A
  • An excessive localised swelling of the wall of an artery
  • Abnormal bulge in wall of blood vessel
125
Q

ANEURYSM - CAUSE

A
  • High blood pressure/hypertension over many years→damage/weakening of blood vessels
  • Atherosclerosis – weakens blood vessels
126
Q

ANEURYSM - POPULATION AFFECTED

A
  • Women 30-60
127
Q

ANEURYSM - RISK FACTORS

A
  • Hypertension
  • Size, location, growth
  • Family history
128
Q

ANEURYSM - TYPES OF ANEURYSM

A
  • Brain
  • Aortic
  • Abdominal
  • Peripheral
129
Q

PERICARDITIS - DEFINITION

A
  • Inflammation of the pericardium
130
Q

PERICARDITIS - POPULATION AFFECTED

A
  • People with predisposing conditions
  • Men between 20 and 50
131
Q

PERICARDITIS - RISK FACTORS

A
  • Past heart attack
  • Previous heart surgery
  • Autoimmune disease
  • Trauma or injury from an accident
  • Certain bacterial, viral and fungal infections
  • Kidney failure
  • HIV/AIDS
  • Tumours
132
Q

PERICARDITIS - CLINICAL PRESENTATION

A
  • Chest pain is most common - Usually feels sharp or stabbing
  • Pain usually occurs behind breast bone or on left side of chest
  • Pain may
    • Spread to the left shoulder or neck
    • Get worse when coughing, lying down or taking a deep breath or Get better when sitting up or leaning forward
  • Cough
  • Fatigue or general feeling of weakness or being sick
  • Leg swelling
  • Low-grade fever
  • Pounding or heart palpitations
  • Shortness of breath when lying down
  • Swelling of the abdomen
133
Q

PERICARDITIS - PROGNOSIS

A
  • Pt with acute idiopathic or viral pericarditis generally have a good long-term prognosis
134
Q

CONGESTIVE HEART FAILURE - DEFINITION

A
  • Where the heart is unable to pump blood around the body properly and needs treatment to help it work
  • Chronic, progressive condition that affects pumping power of your heart muscle
  • CHF specifically refers to stage in which fluid builds up within the heart and causes it to pump inefficiently
135
Q

CONGESTIVE HEART FAILURE - CAUSE

A
  • Develops when ventricles can’t pump enough blood to the body
  • Eventually, blood and other fluids can back up inside lungs, abdomen, liver and lower body
136
Q

CONGESTIVE HEART FAILURE - POPULATION AFFECTED

A
  • Adults ages 45-64
137
Q

CONGESTIVE HEART FAILURE - RISK FACTORS

A
  • Coronary artery disease, Heart valve disease, Congenital heart disease
  • Heart attack
  • Hypertension
  • Irregular heartbeat
  • Diabetes
  • Alcohol use, Smoking
  • Sleep apnoea
  • Obesity
  • Viruses
138
Q

CONGESTIVE HEART FAILURE - CLINICAL PRESENTATION

A
  • Shortness of breath with activity or when lying down
  • Fatigue and weakness
  • Swelling in legs, ankles and feet
  • Rapid or irregular heartbeat
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood-tinged mucus
  • Swelling of the abdomen
  • Very rapid weight gain from fluid build-up
  • Nausea and lack of appetite
  • Difficulty concentrating or decreased alertness
139
Q

HYPERTROPHIC CARDIOMYOPATHY - DEFINITION

A
  • Disease in which the heart muscle becomes hypertrophied (thickened)
  • Hypertrophic changes in the heart
140
Q

HYPERTROPHIC CARDIOMYOPATHY - CAUSE

A
  • Genetic mutation that causes muscle thickening
141
Q

HYPERTROPHIC CARDIOMYOPATHY - POPULATION AFFECTED

A
  • Can be diagnosed at any age
142
Q

HYPERTROPHIC CARDIOMYOPATHY - RISK FACTORS

A
  • Inherited
143
Q

HYPERTROPHIC CARDIOMYOPATHY - CLINICAL PRESENTATION

A
  • Shortness of breath
  • Chest pain inc chest pain during exercise
  • Changes to hearts electrical system - Can lead to life threatening irregular heart rhythm/sudden death
  • Fainting post exercise
  • Heart murmur
  • Sense of palpitations
  • Shortness of breath
144
Q

ATRIAL FIBRILLATION - DEFINITION

A
  • Condition that causes an irregular and often fast heartbeat
145
Q

ATRIAL FIBRILLATION - POPULATION AFFECTED

A
  • People over 65
146
Q

ATRIAL FIBRILLATION - RISK FACTORS

A
  • Older age = higher risk
  • Heart disease
  • High blood pressure
  • Thyroid disease
  • Excessive alcohol
  • Obesity
  • Family Hx
147
Q

ATRIAL FIBRILLATION - CLINICAL PRESENTATION

A
  • Some asymptomatic
  • Sensations of fast, fluttering or pounding heartbeat
  • Chest px
  • Dizziness
  • Fatigue
  • Shortness of breath
148
Q

VASCULITIS - DEFINITION

A
  • Vasculitis is the inflammation of the body’s blood vessels
  • Vasculitis can affect very small blood vessels (capillaries), medium-size blood vessels or large blood vessels, such as the aorta
149
Q

VASCULITIS - CAUSE

A
  • In most cases, the exact cause is unknown
  • It is clear that the immune system plays a big role
150
Q

VASCULITIS - POPULATION AFFECTED

A
  • Women over 50
151
Q

VASCULITIS - RISK FACTORS

A
  • Age - Depends on type
    • Giant cell arteritis occurs before the age of 50
    • Kawasaki disease is most common in children under 5
  • Family history
  • Lifestyle choices
  • Medications
  • Infections
  • Immune disorders
  • Sex - Depends on type
    • Giant cell arteritis is more common in women
    • Buerger’s disease is more common in men
152
Q

VASCULITIS - CLINICAL PRESENTATION

A
  • Skin rashes
  • Fatigue
  • Weakness
  • Fever
  • Joint pains
  • Abdominal pains
  • Kidney problems (dark or bloody urine)
  • Nerve problems (numbness, weakness and pain)
  • Cough and/or shortness of breath
  • Additional symptoms can occur depending on the area of the body that is affected by vasculitis
153
Q

S&S OF CARDIAC DISEASE - DEFINITION

A
  • Cardiovascular disease (CVD), also called heart and circulatory disease, is an umbrella name for conditions that affect your heart or circulation
  • These include high blood pressure, stroke and vascular dementia
154
Q

S&S OF CARDIAC DISEASE

A
  • Chest px
  • Px, weakness or numb legs and/or arms
  • Breathlessness
  • Very fast or slow heartbeat
  • Heart palpitations
  • Fatigue
  • Swollen limbs
155
Q

S&S OF CARDIAC DISEASE - RISK FACTORS

A
  • Smoking
  • Stress
  • Alcohol
  • Hypertension
  • High blood cholesterol
  • Being physically inactive
  • Being overweight or obese
  • Diabetes
  • Family history of heart disease
  • Ethnic background
  • Sex
    • Men more likely
  • Age
    • Older people more likely
156
Q

NON-CARDIAC CAUSES OF CHEST PAIN - GASTROESOPHAGEAL

A
  • Spasm
  • Reflux
157
Q

NON-CARDIAC CAUSES OF CHEST PAIN - PULMONARY

A
  • Pleuritic in nature
  • Spontaneous pneumothorax
  • Pulmonary embolism
  • Pneumonitis
  • Bronchitis
  • Intrathoracic neoplasm
158
Q

NON-CARDIAC CAUSES OF CHEST PAIN - MSK

A
  • Costochondritis
  • Rib fracture
  • Myalgia
  • Herpes zoster
159
Q

CVS - PALPITATIONS - DEFINITION

A
  • A noticeably rapid, strong, or irregular heartbeat due to agitation, exertion or illness
160
Q

CVS - PALPITATIONS - CAUSE

A
  • Stress
  • Depression
  • Strenuous exercise
  • Stimulants - Caffeine, Nicotine, Cocaine
  • Hormone changes
161
Q

CVS - PALPITATIONS - POPULATION AFFECTED

A
  • More common in women
162
Q

CVS - PALPITATIONS - RISK FACTORS

A
  • Stress
  • Anxiety disorders
  • Panic disorders
  • Pregnancy
  • Hyperthyroidism
163
Q

CVS - PALPITATIONS - CLINICAL PRESENTATION

A
  • Feeling of fast-beating, fluttering or pounding heart
  • May be felt in throat or neck as well as chest
  • Can occur at rest or during activity
164
Q

CVS - PALPITATIONS - PROGNOSIS

A
  • Usually harmless
  • Rarely a symptom of a more serious condition
165
Q

DYSNOEA - DEFINITION

A
  • Difficult, painful breathing or shortness of breath
166
Q

DYSNOEA - CAUSE

A
  • Strenuous exercise
  • Extreme temps
  • Obesity
  • Higher altitude
  • Likely sign of medical problem in situations other than above
167
Q

DYSNOEA - POPULATION AFFECTED

A
  • Older adults
168
Q

DYSNOEA - RISK FACTORS

A
  • Heart disease
  • Respiratory infection
  • Cancer - Especially lung
  • Asthma
  • Obesity
169
Q

DYSNOEA - CLINICAL PRESENTATIONS

A
  • Shortness of breath
  • Intense tightening of chest
170
Q

DYSNOEA - PROGNOSIS

A
  • Bronchodilators can open airways
  • Steroids reduce swelling
  • Px medication
171
Q

SYNCOPE - DEFINITION

A
  • Temporary loss of consciousness caused by a fall in blood pressure
  • Triggers heart rate and blood pressure to drop suddenly
  • Reduced blood flow to the brain→brief loss of consciousness
172
Q

SYNCOPE - CAUSE

A
  • Occurs when part of nervous system that regulates HR and blood pressure malfunctions to a trigger
  • HR slows and blood vessels in legs dilate
  • Allows blood to pool in legs, which lowers blood pressure
  • Combined drop in blood pressure and slowed HR quickly reduces blood flow to your brain→ fainting
  • Common triggers - heat exposure, standing for long period of time, seeing blood, having blood drawn, fear of bodily injury
173
Q

SYNCOPE - POPULATION AFFECTED

A
  • Most common in children and young adults
174
Q

SYNCOPE - RISK FACTORS

A
  • Over heating
  • Dehydration
  • Heavy sweating
  • Sudden changes of body position- blood pooling in legs
175
Q

SYNCOPE - CLINICAL PRESENTATION

A
  • Pale skin
  • Light-headedness
  • Tunnel/blurred vision
  • Nausea
  • Feeling warm
  • Cold, clammy sweat
  • During episode- dilated pupils, slow, weak pulse, and jerky movements
176
Q

SYNCOPE - PROGNOSIS

A
  • Usually harmless and requires no treatment
  • Potential to injure yourself during syncope episode
  • Doctor may recommend tests to rule out more-serious causes, such as heart disease
  • Cant prevent- lie down and lift legs if feeling faint
177
Q

OEDEMA - DEFINITION

A
  • A condition characterised by an excess of watery fluid collecting in the cavities or tissues of the body
178
Q

OEDEMA - CAUSES

A
  • Non-pitting - due to lymphatic blockage, cant get rid of excess water, typically cancer or lymphatics
  • Pitting - venous, typically CV, kidney or liver
  • Unilateral - deep vein thrombosis, soft tissue infection, trauma, immobility, lymphatic obstruction
  • Bilateral - heart failure, chronic venous insufficiency, drugs (e.g., NSAIDs), inferior vena cava obstruction, immobility
  • Pregnancy
179
Q

OEDEMA - POPULATION AFFECTED

A
  • Older adults
  • Pregnant women
180
Q

OEDEMA - RISK FACTORS

A
  • Being pregnant
  • Certain medication
  • Having long-lasting illness, e.g., congestive heart failure
  • Having surgery that involves a lymph node
181
Q

OEDEMA - CLINICAL PRESENTATION

A
  • Swollen lower limbs (can affect anywhere in body)
  • Pitting- leaves dimple
  • Puffiness
  • Stretched or shiny skin
  • If left too long legs may turn brown, haemosiderin- toxin in blood comes to surface to try and be removed
182
Q

OEDEMA - PROGNOSIS

A
  • See a doctor if shortness of breath, irregular heartbeat, chest P
  • Mild usually goes away - compression socks, raising affected arm/leg higher than heart
183
Q

CLAUDICATION - DEFINITION

A
  • Pain in the legs or arms that occurs while walking or using the arms
  • Too little blood flow to muscles during exercise, causes P due to lack of exercise
184
Q

CLAUDICATION - CAUSE

A
  • Too little blood flow to the arms or legs
  • Symptom of disease, most often peripheral artery disease (narrowing of arteries in limbs that restricts blood flow)
  • Damage to peripheral arteries usually due to atherosclerosis (plaque blocks arteries)
185
Q

CLAUDICATION - POPULATION AFFECTED

A
  • People over 50
  • Smokers
  • Diabetics
  • People with high blood pressure or high levels of cholesterol in the blood
186
Q

CLAUDICATION - RISK FACTORS

A
  • Usually a symptom of peripheral artery disease
  • Family Hx of atherosclerosis
  • 50+ if smoke or have diabetes
  • 70+
  • Diabetes
  • High blood pressure
  • High cholesterol
187
Q

CLAUDICATION - CLINICAL PRESENTATION

A
  • Pain, ache, discomfort or fatigue in muscles during exercise
  • Pain likely in calves, thighs, buttocks, hips or feet
  • Pain relived after rest
  • Can develop over time and cause pain at rest as well as cool skin, skin discolouration, wounds that don’t heal
188
Q

CLAUDICATION - PROGNOSIS

A
  • Speak to doctor
  • Identify underlying condition

SYSTEMIC CONDITIONS (13 decks)

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