🫀CVS Medicine Flashcards

1
Q

What are the main components of the cardiovascular system?

A

Heart
Arteries
Veins
Capillaries

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2
Q

Which system is the cardiovascular system closely associated with?

A

The respiratory system

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3
Q

What happens when any component of the cardiovascular system is impaired?

A

It results in cardiovascular system (CVS) disease

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4
Q

What are the two main circulations the heart pumps blood to?

A

Pulmonary circulation
Systemic circulation

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5
Q

Which side of the heart pumps blood to the lungs, and through which vessel?

A

The right side of the heart pumps blood to the lungs through the pulmonary artery.

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6
Q

Which side of the heart pumps blood to the systemic circulation, and through which vessel?

A

The left side of the heart pumps blood to the systemic circulation through the aorta.

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7
Q

What is the myocardium?

A

Heart muscle

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8
Q

How many chambers does the heart have? Name them.

A

The heart has 4 chambers:
Right atrium
Right ventricle
Left atrium
Left ventricle

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9
Q

What are the four heart valves and their locations?

A

Aortic valve: Between the left ventricle (LV) and the aorta.
Pulmonary valve: Between the right ventricle (RV) and pulmonary artery.
Tricuspid valve: Between the right atrium (RA) and RV.
Mitral (bicuspid) valve: Between the left atrium (LA) and LV.

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10
Q

What system regulates the heartbeat and coordinates contractions of the heart?

A

The electrical conduction system.

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11
Q

Name the key components of the heart’s electrical conduction system.

A

Sinoatrial (SA) node
Atrioventricular (AV) node
Bundle of His
Purkinje fibers

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12
Q

What type of blood do arteries typically carry, and in which direction?

A

Arteries carry oxygenated blood away from the heart.

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13
Q

What type of blood do veins typically carry, and in which direction?

A

Veins carry deoxygenated blood back to the heart.

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14
Q

What happens when blood vessels narrow and what are the consequences?

A

Narrowing of vessels results in impaired blood flow to and away from tissues.
cons:
Reduced oxygen and nutrient delivery to tissues.
Reduced waste removal from tissues.

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15
Q

What is atherosclerosis?

A

A condition where fatty deposits (plaques) accumulate in the walls of arteries.

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16
Q

What effect does atherosclerosis have on arteries?

A

It causes stiffening and narrowing of the arteries, a condition called stenosis.

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17
Q

Name four non-modifiable risk factors for cardiovascular disease (CVD).

A

Older age
Male
Family history of CVD
Ethnicity

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18
Q

Name at least five modifiable risk factors for cardiovascular disease.

A

Hypertension
Obesity
Diabetes
High lipid levels
Smoking
Alcohol
Stress
Poor sleep

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19
Q

What are the key contributors to the formation of plaques in atherosclerosis?

A

1.Vessel wall damage
2.High LDL cholesterol levels
3.High circulating glucose (diabetes)
4.Immune cell activity

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20
Q

What are two common causes of vessel wall damage that contribute to atherosclerosis?

A

1.Hypertension (high blood pressure)
2.Smoking

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21
Q

What is hypertension?

A

High blood pressure, defined as a reading consistently above 140/90 mmHg.

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22
Q

What are the complications of untreated hypertension?

A

Atherosclerosis
Chronic kidney disease
Heart failure
Stroke
Retinopathy
Vascular dementia

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23
Q

List non-modifiable risk factors for hypertension.

A

Age
Gender
Ethnicity (e.g., black African, black Caribbean)
Family history (genetic predisposition)

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24
Q

List modifiable risk factors for hypertension.

A

Smoking
Alcohol excess
High dietary salt intake
Obesity
Lack of physical exercise
Anxiety
Emotional stress
Caffeine consumption

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25
Q

How is hypertension managed?

A

-Lifestyle modifications:
Obesity, dietary modifications, smoking, alcohol consumption, caffeine, salt intake, stress management

-Medications:
ACE inhibitors
Angiotensin-II receptor blockers (ARBs)
Beta blockers
Calcium channel blockers
Diuretics

26
Q

What is coronary artery disease?

A

A condition where atherosclerosis causes hardening and narrowing of the coronary arteries, leading to ischemic heart disease.

27
Q

What are the two main manifestations of ischemic heart disease?

A

Angina
Myocardial infarction (MI)

28
Q

What is angina, and how is it classified?

A

Angina is chest pain due to myocardial ischemia:

Stable angina: Occurs only during exertion.
Unstable angina: Occurs at rest.

29
Q

What are the classic symptoms of angina?

A

Central crushing chest pain that radiates to the left arm or jaw.

30
Q

What lifestyle changes can help manage coronary artery disease?

A

Weight loss.
Healthy diet.
Stop smoking.
Reduce alcohol consumption.

31
Q

What medication is used for immediate symptom relief in coronary artery disease?

A

GTN (glyceryl trinitrate) spray.

32
Q

What are the key components of long-term secondary prevention for coronary artery disease?

A

Managing hypertension.
Controlling lipid levels.
Using aspirin as antiplatelet therapy.

33
Q

What is percutaneous coronary intervention (PCI)?

A

A minimally invasive procedure that uses a balloon to widen diseased coronary arteries, often followed by stent insertion to maintain artery patency.

34
Q

Through which arteries is percutaneous coronary intervention typically performed?

A

Via the radial or femoral artery.

35
Q

What is a coronary artery bypass graft (CABG)?

A

A surgical procedure that bypasses narrowed or blocked coronary arteries using a harvested vessel from another part of the body (commonly the leg).

36
Q

What is the purpose of a stent in PCI?

A

To maintain the widened artery and prevent it from narrowing again.

37
Q

What is heart failure?

A

A condition where the heart fails to pump blood effectively.

38
Q

What are the types of heart failure?

A

-Left-sided heart failure: Blood backs up into the lungs, causing pulmonary edema.
-Right-sided heart failure: Blood backs up into systemic circulation, causing peripheral edema.

39
Q

What are common causes of heart failure?

A

Hypertension
Coronary artery disease (e.g., previous MI)
Valvular heart disease
Arrhythmias
Congenital heart defects

40
Q

What are the symptoms of heart failure?

A

Shortness of breath (SoB)
Cough (frothy sputum)
Orthopnoea – SoB when lying flat
Paroxysmal nocturnal dyspnoea –suddenly waking at night with SoB
Peripheral oedema – fluid in the legs, abdomen, sacrum
Fatigue

41
Q

How is heart failure managed?

A

-Lifestyle modifications:
Diet, exercise, smoking cessation.
-Medical management:
Control hypertension.
Off-load fluid with diuretics.
Improve heart function with beta blockers or digoxin.
-Devices:
Cardiac resynchronization therapy (CRT).
-Surgery:
Heart transplant for suitable patients.

42
Q

What is an arrhythmia?

A

An abnormal heart rhythm caused by interrupted electrical signals that coordinate heart muscle contraction.

43
Q

What is atrial fibrillation (AF)?

A

A common arrhythmia where disorganized electrical activity in the atria causes fibrillation (random muscle twitching) and an irregular pulse.

44
Q

Why does atrial fibrillation increase the risk of stroke?

A

Uncoordinated heart activity in AF disrupts smooth blood flow, increasing the likelihood of blood clot formation that can travel to the brain.

45
Q

How is atrial fibrillation managed?

A

Anticoagulants (e.g., DOACs) to prevent clot formation.
Rate-controlling medications (e.g., bisoprolol).

46
Q

What is the function of pacemakers in managing arrhythmias?

A

Pacemakers deliver controlled electrical impulses to restore and maintain a normal heart rhythm.

47
Q

What are the two main types of valvular dysfunction?

A

Stenosis: Valve becomes stiff and doesn’t fully open.
Regurgitation: Valve doesn’t fully close, causing leaks.

48
Q

What causes valvular disease?

A

Aging (e.g., aortic stenosis due to calcification).
Congenital defects (e.g., bicuspid aortic valve).
Damage from myocardial infarction (e.g., papillary muscle rupture).
Rheumatic heart disease.
Infective endocarditis.

49
Q

How does rheumatic heart disease cause valvular damage?

A

The immune system attacks heart valves following an untreated Group A streptococcal throat infection, mistaking valve proteins for the bacteria’s M protein.

50
Q

What are the types of valve replacements?

A

Bioprosthetic valves: Made from pig tissue, lower clot risk, but shorter lifespan.
Metallic valves: Longer lifespan, higher clot risk, require anticoagulation therapy (e.g., warfarin).

51
Q

What is infective endocarditis?

A

A life-threatening infection of the heart lining (endocardium), particularly affecting heart valves.

52
Q

How is infective endocarditis related to dental procedures?

A

Bacteria from invasive dental procedures can enter the bloodstream and infect damaged heart valves, especially in predisposed individuals.

53
Q

What are the three main consequences of infective endocarditis?

A

Impaired heart valve function, leading to heart failure.
Focus of infection, causing sepsis.
Source of emboli, leading to strokes.

54
Q

How is infective endocarditis managed?

A

4–6 weeks of IV antibiotics.
Surgery may be required to replace damaged valves.

55
Q

What are the current guidelines for antibiotic prophylaxis in UK dentistry?

A

Antibiotic prophylaxis is not routinely recommended for dental procedures but may be considered for high-risk patients after consulting with their cardiologist.

56
Q

What preventive measures reduce the risk of infective endocarditis?

A

Regular dental check-ups
Toothbrushing instruction
Dietary advice
High-fluoride toothpaste.

57
Q

What are the dental implications of anticoagulant use in cardiovascular disease patients?

A

Increased bleeding risk during and after dental procedures.

58
Q

How might polypharmacy affect dental patients with cardiovascular disease?

A

Dry mouth from medications.
Lichenoid tissue reactions caused by some antihypertensive drugs.

59
Q

Why is lying back a concern for patients with heart failure?

A

It may cause orthopnea (shortness of breath when lying flat).

60
Q

What is the connection between periodontal disease and cardiovascular disease?

A

Periodontitis is increasingly recognized as a risk factor for cardiovascular disease.

61
Q
A