Fed 10 CVD Flashcards
How do I lower my cholesterol? (Name 4)
Why saturated fat?
- Diet (lower saturated fat intake)
- Weight Loss
- Exercise
- Medications (statins)
because it has a Greater impact on cholesterol levels because of the liver. Sat fat is very good for the liver to make LDL.
Why is visceral fat bad?
Why is Subcutaneous fat good?
What do adipose sites do?
What do simple sugars do?
What do Fat do?
Visceral fat = more active = sends more fatty acids to the liver. Subcutaneous (especially glutes and thighs) = less active = great for CVD profile, but it’s hard to reduce.
Adipose sites send extra fatty acids to your liver = more LDL production
Simple sugars tell the liver to make more LDL and glucose.
Fat is not just a storage cell. You can get fatty acids from your fat cells, dietary fat, or create them from carbs, which all get packaged into LDL by the liver.
Blood Pressure what is systolic vs diastolic
Heart Beats (systole)
Heart Relaxes (diastole)
SBP = Systolic Blood Pressure
DBP = Diastolic Blood Pressure
Blood Pressure Numbers Mean
Hypertension
prehypertension
normal
optimal
Blood Pressure Numbers Mean
Systolic
Hypertension = 130+
prehypertension = 120-129
normal = less than 120
optimal = less than 110
diastolic
Hypertension = 80+
prehypertension = 75-79
normal = less than 75
optimal = less than 70
Fibrosis and Thrombosis Development (4 steps)
LDL enters smooth muscle
Cholesterol build up. Early fatty streak
Fibrous cap. Lumen narrows
Fibrous cap cracks and forms a thrombosis blocking the vessel lumen.
Consequences of Hypertension
Brain
Eyes
Heart
Kidneys
Arteries
Brain – aneurysms and thrombus -> stroke Eyes – damage to retinal blood vessels ->Blindness
Heart – Increased cardiac load ->Myocardial Infarction
Kidneys – impaired blood flow -> kidney damage
Arteries – atherosclerosis -> thrombosis or embolism
CVD Medications?
Heart Rate (Name 2)
Blood Volume (Name 1)
Relaxes Blood Vessels (Name 3)
Heart Rate
– Beta-blocker
– Calcium Channel Blocker
Blood Volume
– Diuretic
Relaxes Blood Vessels
– Angiotensin II receptor blockers
– ACE Inhibitors
– Renin Inhibitors
Consequences of CVD
Heart =
Brain =
Lungs =
Legs =
Heart = Myocardial Infarction
Brain = Stroke
Lungs = Pulmonary Embolism
Legs = Deep Vein Thrombosis
Myocardial Infarction
(4 steps)
White areas in the heart?
Blocked Blood Flow = Plaque blocking the coronary artery = Blood flow impaired artery (oxygen deprived tissue) = Blood-filledartery
White areas are where necrotic tissue is replaced by fibrous/collagenous tissue
Risk Factors for Myocardial Infarction
(Name 6)
- Hypertension
- High red blood cell count
- Blood cholesterol
- Diabetes
- Smoking
- Ethnicity (Black, Indigenous, Filipino and South Asian)
Golden hour after a heart attack
Appropriate action after the first hour of a heart attack can reverse the damage.
EKG or ECG (Electrocardiogram): (3 things)
A simple test that detects and records the electrical activity of your heart.
Shows the strength and timing of electrical
signals as they pass through each part of
your heart.
Some people with angina have a normal EKG
Cardiac Cycle- ECG
P Q R S T
Stress Tests: (3 things)
Exercise or medicine is given to make your heart work hard and beat fast while the doctor measures blood pressure and EKG.
When your heart is working hard, it needs more blood and oxygen. Arteries narrowed by plaque can’t supply enough oxygen-rich blood to meet your heart’s needs.
Can show possible signs of CAD, such as: – Abnormal changes in heart rate or blood pressure – Symptoms such as shortness of breath or chest pain – Abnormal changes in your heart rhythm or your heart’s electrical activity (ECG)
The most important cause of ST segment abnormality is?
The most important cause of ST segment abnormality (elevation or depression) is myocardial ischaemia / infarction.
Angiography ( 6 things)
- Uses dye and x-rays to show the insides of your coronary arteries.
- A long, thin, flexible tube (catheter) is put into a blood vessel in your arm, groin, or neck.
- The tube is then threaded into your coronary arteries, and the dye is released into your bloodstream.
- X-rays are taken while the dye is flowing through the coronary arteries.
- Angiography is usually performed prior to surgery with a view to coronary bypass grafting or angioplasty
- provides information regarding the extent and nature of coronary artery disease.
Treatment for Angina:
(2 main meds)
(2 other meds)
Main Medications
– Nitrates (most common - nitroglycerin): relax and widen blood vessels. This allows more blood to flow to the heart while reducing its workload.
* Nitroglycerin dissolves under your tongue or between your cheeks and gum. Is used to relieve angina episode.
– Blood pressure and cholesterol medicines
–Other medicines that:
* Slow the heart rate (beta blockers, calcium channel blockers)
* Relax blood vessels (ACE, Angiotensin II, Renin Inhibitors)
* Reduce strain on the heart (ie. diuretics)
* Prevent blood clots from forming (i.e. anticoagulants)
Angioplasty:
- The patient is awake for the procedure.
- They are given pain medicine and blood thinners to keep blood clots from forming.
- The doctor will make a small incision usually near the groin, and feed a catheter (flexible tube) into an artery to the heart.
- Dye will be injected into your body to highlight blood flow through the arteries.
Angioplasty process (3 steps)
A balloon catheter is pushed over the guide wire and into the blockage.
The balloon is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.
The stent remains in the vessel to maintain blood flow to the heart.
Coronary Graft Bypass:
Sometimes if the blockage is too severe, the physician will try to bypass (avoid) the blocked area using the Saphenous vein (leg) or the Internal Mammary Artery (chest).
Traditional coronary artery bypass graft (CABG) surgery: (4 things)
- Large incision down the center the sternum
(breastbone), to get direct access. - The heart is stopped
- Connected to the heart-lung bypass machine
to circulate the blood - Surgeon sees and cuts directly
Less Invasive Endoscopic surgeries (TECAB or MIDCAB): (4 things)
- Several small incisions
- Heart is not stopped
- Newer robotic techniques are used
- Surgeon uses cameras and robots controlled byjoysticks
TECAB surgery:
Totally endoscopic coronary artery bypass:
(5 things)
- only needs a few openings each about the size of a dime.
- The procedure is carried out by a surgical robot (“da Vinci“)
- A tiny fiber optic video camera is mounted onto a robot arm and is controlled by foot
pedals. - The procedure is performed by a surgeon operating two more mechanical arms
using a joystick, or with rings the surgeon can insert his fingers into to operate the
robot’s “fingers.” - The entire procedure is carried out watching a video monitor
