Ischaemic heart disease Flashcards
What is atherosclerosis?
A combination of fatty deposits (atheromas) in the artery walls, and sclerosis of the vessel walls
How does atherosclerosis cause ischaemia?
Plaque rupture creates a thrombus that can block a distal vessel and cause ischaemia
What are the non-modifiable risk factors for cardiovascular disease?
Older age
Family history
Male
What are the modifiable risk factors for cardiovascular disease?
Hypercholesterolaemia
Smoking
Alcohol excess
Poor diet
Sedentary lifestyle
Obesity
Poor sleep
Stress
What co-morbidities increase the risk of cardiovascular disease?
Diabetes
HTN
CKD
Inflammatory conditions e.g rheumatoid
Atypical antipsychotic medications
What are the end results of cardiovascular disease?
Angina
MI
TIA
Stroke
Peripheral arterial disease
Chronic mesenteric ischaemia
What diet advice is recommended for prevention of cardiovascular disease?
Total fat less than 30% of total calories
Low saturated fat
Reduced sugar intake
Wholegrain foods
5 portions of fruit and veg a day
2 portions of fish a week
4 portions of legumes, seeds and nuts a week
What exercise advice is recommended for prevention of cardiovascular disease?
150 minutes of moderate intensity exercise a week
or
75 minutes of vigorous intensity exercise a week
Strength training activities at least 2 days a week
What score is used to assess risk in patients with CVD?
QRISK3
How should patients with a high QRISK score be managed?
Patients with a score of >10% should be offered atorvastatin 20mg daily
What are the side effects of statins?
Myopathy
Rhabdomyolysis
Type 2 diabetes
Haemorrhagic strokes
What type of antibiotics do statins interact with?
Macrolides - clarithromycin, erythromycin
What medications are used in the secondary prevention of CVD?
4 As
- Antiplatelet
- Atorvastatin 80mg
- Atenolol
- ACE inhibitor
What is familial hypercholesterolaemia?
An autosomal dominant disorder that causes very high cholesterol levels
