Ischaemic Heart Disease Flashcards
what score assesses CVD risk
ASSIGN score
age, sex, smoking, systolic BP, diabetes, deprivation, cholesterol, fhx
what type of day to day interventions should doctors suggest for CVD
wt loss, smoking cessation, diet low in fats, limit alcohol intake, reduce salt intake
what are signs of hyperlipidaemia
xanthomata, xanthelasma, tendon xanthoma
tx for hyperlipidaemia
statins, PCSK inhibitors, ezetimibe, fibrates
what is a genetic disorder resulting in excessively high cholesterol
familial hypercholesterolaemia
what is the epidemiology of atherosclerosis
causes 1/3rd of all deaths, male
what is the class progression of atherosclerosis
atheromatous plaque> fatty streak> fibrofatty plaque> complicated plaque
what is atherosclerosis
formation of plaque in arteries
how does a plaque form
1y endothelial injury e.g. smoking, accumulation of lipids, SM cells migrate to site
causes of atherosclerosis
smoking, fatty diet, physical inactivity, alcohol, diabetes
complications of atherosclerosis
arterial stenosis, arterial thrombosis, aneurysm, dissection, embolism
what is an aneurysm
persistent dilation of an artery due to wall wakens - can rupture / erode adjacent structures
what is a common aneurysm
AAA
abdominal aortic aneurysm- must be checked if acute umbilical pain presentation
why is arterial stenosis bad
causes tissue ischaemia where myocytes are replaced by fibrotic tissue so loss of contractility> reduced elasticity & filling
what is the prevalence of hypertension
25% of the population, higher in black
what are the classes of hypertension according to cause
1y: no obvious cause-diet
or 2y: underlying disease e.g. renal
what are the classes of hypertension according to consequence
benign: asymptomatic but may still cause disease
malignant: life threatening, diastolic BP >130
what are rarer causes of hypertension
pheochromocytoma (tumour of adrenal gland) fibromuscular dysplasia (abnormal growth in wall of artery)
what end-organ damage can hypertension cause
LV Hypertrophy, fibrinoid necrosis, microvascular injury (retinopathy etc), peripheral vascular disease, diabetes
what happens in LV Hypertrophy
inc LV load > LV hypertrophy > muscle can’t all be perfused > myofibrils become unstable > ischaemia
what are the ranges for hypertension
BP 140/90 (day time average: 135/85)= class 1 class 2: 160/100 class 3: systolic >180/ diastolic >110
True/False…
RAAS pathway responsible for hypertension mechanism
True
presenting symptoms of hypertension
asymptomatic, palpitations?
Ix for hypertension
U&Es, glucose, cholesterol, ECG, BP
ambulatory BP monitoring
