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current topics 1 > L4: Stress & Cardiovascular Disease > Flashcards

L4: Stress & Cardiovascular Disease Flashcards

1
Q

why is it important to study cardiovascular physiology?

A
  • worldwide cardiovascular diseases is the leading cause of death (32% of all deaths)
  • in nl: leading cause of death in women
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2
Q

does cardiovascular disease have chronic or acute risk factors?

A

there is chronic risk factors that raise your chances of getting it throughout your life, but
acute risk factors that raise your chances in the moment
these can then together lead to passing the treshhold for ischemia, plaque rupture, occlusive thrombosis, arrythmia

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3
Q

What are the acute risk factors of cardiovasc disease?

A
  • hemodynamic
  • vasoconstriuctive
  • prothrombotic
  • electrophysiologicc
  • intense stress/anger! (within 1-2h)
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4
Q

What are the chronic risk factors of cardiovasc disease?

A
  • gender
  • age
  • diabetes
  • smoking
  • hypertension
    -hypercholesterolemia
  • basal hemostatic variables
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5
Q

what are arteries vs veins

A

veins: from muscles to heart
arteries: from heart to muscles

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6
Q

what does the cardiovascular system consist of?

A
  • the heart (pump)
  • the blood vessels (to supply all tissues of the body w oxygens and nutrients)
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7
Q

what does the inside of the heart look like?

A

heart is pump that pumps oxygenated blood out of left ventricle (systemic circulation)
pumps used blood through the lungs via the right ventricle

coronary arteries lie “on top” of the heart muscle, they supply the heart muscle with blood

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8
Q

what are the main types of cardiovascular disease?

A
  1. coronary heart disease (like MI)
  2. heart failure
  3. valve disease
  4. arrythmias / sudden cardiac death
  5. stroke / cva (and tia)
  6. other (like endocarditis)
    -> MI and sudden cardiac death are the end stage of progressive coronary artery disease
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9
Q

what are the types of coronary heart disease?

A
  • coronary artery disease CAD
  • myocardial infarction MI
  • coronary spasm
  • coronary micorvascular disease
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10
Q

what are the symptoms of coronary heart disease?

A
  • chest pain (angina pectoris)
  • shortness of breath
  • fatigue
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11
Q

what is coronary heart aka coronaryartery disease?

A

the arteries on the heart muscle are narrowed which leads to tissue damage behind the narrowed artery, cause it gets less blood

can even become blood clot if its completely blocked, which results in sudden death

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12
Q

what are the risk factors for coronary artery disease?

A

modifiable
- hypertension
- diabetes
- elevated lipid levels (cholesterol, LDL, low HDL)
- smoking
- overweight
- psychosocial factors
non modifiable
- age
- sex (male)
- genetic factors / family hx CVD

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13
Q

what are the treatment options of coronary artery disease?

A
  • percutaneous coronary intervention (re open narrowed coronary artery)
  • coronary artery bypass graft surgery (bypass a narrowed segment in artery)
  • thrombolysis (reopen a (nearly) completely blocked)
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14
Q

what are the psychosocial risk fators for coronary artery disease?

A
  1. acute factors (triggers): anger, mental arousal etc
  2. episodic factors: MDD, exhaustion etc can be transient, recurring
  3. chronic factors (traits): anxiety, hostiliy, negative affectivity, low SES etc
    -> are all usually sub treshhold (not meeting diagnostic criteria for psych diagnosis)
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15
Q

define psychological distress

A

negative internal state of the individual that is dependent on interpretation or appraisal of threat, harm, or demand

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16
Q

what is eustress vs distress?

A
  • distress response (what we usually mean by stress): how environmental events (stressors) threaten us, stress evoked by negative feelings & events
  • eustress: stress evoked by positive emotions or events
17
Q

what 3 variables affect stress response?

A
  • time
  • control
  • individual vulnerability
18
Q

what is yerkes dodson law?

A

everyone has an optimal level of stress for their optimal performance

19
Q

what are the 3 components of stress response?

A
  • the affect response
  • the behavioural response
  • the physiological stress response: variations in heart rate, blood pressure, immune system etc

-> cardiac disease progression

20
Q

what are the acute psychological stressors for ppl that already have cardiovascular disease?

A
  • anger
  • anxiety
  • acute distress
  • disaster (earthquake)
  • acts of war / aggression
  • major public events (sports, elections)
21
Q

what is mental stress ischemia?

A
  • decreased cardiac supply (due to narrowing coronary arteries)
  • increased cardiac demand
    the heart muscle itself is not getting enough blood cause of imbalance between supply and demand
  • observed in 30-70% of patients w coronary artery disease
  • associated w poor prognosis & increased risk ofmortality
  • acute mental stress
22
Q

how are acute mental stress & depression related to CVD?

A

both associated w elevated inflammation markers
– Acute stress reactivity elevated in CAD patients
– Results depression-inflammation inconsistent in CAD patients
– Effect sizes are small

23
Q

what is ECG?

A

recording of moving current: measure of the changes in electric loading of extracellular fluid due to electric changes that occur in all cardiac muscle cells together
- big peak in heartfilm is when the heart contracts: R
- after this comes the ST part: s goes down (ischemia), then t goes straight line again with little peak

24
Q

how can you measure relation between ischemia and emotions?

A

measure w diaries/ ecological momentary assessment and compare it with ECG if theres a dip after the peak

25
Q

what is the end stage of progressive coronary artery disease?

A

myocardial infarcation & sudden cardiac death

26
Q

what can trigger MI and myocardial ischemia?

A

acute mental stress during daily life - partially mediated by changes in autonomic NS activity

27
Q

how can you study mental stress myocardial ischemia in the lab?

A

induce mental stress (by doing an exercise or something) then measure various markers of myocardial ischemia (wall motion, perfusion, ECG, chest pain, SPECT)

28
Q

what is the relation between depression/stress & cardivoascular disease?

A

the more you have depression/stres the more risk youre at for heart disease
but its a bidirectional relationship!
also get more depression (15-40% of patients) & stress from having heart disease

29
Q

what are the 4 main pathways through which depression is related to cardiovascular disease?

A
  • altered brain function (CNS)
  • altered blood clotting system
  • altered autonomic NS: increased sympathetic activity (fight or flight) & reduced parasympathetic (rest & digest)
  • inflammation & immune system dysregulation : increased inflammation markers (like cytokines) that contribute to ahterosclerosis)
30
Q

what is tako tsubo cardiomyopathy aka broken heart syndrome?

A
  • triggered by extreme emotional or physical stress
  • temporary heart dysfunction
  • mimics a heart attacks but typically resolves after short period
  • more common in post menopausal women
  • associated w high levels of stress hormones
31
Q

what is ahterosclerosis?

A

buildup of plaques in artery leading to heart problems like myocardial infarction (heart attack)

32
Q

what should future studies look at in CVD & stress?

A

– Develop models of mutually reinforcing risk factors: i.e., psychosocial, health behavior, biological processes and disease outcomes
– Identify high-risk subgroups and targeted interventions based on these dynamic models

33
Q

what are the 3 phases of CVD progression?

A
  1. Gradual subclinical disease progression: Early stages of heart disease without noticeable symptoms.
  2. Vulnerable disease stage: More advanced disease with a high risk of triggering events like heart attacks.
  3. Acute coronary syndromes: Severe symptoms like chest pain or heart attacks.
34
Q

what is a possible psych intervention for CVD?

A
  • CBT or stress management techniques to reduce psych distress
    but effects are mixed

current topics 1 (5 decks)

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