Module 1 - Cardiovascular Pathophysiology and Pharmacotherapeutics

Question 1

State the risk factors of atherosclerosis

Answer 1

Modifiable RF: HTN, Smoking, Diabetes, Obesity
Non-Modifiable RF: Age, Sex, Genetics

Question 2

State the pathogenesis of atherosclerosis

Answer 2

Once endothelial injury (e.g. smoking, diabetes, etc.) occurs, cells become sticky. Platelets form in attempt to clot, monocytes surface as well. Monocytes eat away at fat and begin to oxidise, smoking can exacerbate this process. Fat accumulates in blood vessel. Smooth muscle cells migrate to accumulation, creating a fibrous cap. Cap stabilises and leads to narrow lumen, then ischemia.

Question 3

State the complications (based on common locations) of atherosclerosis

Answer 3

Heart:
Partial - Angina
Total - MI
Brain:
Partial - TIA
Total - CVA
Peripheral Arteries:
Partial - Aneurysm
Total - PVD

Question 4

Explain the development of hypertension

Answer 4

Primary: Genetic, Family History, Diet
Secondary: Endocrine or Renal issues

Question 5

Explain the adverse long term effects of hypertension

Answer 5

CNS: CVA -> Stroke (haemorrhage)
Eye: Retina -> Visual Impairment
Heart: L) Ventricular Hypertrophy -> HF
Kidney: Hy.tensive Nephropathy -> nephrons die

Question 6

Compare and contrast the pathophysiology of myocardial
infarction and angina

Answer 6

MI: 1) Thrombus may build to n
obstruct artery
2) Vasospasm may occur in
presence of partial occlusion
by an atheroma -> total
obstruction
3) Part of thrombus may break
off -> forming an embolus ->
embolus flows through
coronary artery -> lodging in
smaller branch -> blocking
vessel
Angina: Lumen size of arteries is
diminished due to either
atherosclerotic plaque or
coronary vasospasms ->
reduced O2 and nutrient
supply to myocardium

Question 7

Compare and contrast the clinical manifestations of myocardial
infarction and angina

Answer 7

MI: Hypotension, Diaphoresis, Nausea, Dyspnoea, Pallor
Angina: Pallor, Diaphoresis, Nausea

Question 8

Compare and contrast the diagnosis of myocardial
infarction and angina

Answer 8

MI: ECG, Blood Tests (Troponin levels), Abnormal K and Na levels
Angina: ECG, Blood Tests (Troponin levels)

Question 9

What are the 3 Types of Angina?

Answer 9

1. Stable
2. Unstable
3. Variant

Question 10

What is Stable Angina?

Answer 10

The result of atherosclerotic plaque within one or several coronary blood vessels. Blood flow is adequate at rest, but compromised when individual exerts themselves. Pain lasts 5-15 minutes.

Question 11

What is Unstable Angina?

Answer 11

The result of atherosclerotic plaque - a greater degree of vasoconstriction than stable. Individual has compromised blood flow at rest -> marked pain without exertion.

Question 12

What is Variant Angina?

Answer 12

Rare form marked by unexplained vasospasms, and occurs in conjunction with ST elevation on ECG trace. Individuals can experience pain at any time, and there is no recognised trigger.

Question 13

Explain the risk factors for heart failure

Answer 13

Diet, Smoking, Alcohol Abuse

Question 14

Explain the aetiology for heart failure

Answer 14

IHD, Venous Insufficiency, Cardiomyopathies

Question 15

Explain the pathophysiology for heart failure

Answer 15

Reduced arterial blood flow to systemic circulation leads to an increased renin and aldosterone secretion. This causes vasoconstriction and an increase in blood volume, which leads to the heart’s increase in workload.