Screening for Cardiovascular Disease Flashcards
What are the three main known risk factors for cardiovascular disease (CVD)?
- hypertension
- smoking
- high cholesterol
What percentage of Americans have at least one of the known risk factors for CVD?
47% of Americans have at least one known risk factor for CVD.
What is the leading cause of death in industrialized nations?
Cardiovascular disease (CVD).
What are modifiable and non-modifiable risk factors for CVD?
Modifiable: Hypertension, obesity, sedentary lifestyle, excessive alcohol consumption, oral contraceptive use (in women over 35 who smoke), tobacco use, abnormal cholesterol levels.
Non-modifiable: advancing age, first-generation family history, race
What areas can cardiac pain radiate to due to multi-segmental innervation?
- neck, jaw
- upper trapezius
- shoulder
- back
- arm (following ulnar nerve distribution)
What are common symptoms that accompany cardiac pain?
- nausea
- vomiting
- fatigue
- pallor
- syncope
- sweats
What are common heart attack symptoms in women one month prior to the event?
- fatigue
- sleep disturbance
- dyspnea
- GERD
- anxiety
- racing heart
- weak/heavy arms
What is considered a normal frequency for palpitations?
Less than 6 times per minute.
Referred to a physician = Palpitations occur with other symptoms or if there is a family history of sudden cardiac death.
What is claudication and how is it assessed?
Pain in the legs due to inadequate blood flow, assessed by checking peripheral pulses.
When should a patient experiencing dyspnea be evaluated by a physician?
Anyone who cannot climb a flight of stairs without getting moderately to severely winded or who awakens with shortness of breath needs to be evaluated by a physician.
What conditions can aggravate a cough associated with cardiovascular disease?
Exercise, metabolic stress, lying supine, left ventricular dysfunction, or left-sided heart failure.
What are signs of peripheral edema that warrant physician referral?
Weight gain of more than 3 lbs over several days, swelling in the ankles, abdomen, or hands, combined with shortness of breath, fatigue, or dizziness.
What is syncope and when does it warrant a physician referral?
Fainting due to decreased oxygen to the brain, warranting referral if unexplained, or if the patient has a history of heart problems or risk factors for heart attack or stroke.
What are abnormal responses to exercise related to vital signs?
- heart rate too high or low,
- systolic blood pressure not increasing gradually,
- diastolic blood pressure changing more than 15-20 mmHg.
What are the common cardiac issues that mimic musculoskeletal dysfunction?
- angina
- myocardial infarction
- pericarditis
- dissecting aortic aneurysm
- What are the side effects of statins related to muscle symptoms = ?
- What are risk factors for statin-associated muscle symptoms = ?
Side Effects: Mild myalgia, myositis, rhabdomyolysis
Risk Factors: Older age, small body frame, alcohol abuse, excessive grapefruit juice consumption, comorbid kidney or liver disease, hypothyroidism.
What is
- angina = ?
- causes it = ?
- differences between stable and unstable = ?
- Angina: An imbalance of oxygen supply and demand to the cardiac muscle.
- Primarily caused by atherosclerosis.
- Stable angina has a predictable pattern and is alleviated by rest or medication,
- Unstable angina is non-predictable and does not respond to medication.
Describe the angina scale
- 1+ = light barely noticable
- 2+ = moderate, bothersome
- 3+ = severe, uncontrollable
- 4+ = most severe pain ever experienced
What are the three ‘P’s’ that indicate pain is not myocardial infarction (MI)?
- pleuritic pain
- pain on palpation,
- pain with changes in posture
- Women have protective effect of estrogen until around age 50
What are the symptoms of pericarditis that distinguish it from MI?
- pain is relieved by leaning forward
- worsened by left side lying,
- increased with trunk movements
- May also have fever, chills, or weakness.
What are risk factors for thoracic aneurysms?
- hypertension
- male gender
- ages 40-70
What are the signs and symptoms of a peripheral aneurysm?
Increased pulse amplitude and ischemia.
What is an abdominal aortic aneurysm (AAA) and what are its risk factors?
An abnormal dilation of the aorta, risk factors include:
- trauma,
- Marfan’s syndrome,
- smoking,
- coronary artery disease
What are the symptoms of an abdominal aortic aneurysm (AAA)?
- knife-like pain
- worsening in supine position
- palpable pulsating mass in the abdomen
What are non-cardiac causes of angina?
- heartburn,
- cervical disc disease,
- gallbladder disease
What red flags during an interview suggest non-cardiac chest pain?
- Younger than 40,
- Type A personality,
- recent stressful life events
What are the guidelines for immediate medical attention in cardiovascular disease?
- worsening of intermittent claudication,
- angina not relieved by rest, nitroglycerin, or position change within 20 minutes,
- angina pattern changes (from stable to unstable)
What are the guidelines for physician referral in cardiovascular disease?
- chest pain in women with a family history of CAD,
- palpitations with a family history of sudden death,
- inability to climb stairs or shortness of breath at night,
- syncope without warning
What is Virchow’s Triad in relation to DVT?
- venous stasis
- endothelial injury
- hypercoagulability
What are the acquired risk factors for DVT?
Immobilization, surgery, trauma, cancer, pregnancy, post-childbirth, female hormones, oral contraceptives.
What are the genetic and demographic risk factors for DVT?
Age over 50, obesity, Caucasian or African-American ethnicity, genetic mutations such as Factor V or Prothrombin mutations.
What is the significance of Wells Score in DVT screening?
The Wells Score helps categorize the risk of DVT:
- low risk (< 0),
- moderate risk (1),
- high risk (> 2).
What are the screening criteria for upper extremity DVT?
Presence of venous material such as a catheter or pacemaker, pitting edema, localized pain.
