Cardiovascular Disease Overview
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Questions and Answers

What is the primary purpose of tissue plasminogen activator (tPA) in stroke treatment?

  • To prevent the occurrence of further strokes
  • To facilitate rapid surgery
  • To reduce adverse effects of the stroke (correct)
  • To restore full brain function
  • What imaging technique does Duplex ultrasound utilize for assessing carotid artery condition?

  • Ultrasound technology for 2D imaging (correct)
  • Electrocardiogram imaging
  • MRI for detailed images
  • X-ray for structure visualization
  • In patients showing more than 70% stenosis of the carotid artery, what treatment option may be necessary?

  • Continuous blood pressure monitoring
  • Intravenous anticoagulants
  • Increased physical exercise
  • Carotid endarterectomy surgery (correct)
  • Which factor is NOT typically associated with peripheral vascular disease (PVD)?

    <p>Obstruction of coronary arteries</p> Signup and view all the answers

    What significant risk is associated with diabetic foot ulcers in terms of mortality?

    <p>50% mortality within 5 years of development</p> Signup and view all the answers

    What is a common initial symptom of an abdominal aortic aneurysm (AAA)?

    <p>Pulsating mass in the abdomen</p> Signup and view all the answers

    What screening is recommended for all men over 65 in the UK regarding aortic health?

    <p>Ultrasound screening for AAA</p> Signup and view all the answers

    What condition is a significant risk factor for developing aortic aneurysms?

    <p>Pro-atherogenic stimuli such as high blood pressure</p> Signup and view all the answers

    What is the primary function of the endothelium in blood vessels?

    <p>To control vascular tone by signaling vasodilation or vasoconstriction</p> Signup and view all the answers

    How is pulse wave velocity clinically significant?

    <p>It assesses arterial stiffness and overall blood vessel health</p> Signup and view all the answers

    What changes can occur in the endothelium due to disturbed shear stress?

    <p>It can encourage conditions promoting cardiovascular disease</p> Signup and view all the answers

    Which mechanism primarily contributes to the formation of atherosclerotic plaque within arteries?

    <p>Accumulation of lipoproteins leading to fibrosis and calcification</p> Signup and view all the answers

    Which type of blood flow is associated with healthier endothelial function?

    <p>Laminar flow</p> Signup and view all the answers

    What does the measurement of pulse wave velocity involve calculating?

    <p>Distance divided by the time taken for the pressure wave to travel</p> Signup and view all the answers

    What is a notable characteristic of vascular calcification observed in individuals aged 60 and above?

    <p>Deposits usually occur in both intimal and medial layers of arteries</p> Signup and view all the answers

    In a carotid artery plaque scan, what does the color yellow represent?

    <p>High velocities</p> Signup and view all the answers

    What leads to vessel stiffness and increased blood pressure as a consequence of atherosclerosis?

    <p>Increased lipid deposition in vessel walls</p> Signup and view all the answers

    Which treatment is advised first for unstable angina?

    <p>Nitrate therapy, Ca2+ channel blockers, or beta blockers</p> Signup and view all the answers

    What is a common clinical presentation of acute myocardial infarction?

    <p>Chest pain and shortness of breath</p> Signup and view all the answers

    What causes the risk of in-stent restenosis?

    <p>Neointimal hyperplasia due to injury from stent placement</p> Signup and view all the answers

    What is typically used to diagnose myocardial infarction based on serum levels?

    <p>Serum troponin levels</p> Signup and view all the answers

    Which statement accurately describes coronary artery bypass graft (CABG) procedures?

    <p>The internal mammary artery is commonly used for grafting.</p> Signup and view all the answers

    How does ischaemic stroke typically occur?

    <p>As a result of local thrombus formation in the brain or plaque rupture</p> Signup and view all the answers

    Which of the following is NOT a recommended initial treatment for patients with stable angina?

    <p>Coronary artery bypass grafting</p> Signup and view all the answers

    Study Notes

    Cardiovascular Disease

    • Endothelium: The inner lining of blood vessels, single-cell layer thick. It's mechanosensitive, responding to blood flow and pressure. It regulates vascular tone (dilation/constriction) and homeostasis. It reacts to various body signals.

    • Pulse Wave Velocity (PWV): Measures speed of arterial pressure waves along arteries; calculated by distance/transit time. Used to assess arterial stiffness.

    • Atherosclerosis: Buildup of lipoproteins in artery walls, forming plaque. This narrows vessels, increasing risk of thrombi and plaque rupture. Affects blood flow to organs (heart, brain, etc.). A carotid artery plaque scan (ultrasound) can reveal normal flow (red), high velocities (yellow), and very high velocities (blue).

    • Shear Stress: Frictional force from blood flow affecting vessel health. Disturbed flow (irregular) is different from laminar flow (smooth), impacting endothelial cell behavior.

    • Vascular Calcification: Calcium deposits in arterial walls (intima and/or media), increasing over time. Causing vessel stiffness and elevated blood pressure.

    Consequences of Atherosclerosis

    • Ischemic Heart Disease (Angina): Coronary artery obstruction reduces oxygen to the heart muscle, causing angina (chest pain). Exercise, stress, and cold can trigger symptoms. Unstable angina can lead to myocardial infarction. Treatment includes nitrates, calcium channel blockers, or beta-blockers.

    • Acute Myocardial Infarction (Heart Attack): Coronary artery blockage by an embolus (blood clot). Leading to heart muscle ischemia (lack of oxygen). Severity depends on blockage size and location. Symptoms like chest pain, shortness of breath, weakness, anxiety, plus elevated serum troponin (indicating cardiac muscle death).

    • In-Stent Restenosis: Re-narrowing of an artery after a stent (a small tube placed to keep the artery open) insertion. Caused by neointimal hyperplasia (tissue growth inside the stent triggered by artery injury from stent placement). Drug-eluting stents are used to prevent this but re-endothelialization takes months.

    • Coronary Artery Bypass Graft (CABG): Surgeons graft a blood vessel (e.g., saphenous vein or internal mammary artery) to bypass coronary artery blockage. Increases blood flow to the heart, reducing myocardial infarction risk. Procedures range from single to quadruple bypass.

    • Ischemic Stroke: Reduced blood supply to a brain region. Causes include thrombus formation in the brain or plaque rupture elsewhere (often the internal carotid artery). Symptoms vary based on affected brain area. a thrombolytic agent (tissue plasminogen activator, tPA) helps reduce stroke effects, and anticoagulants and carotid endarterectomy might be needed. Identifying vulnerable carotid plaques prevents complications. Patients displaying symptoms such as dizziness, visual disturbances, or memory loss are scanned.

    • Peripheral Vascular Disease (PVD): Obstruction of large arteries outside the heart, aorta, and brain, often due to atherosclerosis in lower extremities. Symptoms include claudication (leg pain during activity), color changes, slow-healing wounds/ulcers. Serious PVD can lead to limb loss. High mortality rate after foot ulcer development.

    • Aortic Aneurysms: Pro-atherogenic stimuli (high blood pressure, high cholesterol, smoking, inflammation) cause aortic stiffening, weakening and bulging. Often asymptomatic, but rupture is life-threatening. All men over 65 in the UK are screened through ultrasound for aortic aneurysms. Grafts can increase aortic stability.

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    Description

    Explore key concepts related to cardiovascular disease, including the role of the endothelium, pulse wave velocity, atherosclerosis, shear stress, and vascular calcification. This quiz will test your understanding of how these factors influence heart health and blood circulation.

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