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Questions and Answers
What is the primary focus of cardiovascular disease?
Which of the following is NOT a type of cardiovascular disease?
How many people in the UK are currently living with cardiovascular disease?
Which of the following health risks is associated with diet and substance misuse in relation to cardiovascular disease?
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What is the estimated total annual healthcare cost of cardiovascular disease in the UK?
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Which condition is commonly associated with strokes and affects blood circulation in the brain?
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What is a primary risk factor for developing cardiovascular disease related to lifestyle?
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What is one common lifestyle risk factor for cardiovascular disease?
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Which stage of atherosclerosis involves the accumulation of lipids beneath the damaged endothelium?
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Which statement is true regarding cardiovascular diseases?
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Which of the following complications can result from atherosclerosis?
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What does myocardial ischaemia increase the production of?
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What is a potential consequence of a ruptured vulnerable atheromatous plaque?
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What type of medication is commonly used to manage angina pectoris?
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Which lifestyle modification is recommended for managing hyperlipidaemia?
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What is a severe symptom of myocardial infarction?
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Which of the following factors is NOT typically associated with high blood cholesterol?
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What is the primary cause of ischaemic heart disease?
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What is a common presentation of myocardial infarction in patients?
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Which of the following is NOT a symptom associated with a myocardial infarction?
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What is the first action to take in a case of suspected myocardial infarction?
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What complication can occur immediately after the onset of chest pain in a myocardial infarction?
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Which treatment is administered unless there is a known allergy in a myocardial infarction?
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Which of the following is a possible longer-term complication following a myocardial infarction?
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What is a recommended action in the case of cardiac arrest with a shockable rhythm?
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What does cerebral hypoxia resulting from cardiac arrest potentially lead to?
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Which of the following statements about cardiac arrest is false?
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What intervention is part of the 'chain of survival' for cardiac arrest management?
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Study Notes
Cardiovascular Disease
- Cardiovascular disease (CVD) is a group of disorders affecting the heart and blood vessels.
- 7.6 million people in the UK live with CVD.
- CVD is responsible for 450 deaths daily in the UK.
- CVD accounts for 100,000 hospital admissions annually in the UK.
- There is a stroke every 5 minutes in the UK.
- The total annual healthcare cost of CVD in the UK is £9 billion.
Types of Cardiovascular Disease
- Coronary heart disease
- Cerebrovascular disease
- Peripheral vascular disease
- Deep vein thrombosis and pulmonary embolism
- Valvular heart disease
- Congenital heart disease
Risk Factors for Cardiovascular Disease
-
Lifestyle Factors
- Unhealthy diet (high in salt)
- Physical inactivity
- Obesity
- Smoking
- Alcohol
-
Other Factors
- Hypertension
- High cholesterol
- Diabetes
- Kidney disease
- Age
- Gender
- Ethnicity
- Family history
Atherosclerosis
- Atherosclerosis is the underlying cause of CVD.
- It involves the narrowing of arteries due to plaque build-up (atheroma).
- This limits oxygen-rich blood flow to organs.
- Damage to the endothelium triggers a chronic inflammatory response.
Stages of Atherosclerosis
- Endothelial injury or dysfunction.
- Fatty streak formation with lipid accumulation beneath the damaged endothelium.
- Inflammatory response - Recruitment of white blood cells and foam cell formation.
- Plaque progression with smooth muscle cell migration, increased connective tissue, calcification, platelet adhesion, and fibrous cap formation.
- Plaque disruption.
Risk Factors for Atherosclerosis
- Physical stress on arteries, particularly where they branch.
- Smoking and air pollution due to reactive oxygen radical circulation.
- Dyslipidaemia: High total cholesterol, high LDL levels, low HDL levels.
- Chronically elevated blood glucose levels.
Complications of Atherosclerosis
- Thrombosis: Complete blockage of the artery.
- Infarction: Tissue death due to impaired blood flow.
- Embolus: A clot that can travel in the bloodstream to a coronary artery or artery supplying the brain.
- Ischaemic heart disease, Angina, Myocardial infarction (heart attack), Cerebrovascular disease (stroke), Aneurysm, Peripheral vascular disease.
Ischaemic Heart Disease
- Ischaemia refers to restricted blood supply to tissues.
- Ischaemic (coronary) heart disease is caused by atherosclerosis and hypertension.
- It can lead to angina pectoris and myocardial infarction.
- Infarction can cause acute circulatory failure, loss of cerebral blood supply, and death.
- Risk factors include age, smoking, hyperlipidaemia, diabetes, and hypertension.
Hyperlipidaemia
- High blood cholesterol can be familial and associated with age, gender, inactivity, overweight status, low dietary fibre, smoking, ethnicity, low socioeconomic status, and other diseases (hypertension, diabetes, and chronic kidney disease).
- Management aims to lower LDL and raise HDL levels through lifestyle modifications.
- Statins may be required.
Angina Pectoris
- Severe chest pain caused by narrowing of the coronary arteries.
- Myocardial ischaemia leads to increased blood lactic acid.
- Characterized by squeezing, crushing, gripping substernal pain that may radiate to the left arm or jaw.
- Can be stable or unstable.
Management of Angina Pectoris
- Relieved by rest or glyceryl trinitrate (GTN) medication, which stimulates vasodilation.
- Pain resolution occurs within 2-3 minutes.
- Other medications include aspirin, calcium channel blockers, beta blockers, ACE inhibitors, and statins.
- Angioplasty or surgery with stents or a coronary artery bypass graft may be needed.
Myocardial Infarction
- A heart attack or coronary thrombosis.
- It is a sudden injury caused by a blocked coronary artery.
- Occurs due to the rupture of a vulnerable atheromatous plaque.
- The resulting ischaemia leads to myocardial necrosis.
Clinical Presentation of Myocardial Infarction
- Severe, central crushing pain radiating to the left arm or jaw.
- Pain may begin at rest and persist.
- Restlessness, facial pallor, sweating, nausea, vomiting, confusion, and apprehension.
- 10-20% of patients experience silent infarctions without pain.
- Women may present with atypical symptoms.
- Death can occur soon after the onset of chest pain due to ventricular fibrillation and cardiac arrest.
Management of Myocardial Infarction
- Emergency medical help (Call 999).
- Immediate hospitalization for:
- Comfortable positioning.
- GTN spray for known angina.
- Dispersible aspirin (300mg chewed) unless there is a clear allergy.
- Oxygen if the patient is hypoxaemic.
- ECG, blood tests, echocardiogram.
- Thrombolytic therapy.
- Analgesics.
- Anticoagulants.
- ACE inhibitors.
- Sedatives.
- Bed rest.
- Surgery.
- Monitor the patient and be prepared to initiate CPR and AED.
Complications of Myocardial Infarction
- Outlook depends on the onset to treatment time.
- Acute: Cardiac dysrhythmias, cardiac failure, and pericarditis.
- Later: Angina, thromboembolism, aneurysm, cardiac rupture.
- Long Term: Post MI Syndrome (Dressler’s Syndrome), shoulder-hand syndrome, psychological problems, and depression.
Cardiac Arrest
- Cardiopulmonary arrest.
- Abrupt loss of heart function, breathing, and consciousness.
- Electrical malfunction that stops the heart from beating, preventing oxygen-rich blood from reaching the brain, lungs, and other organs.
- Common causes include myocardial infarction, but other causes exist.
Consequences of Cardiac Arrest
- Cardiac arrest is a critical and often fatal event.
- Cerebral hypoxia leads to respiratory arrest and brain injury.
- Survivors may experience personality changes, memory and speech impairment, involuntary movements, and incontinence.
Management of Cardiac Arrest
- The longer the arrest, the lower the chance of restoring health.
-
Chain of Survival:
- CPR for circulatory support.
- AED (if a shockable rhythm is present: ventricular fibrillation or pulseless ventricular tachycardia).
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Description
Explore the critical aspects of cardiovascular disease (CVD), including its types, impact on health, and major risk factors. This quiz covers essential information that can help you understand how CVD affects millions of people and the importance of lifestyle choices in its prevention.
