Cardiovascular Disease Overview
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Questions and Answers

What effect do beta-adrenergic blocking agents have on heart rate and cardiac output?

  • Decrease both heart rate and cardiac output (correct)
  • Increase both heart rate and cardiac output
  • Increase heart rate but decrease cardiac output
  • Decrease heart rate but increase cardiac output

    • Which class of medication primarily inhibits calcium movement to affect blood pressure?

  • Calcium Channel Blockers (correct)
  • ACE inhibitors
  • Diuretics
  • Beta-Blockers

    • Which of the following lifestyle changes is NOT recommended after a CVD risk assessment?

  • Smoking cessation
  • Eating a healthy diet
  • Avoiding all physical activity (correct)
  • Weight loss if overweight or obese

    • How often are individuals aged 40-74 invited for a free health check to assess CVD risk in England?

    <p>Every 5 years</p> Signup and view all the answers

    Which medication class is used to relieve the heart's workload by lowering blood volume?

    <p>Diuretics</p> Signup and view all the answers

    What condition is NOT caused by atherosclerosis?

    <p>High blood pressure</p> Signup and view all the answers

    Which group has the highest risk of dying early from heart disease and stroke?

    <p>Black men</p> Signup and view all the answers

    Which of the following is a non-modifiable risk factor for cardiovascular disease?

    <p>Age</p> Signup and view all the answers

    What percentage of first heart attack cases is due to modifiable risk factors?

    <p>90%</p> Signup and view all the answers

    Which of the following ethnic backgrounds is associated with a lower risk of CVD?

    <p>South American</p> Signup and view all the answers

    Coronary heart disease includes which of the following conditions?

    <p>Angina</p> Signup and view all the answers

    Which factor is considered a modifiable risk factor for CVD?

    <p>High non-HDL cholesterol levels</p> Signup and view all the answers

    What is the leading cause of morbidity and mortality worldwide?

    <p>Cardiovascular disease</p> Signup and view all the answers

    Which of the following comorbidities is NOT linked to an increased risk of cardiovascular disease (CVD)?

    <p>Healthy diet</p> Signup and view all the answers

    What is the purpose of the HA2DS2-VASc Score?

    <p>To evaluate risk of stroke in patients with atrial fibrillation</p> Signup and view all the answers

    Which cardiovascular condition is characterized by a narrowing of the aortic valve?

    <p>Aortic valve stenosis</p> Signup and view all the answers

    Which treatment is not commonly recommended for hypertrophic cardiomyopathy?

    <p>Heart transplant</p> Signup and view all the answers

    What is a common symptom of aortic valve stenosis?

    <p>Chest pain (angina pectoris)</p> Signup and view all the answers

    Which of these factors is NOT considered a risk factor for heart failure?

    <p>Regular exercise</p> Signup and view all the answers

    Which type of cardiomyopathy is primarily inherited?

    <p>Hypertrophic cardiomyopathy</p> Signup and view all the answers

    What is the primary characteristic of dilated cardiomyopathy?

    <p>Stretched, thin, and floppy heart muscle</p> Signup and view all the answers

    Which treatment is recommended for aortic valve stenosis?

    <p>Aortic valve replacement</p> Signup and view all the answers

    What is the most probable consequence of untreated aortic valve stenosis after symptoms develop?

    <p>Poor life expectancy of around 2 to 5 years</p> Signup and view all the answers

    Which scoring system is used to estimate the risk of cardiovascular disease events in adults?

    <p>QRISK 3-2018</p> Signup and view all the answers

    Which of the following conditions is associated with electrical defects leading to heart issues?

    <p>Arrhythmogenic right ventricular cardiomyopathy</p> Signup and view all the answers

    What is the significance of an ejection fraction below 50%?

    <p>Signifies the beginning of heart failure</p> Signup and view all the answers

    Study Notes

    Cardiovascular Disease (CVD)

    • CVD encompasses various heart and blood vessel conditions, primarily caused by blood clots (thrombosis) or atherosclerosis.
    • Atherosclerosis involves plaque buildup in arteries, leading to hardening and narrowing, restricting blood flow.
    • Major CVD types include coronary heart disease (angina, myocardial infarction), stroke, transient ischemic attack (TIA), and peripheral arterial disease.

    Statistics

    • CVD is a leading cause of morbidity and mortality globally.
    • Approximately one in three deaths are related to CVD.
    • The NHS spends over £29 billion annually managing CVD.
    • CVD impact varies regionally due to different lifestyles, healthcare availability, and living standards.

    Risk Factors

    • Non-modifiable:
      • Age: Risk increases significantly after 50.
      • Gender: Men generally develop CVD earlier and at higher rates than women.
      • Family history: Shared genetics and environment contribute to increased risk.
      • Ethnicity: Some ethnic groups (e.g., South Asian, sub-Saharan African) have higher risks, while others (e.g., South American, Chinese) have lower risks compared to those of European descent.
    • Modifiable:
      • Smoking
      • Low HDL cholesterol
      • High non-HDL cholesterol
      • Sedentary lifestyle
      • Unhealthy diet
      • Excessive alcohol intake
      • Overweight/obesity.
    • 90% of first heart attacks are due to modifiable factors.
      • Women over age 55 and consuming 5 or less units of alcohol weekly are safer than others.

    Comorbidities Increasing CVD Risk

    • Hypertension
    • Diabetes mellitus/prediabetes/metabolic syndrome
    • Chronic kidney disease
    • Dyslipidemia (familial & non-familial; some medications increase it)
    • Atrial fibrillation
    • Systemic inflammatory disorders (e.g., rheumatoid arthritis, lupus)
    • Influenza
    • Serious mental health conditions (e.g., schizophrenia, PTSD; anxiety independently increases risk of CAD)
    • Periodontitis

    CVD Risk Evaluation

    • HA2DS2-VASc score assesses stroke risk in atrial fibrillation patients, informing anticoagulation decisions.
    • QRISK 3-2018 estimates CVD risk (heart attack, stroke) in 10 years for adults.

    CVD Prevention & Management

    • National health checks available for 40-74 year olds (without CVD/diabetes/CKD) include CVD risk assessment, alcohol assessment, physical activity, cholesterol, BMI, dementia screening (65+), and screenings for diabetes and CKD.
      • Lifestyle advice (smoking cessation, weight loss, healthy diet, moderate alcohol, physical activity) is recommended for all, regardless of risk score.

    Specific CVD Conditions

    Aortic Valve Stenosis

    • Progressive narrowing/stiffening/thickening (calcification) of the aortic valve.
    • Normal valve area: 3.5-4 cm².Critical stenosis <0.8cm².
    • Symptoms: chest pain (angina), fatigue, syncope, heart failure.
    • Risk factors: old age, past heart disease, infection, degeneration, radiation, chronic kidney disease (CKD), other CVD risk factors.
    • Treatment: aortic valve replacement.
    • Complications: heart failure, arrhythmias, blood clots, bleeding, endocarditis, stroke, death.

    Cardiomyopathies

    • Diseases of the heart muscle, inherited or acquired, impacting heart function.
    • Types:
      • Hypertrophic cardiomyopathy (HCM): Thickened heart muscle. Inherited (autosomal dominant), often via mutation of sarcomere proteins (e.g., β-myosin heavy chain).
      • Dilated cardiomyopathy (DCM): Enlarged, thin, floppy heart muscle. Inherited or acquired.
      • Arrhythmogenic right ventricular cardiomyopathy (ARVC): Genetic with abnormalities affecting myocyte adhesion (desmosomes).
    • Takotsubo Cardiomyopathy: Stress-induced, not inherited, often resolves.

    Heart Failure

    • Inability of the heart to pump sufficient blood.
    • Ejection fraction below 50% indicates heart failure.
    • Thickened muscle reduces ejection space.
    • Causes: obesity, CKD, sleep apnea, hypertension, coronary artery disease, heart attacks ,valve disease, myocarditis, congenital issues, family history.

    Management - Treatments

    • Pharmacotherapy:
      • Statins for cholesterol lowering; recommended for >20% 10-year CVD risk.
      • Beta-blockers that decrease heart rate and blood pressure.
      • Calcium channel blockers reducing heart workload through influencing calcium movement.
      • Diuretics that reduce blood volume and pressure.
      • Vasodilators (ACE inhibitors, ARBs).
      • Positive inotropes (digitalis)
    • Other:
      • Anti-coagulants(warfarin, DOACs) prevent blood clots; thrombolytics dissolve clots; anti-platelets reduce platelet aggregation
      • Anti-arrhythmic drugs for irregularity
      • Ablation, cardiac resynchronization therapy (pacemakers/implants)

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    Description

    This quiz covers essential information about cardiovascular diseases, including their types, statistics, and risk factors. Learn about the impact of lifestyle, healthcare differences, and non-modifiable elements like age and gender on heart health. Test your knowledge and awareness of this critical health issue.

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