Cardiovascular Disorders Lecture 8
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Questions and Answers

What is the leading cause of death globally?

  • Respiratory diseases
  • Infectious diseases
  • Cardiovascular diseases (correct)
  • Cancer
  • Which of the following risk factors is NOT associated with cardiovascular diseases?

  • Harmful use of alcohol
  • Engaging in physical activity (correct)
  • Excessive sugar consumption
  • Tobacco use
  • What is myocardial infarction commonly known as?

  • Cardiac arrest
  • Angina pectoris
  • Heart attack (correct)
  • Stroke
  • Which type of heart disease involves the narrowing of blood vessels due to fatty deposits?

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

    What percentage of cardiovascular disease deaths were due to heart attacks and strokes in 2019?

    <p>85%</p> Signup and view all the answers

    Which diagnostic test is primarily used to measure the electrical activity of the heart?

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

    What percentage of premature deaths due to noncommunicable diseases in 2019 were caused by cardiovascular diseases?

    <p>38%</p> Signup and view all the answers

    Which condition involves abnormal heart rhythms?

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

    What is the primary cause of myocardial infarction?

    <p>Obstruction caused by a blood clot due to plaque rupture</p> Signup and view all the answers

    How long does it take for irreversible damage to occur to heart muscle cells after a blockage?

    <p>Within 30 minutes</p> Signup and view all the answers

    Which of the following biochemical markers is NOT typically released after myocardial infarction?

    <p>C-reactive protein</p> Signup and view all the answers

    What confirms the diagnosis of myocardial infarction according to WHO criteria?

    <p>History of chest pain plus two specific criteria</p> Signup and view all the answers

    What role does troponin C play in the troponin complex?

    <p>Responsible for binding calcium</p> Signup and view all the answers

    What is the significance of the soluble fraction of troponin after cardiac myocyte necrosis?

    <p>It contributes to the prolonged plateau of troponin release.</p> Signup and view all the answers

    What happens to the heart's muscle cells during a myocardial infarction?

    <p>They start to die due to lack of oxygen</p> Signup and view all the answers

    Which of the following markers is sensitive but not specific for myocardial damage?

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

    What does a BNP level over 100 pg/mL indicate?

    <p>Possible heart failure</p> Signup and view all the answers

    Which statement accurately describes the composition of plaque related to myocardial infarction?

    <p>Consists of cholesterol and various other substances</p> Signup and view all the answers

    Which condition may indicate the onset of myocardial ischemia?

    <p>Symptoms of chest pain or discomfort</p> Signup and view all the answers

    Which of the following is NOT a symptom of heart failure?

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

    In the context of myocardial damage, which marker is more sensitive and specific than total CK?

    <p>CK-MB</p> Signup and view all the answers

    What characterizes a thromboembolism?

    <p>A circulating blood clot that causes obstruction.</p> Signup and view all the answers

    Why is ischaemia-modified albumin not widely used as a marker?

    <p>It lacks specificity.</p> Signup and view all the answers

    What is a common cause of heart failure?

    <p>Blocked arteries</p> Signup and view all the answers

    What is D-dimer a degradation product of?

    <p>Crosslinked fibrin</p> Signup and view all the answers

    Which of the following tests can indicate ongoing activation of the hemostatic system?

    <p>D-dimer test</p> Signup and view all the answers

    What enzymes are involved in the generation of D-dimers?

    <p>Thrombin, activated factor XIII, and plasmin</p> Signup and view all the answers

    What type of imaging is used to diagnose thromboembolism?

    <p>Vascular ultrasound</p> Signup and view all the answers

    Which is NOT a recognized risk factor for heart disease?

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

    Which of the following best describes the role of factor XIII in clot formation?

    <p>It cross-links fibrin monomers.</p> Signup and view all the answers

    In which step does the transition from fibrinogen to fibrin monomers occur?

    <p>Thrombin-mediated conversion</p> Signup and view all the answers

    What is the BMI threshold indicating overweight status?

    <p>25</p> Signup and view all the answers

    Study Notes

    Cardiovascular Disorders Lecture 8

    • Cardiovascular diseases (CVDs) are the leading cause of death globally
    • In 2019, an estimated 17.9 million people died from CVDs, accounting for 32% of all global deaths.
    • 85% of these deaths were due to heart attack and stroke
    • Over three-quarters of CVD deaths occur in low- and middle-income countries.
    • 38% of 17 million premature deaths (under 70) in 2019 were from CVD.
    • Most CVDs are preventable by addressing behavioral risk factors like tobacco use, unhealthy diets, obesity, physical inactivity, and harmful alcohol use.
    • Early detection is crucial for effective management through counseling and medications.

    Outline

    • How the heart works?
    • Cardiovascular Disorders
    • Myocardial Infarction
    • Heart failure
    • Thromboembolic disease
    • Cardiovascular risk factors
    • Metabolism of plasma lipoproteins
    • Investigation of lipid abnormalities

    Heart Disease Types

    • Narrowing of heart blood vessels due to fatty deposits (coronary artery disease)
    • Abnormal heart rhythms (arrhythmias)
    • Heart valve diseases
    • Abnormal heart muscle (cardiomyopathy)
    • Heart squeezing and relaxation difficulties (heart failure)
    • Heart issues present at birth (congenital heart disease)
    • Issues surrounding the fluid-filled sac surrounding the heart (pericardium)

    Classification of CVDs

    • Hyper-tension, Peripheral Disease, Ischemic Heart Disease, Cardiomyopathy, Valve Disease, Arrhythmias, Stroke
    • PAD, VT&VI, CMD, CAD, CHD, HF (HFrEF, HFpEF), AF, Other, VT, VF, SVT, Cardiac arrest, Sudden cardiac death

    Tests for Diagnosing Heart Disease

    • Electrocardiogram (EKG or ECG)
    • Ambulatory monitors
    • Echocardiogram (Echo)
    • Cardiac computerized tomography (CT)
    • Heart magnetic resonance imaging (MRI)
    • Blood tests
    • Stress test
    • Cardiac catheterization

    Myocardial Infarction (MI)

    • MI, commonly known as a "heart attack," is caused by decreased or complete blockage of blood flow to a portion of the myocardium.
    • MIs can be silent and undetected or catastrophic, leading to hemodynamic deterioration and sudden death.
    • MIs occur when one or more areas of heart muscle do not receive enough oxygen due to blocked blood flow.
    • Plaque buildup (atherosclerosis) is a primary cause, rupturing and forming blood clots that block blood flow.
    • Irreversible heart muscle damage can start within 30 minutes of blockage.

    Diagnosis of MI according to WHO

    • At least two of the following: history of chest pain, ECG abnormalities, rise in biochemical markers
    • Or, one of the following: symptoms of ischemia, ECG changes of new ischemia, imaging evidence of new loss of viable myocardium, or new regional wall motion abnormality

    Biochemical Tests for MI and Ischemia

    • Troponin I & Troponin T
    • Creatine kinase
    • CK-MB
    • Aspartate aminotransferase (AST)
    • Lactate dehydrogenase (LDH)
    • Myoglobin
    • Ischemia-modified albumin

    Heart Failure

    • Heart failure occurs when the heart cannot pump blood effectively throughout the body
    • Often caused by weakness or stiffness of the heart muscle.
    • Common symptoms include trouble breathing, irregular heartbeats, swollen legs, swollen neck veins, and unusual lung fluid noises.

    BNP (B-Natriuretic Peptide)

    • Normal BNP levels in individuals without heart failure are less than 100 picograms per milliliter (pg/mL)
    • BNP levels above 100 pg/mL may signal heart failure.

    Thromboembolic Disease

    • Thromboembolism involves a circulating blood clot that obstructs blood flow, either in deep veins (DVT) or the lungs (pulmonary embolism).
    • Venous thromboembolic diseases include DVT and pulmonary embolism as both have the potential to obstruct blood flow.

    D-dimer Test

    • Measures a substance released when blood clots dissolve.
    • D-dimer is the breakdown product of cross-linked fibrin.
    • Elevated levels suggest ongoing activation of the hemostatic system.
    • Helpful for diagnosing potential blood clotting disorders.

    Cardiovascular Risk Factors

    • High cholesterol
    • High blood pressure
    • Tobacco use
    • Inactivity
    • Family history of heart disease
    • Type 2 diabetes
    • Obesity (BMI >25)
    • Unhealthy eating habits
    • Substance use disorders

    Lipids

    • Major components in plasma, including fatty acids, triglycerides, cholesterol, and phospholipids.
    • Elevated lipid levels, specifically cholesterol, are linked to atherosclerosis (formation of plaques in arteries), a major contributor to cardiovascular diseases.

    Lipoproteins

    • Lipoproteins transport lipids in the bloodstream.
    • Different types of lipoproteins include chylomicrons, VLDL, IDL, LDL, and HDL, each with varying compositions and functions.

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    Description

    Explore the critical aspects of cardiovascular diseases (CVDs) in this detailed quiz. Understand the mechanisms of heart function, various types of CVDs, and key risk factors impacting health. Learn about prevention, management, and the significance of early detection in combating this global health issue.

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