Introduction to Cardiovascular Disease
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Questions and Answers

Which of the following best defines cardiovascular disease?

  • A collective term for diseases affecting only blood vessels.
  • A group of disorders affecting the heart and blood vessels. (correct)
  • A group of disorders related only to the heart muscle.
  • A disease that only occurs in old age.

    • Which cardiovascular disease is characterized by narrowed arteries supplying blood to the heart?

  • Peripheral vascular disease
  • Congenital heart disease
  • Coronary heart disease (correct)
  • Valvular heart disease

    • What is the annual healthcare cost associated with cardiovascular disease in the UK?

  • £12 billion
  • £5 billion
  • £9 billion (correct)
  • £15 billion

    • Which of the following is NOT considered a type of cardiovascular disease?

    <p>Rheumatic fever</p> Signup and view all the answers

    What lifestyle factor is commonly identified as a risk for developing cardiovascular disease?

    <p>Smoking tobacco</p> Signup and view all the answers

    How frequently does a stroke occur, according to statistics provided?

    <p>Once every 5 minutes</p> Signup and view all the answers

    Which of the following is a common medical emergency related to cardiovascular disease?

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

    What population statistic reflects the prevalence of cardiovascular disease in the UK?

    <p>7.6 million</p> Signup and view all the answers

    Which of the following risk factors is NOT related to atherosclerosis?

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

    What is a common complication of atherosclerosis?

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

    What defines angina pectoris?

    <p>Severe chest pain due to coronary artery narrowing</p> Signup and view all the answers

    What is a primary management strategy for hyperlipidaemia?

    <p>Lower LDL levels and raise HDL levels</p> Signup and view all the answers

    Which statement about myocardial infarction is true?

    <p>It results from blockage of a coronary artery</p> Signup and view all the answers

    What physiological response occurs during the initial stage of atherosclerosis?

    <p>Endothelial injury or dysfunction</p> Signup and view all the answers

    Which lifestyle factor is a significant risk factor for cardiovascular disease?

    <p>High salt diet</p> Signup and view all the answers

    Which of the following is a symptom of myocardial ischaemia?

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

    Which medications may be required for the management of angina pectoris?

    <p>Glyceryl trinitrate and beta blockers</p> Signup and view all the answers

    Which of the following is a hallmark of atherosclerosis progression?

    <p>Formation of plaques in arteries</p> Signup and view all the answers

    What is the most common symptom of a myocardial infarction?

    <p>Severe, central crushing pain radiating to left arm or jaw</p> Signup and view all the answers

    What management step should be taken first for a suspected myocardial infarction?

    <p>Call 999 for emergency assistance</p> Signup and view all the answers

    Which of the following is a possible complication that can occur later after a myocardial infarction?

    <p>Shoulder-hand syndrome</p> Signup and view all the answers

    What percentage of myocardial infarction patients may experience silent infarctions without chest pain?

    <p>10-20%</p> Signup and view all the answers

    Which of the following is a recommended treatment for an acute myocardial infarction?

    <p>Dispersible aspirin 300mg chewed</p> Signup and view all the answers

    Which factor is crucial for improving the outcome of a cardiac arrest situation?

    <p>Time from arrest to treatment</p> Signup and view all the answers

    What is one of the immediate interventions for a patient in cardiac arrest?

    <p>Perform CPR</p> Signup and view all the answers

    Which of the following symptoms may indicate atypical presentation of a myocardial infarction in women?

    <p>Chronic fatigue</p> Signup and view all the answers

    What consequence might survivors of cardiac arrest experience?

    <p>Personality changes</p> Signup and view all the answers

    Which medication should be avoided if there is clear evidence of an allergy to it during myocardial infarction treatment?

    <p>Dispersible aspirin</p> Signup and view all the answers

    Study Notes

    Cardiovascular Disease (CVD)

    • CVD refers to a group of disorders of the heart and blood vessels
    • 7.6 million people in the UK live with CVD
    • 450 deaths occur daily in the UK due to CVD
    • CVD accounts for 100,000 hospital admissions annually in the UK
    • CVD is the leading cause of death globally
    • The total annual healthcare cost of CVD in the UK is £9 billion

    Types of CVD

    • Coronary heart disease
    • Cerebrovascular disease
    • Peripheral vascular disease
    • Deep vein thrombosis and pulmonary embolism
    • Valvular heart disease
    • Congenital heart disease

    Risk Factors for CVD

    • Lifestyle:
      • Unhealthy diet (high salt intake)
      • Physical inactivity
      • Obesity
      • Smoking
      • Alcohol
    • Other:
      • Hypertension
      • High cholesterol
      • Diabetes
      • Kidney disease
      • Age
      • Gender
      • Ethnicity
      • Family history

    Atherosclerosis

    • The underlying cause of most CVD
    • Narrowing of arteries due to the build-up of plaques (atheroma)
    • Restricts the flow of oxygen-rich blood to organs
    • Caused by damage to the endothelium of the artery, triggering a chronic inflammatory response

    Stages of Atherosclerosis

    • Endothelial injury or dysfunction
    • Fatty streak - Lipids accumulate beneath the damaged endothelium
    • Inflammatory response – Recruitment of white blood cells and foam cell formation
    • Plaque progression – migration of smooth muscle cells, increased connective tissue, calcification, platelet adhesion and fibrous cap formation
    • Plaque disruption

    Risk Factors for Atherosclerosis

    • Physical stress on arteries (turbulent flow at branch points)
    • Smoking/air pollution (circulation of reactive oxygen radicals)
    • Dyslipidaemia (High total cholesterol, high LDLs, low HDLs)
    • Chronically elevated blood glucose levels

    Complications of Atherosclerosis

    • Thrombosis - Complete blockage (occlusion) of the artery
    • Infarction - Tissue death due to impaired blood flow
    • Embolus - A blood clot that travels in the bloodstream and can block an artery
    • Ischaemic heart disease, Angina, Myocardial infarction (heart attack), Cerebrovascular disease (stroke), Aneurysm, Peripheral vascular disease

    Ischaemic Heart Disease

    • Restriction of blood supply to tissues
    • Caused by atherosclerosis and hypertension
    • Leads to angina pectoris and myocardial infarction
    • Infarction can lead to acute circulatory failure, loss of cerebral blood supply and death
    • Risk factors: age, smoking, hyperlipidaemia, diabetes, hypertension

    Hyperlipidaemia

    • High blood cholesterol
    • May be familial (inherited)
    • Associated with: age, gender, inactivity, being overweight, low dietary fiber, smoking, ethnicity, low socioeconomic status and other diseases (hypertension, diabetes and chronic kidney disease)
    • Management aims to lower LDL levels and raise HDL levels through lifestyle changes
    • Statins may be required

    Angina Pectoris

    • Chest pain caused by narrowing of the coronary arteries
    • Associated with myocardial ischaemia and increased blood lactic acid
    • Squeezing, crushing, gripping substernal pain (may radiate to left arm/jaw)
    • Can be stable or unstable

    Angina Pectoris - Management

    • Relieved by rest or glyceryl trinitrate (GTN) medication
    • GTN stimulates vasodilation, resolving pain within 2-3 minutes
    • Other medications may be required - Aspirin, calcium channel blockers, beta blockers, ACE inhibitors, statins
    • Angioplasty or surgery to place stents or perform a coronary artery bypass graft may be required

    Myocardial Infarction

    • Heart attack or coronary thrombosis
    • Sudden injury caused by blockage of a coronary artery
    • Rupture of a vulnerable atheromatous plaque
    • Ischaemia (oxygen shortage) leads to necrosis (tissue death) of the myocardium

    Myocardial Infarction - Clinical Presentation

    • Severe, central crushing pain radiating to left arm or jaw
    • May start at rest and persist
    • Restlessness, facial pallor, sweating, nausea, vomiting, confusion and apprehension
    • 10-20% of patients experience no pain (silent infarctions)
    • Women may present with atypical symptoms
    • Death can occur soon after the onset of chest pain due to ventricular fibrillation and cardiac arrest

    Myocardial Infarction - Management

    • Call 999 for emergency assistance
    • Immediate hospital admission
    • Comfortable position
    • GTN spray if known angina
    • Dispersible aspirin 300mg chewed (unless clear evidence of allergy)
    • Oxygen if the patient is hypoxaemic
    • Monitor and be prepared to start CPR/AED
    • ECG, blood tests, echocardiogram
    • Oxygen
    • Thrombolytic therapy
    • Analgesics
    • Anticoagulants
    • ACE inhibitors
    • Sedatives
    • Bed rest
    • Surgery

    Myocardial Infarction - Complications

    • Outlook depends on the time from onset to treatment
    • Acute - cardiac dysrhythmias, cardiac failure and pericarditis
    • Later – angina, thromboembolism, aneurysm, cardiac rupture
    • Longer term - post MI syndrome (known as Dressler’s syndrome), shoulder-hand syndrome, psychological problems and depression

    Cardiac Arrest

    • Abrupt loss of heart function, breathing and consciousness
    • Electrical malfunction in the heart prevents oxygenated blood being pumped to the brain, lungs and other organs
    • Can occur after a myocardial infarction but often has other causes

    Consequences of Cardiac Arrest

    • Cerebral hypoxia causes 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 lasts, the less likely a healthy life can be restored
    • Chain of survival:
      • CPR to provide circulatory support
      • AED if shockable rhythm present (ventricular fibrillation or pulseless ventricular tachycardia)

    Maintaining Knowledge for Dental Emergency Management

    • Ongoing professional development, including CPD courses
    • Continued exposure to emergency situations via simulations and clinical practice
    • Membership of professional organizations that provide resources and training
    • Maintaining up-to-date knowledge of relevant clinical guidelines
    • Staying informed about current research and advancements in emergency medicine

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    Cardiovascular Disease PDF - DTH22

    Description

    This quiz provides an overview of cardiovascular disease (CVD), including its types, risk factors, and impact on public health. Understand the significance of CVD as a leading cause of mortality and its associated healthcare costs in the UK. Test your knowledge about atherosclerosis and the lifestyle choices that contribute to CVD.

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