CVD

Question 1

CVD = group of disorders of the heart and blood vessels, such as… (name 5)

Answer 1

• Strokes
• Heart attacks
• Heart failures
• Arrhythmias
• Heart valve problems

Question 2

Most cvd are due to ..

Answer 2

plaque build-up in the circulatory system (atherosclerosis)

Question 3

X = important causes of the following diseases:

• coronary heart disease – A
• cerebrovascular disease – B
• peripheral arterial disease – C
• deep vein thrombosis (DVT) and pulmonary embolism – D

Explain (very roughly) what is going on with these diseases

Answer 3

Atherosclerosis + high blood pressure

A) a disease of the blood vessels supplying the heart muscle;
B) a disease of the blood vessels supplying the brain;
C) a disease of blood vessels supplying the arms and legs
D) blood clots in the leg veins, which can dislodge and move to the heart and lungs

Question 4

Often, the first signs of an underlying cardiovascular disease are..

A)
B)

..As C and D are often unnoticed.

Answer 4

A Heart attack (myocardial infarction)
B Stroke (cerebrovascular incident)
C atherosclerosis
D high blood pressure

Question 5

What is angina? What might follow after angina?

Answer 5

(= chest pain as a result of myocardial ischemia = reduced blood flow).
Myocardial infarction might follow (= blood flow = completely cut off)

Question 6

Besides lifestyle-related types of CVD, there is also congenital heart disease:

Answer 6

birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth; the exact cause is unknown.

Question 7

What may play a role in congenital heart disease?

Answer 7

 Genes may play a role, or when a baby is exposed to viral infections, alcohol, or drugs before it is born

Question 8

Risk factors for CVD?

Answer 8

• Unhealthy diet
• Physical inactivity
• Tobacco use
• Harmful use of alcohol

Question 9

How do the effects of the risk factors may show up?

Answer 9

The effects may show up as

• Raised blood pressure
• Raised blood glucose
• Raised blood lipids
• Overweight
• Obesity

Question 10

Symptoms CVD?

Answer 10

• Inactivity, due to exhaustion, pain, inability to do something
• Other symptoms, depending on the type of CVD, can be.. (see later in this chapter)
• shortness of breath
• fluid & water retention
• dizziness
• fainting
• irregular heart beat

Question 11

For most cardiovascular diseases, the following four play a role:

Answer 11

hypertension, increased blood lipids, atherosclerosis and thrombosis

Question 12

• explain the cascade from high LDL cholesterol via atherosclerosis to thrombus formation using terms like fatty streaks, foam cells, macrophages

Answer 12

1. High cholesterol -> fatty streaks in the walls of the arteries -> plaques = atherosclerosis
2. macrophages in plaques attach to damaged vessels -> eat LDL -> accumulation of lipids: foamy appearance.
3. These foam-cells make the plaque grow: inflammatory response.
4. Fibrous tissue + calcium stiffens the arteries
5. Plaque ruptures: formation blood clot: thrombus.
6. Blocked blood flow -> no oxygen supply. Can cause heart attack/myocardial infarction.

Question 13

Ventricular fibrillation may lead to..

Answer 13

cardiac arrest

Question 14

• describe the cause of heart failure and who is at increased risk

Answer 14

when the heart is too weak/stiff to pump the blood into the body.
Patients with previous myocardial infarction and hypertension are at increased risk.

Question 15

• distinguish the two major types of cerebrovascular disease (stroke) and their causes

Answer 15

1. Ischemic stroke: blocked brain artery
2. Embolic stroke: thrombus from elsewhere
3. Hemorrhagic stroke: ruptured brain vessel

Question 16

• distinguish a TIA from a stroke based on the duration of the symptoms

Answer 16

TIA: symptoms disappear within 24 hours, no permanent damage, but warning sign for real stroke. ‘mini stroke’.

Question 17

• describe the cause and symptoms of intermittent claudication, a form of peripheral arterial disease

Answer 17

= artery in leg is narrowed bc of atherosclerosis. Reduces nutrient and oxygen supply to calve muscles, causing pain during walking.

Question 18

What is the difference between systolic + diastolic bp and which is a better predictor for CVD?

Answer 18

systolic = when heart pumps blood into the body (top measure), diastolic = when the blood fills the heart: at rest (bottom measure). Systolic = better predictor CVD

Question 19

• recall at what systolic blood pressure (mm Hg) anti-hypertensive treatment is started

Answer 19

> 140

Question 20

• recall at what level of total cholesterol (mmol/L or mg/dL) cholesterol-lowering treatment is started

Answer 20

> 5 mmol/L or >200 mg/dL
Cholesterol is not a major risk factor for stroke: