SBI241 Weeks 5-6 - Cardiovascular Disorders

List modifiable risk factors for Myocardial Infarction:

All of the above

List non-modifiable risk factors for Myocardial Infarction:

All of the above

What is metabolic syndrome?

A cluster of conditions that increase the risk of heart disease, stroke, and diabetes

Name some inflammatory markers important in determining Myocardial Infarction risk.

C) Both A and B

What LDL level is desirable for Myocardial Infarction prevention?

LDLs <1.8 mmol/L or dependent on individual risk factors

What HDL level is recommended for Myocardial Infarction prevention?

HDLs > 1.0 mmol/L or > 1.3 mmol/L for women

What is Angina?

Chest pain or discomfort caused by reduced blood flow to the heart

What duration does Angina usually last and does it cause permanent damage?

Usually 3-5 minutes, with no permanent damage.

List the types of Angina:

All of the above

What best describes Stable Angina?

Predictable chest pain triggered by exertion or stress, relieved by rest

What best describes unstable angina?

Unpredictable, severe chest pain that may occur at rest, often a sign of an impending heart attack

What best describes Prinzmetal's Angina?

Chest pain caused by transient coronary artery spasms

What happens after cell death due to ischemia in Myocardial Infarction?

The dead cells are replaced by scar tissue

List some symptoms of Myocardial Infarction apart from pain:

All of the above

List some substances released by dead myocytes during Myocardial Infarction:

All of the above

List some methods of evaluation during Myocardial Infarction:

All of the above

What are some complications of Myocardial Infarction?

All of the above

What is a primary aim of managing Myocardial Infarction?

Restore blood flow to the affected area

What is the purpose of dual antiplatelet therapy post ACS?

To prevent clot formation on stents and reduce ischemic events

What is Heart Failure?

A condition where the heart is unable to pump enough blood to meet the body's needs

What are the symptoms of Congestive Heart Failure (CHF)?

Shortness of breath, fatigue, and swelling in legs

What is Acute Heart Failure?

A sudden onset or worsening of heart failure symptoms requiring urgent medical attention

What is Chronic Heart Failure

A gradual and persistent decline in heart function over time

What is Right-Sided Heart Failure (RSHF)?

Failure of the right ventricle to pump blood into the pulmonary circulation, causing peripheral congestion

What is Left-Sided Heart Failure (LSHF)?

Failure of the left ventricle to pump blood effectively to the body, causing pulmonary congestion

What are the investigations for Heart Failure?

All of the above

What is an Echocardiogram?

An imaging test that uses sound waves to visualize the heart's structure and function

What does an Echocardiogram provide?

Assessment of heart structure and function, including valve function and chamber size

What are the clinical Features of RSHF?

Peripheral Oedema, Hepatosplenomegaly, Pleural Effusion, Ascites

What is backward Left-Sided Heart Failure (LSHF) characterized by?

Fluid accumulation in the lungs (pulmonary congestion)

What is forward Left-Sided Heart Failure (LSHF) characterized by?

Decreased cardiac output to the systemic circulation

What are common clinical features of Left-Sided Heart Failure (LSHF)?

Pulmonary congestion, orthopnea, and paroxysmal nocturnal dyspnea

What are the pharmacological management options for Heart Failure?

ACE inhibitors, beta blockers, diuretics such as Furosemide (frusemide), anticoagulant and anti‐arrhythmia medications

What non-pharmacological interventions are commonly recommended for Heart Failure management?

Fluid restriction, sodium restriction, and regular exercise

What are the systemic complications of Heart failure?

Renal dysfunction, hepatic congestion, and cardiac cachexia

What are the three distinct layers that compose blood vessels (excluding capillaries)?

Tunica intima, tunica media, and tunica externa

What is the main component of the tunica externa and its function?

Connective tissue, providing support and protection

Which nervous system innervates the smooth muscle layer of the tunica media, and what does it control?

Sympathetic nervous system, controlling vasoconstriction and vasodilation

What lines the tunica interna, and what is its function?

Endothelial cells, regulating blood flow and preventing clotting

What are some key functions of the endothelium?

Regulating blood flow, preventing clotting, and controlling inflammation

Name three factors that cause vasodilation:

Nitric oxide, prostacyclin, and histamine

How do arteries differ from veins?

Arteries have thicker walls and higher pressure, while veins have thinner walls and lower pressure

What is arteriosclerosis?

A condition where arteries become narrowed or hardened due to plaque buildup

What is atherosclerosis?

A type of arteriosclerosis characterized by plaque buildup in arterial walls

Name some risk factors for atherosclerosis:

High blood pressure, high LDL cholesterol, smoking, and diabetes

What is the role of lipids in atherosclerosis?

They contribute to the formation of atherosclerotic plaques

Name some consequences of atherosclerosis:

Myocardial infarction (heart attack), stroke, and peripheral artery disease

What is dyslipidemia?

An abnormal level of lipids (cholesterol or triglycerides) in the blood

What are some possible clinical manifestations of atherosclerosis?

Chest pain (angina), intermittent claudication, and transient ischemic attacks (TIAs)

How can one manage atherosclerosis?

Through lifestyle modifications, medications, and medical interventions

Where does DVT primarily occur?

Veins of the legs (e.g., femoral and popliteal veins)

What can a thrombus in the deep veins of the legs lead to?

Pulmonary embolism

What are the diagnostic criteria for hypertension?

Systolic BP ≥ 140 mmHg or Diastolic BP ≥ 90 mmHg

What is the formula relating blood pressure to cardiac output and total peripheral resistance?

Blood Pressure = Cardiac Output x Total Peripheral Resistance

What are the two main types of hypertension?

Primary and secondary hypertension

What are the risk factors for primary hypertension?

Family history, age, obesity, physical inactivity, and high-sodium diet

What are some clinical manifestations of hypertension?

Often asymptomatic, but may include headaches, dizziness, and nosebleeds

What are some possible consequences of persistent or chronic hypertension?

Heart failure, stroke, kidney disease, and vision loss

What are some lifestyle regimens for hypertension management?

Regular exercise, balanced diet (DASH), weight management, and stress reduction

Within a normal physiological range, an increase in left ventricular end-diastolic volume leads to according to Frank Starling's Law:

An increased force of contraction

Total peripheral resistance (TPR) is an important determinant of blood pressure. Which of the following type of blood vessels contributes mainly towards determining the TPR?

Arterioles

High LDL-cholesterol predisposes to atherosclerosis by:

Causing endothelial injury

A 75 year-old male presents with severe chest pain. Lab tests in hospital reveal elevated levels of creatine kinase and lactic dehydrogenase. These elevated levels indicate probable:

Myocardial infarction

Which of the following statements correctly describes a direct end effect of the renin-angiotensin-aldosterone system (RAAS)?

Angiotensin II causes systemic vasoconstriction

A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following type of heart failure generally results from this condition?

Right heart failure failure

A 60-year-old male presents to his GP complaining of chest pain. He is diagnosed with atherosclerosis. This disease is caused by:

Abnormal thickening and hardening of vessel walls

A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counselling. He is told that foods which ______ LDL levels and ______ HDL levels should be avoided.

raise, lower

Atherosclerotic plaques may dislodge and cause:

Embolic stroke

A 72-year-old female has a history of right heart failure caused by right ventricular myocardial infarction. Which of the following symptoms are directly related to her right heart failure?

Jugular venous distension and peripheral edema

A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure, which is most likely caused by:

Sympathetic nervous system compensation for decreased cardiac output

Which of the following symptoms are directly related to the right heart failure?

Peripheral edema, SOB, fatigue and fluid retention

The most common cause of myocardial ischaemia is:

Atherosclerosis

The results of an adult patient's blood pressure screening on three occasions are: 120/80 mmHg, 119/76 mmHg , and 118/79 mmHg. How will the healthcare provider interpret this information?

Normal blood pressure

Cardiac cells can withstand ischaemic conditions for _____ before necrosis ensues.

20-40 minutes

Foam cells in an atheroma are:

Macrophages laden with LDL particles

Ventricular remodelling in chronic heart failure is primarily drive by:

Persistent neurohormonal activation

Increased afterload contributes to the progression of heart failure by:

Promoting left ventricular hypertrophy

A 62 year-old woman is at her health clinic for an annual physical exam. After walking from the car to the clinic, she developed substernal pain. She also reported discomfort in her left shoulder and jaw, lasting two to three minutes and then subsiding with rest. She indicated that this has occurred frequently over the past few months with similar exertion. She is most likely experiencing:

Stable angina

A 48 year-old female presents to ED complaining of an acute severe headace, nausea, photophobia, and nuchal rigidity. These signs and symptoms are probably caused by:

Subarachnoid Haemorrhage (SAH)

A 50 year-old man with history of hypertension for 15 years presents with confusion and headache. MRI scan reveals multiple lacunar infarcts. These kind of lesions are caused by"

Thrombosis in small end-arterioles

A 52-year-old female is diagnosed with coronary heart disease. She would be expected primarily to suffer from myocardial:

Ischaemia

A 56-year-old male is diagnosed with coronary heart disease. Which of the following modifiable risk factors would most likely influence development of this disease?

Cigarette smoking

A 53-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. The pain he experiences occurs when:

The myocardial oxygen supply has fallen below demand

A 62 year-old male presents to his GP complaining of chest pain at rest and on exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina:

Prinzmetal's angina

A 49-year-old male presents to his GP complaining of chest pain. An ECG reveals ST elevation. Which of the following interventions would be most beneficial:

Increase myocardial oxygen supply

A 60-year-old female had a myocardial infarction. She was brought to hospital one hour later. She survived but now has impaired ventricular function because:

The ischaemia led to hypoxic injury and myocardial cell death

As left heart failure progresses:

Left ventricular preload increases

A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. The most likely reason is:

Myocardial hypertrophy and ventricular remodelling

A 59-year-old female is diagnosed with left ventricular failure. The associated decrease in kidney perfusion would tend to cause:

Increased systemic vascular resistance

ECG alone is the best indicator of myocardial ischaemia/infarction. True/False

False

In general, atherosclerosis is triggered by:

Endothelial injury and inflammation

Most cases of combined systolic and diastolic hypertension have no known cause and are
diagnosed as _____ hypertension.

Primary

A detached blood clot is called a(n):

Thromboembolus

A 32-year-old female presents with lower leg pain and redness. An ultrasound reveals venous thrombus. Which of the following would be most likely to have caused her condition?

Vascular injury and inflammation

A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:

Deep veins of the leg

It is normal to have a higher blood pressure in the morning. True/False

True

Nervous anticipation and uncertainty regarding visiting a clinician can cause an acute and
transient rise in blood pressure. This phenomenon is called ______________.

White coat hypertension

Sympathetic activation of Alpha 1 receptors on smooth muscles, glands and organs will:

Increase vascular tone and blood pressure

Sympathetic activation of Beta 1 receptors on the heart and kidneys will:

Increase heart rate and blood pressure

Sympathetic activation of Beta 2 receptors on smooth muscles, glands and organs will cause:

Inhibition/relaxation