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27 Cards in this Set
- Front
- Back
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CVD kills more ( women or men) and is the #___ cause of death in the ___ |
women #1 in US and world |
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what's the first step of CVD? |
atherosclerosis- specifically endothelial dysfunction so LDL is able to get into subendothelial space. That is the most important part.
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the process of LDL in the walls of the arteries building up as a plaque and then causing stenosis is called? |
the "Glagov Phenomenon"
the disease is in the wall of the artery, not the lumen |
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what's the difference between a stablized and unstable plaque? |
the early atheroma is reduced so that there is less CE and a thicker cap
in a vulnerable plaque: there is a lot of LDL and only a thin fibrous cap |
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what is a ruptured plaque |
acute coronary syndrome
myocardial infarction
the ruptured plaque is very thrombogenic so causes an instant clot basically, even if the fat itself doesn't come out to block the artery |
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what is STEMI and NSTEMI |
ST segment elevation myocardial infarction
non-""""
in NSTEMI, the artery isn't completely occluded |
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who all has atherosclerosis? |
everyone but only some have unstable versions that will actually be dangerous |
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what is the gold standard for seeing the heart vessels in a live person
what else can you do? |
angiogram but you can only see stenosis after the plaques are fairly large
IVUS in the artery. |
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atherosclerotic lesions <__% do not cause clinical symptoms
what percent do?
these lesions cause ___? |
<50% = no sx 50-70 might/borderline >70% can cause sx, you can pick up on a stress test.
cause progressive luminal obstruction |
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what is the benefit to having a stent? |
it's going to open up and keep open the artery, so that blood flow is better with better CO. Exercise ability is better without angina.
It will NOT change the dz process or the presence of plaques |
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when the lesions crack open it's because of
what size are the ones that crack? |
risk factors -> endothelial dysfunction -> inflammation which weakens the cap of the plaque
often the ones that stenose less than 50%. They are asymptomatic but they can cause the acute problems. They aren't stable. |
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so what are the risk factors that are going to lead to a plaque rupturing |
ho fit padd
htn obesity/overweight family hx inactivity tobacco pyschosocial stress age diabetes dyslipidemia |
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how does we figure what the pt risk for a CV event is?
what are some notes |
use a calculation based on their risk factors
the used now is the ASCVD
if they already have CVD, then they're at high risk, there's nothing to risk calculate. |
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how does kentucky rank in prevalence of risk factors for CVD?
specifics? |
highest of all fifty states
htn hypercholesterolemia dm smoking inactivity obesity |
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what percent of risk factor is calculateable? |
90% |
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what are the different levels of prevention of CVD? |
primordial prevention: prevent dz from occuring
primary prevention: preventing first event from dz
secondary prevention: preventing recurrence of dz event |
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what are the ideal CV stats/factors you want? |
total CE < 200 low as possible LDL bp < 120/80 fasting glc <100 no tobacco
BMI <25 moderate physical activity healthy diet |
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having all the good stats/factors results in |
general healthy longevity and QOL and reduced healthcare prevents CVD, cancer, diabetes, kidney dz, blindness, lung dz
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how does someone with optimal risk factors compare to someone with 2 at age 50
in risk and years to live |
5% risk vs 50 or 69% (f or m)
and >40 year survival compared to 30 |
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what does the statin therapy benefit in the cholesterol guidelines |
ASCVD elevated LDL DM high risk primary prevention |
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so what are some of the things people can do that studies have shown really help |
plant based diet losing some weight and keeping it off |
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how do you keep from getting htn? |
activity normal BMI healthy diet |
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what is ASCVD? |
atherosclerotic cardiovascular dz |
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which is worse: systolic or diastolic htn?
what's the intensity:risk like? |
they're both bad
for every 20 sys or 10 dia that's htn, the risk doubles
so 40 or 20 over is 4x, 175/105 is 8x risk of CV mortality |
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what's the first step of tx htn? |
lifestyle modification:
DASH diet activity healthy weight no tobacco or excess alcohol avoid stress |
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what is DASH diet |
small amounts of Na lots veg/fruit, whole grain low-fat dairy low sat and trans fat |
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for the diabetes a fasting glc is like what? hg A1c? |
>126 fasting > 6.4 |
