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NR 507 CARDIOVASCULAR QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NR 507 CARDIOVASCULAR QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NR 507 CARDIOVASCULAR QUESTIONSAND ANSWERS WITH SOLUTIONS 2024
CardiovascularLdisordersL-
LANSWERLCardiovascularLdisordersLareLprevalentLinLprimaryLcare.LManyLofLtheLdisordersLdevelopLoverLseve
ralLyears,LdueLtoLtheLriskLfactorsLtoLwhichLindividualsLhaveLbeenLexposed.LForLeachLdisorderLcoveredLinLthisL
unit,LaLdiscussionLofLriskLfactorsLwillLbeLincluded.LForLtheLconceptsLcoveredLbelow,LclinicalLapplicationLofLea
chLdiseaseLwillLbeLprovidedLsoLthatLstudentsLcanLunderstandLtheLimportanceLofLpathophysiologyLinLdiagnos
ingLandLtreatingLtheLdisease.
PrerequisiteLknowledge:
ForLthisLcontent,LyouLshouldLhaveLaLbasicLknowledgeLofLcardiacLanatomy;LknowLtheLdifferencesLbetweenLth
eLrightLandLleftLsidesLofLtheLheart,LinLtermsLofLstructureLandLfunction.LYouLshouldLalsoLpossessLsolidLknowle
dgeLofLtheLunidirectionalLbloodLflowLthroughLtheLheart.LForLexample,LdeoxygenatedLbloodLarrivesLtoLtheLrig
htLsideLofLtheLheart,LtravelsLtoLtheLpulmonaryLarteriesLtoLreleaseLCO2LandLpickLupLoxygen.LAtLthisLpoint,LtheL
oxygenatedLbloodLisLcarriedLfromLtheLlungsLthroughLtheLpulmonaryLveinsLtoLtheLleftLsideLofLtheLheartLwher
eLitLeventuallyLreachesLtheLaortaLtoLcarryLoxygenatedLbloodLoutLtoLtheLbodyLorgans.LTheLcellularLphysiology
LrelatedLtoLcardiacLcontractionLisLanotherLimportantLbasicLconceptLtoLknow,LasLelectrolytesL(sodium,Lpotass
iumLandLcalcium)LplayLaLmajorLroleLinLmuscleLcontraction.LFinally,LtheLconceptsLofLpreload,Lafterload,LandLc
ontractilityLareLessentialLtoLunderstand,LasLallLofLtheseLcanLbeLaffectedLinLsomeLwayLwhenLaLpersonLhasLcar
diovascularLdisease.
WhatLisLCoronaryLArteryLDiseaseL(CAD)?L-
LANSWERLCADLisLconsideredLtheLleadingLcauseLofLdeathLinLtheLUnitedLStatesL(U.S.).LItLisLtheLresultLofLlongsta
ndingLatherosclerosis.L
AtherosclerosisLbeginsLwithLdamageLtoLtheLendothelium.LItLisLtheLendothelium,LunderLnormalLfunctioningLt
hatLmaintainsLbalanceLbetweenLtheLvasoconstrictiveLandLvasodilationLactions,LpreventsLplateletsLfromLagg
regatingLandLcontrolLofLtheLproductionLofLfibrin.LWhenLtheLendotheliumLbecomesLdamaged,LourLfamiliarLin
flammatoryLprocessesLoccur.LMacrophagesLattachLtoLtheLendothelium,LsettingLupLphagocytosis;LplaqueLfor
mationLandLvasoconstrictionLalsoLoccursLmarkingLtheLbeginningLofLatherosclerosis.LTheLplaqueLlesionsLloca
tedLinLtheLvesselsLbecomeLenlargedLwhichLallowsLtheLplaqueLtoLprogressLwithinLtheLenlargedLvesselLlumen.
LTheLplaqueLlesionLdisruptsLnormalLbloodLflowLandLcausesLthrombusLformationLwhichLcanLbeLtriggeredLbyLc
ardiacLriskLfactorsLsuchLasLelevatedLLDL,Lcholesterol,LsmokingLandLdiabetes.L
So,LwhyLisLthisLaLproblem?L
Well,LtheLplaqueLtakesLdecadesLtoLdevelopLinLtheLcoronaryLarteries.LWithLmildLdisease,LbloodLflowLcanLgetLt
hroughLtheLarteriesLandLtheLpatientLisLasymptomatic.LOvertime,LthisLbuildLupLcanLleadLtoLnarrowingLwhichL
, resultsLinLdecreasedLoxygenLsupply.LWhenLatherosclerosisLreachesLaLclinicallyLsignificantLlevel,LtheLpatientL
willLbeginLtoLexperienceLangina.LFurtherLprogressionLofLtheLdiseaseLwillLresultLinLacuteLcoronaryLsyndromeL
(ACS),LformerlyLknownLasLmyocardialLinfarctionL(MI).
TheLmajorLriskLfactorLforLtheLdevelopmentLofLCADL-
LANSWERLTheLmajorLriskLfactorLforLtheLdevelopmentLofLCADLisLfamilyLhistory.LThereLisLaL50%LhigherLriskLforLi
ndividualsLtoLdevelopLheartLdiseaseLifLtheyLhaveLaLfirstLdegreeLrelativeL(especiallyLfather)LorLsiblingLwhoLhas
LsufferedLfromLACSLorLprematureLcardiacLdeathL(<LageL55Lyears).LLifestyleLalsoLimpactsLrisk,LespeciallyLtobac
coLuseLandLevenLsecondhandLsmokeLexposure.LItLisLalwaysLimportantLforLtheLNPLtoLstressLsmokingLcessatio
nLwithLallLpatientsLwhoLsmokeLtobacco,LinLorderLtoLdecreaseLtheLpatient'sLriskLforLCAD.LSedentaryLlifestyleL
willLalsoLincreaseLone'sLriskLforLdevelopingLCAD.LPhysicalLinactivityLcanLleadLtoLoverweightL(BMIL25-
29.9)LorLobesityL(BMIL30LandLabove).LMaleLgender,Lhypertension,LElevatedLtotalLcholesterol,LelevatedLlow-
densityLlipoproteinL(LDL),Land/orLdecreasedLhigh-
densityLlipoproteinL(HDL)LareLalsoLriskLfactors,LasLwellLasLdiabetesLmellitus.
MyocardialLischemiaL-
LANSWERLMyocardialLischemiaLisLtheLcauseLofLhisLchestLpain.LIschemiaLoccursLwhenLtheLheart'sLoxygenLde
mandLexceedsLsupply.LForLthisLpatient,LheLexperiencedLhisLchestLpainLduringLexercise.LIschemiaLoccurredLb
ecauseLofLtheLnarrowingLofLatLleastLoneLcoronaryLarteryLbyLatheroscleroticLplaques.LTheLresultLisLtheLnarro
wingLofLtheLdiameterLofLtheLcoronaryLartery.LThisLreducesLoxygenatedLbloodLflowLthroughLtheLarteryLthatLl
eadsLtoLanLinsufficientLoxygenLsupplyLtoLtheLheart.LAdenosineLisLalsoLreleasedLthatLstimulatesLsympatheticL
nerveLfibersLthatLcausesLatrialLandLventricularLcontraction.LInLaddition,LsympatheticLstimulationLoccursLatLt
heLupperLthoracicLdorsalLrootsLofLtheLspinalLcordLthatLleadsLtoLtheLarmLpain.
C.G.LhasLseveralLriskLfactorsLcontributingLtoLtheLdevelopmentLofLCAD:L-LANSWERL1)Lmale
2)LfamilyLhistoryLofLCAD
3)Lhypertension
4)Lsmoking
CADLshouldLstronglyLbeLsuspectedLandLfurtherLtestingLtoLassessLtheLextentLofLtheLpatient'sLdiseaseLincludin
g:L-
LANSWERLElectrocardiogramL(ECG),LcardiacLenzymesL&Ltroponin,Llipids,LandLcardiacLstressLtest.LInLmostLcas
es,LtheLpatientLwillLbeLreferredLtoLandLco-managedLbyLaLcardiologist.LTreatmentLwillLincludeLbothLnon-
pharmacologicalLandLpharmacologicalLmanagementLofLtheLdisease.
HeartLFailureL-
LANSWERLHeartLfailureLisLaLveryLcomplexLdiseaseLstateLthatLcanLbeLtheLresultLofLstructuralLorLfunctionalLimp
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