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What is the most common cardiovascular disease in the US?
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Coronary Artery Disease (CAD)
What is Acute Coronary Syndrome?
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A form of coronary artery disease that presents with unstable angina and myocardial infarction. It is more serious.
What are the fatty deposits called that build up in the arteries, leading to atherosclerosis?
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Atheromas
What are the three general phases in the development of atherosclerosis?
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Fatty streak, Fibrous Plaque and Complicated Lesion
______ are the earliest lesions associated with atherosclerosis and appear around age 15. Lowering LDL may reverse this process.
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Fatty streaks (in smooth muscle cells)
Formation of _________ results in a narrowing of vessel lumens and a reduction in blood flow to distal tissues. They begin to form around age 30 and increase in number with age.
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Fibrous plaques
A _______ is the most dangerous stage of formation during atherosclerosis. Continuation of development leads to instability and can result in the development of a thrombus.
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Complicated lesion
T/F Men are likely to experience angina prior to an MI.
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False, men commonly experience MI as the initial cardiac event
What is collateral circulation?
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The development of arterial anastomoses (connections) to compensate for an occlusion of blood flow in the coronary arteries.
Who has the highest instance of CAD?
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White, middle aged men
What are the non-modifiable risk factors for CAD? (5)
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Age, gender, family history, genetic predisposition, ethnicity
What are the modifiable risk factors for CAD?
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Elevated serum lipids, smoking, hypertension, physical inactivity, diabetes, metabolic syndrome, obesity, psychological states and homocysteine level
What is the most common presenting symptom for women experiencing their first cardiac event?
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Angina
What genetic disorder has been associated with an increased risk of CAD?
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Hypercholesterolemia
What is the function of HDL?
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Carries lipids away from arteries and to the liver for metabolism, therefore high levels are desirable
Which HDL type is typically higher in women until the onset of menopause?
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HDL2
What can lead to increases in HDL levels?
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Exercise, moderate alcohol consumption, estrogen
What lifestyle factors can contribute to increased triglycerides?
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High alcohol consumption, high intake of refined carbs and simple sugars, physical inactivity
What medications can increase triglycerides?
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Corticosteroids, HRT
What is involved in calculating the 10 year risk of a person having a nonfatal MI or dying from a cardiac event?
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-Age -Gender -Tobacco use -Systolic BP -Use of BP meds -Total cholesterol -HDL cholesterol level
The goal for serum LDL is...
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Less than 160 unless they have a high risk. High risk is less than 70
Why is smoking associated with an increased risk of CAD?
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Nicotine causes catecholamine release (norepinephrine and epinephrine) which increases heart rate and cardiac workload and it also promotes platelet adhesion that increases the risk of emboli formation
What were identified as the common barriers to smoking cessation? (5)
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History of relapses, stress, gaining weight, no support, depression
How does a diagnosis of diabetes impact the risks for developing CAD?
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People with diabetes, even if it is well controlled, develop CAD more often and earlier and with no differences in gender.
What are the cluster of risk factors referred to as Metabolic Syndrome? (5)
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Obesity, elevated triglycerides, hypertension, abnormal serum lipids, elevated fasting blood glucose.
How can a person reduce the amount of homocysteine in their system (which is a risk factor for CAD)?
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By taking B-complex vitamins (B6, B12, folic acid)
What is the FITT formula?
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Frequency. Intensity (how hard). Type (isotonic) Time (how long)
When is a complete lipid profile recommended?
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Every 5 years, starting at age 20
What are the initial treatments for someone who has a serum cholesterol over 200 mg/dL?
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Dietary caloric restriction if overweight, decreased fat and cholesterol intake, increased physical activity
Although rare, what are the risks associated with use of statin medications to control serum lipid levels?
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Liver damage, myopathy that progresses to rhabdomyolysis


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