Cardiovascular diseases: connect the vessel, tissue and risk
Cardiovascular disease covers conditions affecting the heart and blood vessels. First determine the part involved and the tissue supplied. This provides a clearer description than treating every circulation-related condition as one disease.
Different vessels supply different tissues
The coronary arteries supply the heart muscle. Other arteries supply the brain, limbs and remainder of organs. The aorta is the primary artery exiting the heart. Depending upon the location and nature of the problem the consequences will vary. Diagnosing a vascular condition requires additional information beyond just stating that there is poor circulation.
Identify one path through a diagram: identify the vessel, flow direction and tissue receiving blood. Next explain how a problem along this path could affect blood supply. This associates cardiovascular disease with anatomy and physiology. Additionally, it allows the disease of the heart's own blood supply to remain separate from a problem associated with another part of the circulation.
A blockage is different from a weakened vessel wall
Atherosclerosis involves material building up within walls of arterial passages and could narrow passage for blood. Clots can also obstruct flow. An aneurysm concerns abnormal widening of a vessel with a different underlying issue in wall of the vessel. These examples illustrate why diseases should be grouped according to mechanism as well as site affected in the body.
An image illustrating a narrowed artery will not explain all types of cardiovascular condition. Describe what the image demonstrates and what it does not demonstrate. Symptoms alone do not reliably identify the mechanism. New symptoms suggesting an emergency need urgent evaluation, regardless of whether another cardiovascular disease has already been diagnosed.
Risk factors inform prevention rather than proving a diagnosis
Factors such as smoking, high blood pressure, elevated cholesterol, diabetes can contribute to cardiovascular risk. Similarly, both family history and age matter. While some influences can be modified others cannot. Possession of a risk factor does not establish that specific symptom results from cardiovascular disease; likewise absence of one risk factor does not exclude disease.
Combining a patient’s history, examination, blood-pressure measurements, laboratory findings and selected studies provides different information to assist assessment. For revision, separate a measurement used to predict future risk from evidence investigating a current problem. A personal risk estimate or treatment decision needs the full clinical context and an appropriate assessment method.
Connect prevention with the person’s circumstances
Support may include assistance with stopping smoking, appropriate physical activity, dietary changes and medicines where indicated. Certain conditions also require a procedure or surgery. The diagnosis, potential benefits, possible harms and the person’s priorities determine the balance. A treatment used for one cardiovascular condition is not automatically suitable for every condition within the same category.
In developing teaching plan identify which action addresses a risk factor, which treats established condition and which supports recovery. Although objectives may overlap they are not identical. Follow-up allows team to evaluate symptoms, progress and treatment effects. Changes to prescribed medicines or activities after a cardiovascular event must be based upon advice relevant to that individual.
Check your understanding
A short quiz, with an explanation after each answer.
What do coronary arteries supply?
Review section identified most difficult and provide example without referring to page. Review explanation provided and take quiz again later. Ability to describe reasoning behind answer more useful than simply remembering correct position on quiz.