Read the summary and the most important questions on Nutrition and Cardiometabolic Diseases

• Introduction & Cardiometabolic Diseases

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• Is mortality a good indicator for the burden of disease?

  No, only partly.
  
  But mortality is the best data that is available when comparing countries.
  
  Changes in the burden of disease are related to incidence, mortality, cure, population ageing etc. 

• How does the artherothrombotic process looks like?

  See the image  
  
  

  1. normal 
  2. Fatty streak 
  3. Fibrous plaque 
  4. Complicated lesion 

• Acute coronary syndrome (ACS) comprises three diseases that involve the coronary arteries:

  • STEMI = ST elevation myocardial infarction 
    
  • caused by a sudden complete (100%) blockage of a heart artery (coronary artery)
  • NSTEMI = Non-ST elevation myocardial infarction 
  • usually caused by a severely narrowed artery but the artery is not completely blocked 
  • AP = Unstable angina pectoris 

• How do the ECG (or EKG) pictures of STEMI, NSTEMI (ST depression) and NSTEMI (T inversion) look like

  See the image

• How is the Ejection Fraction, EF, calculated

  EF = (SV/EDV) * 100 
  
  
  SV = stroke volume (amount of blood pumped from left ventricle per beat)
  EDV = end-diastolic volume 
  
  Healthy heart = 60% or more 
  Heart failure = 40% or less 

• There are two types of ventricular failure, namelijk

  Left ventricular failure 
  

  • Fluid builds up in the lungs due to congestion of the veins in the lungs (dyspnoea)

  
  Right ventricular failure 
  

  • Fluid accumulates in the body, esp. In the legs and abdominal organs (e.g. liver)

• How can you diagnose PAD?

  You have PAD is ankle/brachial blood pressure index (ABI) <= 0.9 

• What can you tell about arterial (thrombo) embolism?

  • Artery in the leg or elsewhere 
    
  • When it ends up in coronary artery: myocardial infarction 
  • Can also starting in carotid artery or in the heart due to arterial fibrillation --> travels to the brain --> ischemic stroke 

• What can you tell about venous (thrombosis) embolism, VTE?

  Arises in systemic vein --> travels to the lung --> pulmonary embolism (e.g. After deep venous thrombosis = DVT)

• Name the 4 types of strokes (cerebrovascular disease)

  • Ischemic stroke
    
  • blocked brain artery
  • Embolic stroke
  • Thrombus from elsewhere
  • Hemorrhagic stroke
  • Ruptured brain vessel

  
  
  

  • TIA
  • mini-stroke
  • symptoms <24 hours