K22 Risk factor cardiovascular disease (ICD-10:Z82.4)

Introduction

Cardiovascular disease is a significant health condition that affects the heart and blood vessels. It is a leading cause of death worldwide, and risk factors play a crucial role in its development^[1]. This guide aims to provide healthcare professionals with a comprehensive understanding of risk factors for cardiovascular disease and the necessary steps for diagnosis and intervention.

Codes

• ICPC-2 Code: K22 Risk factor cardiovascular disease^[2]
• ICD-10 Code: Z82.4 Family history of ischaemic heart disease and other diseases of the circulatory system^[3][4]

Symptoms

• High blood pressure: Persistent elevated blood pressure readings^[5].
• Chest pain or discomfort: A feeling of pressure, squeezing, or pain in the chest^[6].
• Shortness of breath: Difficulty breathing or feeling breathless during physical activity or at rest^[6].
• Fatigue: Feeling excessively tired or lacking energy^[6].
• Dizziness or lightheadedness: Feeling faint or dizzy, especially upon standing up^[6].
• Swelling in the legs, ankles, or feet: Accumulation of fluid in the lower extremities^[6].

Causes

• High blood pressure: Chronic elevation of blood pressure can damage blood vessels and increase the risk of cardiovascular disease^[7].
• High cholesterol levels: Elevated levels of LDL cholesterol can lead to the formation of plaques in the arteries, narrowing the blood vessels and increasing the risk of cardiovascular events^[7].
• Smoking: Tobacco smoke contains harmful chemicals that can damage blood vessels and increase the risk of cardiovascular disease^[7].
• Diabetes: Uncontrolled diabetes can lead to damage of blood vessels and increase the risk of cardiovascular complications^[7].
• Obesity: Excess body weight puts strain on the heart and blood vessels, increasing the risk of cardiovascular disease^[7].

Diagnostic Steps

Medical History

• Gather information about the patient’s risk factors, including family history of cardiovascular disease, smoking history, and medical conditions such as diabetes or hypertension^[8].
• Assess the presence of symptoms associated with cardiovascular disease, such as chest pain, shortness of breath, or fatigue^[8].
• Inquire about lifestyle factors, including physical activity levels, diet, and alcohol consumption^[8].

Physical Examination

• Measure blood pressure to assess for hypertension^[8].
• Auscultate the heart for abnormal sounds, such as murmurs or irregular rhythms^[8].
• Palpate peripheral pulses to evaluate blood flow to the extremities^[8].
• Inspect the lower extremities for signs of swelling or edema^[8].

Laboratory Tests

• Lipid profile: Measure total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels to assess lipid abnormalities^[8].
• Fasting blood glucose: Evaluate blood glucose levels to screen for diabetes or impaired glucose tolerance^[8].
• Hemoglobin A1c: Assess long-term blood glucose control in patients with diabetes^[8].
• C-reactive protein: Measure levels of this marker of inflammation, which is associated with increased cardiovascular risk^[8].
• Complete blood count: Evaluate for anemia or other blood disorders that may contribute to cardiovascular disease^[8].

Diagnostic Imaging

• Electrocardiogram (ECG): Record the electrical activity of the heart to detect abnormal rhythms or signs of ischemia^[8].
• Echocardiogram: Use ultrasound to visualize the structure and function of the heart, including the valves and chambers^[8].
• Stress test: Monitor the heart’s response to physical exertion to assess for signs of ischemia or abnormal heart rhythms^[8].
• Coronary angiography: Inject a contrast dye into the coronary arteries to visualize any blockages or narrowing^[8].

Other Tests

• Carotid ultrasound: Assess the carotid arteries for plaque buildup and narrowing^[8].
• Ankle-brachial index (ABI): Measure blood pressure in the arms and legs to assess for peripheral artery disease^[8].
• Cardiac CT scan: Obtain detailed images of the heart and blood vessels to assess for blockages or abnormalities^[8].

Follow-up and Patient Education

• Schedule regular follow-up appointments to monitor the patient’s progress and adjust treatment as necessary^[9].
• Educate the patient about the importance of lifestyle modifications, including a healthy diet, regular exercise, smoking cessation, and stress management^[9].
• Provide information about the prescribed medications, their purpose, potential side effects, and the importance of adherence^[10].

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Risk factor cardiovascular disease:

1. Statins (e.g., Atorvastatin, Simvastatin, Rosuvastatin):
   • Cost: Generic versions can be $3-$50/month.
   • Contraindications: Active liver disease, hypersensitivity.
   • Side effects: Muscle pain, diarrhea, upset stomach.
   • Severe side effects: Rhabdomyolysis, liver damage.
   • Drug interactions: Grapefruit juice, other cholesterol-lowering agents.
   • Warning: Regular liver function tests required.
2. Antiplatelet agents (e.g., Clopidogrel, Aspirin):
   • Cost: Aspirin is inexpensive (<$10/month). Clopidogrel is $10-$100/month for generic.
   • Contraindications: Active bleeding, peptic ulcer disease.
   • Side effects: Upset stomach, bleeding.
   • Severe side effects: Severe bleeding, allergic reactions.
   • Drug interactions: NSAIDs, other blood thinners.
   • Warning: Risk of bleeding.
3. ACE inhibitors (e.g., Ramipril, Lisinopril):
   • Cost: Generics can be $10-$50/month.
   • Contraindications: History of angioedema with ACE inhibitors, renal artery stenosis.
   • Side effects: Cough, elevated blood urea nitrogen.
   • Severe side effects: Angioedema, hyperkalemia.
   • Drug interactions: Potassium supplements, NSAIDs.
   • Warning: Monitoring of renal function and potassium is required.
4. Beta-blockers (e.g., Metoprolol, Atenolol):
   • Cost: Generic versions are typically <$30/month.
   • Contraindications: Severe bradycardia, uncontrolled heart failure.
   • Side effects: Fatigue, dizziness, bradycardia.
   • Severe side effects: Bronchospasm, heart block.
   • Drug interactions: Calcium channel blockers, insulin.
   • Warning: Should not be abruptly stopped.
5. Calcium channel blockers (e.g., Amlodipine, Diltiazem):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Severe hypotension, heart block.
   • Side effects: Edema, dizziness, flushing.
   • Severe side effects: Heart failure, liver dysfunction.
   • Drug interactions: Grapefruit juice, beta-blockers.
   • Warning: Monitoring of blood pressure and heart rate is required.

Alternative Drugs:

• Fibrates (e.g., Fenofibrate): Useful for patients with high triglycerides.
• Ezetimibe: A cholesterol absorption inhibitor.
• Niacin: Vitamin B3 derivative that can help with cholesterol.
• Pentoxifylline: An alternative to cilostazol for claudication in peripheral vascular disease.
• Rivaroxaban: An anticoagulant used for peripheral artery disease to reduce the risk of major cardiovascular events.

Surgical Procedures:

• Angioplasty and stent placement: A catheter is used to place a stent to open up narrowed arteries. Cost: $15,000 to $50,000.
• Coronary artery bypass surgery (CABG): Redirects blood around blocked or narrowed coronary arteries. Cost: $70,000 to $200,000.

Alternative Interventions

• Acupuncture: May help improve blood flow and reduce pain. Cost: $60-$120 per session.
• Chelation therapy: Controversial treatment involving the administration of chelating agents to remove heavy metals from the body. Cost: $75-$150 per session.
• Hyperbaric oxygen therapy: Involves breathing pure oxygen in a pressurized chamber to increase oxygen delivery to tissues. Cost: $200-$300 per session.
• Herbal supplements: Some herbs, such as garlic and ginkgo biloba, may have potential benefits for improving circulation. Cost: Varies depending on the specific supplement.

Lifestyle Interventions

• Regular exercise: Engaging in aerobic exercise for at least 150 minutes per week can improve cardiovascular health. Cost: Varies (e.g., gym membership, equipment).
• Healthy diet: Adopting a diet rich in fruits, vegetables, whole grains, and lean proteins while limiting saturated fats and sodium can reduce the risk of cardiovascular disease. Cost: Varies depending on food choices.
• Smoking cessation: Quitting smoking can significantly reduce the risk of cardiovascular disease. Cost: Varies (e.g., nicotine replacement therapy, counseling).
• Weight management: Achieving and maintaining a healthy weight can improve cardiovascular health. Cost: Varies (e.g., dietary programs, weight loss medications).
• Stress management: Implementing stress-reducing techniques, such as meditation or yoga, can help lower the risk of cardiovascular disease. Cost: Varies (e.g., classes, apps).

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – K22 Risk factor cardiovascular disease (ICD-10:Z82.4)

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Use the Mirari Cold Plasma device to treat Risk factor cardiovascular disease effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Risk factor cardiovascular disease. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. World Health Organization. (2021). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
2. RxReasoner. (n.d.). ICPC-2 Chapter: K Cardiovascular. https://www.rxreasoner.com/icpc2codes/K
3. AAPC. (n.d.). ICD-10 Code for Family history of ischemic heart disease and other diseases of the circulatory system. https://www.aapc.com/codes/icd-10-codes/Z82.4
4. Unbound Medicine. (2018). Z82.4 – Family history of ischemic heart disease and other diseases of the circulatory system. https://www.unboundmedicine.com/icd/view/ICD-10-CM/868036/2/Z82_4___Family_history_of_ischemic_heart_disease_and_other_diseases_of_the_circulatory_system
5. American Heart Association. (2021). High Blood Pressure Symptoms and Causes. https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer/what-are-the-symptoms-of-high-blood-pressure
6. Mayo Clinic. (2021). Heart disease – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118
7. Centers for Disease Control and Prevention. (2021). Know Your Risk for Heart Disease. https://www.cdc.gov/heartdisease/risk_factors.htm
8. Cleveland Clinic. (2021). Diagnosing Heart Disease. https://my.clevelandclinic.org/health/diseases/17069-heart-disease/diagnosis-and-tests
9. American Heart Association. (2021). Lifestyle Changes for Heart Attack Prevention. https://www.heart.org/en/health-topics/heart-attack/life-after-a-heart-attack/lifestyle-changes-for-heart-attack-prevention
10. Jennings, Brett L ; Anderson, Larry J ; Estes, Anne M ; Fang, Xiao R ; Song, Chi Young ; Campbell, William B ; Malik, Kafait U (2012.0). Involvement of cytochrome P -450 1B1 in renal dysfunction, injury, and inflammation associated with angiotensin II-induced hypertension in rats. DOI: 10.1152/ajprenal.00542.2011