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pathophysiology > 2 - the heart > Flashcards

2 - the heart Flashcards

1
Q

angina

A

alterations in coronary perfusions

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2
Q

Angina pectoris

A
  • due to ischemia of myocardial cells
  • cells temporarily deprived of adequate blood supply
  • caused by anything that causes imbalance between myocardial oxygen supply and demand
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3
Q

Angina causes

A

obstruction

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4
Q

obstructions like… (3)

A
  • vessel spasm
  • atherosclerosis (stable plaque)
  • atherosclerosis (unstable complicated plaques)
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5
Q

Other than obstruction Angina can cause

A
  • hypotension
  • anemia
  • hypoxemia
  • increased demand for oxygen
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6
Q

Angina - manifestations

A

chest pains that are:

  • substernal
  • pressure, tightness, squeezing
  • elephant on chest
  • may radiate to neck, arm and jat
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7
Q

Chest pain of pulmonary origin - manifestations

A

localized and more of a stabbing pain

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8
Q

Angina is more common in

A

men

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9
Q

Angina is associated with

A
  • diaphoresis
  • dyspnea
  • pallor
  • nausea
  • vomiting
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10
Q

Angina is associated with (for women)

A
  • fatigue
  • nausea
  • indigestion
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11
Q

categories of angina

A
  • variant angina
  • stable angina
  • unstable angina
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12
Q

Variant angina

A
  • no evidence of coronary artery disease
  • excess SNS, decreased vasodilators, cocaine
  • treated with calcium channel blocker medications
  • SPASM OF ARTERIES
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13
Q

stable angina

A
  • narrowing of the vessel lumen because of atherosclerosis

- vessels cannot dilate to increase oxygen delivery during exercise or stress

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14
Q

A form of stable Angina is

A

coronary artery disease

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15
Q

stable angina - risk factors

A
  • obesity
  • smoking
  • hypertension
  • male
  • elder
  • ethnicity
  • metabolic syndrome
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16
Q

metabolic syndrome

A
  • insulin resistance syndrom
  • abdominal obesity (Apple shaped tummy)
  • low HDL
  • hyperglycaemia associated with insulting resistance
  • elevated BP
  • elevated triglycerides
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17
Q

metabolic syndrome is also known as

A

syndrome x

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18
Q

stable angina - events that increase demand can trigger ______

A
  • chest pain
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19
Q

3 main things about stable angina

A
  • predictable
  • gets better with rest
  • vessel cannot dilate
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20
Q

stable angina - what to do for relief?

A
  • by rest or nitroglycerin
  • may require interventions to open up or bypass obstruction
  • PCI
  • coronary artery bypass surgery
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21
Q

Unstable angina

A
  • also caused by atherosclerosis
  • plaque is unstable and complicated and prone to rupture
  • falls in the category of acute coronary syndromes
22
Q

3 main things about unstable angina

A
  • unpredictable
  • caused by plaque
  • formation of a CLOT
23
Q

Acute coronary syndromes

A
  • unstable angina

- myocardial infarction

24
Q

unstable angina VS myocardial infarction

A 
unstable angina 
- unpredictable 
- occurs at rest
- increases in frequency or severity 
- ischemia is still reversible 
Myocardial infarction 
- ischemia is no longer reversible 
- 2 types, categorized by ECG changes
25
Q

Myocardial infarction (MI)

A
  • heart attack

- prolonged ischemia causing irreversible hypoxia leading to cellular death

26
Q

angina and muscles

A

muscle tissue hurt but still alive

27
Q

infarction and muscles

A

muscle tissue is dead

28
Q

myocardial infarction - manifestations

A
  • *prolonged angina (greater than 20 mins) *
  • nausea
  • diaphoresis
  • pallor
  • cool and clammy
29
Q

myocardial infarction - diagnosis

A
  1. physical assessment
  2. electrocardiogram (ECG) changes
  3. Cardiac biomarkers
30
Q

cardiac bio markers

A
  • troponin

- CK-MB

31
Q

troponin and CK-MB

A

when you have dead muscle cells it releases troponin and CK-MB into your blood stream

32
Q

myocardial infarction - treatment

A
  • primary prevention
  • secondary prevention
  • tertiary prevention
33
Q

myocardial infarction - secondary prevention

A
  • early intervention of unstable angina

- aspirin, oxygen, morphine, nitroglycerin

34
Q

myocardial infarction - tertiary prevention

A
  • restore coronary circulation (PCI and bypass surgery)
35
Q

myocardial infarction - prognosis

A

depends on:

  • extent of tissue death
  • surrounding tissue
  • location
36
Q

myocardial infarction - complication

A
  • dysrhythmias
  • sudden cardia death
  • heart failure
  • cardiogenic shock
37
Q

heart attack

A

when part of that muscle has died

38
Q

heart failure

A
  • general term used to describe several types of cardiac dysfunctions that result in inadequate perfusion of tissue
39
Q

heart failure due to

A
  • MI
  • Valve dysfunction
  • cardiomyopathies
  • myocarditis
40
Q

heart failure can be

A
  • left/right sided
  • systolic/diastolic
  • high output
41
Q

left heart failure

A
  • inability of left ventricle to effectively push oxygenated blood forward INTO the systemic circulation
  • back up of blood into pulmonary circulation
42
Q

left-sided heart failure causes a decrease in forward flow - manifestation

A
  • pale
  • dizzy
  • numb
  • decreased urine output
43
Q

left-sided heart failure increased congestion in pulmonary vasculature - manifestation

A
  • SOB
  • low O2
  • crackles
  • sputum is frothy
44
Q

right heart failure

A
  • inability of right ventricle to effectively push oxygenated blood forward INTO the pulmonary circulation
  • back-up of blood into systemic veins
45
Q

left-sided heart failure causes

A
  • decrease in forward flow

- increased congestion in pulmonary vasculature

46
Q

right hearted failure causes

A
  • congestion in systemic veins
47
Q

right-sided heart failure causes increased congestion in systemic veins - manifestations

A
  • peripheral edema
  • enlarged liver and spleen
  • JVD
48
Q

systolic

A

cannot pump out effectively

49
Q

diastolic

A

cannot relax and fill effectively

50
Q

high output

A

cannot meet increased body demands

51
Q

heart failure - treatment

A
  • supportive
  • “unload” the heart
  • decrease work load
  • control heart rate
  • control blood pressure

pathophysiology (16 decks)

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