Cardiac Flashcards
What is coronary artery disease?
Narrowing/blocking of the arteries from atherosclerosis which reduces blood flow to the ❤️
Causes of CAD
1)Atherosclerosis
2)coronary artery spasms
3)thrombus formation
What is endothelial dysfunction?
⬇️bioavailability of nitric oxide leads to this which promotes vascular remodeling
Stable angina
Fixed plaque causing predictable ischemia
- chest pain w/ exertion
- relived by rest or nitro
Unstable Angina
Plaque rupture casues chest pain at rest or w/ minimal exertion
-unpredictable
Variant (prinzmetal) angina
Coronary artery spasms temporarily reduce blood flow to the ❤️
-usually in the early am
-stress, smoking, cocaine are triggers
Dx testing for unstable angina
ST depression/ T Wave inversion
Trops=normal
Dx testing Nstemi
ST depression/ T Wave inversion
Trops=⬆️
Atypical symptoms of STEMI
epigastric pain, heart burn, fatigue, weakness
Patho of Myocardial infarction
Prolonged ischemia leading to irreversible ❤️ muscle damage
What is the role of BNP
Hormone that helps ❤️ and blood vessels regulate BP and volume; released to counteract RAAS
What is the role of ANP
Hormone released from right atrium, reduces extracellular volume; released to counteract RAAS
Patho of HF
1)RAAS activated causing fluid retention 2)aldosterone promotes Na+ /H2O retention worsening volume overload
3) sympathetic nervous system activated- release norepinephrine
HF w/ preserved EF
1-Hypertrophy; left ventricle unable to relax enough to allow it to fill completely during diastole
2-left atrium compensates by increasing its pressure, which leads to pulmonary congestion
3- increase pre load/afterload from neurohormonal activation= more fluid
Heart Failure w/ reduced EF
EF <40%
1-Chronic dilation of the left ventricle leads to ⬆️ wall stress/ weakens contractility
2- inadequate pumping causes blood to back up into pulmonary circulation
Heart Failure w/ reduced EF
EF <40%
1-Chronic dilation of the left ventricle leads to ⬆️ wall stress/ weakens contractility
2- inadequate pumping causes blood to back up into pulmonary circulation
Causes of both types of Left side Heart failure
HTN: Causes left ventricular hypertrophy
Obesity/DM: Causes systemic inflammation and endothelial dysfunction
Afib: common in HFpEF
CAD: causes micro vascular ischemia, reduces ventricular compliance
Aging: Natural stiffening of the myocardium and vascular system overtime
Signs and symptoms of both types of left sided heart failure
1- SOB & orthopnea(SOB when lying flat): Pulmonary congestion
2-Fatigue: ⬇️ ❤️ output
3-⬆️urination: BNP/ANP release
4-S3 gallop:rapid ventricular filling
5-cyanosis:⬇️ CO= O2 deprivation
6- peroxysmal nocturnal dyspnea
Signs and symptoms of both types of left sided heart failure
1- SOB & orthopnea(SOB when lying flat): Pulmonary congestion
2-Fatigue: ⬇️ ❤️ output
3-⬆️urination: BNP/ANP release
4-S3 gallop:rapid ventricular filling
5-cyanosis:⬇️ CO= O2 deprivation
6- peroxysmal nocturnal dyspnea
Right side heart failure
Usually secondary to left side heart failure
Blood backs up into systemic venus circulation
Signs and symptoms of right side heart failure
Edema
SOB
Ascites (back up of portal system)
Wt gain
JVD
Signs and symptoms of right side heart failure
Edema
SOB
Ascites (back up of portal system)
Wt gain
JVD
Elevated liver enzymes due to hepatic congestion
Bi-ventricular heart failure
Failure of both left and right ventricles
Causes both pulmonary and systemic congestion
Signs and symptoms of bi- ventricular heartfailure
Complex presentation
Fatigue
Peripheral edema
Loss of appetite
Nausea and weight gain
SOB
Increase urination
