Cardiac Flashcards
always ask about the ______
cough
air hunger
paroxysmal nocturnal dyspnea (PND)
term for a pt that is ashen and sweaty
diaphoresis
not enough blood getting to lower leg muscles
claudication
claudication is a sign of ____
PAD
term for use of bathroom at night
nocturina
chest pain due to lack of O2 to myocardial tissue
angina
cell death of heart muscle
myocardial infarction
4 CV disorders that mimic MS dysfunction
- angina
- MI
- pericarditis
- dissecting aortic aneurysm
3 major disorders of the myocardium causing insufficient blood supply to the heart
- ischemic heart disease
- coronary heart disease
- coronary artery disease
1 cause of morbidity and mortality in US
ischemic heart disease
~2 mil middle aged and older people have _____________
silent MIs
death rates of ischemic heart disease have ___ due to ______________
declined; lifestyle improvements
incidence of ischemic heart disease has ________
not decreased
thickening of the arterial wall due to accumulation of cells
atherosclerosis
disease termed by narrowing of arteries of heart
cardiovascular disease
when the arteries of the heart are narrowed
CAD
when the arteries to the brain are narrowed
CVD
blood vessels in body are narrowed
PAD
15 CAD risk factors
yes 15… sigh
- smoking
- elevated cholesterol
- high LDL
- HTN
- gender
- family history
- stress
- elevated triglycerides
- obesity
- sedentary
- diabetes
- low HDL
- hormonal status
- age
- oxidative stress
total body inflammation from diseases
oxidative stress
LDL should be below _____
100
optimal HDL levels for male and female
male: 40+
female: 50+
after menopause, incidence for CAD _______
increases
starts in young adulthood and signs/sxs appear later
atherosclerosis
normal first sx of CHD
angina
most accurate diagnostic/prognostic assessment of CAD
echocardiogram
PTCA
percutaneous transluminal coronary angioplasty
balloon system passed through a catheter inserted into an artery
PTCA
3 PTCA destinations
femoral, brachial, radial arteries
removal of plaque with a rotating blade
atherectomy
chest artery or graft used to channel blood around narrowed coronary artery
bypass surgery
would you have an elderly person undergo bypass surgery?
no
6 sternal precautions
- no pulling
- no pushing
- no lifting of 5-10#
- no driving
- avoid shoulder horizontal abd w ER
- if sternum is not stable - no flexion or abd
6 types of angina
chronic stable new onset preinfarction (unstable) postinfarction prinzmetals resting
if a pt has new onset angina while they are being treated by you…
call 911
classic, exertional angina; occurs at predictable workloads or stress and responds to rest/NTG
chronic stable
occurs after MI when residual ischemia triggers an episode
postinfarction angina
angina that is a symptom of worsening ischemia
unstable angina
caused by coronary artery spasm; early morning at the same time at rest
Prinzmetal’s angina (variant, vasospastic)
angina that occurs at rest and is relieved when person sits or stands up
resting angina
etiology of angina
decrease in O2 supply from artherosclerotic narrowing or spasm
4 triggers of angina
- exercise
- exposure to cold
- emotional stress
- large meal
angina can be referred to any dermatome from ___ to ____
C3-T4
is exercise helpful or harmful for angina treatment/management?
helpful
80-90% of MIs result from a _______
thrombus (clot)
time of day that MIs frequently occur at
early morning
2 classes of patients that are at higher risk for silent ischemia
diabetics
postmenopausal women not recieving hormones
7 postinfarction complications
- dysrrhythmias
- CHF
- cardiogenic shock
- pericarditis
- rupture of heart
- thrombembolism
- recurrent infarction
condition in which your heart suddenly can’t pump enough blood to meet your body’s needs
cardiogenic shock
inflammation of sac outside heart
pericarditis
HR cap in homecare
20 beats above resting
backup of blood causing high pressure in pulmonary capillaries leading to pulmonary congestion and HTN
CHF
CHF is not a disease. What is it?
a group of clinical manifestations caused by inadequate pump performance from cardiac valves or myocardium
term for left-sided failure vs right-sided
L: CHF
R: Cor Pulmonale
when LV can no longer maintain a normal Q (cardiac output)
left-sided failure - CHF
CHF can turn into
pulmonary edema
biggest giveaway for CHF
3lb weight gain overnight
Where do you see weakness for CHF patients?
Legs
Edema scale
1+: indentation barely visible
2+: slight ind, normal in 15s
3+: deeper indentation and returns <30s
4+: indentation lasts for >30s
For LVAD:
Blood flows from a tube connected to the __________ into a ____________ implanted in __________.
LV
Mechanical pump
Upper abdomen
Can all pts with CAD be stented?
No
LVADs are used before _____________
Transplantation
Definition of HTN
Persistent elevation of BP above 140 OR 90 at least two separate occasions at least 2 weeks apart
HTN is regulated by _____ and _____
Cardiac output
Total peripheral resistance
Force exerted against the walls of the arteries and arterioles
Blood pressure
Pressure in vessels when heart is relaxed between beats
DBP
Pressure exerted in arteries when heart contracts
SBP
At age 55-60, what happens to SBP and DBP?
DBP declines or plateaus
SBP increases
5 types of HTN
- Primary
- Secondary
- Labile
- Malignant
- Isolated systolic HTN
Accounts for 90-95% of HTN
Primary
Intermittent elevation of BP interspersed with normal readings
Labile HTN
A syndrome w markedly elevated BP and organ damage
Malignant HTN
Elevated SBP independent of a change in DBP
Isolated systolic HTN
Risk of _____ doubles with each increment of 20/10 mmHg of increasing BP
CVD
Goal BP for patients with diabetes or renal disease
Less than 130/80
HTN is 2x as prevalent and more severe among _____
Blacks than whites
Is HTN more common in males or females at an earlier age?
Men
At a later age, is HTN more common in males or females?
Females
2 main causes for cases of HTN
Alcohol, salt sensitivity
Most important factor of prevention of HTN
Exercise/physical activity
an excessive fall in BP when an upright position is assumed
Orthostatic hypotension
Drop of BP to constitute orthostatic hypotension (quantify it)
SBP 20+
DBP + SBP 10+
Increase of pulse (#) to constitute orthostatic hypotension
15 bpm
Group of conditions affecting the heart muscle
Cardiomyopathies
Cardiomyopathies mainly affect this age group
Young adults in 20s-30s
Can cardiomyopathy be genetic?
Yes - hypertrophic type
Cure for cardiomyopathy
Cardiac transplantation
Disturbance of HR
Dysrhythmia
Dysrhythmias are classified according to their….(3)
Origin, pattern, rate
Electronic pulse generator for increased vagal tone, SA and AV block
Pacemaker
battery-powered device placed under the skin that keeps track of your heart rate
Implantable cardioverter defibrillator (ICD)
What to do if a pts defibrillator goes off?
Call 911
For supraventricular and ventricular arrythmias - destruction of area generating abnormal rhythm
Radiofrequency catheter ablation
an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever
Rheumatic fever
Rheumatic fever causes…
Heart and valve inflammation
What happens to heart valves in rheumatic fever?
They become stenosed or regurgitative
Infection of endocardium and valves from strep or staph
Infective endocarditis
Where does infective endocarditis manifest?
Mouth, respiratory, GI systems
Pts with endocarditis may also show….
Arthralgia, arthritis
Narrowing of valve
Stenosis
Aortic stenosis is a disease of ________
Aging
5 diseases of heart valves
- Aortic stenosis
- Aortic regurgitation
- Mitral regurgitation
- Mitral stenosis
- Mitral valve prolapse
blood flows backwards into the heart instead of pumping out
aortic regurgitation
a condition in which the heart’s mitral valve doesn’t close tightly, which allows blood to flow backward into the L atrium
mitral regurgitation
the leaflets of the mitral valve bulge (prolapse) upward or back into the left atrium as the heart contracts
mitral valve prolapse
triad of symptoms for MVP
fatigue, palpitations, dyspnea
this condition might cause the patient to have an anxiety attack
MVP
name 2 congenital defects
- patent ductus arteriosus
2. tetraogy of fallot
congenital defect in which the aorta originates from the RV or overrides a hole in the septum
tetralogy of fallot
does PVD just apply to arteries?
no. arteries and veins
occlusive arterial disease most prominently affecting the abdominal aorta and the small- and medium-sized arteries of the lower extremities
arteriosclerosis obliterans
main sign of arteriosclerosis obliterans
diminished or absent pulses
intermittent episodes of small artery or arteriole constriction producing temporary pallor and cyanosis
Raynaud’s Disorder
caused by small blood vessels that become inflamed and swollen
thromboangiitis obliterans
partial or complete occlusion of a vein by a thrombus
thrombophlebitis
6 signs of DVT
- dull ache
- tight feeling
- swelling/warmth in calf or ankle
- slight fever
- tachycardia
- homans sign
proximal thrombosis poses a _______ risk for PE
greater
DVT is a/an ______ emergency
acute
Gnarled, enlarged veins, most commonly appearing in the legs and feet.
varicose veins
occurs when damaged valves prevent venous return
chronic venous insufficiency
abnormal stretching in the wall of an artery, vein or heart
aneurysm
2 types of aneurysms (locations)
thoracic and abnominal
which type of aneurysm is more common?
abdominal
in pts with aneurysm, what must be watched during exercise?
SBP
in abdominal aneurysm, what is able to be felt by therapist?
pulsating mass in supine
two types of shock + define
cardiogenic: decreased ability to pump blood
hemorrhagic: diminished blood volume
3 types of cardiomyopathies
restrictive, hypertrophic, dilated
most common cardiomyopathy
dilated
6 risk factors for dilated cardiomyopathy
smoking, HTN, obesity, alcohol abuse, pregnancy, infection
in LVAD, where does pump propel blood?
into aorta
6 signs of MI
- chest pain
- pallor
- SOB
- profuse perspiration
- nausea
- dizziness/fainting
