Cardiac Disease and Rehabilitation Flashcards
1
Q
what is the heart’s main function? what is it able to do?
A
- pumps blood around the body
- able to get blood returned to the heart to provide nutrients
2
Q
what 4 structures of the heart enables its function?
A
- valves
- conduction system
- orientation cardiac m/s
- circulatory system
3
Q
what is cardiac output?
A
- volume of blood ejected/ minute
4
Q
what is the equation for cardiac output?
A
C0= SV x HR
cardiac output= stroke volume x heart rate
5
Q
what are the units of cardiac output? what is the normal for an adult at rest?
A
- ml/minute
- 5-6 L/min
6
Q
what are the units of stroke volume? what is the normal measurement for an adult at rest?
A
- ml/ beat
- 70-80mls
7
Q
what are the units of heart rate? what is the normal measurement for an adult at rest?
A
- beats/ min
- 60-70bom
8
Q
what is the cardiac index?
A
- hemodynamic measurement that relates cardiac output to body surface area to provide a personalised assessment of heart function
9
Q
what are the four main valves of the heart?
A
- pulmonary valve
- tricuspid valve
- aortic valve
- mitral valve
10
Q
what is adequate cardiac output dependent on?
A
- dependent on coordinated chamber activity
11
Q
what are the 4 factors that adequate cardiac output is dependent on?
A
- filling phase
- contraction phase
- M/s force optimal when cardiac m/s stretched
- consider pressure/ volume relationship
12
Q
what happens during diastole?
A
- atria and ventricles receive blood supply from the lung or systemic circulation
13
Q
what happens during systole?
A
- blood ejected to certain structures of the body
14
Q
will force continue increasing when cardiac m/s is stretched?
A
- up until a point
- could suffer from cardiac myopathy
15
Q
what 2 circulations compromise the whole system?
A
- pulmonary
- systemic
16
Q
what circulation requires more pressure?
A
- systemic as it has to travel further and against gravity
- heart supports other organs e.g., kidney, liver
17
Q
what are the three compensatory mechanisms that allows the cardiac system to have a large reserve?
A
- increased HR
- increased SV
- increased oxygen utilisation by active tissue
18
Q
what are the two conditions with the percentages of deaths from cardiovascular disease?
A
- CHD = 50%
- stroke = 20%
19
Q
what are the 7 types of cardiovascular disease?
A
- atherosclerosis
- chest pain (angina pectoris)
- coronary heart disease
- arrythmia
- congestive heart failure
- congenital and rheumatic heart disease
- stroke
20
Q
what is atherosclerosis characterised by?
A
- characterised by deposits of fatty substances, cholesterol, cellular waste products, calcium and fibrin in the inner lining of the artery
21
Q
is there clear symptoms of atherosclerosis?
A
- no clear symptoms
- described a silent disease
22
Q
what is abnormally high blood lipid level called?
A
- hyperlipidaemia
23
Q
what is the build-up of deposits in the arteries called?
A
- plaque
24
Q
what people are more at risk of atherosclerosis?
A
- obese people
25
what are the two consequences of atherosclerosis on the heart?
- reduction in blood flow
- damage to the vessel (change in adaptability)
26
what is angina pectoris?
- chest pain or discomfort that occurs when part of your heart doesn't receive enough blood and oxygen
27
what is ischemia?
- reduction of the heart's blood and oxygen supply
28
what does the more serious the oxygen deprivation result in?
- the more severe the pain
29
what drug is used to dilate the veins?
- nitro- glycerine
- relaxes the veins
30
what do beta blockers do?
- controls potential overactivity of the heart muscle
31
what happens if the aortic valve closes?
- blood in systemic circulation so heart goes into diastole
- rests with least pressure
32
what is coronary heart disease?
- heart's blood supply is blocked or interrupted by a build- up of fatty substances
33
what is a myocardial infarction? what else is it called?
- blood supplying heart is disrupted as it doesn't receive sufficient oxygen for the heart demand
- also can be called a heart attack
34
how does someone repair from a myocardial infarction? why?
- repair via fibral scaring
- because heart tissue is special
35
what is coronary thrombosis?
- blood clot in the artery
36
what is embolus?
- when the blood clot is dislodged and moves through the circulatory system
37
what is collateral circulation?
- if blockage to the heart is minor, an alternative blood flow is selected
38
what are the 5 structures of the conduction system?
- SA node
- AV node
- bundle of his
- R/L bundle branches
- purkinje fibres
39
what does the sinoatrial node do?
- initiates contraction
- creates a pause between atrial and ventricular contraction
40
what are purkinje fibres? what do they do?
- specialised nerve cells located at the bottom that send electrical signals to the ventricles
41
what are the 6 clinical manifestations of CHD?
- stable angina
- unstable angina
- myocardial infarction
- heart failure
- arrythmia
- sudden death
42
what is stable angina?
- ischaemia due to fixed atheromatous stenosis of one or more coronary arteries
43
what is unstable angina?
- ischaemia caused by obstruction of a coronary artery due to plaque rupture with superimposed thrombosis and spasm
44
what is myocardial infarction?
- myocardial necrosis caused by acute occlusion of a coronary artery due to plaque rupture and thrombosis
45
what is heart failure? what is it due to?
- myocardial dysfunction
- due to infarction or ischaemia
46
what is sudden death caused by? (3)
- ventricular arrhythmia
- asystole
- massive myocardial infarction
47
what is arrhythmia?
- irregularity in heart rhythm
48
what are the three types of arrythmia?
- tachycardia
- bradycardia
- fibrillation
49
what is tachycardia?
- racing heart in the absence of exercise or anxiety
50
what is bradycardia?
- abnormally slow heartbeat
51
what is fibrillation?
- heart beat is sporadic
- quivering pattern
52
what are people with arrythmia at high risk of? why?
- high risk of blood clots
- because blood may pool in the upper chambers
53
what is congestive heart failure?
- damaged or overworked heart muscle is unable to keep blood circulating normally
54
what does the lack of proper circulation in CHF lead to?
- leads to accumulation of blood in the vessels of the legs, ankles, or lungs
55
what drug relieves fluid accumulation?
- diuretics
56
what is pitting oedema?
- excess fluid builds up in the body causing swelling
57
what is damage to the heart muscle from? (3)
- pneumonia
- heart attack
- other cardiovascular problems
58
how many stages are there in congestive heart failure?
- 4 stages
59
what is the first stage of congestive heart failure?
- breathlessness of tiredness (with brisk walk, a jog or taking a flight of stairs)
60
what is stage 2 of congestive heart failure?
- comfortable when resting
- heart races or breathlessness when walking a block or taking the stairs
61
what is stage 3 of congestive heart failure?
-palpation or tiredness with simple tasks like getting up from the sofa and walking over to the kitchen
62
what is stage 4 of congestive heart failure?
- heart and breath go faster even at rest
- tiredness even when sitting
- anxiety and palpitations almost all the time
63
what is acute pulmonary oedema?
- fluid collects in the air sacs of the lung
- difficult to breath normally
64
is pulmonary oedema treatable?
- no
- physiotherapy may aggravate the pain
65
what do around half of patients with CVS have? - give some examples
- around half have additional health problems
e.g., back pain, arthritis, diabetes, respiratory diseases like asthma
66
how many deaths are caused by CVD?
- one in three
- 191,000
67
what is up to 90% of the risk of a first heart attack due to?
- lifestyle factors
68
how many people are affected by CVD in the UK?
- 2.6 million
69
how much does CVD cost the healthcare system?
£14.4 billion
70
what is over 70% of the cost to the healthcare system spent on?
- hospitalisation
71
what does rehabilitation have the potential to do regarding cardiac disease?
- reduces risk of cardiac mortality by 26% in 5 years
72
what are the cost - effective medications for cardiac rehabilitation?
- aspirin
- beta blockers
73
how many cardiac patients are offered physiotherapy?
- small percentage
74
what are the 8 lifestyle risks that you can control?
- exercise regularly
- maintain a healthy weight
- avoid tobacco
- cut back on saturated fat and cholesterol
- modify dietary habits
- control diabetes
- control blood pressure
- manage stress
