Cardiac Disease and Rehabilitation Flashcards
what is the heart’s main function? what is it able to do?
- pumps blood around the body
- able to get blood returned to the heart to provide nutrients
what 4 structures of the heart enables its function?
- valves
- conduction system
- orientation cardiac m/s
- circulatory system
what is cardiac output?
- volume of blood ejected/ minute
what is the equation for cardiac output?
C0= SV x HR
cardiac output= stroke volume x heart rate
what are the units of cardiac output? what is the normal for an adult at rest?
- ml/minute
- 5-6 L/min
what are the units of stroke volume? what is the normal measurement for an adult at rest?
- ml/ beat
- 70-80mls
what are the units of heart rate? what is the normal measurement for an adult at rest?
- beats/ min
- 60-70bom
what is the cardiac index?
- hemodynamic measurement that relates cardiac output to body surface area to provide a personalised assessment of heart function
what are the four main valves of the heart?
- pulmonary valve
- tricuspid valve
- aortic valve
- mitral valve
what is adequate cardiac output dependent on?
- dependent on coordinated chamber activity
what are the 4 factors that adequate cardiac output is dependent on?
- filling phase
- contraction phase
- M/s force optimal when cardiac m/s stretched
- consider pressure/ volume relationship
what happens during diastole?
- atria and ventricles receive blood supply from the lung or systemic circulation
what happens during systole?
- blood ejected to certain structures of the body
will force continue increasing when cardiac m/s is stretched?
- up until a point
- could suffer from cardiac myopathy
what 2 circulations compromise the whole system?
- pulmonary
- systemic
what circulation requires more pressure?
- systemic as it has to travel further and against gravity
- heart supports other organs e.g., kidney, liver
what are the three compensatory mechanisms that allows the cardiac system to have a large reserve?
- increased HR
- increased SV
- increased oxygen utilisation by active tissue
what are the two conditions with the percentages of deaths from cardiovascular disease?
- CHD = 50%
- stroke = 20%
what are the 7 types of cardiovascular disease?
- atherosclerosis
- chest pain (angina pectoris)
- coronary heart disease
- arrythmia
- congestive heart failure
- congenital and rheumatic heart disease
- stroke
what is atherosclerosis characterised by?
- characterised by deposits of fatty substances, cholesterol, cellular waste products, calcium and fibrin in the inner lining of the artery
is there clear symptoms of atherosclerosis?
- no clear symptoms
- described a silent disease
what is abnormally high blood lipid level called?
- hyperlipidaemia
what is the build-up of deposits in the arteries called?
- plaque
what people are more at risk of atherosclerosis?
- obese people
what are the two consequences of atherosclerosis on the heart?
- reduction in blood flow
- damage to the vessel (change in adaptability)
what is angina pectoris?
- chest pain or discomfort that occurs when part of your heart doesn’t receive enough blood and oxygen
what is ischemia?
- reduction of the heart’s blood and oxygen supply
what does the more serious the oxygen deprivation result in?
- the more severe the pain
what drug is used to dilate the veins?
- nitro- glycerine
- relaxes the veins
what do beta blockers do?
- controls potential overactivity of the heart muscle
what happens if the aortic valve closes?
- blood in systemic circulation so heart goes into diastole
- rests with least pressure
what is coronary heart disease?
- heart’s blood supply is blocked or interrupted by a build- up of fatty substances
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
how does someone repair from a myocardial infarction? why?
- repair via fibral scaring
- because heart tissue is special
what is coronary thrombosis?
- blood clot in the artery
what is embolus?
- when the blood clot is dislodged and moves through the circulatory system
what is collateral circulation?
- if blockage to the heart is minor, an alternative blood flow is selected
what are the 5 structures of the conduction system?
- SA node
- AV node
- bundle of his
- R/L bundle branches
- purkinje fibres
what does the sinoatrial node do?
- initiates contraction
- creates a pause between atrial and ventricular contraction
what are purkinje fibres? what do they do?
- specialised nerve cells located at the bottom that send electrical signals to the ventricles
what are the 6 clinical manifestations of CHD?
- stable angina
- unstable angina
- myocardial infarction
- heart failure
- arrythmia
- sudden death
what is stable angina?
- ischaemia due to fixed atheromatous stenosis of one or more coronary arteries
what is unstable angina?
- ischaemia caused by obstruction of a coronary artery due to plaque rupture with superimposed thrombosis and spasm
what is myocardial infarction?
- myocardial necrosis caused by acute occlusion of a coronary artery due to plaque rupture and thrombosis
what is heart failure? what is it due to?
- myocardial dysfunction
- due to infarction or ischaemia
what is sudden death caused by? (3)
- ventricular arrhythmia
- asystole
- massive myocardial infarction
what is arrhythmia?
- irregularity in heart rhythm
what are the three types of arrythmia?
- tachycardia
- bradycardia
- fibrillation
what is tachycardia?
- racing heart in the absence of exercise or anxiety
what is bradycardia?
- abnormally slow heartbeat
what is fibrillation?
- heart beat is sporadic
- quivering pattern
what are people with arrythmia at high risk of? why?
- high risk of blood clots
- because blood may pool in the upper chambers
what is congestive heart failure?
- damaged or overworked heart muscle is unable to keep blood circulating normally
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
what drug relieves fluid accumulation?
- diuretics
what is pitting oedema?
- excess fluid builds up in the body causing swelling
what is damage to the heart muscle from? (3)
- pneumonia
- heart attack
- other cardiovascular problems
how many stages are there in congestive heart failure?
- 4 stages
what is the first stage of congestive heart failure?
- breathlessness of tiredness (with brisk walk, a jog or taking a flight of stairs)
what is stage 2 of congestive heart failure?
- comfortable when resting
- heart races or breathlessness when walking a block or taking the stairs
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
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
what is acute pulmonary oedema?
- fluid collects in the air sacs of the lung
- difficult to breath normally
is pulmonary oedema treatable?
- no
- physiotherapy may aggravate the pain
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
how many deaths are caused by CVD?
- one in three
- 191,000
what is up to 90% of the risk of a first heart attack due to?
- lifestyle factors
how many people are affected by CVD in the UK?
- 2.6 million
how much does CVD cost the healthcare system?
£14.4 billion
what is over 70% of the cost to the healthcare system spent on?
- hospitalisation
what does rehabilitation have the potential to do regarding cardiac disease?
- reduces risk of cardiac mortality by 26% in 5 years
what are the cost - effective medications for cardiac rehabilitation?
- aspirin
- beta blockers
how many cardiac patients are offered physiotherapy?
- small percentage
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