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
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2
Q

what 4 structures of the heart enables its function?

A
  • valves
  • conduction system
  • orientation cardiac m/s
  • circulatory system
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3
Q

what is cardiac output?

A
  • volume of blood ejected/ minute
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4
Q

what is the equation for cardiac output?

A

C0= SV x HR
cardiac output= stroke volume x heart rate

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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
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6
Q

what are the units of stroke volume? what is the normal measurement for an adult at rest?

A
  • ml/ beat
  • 70-80mls
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7
Q

what are the units of heart rate? what is the normal measurement for an adult at rest?

A
  • beats/ min
  • 60-70bom
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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
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9
Q

what are the four main valves of the heart?

A
  • pulmonary valve
  • tricuspid valve
  • aortic valve
  • mitral valve
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10
Q

what is adequate cardiac output dependent on?

A
  • dependent on coordinated chamber activity
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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
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12
Q

what happens during diastole?

A
  • atria and ventricles receive blood supply from the lung or systemic circulation
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13
Q

what happens during systole?

A
  • blood ejected to certain structures of the body
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14
Q

will force continue increasing when cardiac m/s is stretched?

A
  • up until a point
  • could suffer from cardiac myopathy
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15
Q

what 2 circulations compromise the whole system?

A
  • pulmonary
  • systemic
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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
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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
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18
Q

what are the two conditions with the percentages of deaths from cardiovascular disease?

A
  • CHD = 50%
  • stroke = 20%
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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
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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
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21
Q

is there clear symptoms of atherosclerosis?

A
  • no clear symptoms
  • described a silent disease
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22
Q

what is abnormally high blood lipid level called?

A
  • hyperlipidaemia
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23
Q

what is the build-up of deposits in the arteries called?

A
  • plaque
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24
Q

what people are more at risk of atherosclerosis?

A
  • obese people
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25
Q

what are the two consequences of atherosclerosis on the heart?

A
  • reduction in blood flow
  • damage to the vessel (change in adaptability)
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26
Q

what is angina pectoris?

A
  • chest pain or discomfort that occurs when part of your heart doesn’t receive enough blood and oxygen
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27
Q

what is ischemia?

A
  • reduction of the heart’s blood and oxygen supply
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28
Q

what does the more serious the oxygen deprivation result in?

A
  • the more severe the pain
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29
Q

what drug is used to dilate the veins?

A
  • nitro- glycerine
  • relaxes the veins
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30
Q

what do beta blockers do?

A
  • controls potential overactivity of the heart muscle
31
Q

what happens if the aortic valve closes?

A
  • blood in systemic circulation so heart goes into diastole
  • rests with least pressure
32
Q

what is coronary heart disease?

A
  • heart’s blood supply is blocked or interrupted by a build- up of fatty substances
33
Q

what is a myocardial infarction? what else is it called?

A
  • blood supplying heart is disrupted as it doesn’t receive sufficient oxygen for the heart demand
  • also can be called a heart attack
34
Q

how does someone repair from a myocardial infarction? why?

A
  • repair via fibral scaring
  • because heart tissue is special
35
Q

what is coronary thrombosis?

A
  • blood clot in the artery
36
Q

what is embolus?

A
  • when the blood clot is dislodged and moves through the circulatory system
37
Q

what is collateral circulation?

A
  • if blockage to the heart is minor, an alternative blood flow is selected
38
Q

what are the 5 structures of the conduction system?

A
  • SA node
  • AV node
  • bundle of his
  • R/L bundle branches
  • purkinje fibres
39
Q

what does the sinoatrial node do?

A
  • initiates contraction
  • creates a pause between atrial and ventricular contraction
40
Q

what are purkinje fibres? what do they do?

A
  • specialised nerve cells located at the bottom that send electrical signals to the ventricles
41
Q

what are the 6 clinical manifestations of CHD?

A
  • stable angina
  • unstable angina
  • myocardial infarction
  • heart failure
  • arrythmia
  • sudden death
42
Q

what is stable angina?

A
  • ischaemia due to fixed atheromatous stenosis of one or more coronary arteries
43
Q

what is unstable angina?

A
  • ischaemia caused by obstruction of a coronary artery due to plaque rupture with superimposed thrombosis and spasm
44
Q

what is myocardial infarction?

A
  • myocardial necrosis caused by acute occlusion of a coronary artery due to plaque rupture and thrombosis
45
Q

what is heart failure? what is it due to?

A
  • myocardial dysfunction
  • due to infarction or ischaemia
46
Q

what is sudden death caused by? (3)

A
  • ventricular arrhythmia
  • asystole
  • massive myocardial infarction
47
Q

what is arrhythmia?

A
  • irregularity in heart rhythm
48
Q

what are the three types of arrythmia?

A
  • tachycardia
  • bradycardia
  • fibrillation
49
Q

what is tachycardia?

A
  • racing heart in the absence of exercise or anxiety
50
Q

what is bradycardia?

A
  • abnormally slow heartbeat
51
Q

what is fibrillation?

A
  • heart beat is sporadic
  • quivering pattern
52
Q

what are people with arrythmia at high risk of? why?

A
  • high risk of blood clots
  • because blood may pool in the upper chambers
53
Q

what is congestive heart failure?

A
  • damaged or overworked heart muscle is unable to keep blood circulating normally
54
Q

what does the lack of proper circulation in CHF lead to?

A
  • leads to accumulation of blood in the vessels of the legs, ankles, or lungs
55
Q

what drug relieves fluid accumulation?

56
Q

what is pitting oedema?

A
  • excess fluid builds up in the body causing swelling
57
Q

what is damage to the heart muscle from? (3)

A
  • pneumonia
  • heart attack
  • other cardiovascular problems
58
Q

how many stages are there in congestive heart failure?

59
Q

what is the first stage of congestive heart failure?

A
  • breathlessness of tiredness (with brisk walk, a jog or taking a flight of stairs)
60
Q

what is stage 2 of congestive heart failure?

A
  • comfortable when resting
  • heart races or breathlessness when walking a block or taking the stairs
61
Q

what is stage 3 of congestive heart failure?

A

-palpation or tiredness with simple tasks like getting up from the sofa and walking over to the kitchen

62
Q

what is stage 4 of congestive heart failure?

A
  • heart and breath go faster even at rest
  • tiredness even when sitting
  • anxiety and palpitations almost all the time
63
Q

what is acute pulmonary oedema?

A
  • fluid collects in the air sacs of the lung
  • difficult to breath normally
64
Q

is pulmonary oedema treatable?

A
  • no
  • physiotherapy may aggravate the pain
65
Q

what do around half of patients with CVS have? - give some examples

A
  • around half have additional health problems
    e.g., back pain, arthritis, diabetes, respiratory diseases like asthma
66
Q

how many deaths are caused by CVD?

A
  • one in three
  • 191,000
67
Q

what is up to 90% of the risk of a first heart attack due to?

A
  • lifestyle factors
68
Q

how many people are affected by CVD in the UK?

A
  • 2.6 million
69
Q

how much does CVD cost the healthcare system?

A

£14.4 billion

70
Q

what is over 70% of the cost to the healthcare system spent on?

A
  • hospitalisation
71
Q

what does rehabilitation have the potential to do regarding cardiac disease?

A
  • reduces risk of cardiac mortality by 26% in 5 years
72
Q

what are the cost - effective medications for cardiac rehabilitation?

A
  • aspirin
  • beta blockers
73
Q

how many cardiac patients are offered physiotherapy?

A
  • small percentage
74
Q

what are the 8 lifestyle risks that you can control?

A
  • 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