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Adult Health > Cardiac Disease Part I > Flashcards

Cardiac Disease Part I Flashcards

1
Q

CAD

A

Plaque deposits that restrict load flow to the heart major blood vessels

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2
Q

Stable angina

A

CP less than 5 min
- predictable relieved with nitro

Goal : relief of symptoms and reduce lifestyle

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3
Q

ACS

A

Unstable - pain last longer than 20 min and NOT relieved by rest or medication

  • need EKG to see ischemic changes
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4
Q

Silent ischemia

A

Goes undetected due to atypical presentation

Common in elderly, dm, and known CAD puts

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5
Q

Coronary spams

A

Typically right coronary artery, transient pain at rest, ST elevation, relieved with nitro

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6
Q

Microvascular disease

A

Angina -like CP in setting of normal coronary arteries

It’s a reduce capacity to respond to increased demand

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7
Q

GERD

A

Pain typically at night but think about this and work this up

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8
Q

Cholecystitis

A

+ Murphy sign, N/V

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9
Q

Costrochrondritis

A

Recent lifting, coughing , often reproducible pain

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10
Q

Pleurisy

A

Inflammation - sharp pain with deep breath, cough , pleural friction rub present

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11
Q

CP presentation with women / elderly / DM

A

Fatigue, SOB w or w/o CP,
W : discomfort in arms, back, neck, shoulder blades
Nausea, lightheadedness, sudden cold sweat
Waxing and waxing chest discomfort
Abdominal fullness or burning sensation

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12
Q

APRN role in CAD

A

Assure cardiology follow
Management of risks
Education

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13
Q

Murmurs

A

Sound produced by turbulent blood flow across a heart valve. Occurs during systole or diastole

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14
Q

Stenosis

A

Narrowed opening

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15
Q

Regurgitation

A

Backward flow of blood

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16
Q

Prolapse

A

Valves are floppy and do not close tightly

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17
Q

Grade of murmurs 1-6

A

1 being very soft to 6 being so pound that it audible even without direct placement of stethoscope on the chest

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18
Q

Grade 2 M

A

Is soft but can be readily heard by skilled examiner

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19
Q

Grade 3

A

Is easy to hear

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20
Q

Grade 4

A

Is slightly loud and accompanied by a palpable thrill

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21
Q

Grade 5

A

Is very loud and accompanied by a easily palpable thrill

22
Q

Systolic murmurs

A

AS, MR, MP

Occurs between s1 and s2

23
Q

Aortic Stenosis definition

A

Narrowed aortic valve resulting in obstruction of the blood flow from the left ventricular into the aorta

A systolic crescendo-decrescendo murmur that results in increased afterload on the left ventricle and ultimate LV failure

24
Q

AS pathophysiology

A

As the valve area decreases the left ventricle works harder to pump blood throughout the body

The increased work load of the left ventricle increases left ventricular myocardial oxygen demand and in response to the increased workload, the myocardium of the left ventricular —> hypertrophies

25
Q

AS PE

A

Weak or delayed carotid upstroke due to delay in blood flow

LV hypertrophy

Palpable wide apical impulse

Paradoxical splitting of s2

26
Q

Maneuver to accentuate murmurs

A

Valsalva and standing - decreases venous return, decreases ejection fraction resulting in decrease murmur

27
Q

Mitral Valve Prolaspe (MP)

A

Occurs during mid to late systole, the mitral valve leaflets bulge back into he left atrium and can lead to mitral regurgitation

W >M

28
Q

MP PE

A

Mid-systolic click

29
Q

MP treatment

A

ECHO - will show displacement of mitral valve leaflets during systole

30
Q

Mitral Valve regurgitation

A

Changes to the mitral valve so that is no longer to able to close properly

Blood in the left ventricle is primped back into the pulmonary veins and pulmonary circulation

31
Q

MR ( PE)

A

Prominent PMI
Apical thrills may be felt in severe MR

Muffled 1st heart sounds
Holosystolic murmur w/blowing quality heard best at the apical area

32
Q

How to differentiate between AS and MR

A

Sustained hand grip increased vascular resistance and after load. In MR the murmur increases and in AS it decreases

33
Q

Diastolic Murmurs

A

Mitra stenosis and Aortic Regurgitation

Occurs between S2 and S1

34
Q

Mitral stenosis ( MS)

A

Occurs during diastole due to the narrowed, stenotic valve in whose obstructs blood flow between the left atrium and left ventricle, this obstructing fling of the left ventricle

35
Q

MS PE

A

Mid-diastolic rumbling murmur

Heard loudest at the 5ht intercostal space midclavivular line with patient lying on the left side

Opening snap can be heard as the calcified calve is forced open the LA contraction

Pulmonary HTN can occur in severe MVS

36
Q

Aortic Regurgitation

A

Incomplete aortic valve disorder characterized by incomplete aortic valve close.

Results in the regurgitation of blood from teh aorta into the left ventricle during diastole

37
Q

AR PE

A

High pitched diastolic decrescendo blowing murmur

Best heard at 2nd and 3rd intercostal space R and L sternal border

Maybe associated with S3

Maneuvers to accentuate sound

  • squatting and hand grip increased murmur
    • sitting up right and leaning forward
38
Q

Afibb definition

A

Common rhythm disturbance cauterized by irregular QRS complexes adn loss of synchronous atrial contraction

39
Q

Afibb causes

A

Mitral valve defect, HTN, HF, ischemic heart disease , cardiomyopathy

COPD, PE, hyperthyroidism
Hypokalemia
Alcohol
Lyme carditis

40
Q

Afibb S.S

A

Often none

Palpitations irregular heart rate, chest pain, dyspnea, lightheadedness , dizziness and snycope

41
Q

Afibb PE

A

EKG - absence of P waves and irregularly irregular conduction tot he ventricules with irregular RR intervals

Irregular pulse

  • Rapid > 100
  • Slow <60
42
Q

Afibb dx testing

A

EKG, 24 holter EKG, Cardiac Echo

43
Q

Afibb treatment

A

Correct reversible risk factors
- Electrolytes and Hyperthyroidism

Restore Rhythm control

  • cardioversion, ablation w/implantation
  • pharm cardioversion
  • rate control with BB, CCB and digoxin

Prophylaxis of thromboembolism with anticoagulation
- CHAD score

44
Q

Types of anticoagulation

A

Warfarin target inr 2-3
Dabigatran
Rivoraxaban - factor Xa inhibitor
Apixaban “ “

45
Q

AV block - def

A

A slowing down of signal conduction in electrical impulse as it travels from the atria to the ventricles through he AV node

46
Q

AV block s/s

A

Varies depending on degree of block, range from none to sycophants to cardiogenic shock

47
Q

First degree block

A

Not an actual block
Only prolonged AV conduction

PR interval is prolonged > .20 sec

48
Q

2nd degree heart block type 1

A

Lengthening of PR interval until it fails to conduct ventricle and a QRS
“ going , going , gone”

48
Q

2nd degree type II

A

P wave but no QRS
Episodic and unpredictable
PR interval the same

48
Q

3rd degree HB

A

Atria and ventricles are controlled by separate pacemaker

PR intervals irregular

48
Q

Prolonged QT

A

QT = Torsades

Meds
Antiemetics
Antifungals
Antimalarials
Antidepressants
Antipsychotics 
Antibiocs - macrolides

Adult Health (12 decks)

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