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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
AS PE
Weak or delayed carotid upstroke due to delay in blood flow LV hypertrophy Palpable wide apical impulse Paradoxical splitting of s2
26
Maneuver to accentuate murmurs
Valsalva and standing - decreases venous return, decreases ejection fraction resulting in decrease murmur
27
Mitral Valve Prolaspe (MP)
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
MP PE
Mid-systolic click
29
MP treatment
ECHO - will show displacement of mitral valve leaflets during systole
30
Mitral Valve regurgitation
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
MR ( PE)
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
How to differentiate between AS and MR
Sustained hand grip increased vascular resistance and after load. In MR the murmur increases and in AS it decreases
33
Diastolic Murmurs
Mitra stenosis and Aortic Regurgitation Occurs between S2 and S1
34
Mitral stenosis ( MS)
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
MS PE
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
Aortic Regurgitation
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
AR PE
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
Afibb definition
Common rhythm disturbance cauterized by irregular QRS complexes adn loss of synchronous atrial contraction
39
Afibb causes
Mitral valve defect, HTN, HF, ischemic heart disease , cardiomyopathy COPD, PE, hyperthyroidism Hypokalemia Alcohol Lyme carditis
40
Afibb S.S
Often none | Palpitations irregular heart rate, chest pain, dyspnea, lightheadedness , dizziness and snycope
41
Afibb PE
EKG - absence of P waves and irregularly irregular conduction tot he ventricules with irregular RR intervals Irregular pulse - Rapid > 100 - Slow <60
42
Afibb dx testing
EKG, 24 holter EKG, Cardiac Echo
43
Afibb treatment
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
Types of anticoagulation
Warfarin target inr 2-3 Dabigatran Rivoraxaban - factor Xa inhibitor Apixaban “ “
45
AV block - def
A slowing down of signal conduction in electrical impulse as it travels from the atria to the ventricles through he AV node
46
AV block s/s
Varies depending on degree of block, range from none to sycophants to cardiogenic shock
47
First degree block
Not an actual block Only prolonged AV conduction PR interval is prolonged > .20 sec
48
2nd degree heart block type 1
Lengthening of PR interval until it fails to conduct ventricle and a QRS “ going , going , gone”
48
2nd degree type II
P wave but no QRS Episodic and unpredictable PR interval the same
48
3rd degree HB
Atria and ventricles are controlled by separate pacemaker | PR intervals irregular
48
Prolonged QT
QT = Torsades ``` Meds Antiemetics Antifungals Antimalarials Antidepressants Antipsychotics Antibiocs - macrolides ```

Adult Health (12 decks)

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