Cardiac Diseases Flashcards
This is a progressive condition in which plaque builds up in the tunic intima of arteries.
Atherosclerosis
Another name for the deposit of lipids and calcified cells found during atherosclerosis
Atheroma
True or False: atherosclerosis can occur in any artery and is categorized by location
True
List 3 modifiable risk factors
cigarette smoking, dyslipidemia, hypertension, DM, obesity, sedentary lifestyle
True or False: atherosclerosis is more common in males than females
True
What are the 5 risk factors for cardiovascular disease?
atherosclerosis, dyslipidemia, diabetes, htn, lifestyle factors
Difference between type 1 and type 2 diabtes
type 1: early onset, beta cells of pancreas are destroyed and can’t make insulin
type 2: gradual onset, NOT autoimmune, person becomes insulin resistance
3 P’s of Diabetes
- polyuria - excessive urination
- polydipsia - excessive thirst
- polyphagia - excessive appetite
Lab findings for Diabetes Patients
fasting BG greater than 126
glucose intolerance test greater than 200
elevated HgbA1C
HgbA1C value for it to be considered diabetes?
greater than 6.5%
Onset, Peak and Duration of Rapid Acting Insulin (humalog/novolog)
Onset: 15-30 min
Peak: 1-2 hours
Duration: 3-6 hours
Onset, Peak and Duration of Short Acting Insulin (regular)
Onset: 30-60 min
Peak: 2-4 hours
Duration: 3-6 hours
Onset, Peak and Duration of intermediate insulin (NPH)
Onset: 2-4 hours
Peak: 8-10 hours
Duration: 10-18 hours
Onset, Peak and Duration of long acting insulin (LANTUS)
Onset: 1-2 hours
Peak: none
Duration: 19-24 hours
LDL versus HDL
LDL - low density lipoproteins or “bad cholesterol”
HDL - high density lipoproteins or “good cholesterol”
High levels of HDL inversely correlate with cardiovascular risk - T or F
True
Normal LDL
Less than 100
Normal HDL
greater than 60
normal cholesterol
less than 200
3 meds for lowering cholesterol
statins, nonstatins, and naicin
Statin-associated muscle symptoms
weakness, aches and cramps
Naicin is prescribed to do what for dyslipidemia?
ordered to increase HDL alongside other anti-lipid agents
Examples of statins
Lipitor or Zocor
Example of nonstatins
Zetia or Fenofibrate
Primary (essential) HTN versus Secondary HTN
primary: unknown cause - coorelates with lifestyle factors
secondary: known primary cause - medication, endocrine disorder
Hypertensive Urgency Definition
BP > 180-110 without evidence of organ dysfunction
Hypertensive Crisis
Systolic BP>180 and/or diastolic BP>120, with impending or progressive organ dysfunction
DASH diet
high in fruits, veggies and lean meats, low in sugar and red meat
suggested for those with HTN
Classes of medications for HTN
ACE inhibitors
ARBs
Calcium Channel Blockers
Thiazide diuretics
True or False: HTN is more common in men less than 50 and woman over 50.
True
Angina Pectoris
chest pain caused by narrowed coronary arteries and presents with negative trop, ST depression and T-wave changes
Stable angina versus unstable
stable: resolves quickly, with rest or medications, can be triggered by exertion, large meals and hot/cold temperatures
unstable: occurs any time, lasts longer than 20 minutes, more severe and not easily relieved
Stable angina versus unstable
stable: resolves quickly, with rest or medications, can be triggered by exertion, large meals and hot/cold temperatures
unstable: occurs any time, lasts longer than 20 minutes, more severe and not easily relieved
Prinzmetal Angina/Variant Angina/vasoplastic
episodes of angina and TEMPORARY ST elevations caused by spasms of coronary artery - easily relieved by nitrates
STEMI versus NSTEMI
STEMI: elevated ST (>1) = COMPLETE occlusion
NSTEMI: ST depression or T-wave inversion
Anterior Wall MI ST change location and artery affected
V1-V4; LAD
LAD supplies what part of the heart
blood to anterior left atrium and ventricle
Inferior Wall MI ST change location and artery affected
II, III, aVF; RCA
Right ventricular MI ST change location and area affected
V4-V6; interior wall MI
Lateral wall MI ST change location and artery affected
I, aVL, V5, V6; Left Circumflex
posterior wall MI ST change location and artery affected
V7-V9 elevation and ST depression in V1-V4
RCA or left circumflex artery
Issues after right ventricular MI
tachycardia, hypotension and JVD
positive inotropes
avoid pre-load reducing meds (beta blockers; diuretics; morphine, nitrates)
Issues after inferior wall MI
bradycardia/hypotension
increase in AV blocks
increase risk for papillary muscle rupture
avoid reducing preload
Papillary muscle rupture
occurs 2-8 days post MI
hemodynamic compromise, pulmonary edema and new LOUD systolic murmur
requires EMERGENT repair
issues after anterior wall MI
increased risk of left heart failure
increased risk of 2nd degree blocks
increased ventricular rupture
Diagnostic tests to look for MI
elevated troponin (>0.1 ng/ml)
elevated CK-MB (>2.5%)
STEMI Process
_______ min door to balloon
_______ min door to fibrinolytic therapy
90 min
30 min
NSTEMI meds
nitro - vasodilation
beta blocker/calcium channel blockers - reduce myocardial oxygen demand
heparin: improve blood flow
morphine: pain not relieved with nitro
If patient cannot take aspirin for managing MI, what is the other option?
Clopidogrel
