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NUR 326 > Cardiac Diseases > Flashcards

Cardiac Diseases Flashcards

1
Q

what are ischemic heart diseases

A

coronary artery disease
stable angina

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2
Q

what is coronary artery disease

A

the coronary arteries become clogged due to atherosclerosis
- heart muscles dont get proper O2 and begin to die

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3
Q

which coronary artery is the most problematic to develop coronary artery disease

A

left anterior descending artery (LAD)
- widow maker

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4
Q

why is the LAD so crucial

A

its the artery that feeds the LV which pumps blood to the whole heart
- LV determines perfusion to the whole body

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5
Q

what are potential problems of the heart

A

electrical –> conduction
plumbing –> artery blockage, spasms, valve issues
pump –> heart muscles

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6
Q

what is atheroscelosis

A

thickening or hardening or bv
- atherosclerotic plaque formation occurs w endothelium injury
- injury causes the endothelium to increase in permeability allowing LDLs to move into vessel wall

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7
Q

what are non modifiable risk factors for CAD

A

age: older
fam hx: shared env exposures
gender: males earlier, women post menopause
ethnicity: ppl of color
genetics

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8
Q

what are modifiable risk factors

A

HTN
smoking
DM
Obesity/inactivity
Diet
HLP!!!!
depression, stress

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9
Q

what is the patho of ischemic heart problems

A

atherosclerosis develops in the arteries that supply blood to the myocardium –> artery blockage
- causes dec tissue perfusion
- endothelial dysfunction
- heart has to work harder

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10
Q

what is endothelial dysfunction

A

vessels aren’t blocked but are narrowed when they should be dilating
- inc of vasoconstriction

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11
Q

causes of endothelial dysfunction

A

DM
HTN
HLP
smoking

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12
Q

what is the main sx of CAD

A

angina

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13
Q

what are other sx of CAD

A

asymptomatic
dizzy
heart burn
irregular heartbeat
anxiety
burning sensation
N
cold sweats

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14
Q

what is angina

A

chest pain

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15
Q

what causes angina

A

dec blood flow to myocardium

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16
Q

what happens with complete occlusion of coronary arteries

A

myocardial infarction

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17
Q

what is stable angina

A

coronary blood flow is diminished but not blocked
- imbalance between oxygen supply and demand
- most often caused by atherosclerosis

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18
Q

what happens with stable angina

A
  • brought on by exertion and relieved with rest
  • usually only lasts 2-5 mins
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19
Q

what areas are associated with the heart

A

heart
L arm
L shoulder
jaw
diaphoresis
pallor

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20
Q

what are signs of cardiac chest pain

A

pressure or tightness
diffuse poorly localized
associated w physical exertion or other stresses
relieved with rest, usually w/in mins
prolonged sx may represent an acute MI

21
Q

what are atypical angina in women

A

discomfort: hot and burning
location: not always in the chest
others:
- indigestion
- heartburn
- N
- fatigue, weakness
- lightheadedness
- dyspnea

22
Q

what are the signs of a myocardial infarction

A
  • chest pain not brought on by exertion
  • chest pain may radiate to other areas
  • pain not relieved within 2-5 mins
  • accompanied by NV, SOA, diaphoresis
23
Q

what do we teach pts about stable angina

A
  • remember to rest and relax to dec heart demands
  • nitrates
  • prevent and treat atherosclerosis
  • teach about differences btw angina and MI
24
Q

what is cardiomyopathy

A

disease that affects the myocardium
- usually idiopathic but can be caused by ischemia, HTN, inherited disorders, infections, toxins, myocarditis, autoimmune

25
what can cardiomyopathy lead to
heart failure
26
what are the two types of cardiomyopathy
dilated restrictive
27
what is heart failure
chronic and progressive condition where the heart is unable to pump enough blood to meet the body's needs - heart can't keep up its workload *weakened myocardium*
28
what is the most common cause of hospitalization
weakened myocardium
29
what does heart factor result in
dec cardiac output because - dec myocardial contractility - inc preload - inc afterload
30
what are the pathological changes that occur with HF
volume overload impaired ventricular filling weakened ventricular muscle dec ventricular contractile function
31
pathological changes that occur with HF: volume overload
heart not pumping effectively resulting in fluid backup in lungs, body, etc
32
pathological changes that occur with HF: impaired ventricular filling
heart ventricles dont fill as well with blood btw contractions - heart fills during diastole
33
pathological changes that occur with HF: dec ventricular contractile function
heart contracts during systole and the sqeeze isnt as effective
34
what are the major causes of HF
- repeated ischemic episodes - MI + papillary muscle rupture - chronic HTN - dysrhythmias - valve disorders, mitral insufficiency - PE
35
risk factors for HF (not major)
- HTN, DM can contribute - within 6 months of MI - incidence is higher in Black/african americans - genetics - COPD - severe anemia - congenital heart defects - viruses - alc/drug abuse - kidney condition
36
major risk factors for HF
age ethnicity fam hx and genetics DM ischemic heart disease obesity HTN lifestyle factors
37
classifications of heart failure
right sided left sided
38
left sided heart failure
left ventricle is affected causing blood to be backed up in pulmonary system - congestion in left chamber - LV inc in size - backflow of pulmonary veins - congestion in the lungs
39
right sided heart failure
right ventricle fails causing blood to be backed up in systemic circulation - often due to COPD - congestion in R chambers - RV inc in size - back flow into vena cava, dec to the lungs - congestion in jugular veins, liver, lower extremities
40
findings of L sided HF
- cough, crackles, wheeze - frothy sputum, may be blood tinged - paroxysmal nocturnal dyspnea: wake up in middle of night feeling smothered - orthopnea: cant catch breath when lying down
41
findings of R sided HF
- JVD - dependent edema: swelling of lower extremities - wt gain - hepatosplenomegaly: enlargement of organs
42
most common cause of L sided HF
poorly controlled HTN
43
most common cause of R sided HF
COPD, pulmonary HTN
44
what is HReEF
heart failure: reduced ejection fracture (systolic HF) - EF less than 40% - caused by impaired contractile function, inc afterload, cardiomyopathy, mechanical problems - LV loses ability to generate pressure to eject blood, weakened muscles cant generate stroke volume, weak LV causes fluid backup and accumulation
45
what is HRpEF
heart failure: preserved ejection fraction (diastole HF) - inability of the ventricles to relax and fill during diastole - LV becomes stiff and noncompliant leading to high filling pressure leading to dec stroke volume and dec cardiac output - reduced CO leading to fluid congestion - EF is normal or only moderately dec - HTN, female, older age, DM, obesity
46
heart failure exists
on a spectrum
47
chronic HF characteristics
- episodes of decompensated HF - new or worsening s/s - frequent visits to the ER - hospitalizations - less common new onset HF
48
what is ventricular remodeling in HF
enlargement and dilation of the LV due to - secretion of molecular substances (angiotensin II, aldosterone, endothelin, TNF alpha, catecholamines, insulin like growth factors, growth hormones - provoke genetic changes, apoptosis, hypertrophy of cardio myocytes as well as collagen deposits and myocardial fibrosis
49
what is S3
gallop that occurs with heart failure heard after S2 - occurs during rapid filling of the ventricle in early part of diastole - high ventricular end diastolic volume (fluid left in the ventricle) - inc pressure in ventricule

NUR 326 (20 decks)

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