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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
Q

what can cardiomyopathy lead to

A

heart failure

26
Q

what are the two types of cardiomyopathy

A

dilated
restrictive

27
Q

what is heart failure

A

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
Q

what is the most common cause of hospitalization

A

weakened myocardium

29
Q

what does heart factor result in

A

dec cardiac output because
- dec myocardial contractility
- inc preload
- inc afterload

30
Q

what are the pathological changes that occur with HF

A

volume overload
impaired ventricular filling
weakened ventricular muscle
dec ventricular contractile function

31
Q

pathological changes that occur with HF: volume overload

A

heart not pumping effectively resulting in fluid backup in lungs, body, etc

32
Q

pathological changes that occur with HF: impaired ventricular filling

A

heart ventricles dont fill as well with blood btw contractions
- heart fills during diastole

33
Q

pathological changes that occur with HF: dec ventricular contractile function

A

heart contracts during systole and the sqeeze isnt as effective

34
Q

what are the major causes of HF

A
  • repeated ischemic episodes
  • MI + papillary muscle rupture
  • chronic HTN
  • dysrhythmias
  • valve disorders, mitral insufficiency
  • PE
35
Q

risk factors for HF (not major)

A
  • 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
Q

major risk factors for HF

A

age
ethnicity
fam hx and genetics
DM
ischemic heart disease
obesity
HTN
lifestyle factors

37
Q

classifications of heart failure

A

right sided
left sided

38
Q

left sided heart failure

A

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
Q

right sided heart failure

A

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
Q

findings of L sided HF

A
  • 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
Q

findings of R sided HF

A
  • JVD
  • dependent edema: swelling of lower extremities
  • wt gain
  • hepatosplenomegaly: enlargement of organs
42
Q

most common cause of L sided HF

A

poorly controlled HTN

43
Q

most common cause of R sided HF

A

COPD, pulmonary HTN

44
Q

what is HReEF

A

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
Q

what is HRpEF

A

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
Q

heart failure exists

A

on a spectrum

47
Q

chronic HF characteristics

A
  • episodes of decompensated HF
  • new or worsening s/s
  • frequent visits to the ER
  • hospitalizations
  • less common new onset HF
48
Q

what is ventricular remodeling in HF

A

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
Q

what is S3

A

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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