Cardiac Diseases Flashcards
_____ is the
leading cause of death
in the United States.
Heart disease
Chronic lower
respiratory disease is the
____ leading killer of
Americans.
third
Heart disease may be due to _______________________________,
Blockage of the coronary arteries
Heart disease can be caused by diseases of the ________________, or ________________
of the heart
Heart muscle or structural abnormalities
- Types of heart disease
- ________________and ________________________________
- ________________________________
- ________________ heart failure
Angina pectoris, coronary artery disease, myocardial infarction, congestive heart failure, cardiomyopathy
Not controllable risk factors for heart disease
1) Age
2) Family history
3) Gender
Controllable risk factors for heart disease
4) Smoking
5) Hyperlipidemia
6) Hypertension
7) Sedentary lifestyle
8) Obesity
9) Diabetes
10) Stress
11) Alcohol
Primary intervention for heart disease
•
Health fairs and lecture
series
Inadequate blood supply to heart
muscle=________________ from coronary artery disease
Ischemia
Secondary intervention for heart disease
• Efforts to stop or slow
progression
• Improving individual’s
risk factor profile
Symptoms of angina pectoris?
How is it relieved?
Chest pain, discomfort, pressure
• Symptoms typically with increased activity
• Can also occur after heavy meal, while resting
• Relieved with rest, nitroglycerin (pills or spray)
Myocardial infarction is ___ of the heart muscle
Death
Symptoms of heart attack
Chest pain, pain in jaw, arm, or teeth, dizziness,
nausea. shortness of breath, sweating, fatigue
Echocardiogram (ECG) description
Creates picture of the heart and looks at the structure of the heart and blood vessels via ultrasound
Electrocardiogram (EKG) description
Stickers with leads are placed on patient. Measures electrical activity and efficiency within the heart
P wave=
Atrial contraction (depolarization
QRS=
Ventricles depolarize then contract (Ventricular systole)
T=
Ventricles repolarize (relax,) heart is at rest.
ST segment elevation could indicate
Acute injury
T wave inversion could indicate
Ischemia
A non-STEMI (ST elevation myocardial infarction) is usually caused by a ____________________
artery but the artery is usually not completely blocked.
Severely narrowed
NSTEMI account for about ___ and STEMI about ___ of all heart attacks (myocardial infarction).
30%
70%
A STEMI or ST-Elevation Myocardial Infarction (heart
attack) is caused by a ________________ _______(100%) blockage of a coronary artery.
Sudden complete
Congestive heart failure (CHF) is a ___ condition caused by an _____
chronic
Ineffective pump
Two implication of heart pump failure in CHF are
- Can’t fill due to hypertrophy of cardiac muscle
* Can’t eject oxygenated blood to the rest of the body
Symptoms of congestive heart failure
- Sudden weight gain
- Inability to lie down
- Persistent dry hacking cough
- Shortness of breath with normal activity
- Swelling in ankles or feet or legs
- Fatigue with activity
- Lack of appetite
- Difficulty focusing one’s attention
Atrial septal defect is a ______ heart defect
congenital
Symptoms of atrial septal defect include?
SOB, fatigue, heart palpitations, decreased exercise capacity• Audible heart murmur • Excessive blood flow into right atrium, right ventricle, and lungs • Hypertrophy of right side • Increased pressure on pulmonary artery • Enlarged right atrium arrhythmias • Lung vessels stiffen • More likely to develop CHF or stroke • Can be surgically closed
Angioplasty is a procedure to ________________________________ to
reduce symptoms of ________________
Improve blood flow
Angina
Methods of performing an angioplasty include?
- Catheter with balloon is inflated to restore blood flow
- Stent remains in place
- Bare metal
- Drug-eluting
An atherorectomy is a procedure to ______
___________________
Remove plaque
Methods of performing an atherorectomy include?
• Catheter with
rotating blade
• Followed by stent
placement
Open heart surgery is procedure that involves ________________
Sternotomy
Types of open heart surgery
Coronary artery bypass graft (CABG)
Valve replacement or repair
A coronary artery bypass graft includes
• Replacement of occluded arteries with artery/vein grafts
• Grafts attached to aorta to allow oxygenated blood flow,
reconnected below level of occlusion
• Mammary, radial arteries or leg veins
Valve replacement or repair types
Prosthetic valve - blood thinners would be required
Tissue or biothesis valve (human/pig) - blood thinners would not be required.
Types of minimally invasive heart bypass
- MIDCAB=Minimally Invasive Coronary Artery Bypass
* OPCAB=Off-Pump Coronary Artery Bypass
MIDCAB=Minimally Invasive Coronary Artery Bypass is also called
Beating heart surgery
Exercise heart rate zone = 50% to ______
85%
Borg Scale of Perceived Exertion
• Subjective measure of __________________
Physical effort
Borg Scale of Perceived Exertion is scaled between __ and __
6 and 20
Borg says there is a high correlation between perceived exertion and ___
Heart rate
Met measurement for sitting quietly for adults
3.5 ml O2/kg body weight/min.
If a person is at a met level of 1-1.4 they can
They can move in bed, sit up for short periods, can only exercise lower extremities while sitting up, and all extremities while lying down.
If a person is at a met level of 1.4-2 they can
Sit up as tolerated. May exercise all extremities but no isometric or strengthening exercises are allowed.
If a person is at a met level of 3-3.5 they can
Unlimited walk on zero grade. Can walk on a treadmill at 1-1.5 mph at 12% grade.
If a person is at a met level of 3.5-4 they can
May walk on level surfaces up to 2.5 mph. Can use up to 10 lbs resistance.
Phase 1 of cardiac rehabilitation includes?
Phase I: Inpatient cardiac rehabilitation • Goals • Prevent muscle loss from bed rest. • Monitor and assess patient’s ability to function. • Instruct in appropriate home activities. • Instruct in application of sternal precautions to daily activities. • Educate about risk factors and methods to reduce them.
Intervention process during phase I: Inpatient cardiac rehabilitation
Evaluate, analyze, and modify patient’s activities of daily living. • During exercise, occupational therapist may monitor HR, BP, EKG, and symptoms. • Individual and group treatment • Calisthenics • Stair climbing Hall walking • Treadmill • Bicycle ergometer
Discharge planning
• Occupational therapist does the following:
• Provides information regarding level of __________________
that patient tolerates at discharge
• Makes recommendations for further therapies
• Provides input regarding possible need for ____________or
extended care services
Physical function
Home health
Home health
• Teach self-awareness of activities according to METs
• Teach pacing and ______ simplification
• Address issues relating to ____________ and sexuality
• 1% of all heart attacks occur during sexual activity
• 0.6%-1.7% risk of death during intercourse
• Physical demands of intercourse = climbing 2 flights of stairs
• Orgasm = increased HR and BP = 10-15 seconds
Work
Depression
Home program after angioplasty
- Teach risk factors and modifications
- Incorporate moderate aerobic exercise into daily routines
- Stress reduction techniques
Home program after myocardial infarction
- Healing of heart muscle 4-6 weeks
- Evaluate activity expenditure, restrict to 2-4 MET range
- Medication effects on mood and sexual desire
Home program for congesting heart failure
• Heavy emphasis on pacing and work simplification due to
limited endurance
• Educate on signs and symptoms of CHF, overexertion and
risk of heart failure
Home program after open heart surgery
• Application of sternal precautions to ADL
• Stretches and mild exercises
• Sexual activity after 6-8 weeks while avoiding strain on
sternum (side-lying, sitting)
Phase II of cardiac rehabilitation is?:
Outpatient cardiac rehabilitation
Goals of phase 2 cardiac rehabilitation are?
• Continue medical surveillance and assessment of an
individual’s cardiovascular response to exercise.
• Limit the physiological and psychological effects of heart
disease.
• Instruct on risk factors for heart disease and how to reduce
their impact.
• Maximize psychological and vocational status.•
• Determine appropriate exercise intensity
• Continuous vs. discontinuous exercise
It is preferable to develop exercise prescription based on results of?
stress test
Phase III of cardiac rehabilitation is?
Community-based rehabilitation
Community-based rehabilitation is generally not ____
Covered by insurance
Community based rehabilitation requires ___
Physician referral
A once per month ___ is part of the community based rehabilitation phase
EKG
