Cardiac Pathologies (Exam 3) Flashcards
What is stable angina?
reproducible with effort or stress
What is unstable anagina?
With or without effort, usually progressive leading to MI
What is prinzmetal/Variant?
at rest due to coronary artery spasm, usually at the same time of day
what is asympotmatic/silent angina?
Unknown ischemia common in patients with diabetes or neuropathy
What is BNP?
Brain naturetic peptide. Measures how much the ventricles stretch
What is claudication?
Pain (usually cramping) with walking or activity in the calf, thigh and/or buttocks
What does claudication indicate?
Blockages in arteries inhibiting blood supply
How can you tease out claudication as a diagnosis?
If you can reproduce the pain, it could be claudication
What are some treatments for HTN?
medications
exercise
stress management
diet
What is atherosclerosis?
Thickening and hardening of coronary artery walls, decreasing flow. Occurs in the intima layer of the vessel.
What are risk factors for Atherosclerosis?
Elevated cholesterol and trygliceride levels High blood pressure Smoking Diabetes Obesity Sedentary lifesetyle High fat diet
What are angina symptoms caused by?
Decreased O2 supply to myocardium
How is angina described?
chest pain, but can also consist of burning or pressure
What type of angina is it ok to exercise with?
Stable angina
What is MI?
Myocardial Infarction-cell death or necrosis of cardiac muscle usually due to artery occlusion
What are some causes of vascular occlusion?
thrombus, embolus, coronary artery spasm
What is a Demand MI?
A MI that occurs in patients with underlying cardiac disease with increased systemic stress
What are the three tissue areas associated with an MI?
Zone of infarction
Zone of injury
Zone of ischemia
How often are cardiac enzymes drawn after a cardiac event?
every 8 hours
What must happen to the cardiac enzymes before you treat the patient?
The cardiac enzymes must be trending down before you treat
What is the target exercise intensity for post MI patients?
< 5 MET’s for 4 weeks post MI
No resisted exercise during recovery phase
What is the response to exercise in a pt with diabetes?
Exercise elicits an increased sensitivity and responsiveness of peripheral tissues to insulin
What is the HR response for diabetic pt’s with CAD?
Tend to be hypertensive with exercise but hypotensive post.
What is the HR response for DM Type 1?
Blunted response
What is an aortic dissection?
Tear in the intima later of the aorta. ALlows blood flow in the media layer, which can extend along aorta lining due to high pressures in the aorta
Where do aortic dissections usually occur?
Close to aortic valve (ascending aorta) due to loss of collagen and elastin in vessel
What is the mortality rate for a ruptured aorta?
~80%
What are the signs and symptoms of Aortic Dissection?
Severe, sudden onset chest or back pain (chest pain with ascending aorta dissection; low back pain with descending aorta dissection)
What distinguishes an Aortic dissection from an MI?
no ECG changes or HF
What is an angioplasty?
Surgery where a guide wire with a ballon is threaded from the leg to the coronary arteries. At the region of plaque, the balloon is inflated to increase vessel lumen size
What is a stent?
Same procedure as an angioplasty, but a wire device is on the end of the guide wire that keeps the vessel open once the guide wire is removed
What is a valvuloplasty?
Where a guide wire with a balloon is threaded from a vein or artery and is inflated to stretch a valve. Indicated
What is a CABG?
Cardiac Artery Bypass Graft
Blockages in the coronary arteries are bypassed using native vessels (usually the saphenous vein or left internal maxillary artery)
When are valve replacements needed?
If there is stenosis or regurgitation
What type of valves are used?
Mechanical or porcine
What is aortic stenosis?
Not enough volume flowing through valve to create aortic dissension causing a decrease in systemic and coronary artery pressures
What is aortic regurgitation?
Blood is forced back into the left ventricle causing decreased coronary artery driving pressures
What causes venous stasis?
phlebitis or DVT
What are some signs/symptoms of venous stasis?
LE edema, varicose veins, chronic edema leads to LE staining (pigmentation from RBC is cause)
how are venous stasis symptoms treated?
elevation
compresion
stockings
What is a DVT?
Deep vein thrombosis, a blood clot that forms within the venous system
What are the 2 risks of a DVT?
A piece can break off and travel to the lungs (pulmonary embolism)
The clot can extend and occlude flow
What are you not recommended to test if on a pt with a DVT?
Homan’s test, not very sensitive and increased risk of PE
What are some causes of DVT’s?
Stasis
Trauma
Hypercoagulability (birth control, smoking, genetics, cancer, polycythemia vera)
What are some symptoms of a DVT?
Swelling or warm skin Red, discolored or white skin Cord in leg that can be felt Tachycardia slight fever dull ache, tightness, tenderness or pain in leg
What is an IVC placement?
A procedure where a small filter is placed (via catheterization) into the inferior vena cava to prevent clots from passing to lungs from legs.
What are the symptoms of Arterial PVD?
cooler temperature
thin brittle or shiny skin with hair loss
Non healing wounds or gangrene
Numbness, weakness, or heaviness in muscles
burning or aching pain
pallor with elevated legs
reddish-blue discoloration of extremities when hanging
What does the ABI measure?
Its a comparison of the blood pressure in the arm and ankle. since the circulatory system is closed the pressure should be the same. If not may be a sign of peripheral vascular disease
