Cardiac Pathologies (Exam 3) Flashcards by s y

What is stable angina?

reproducible with effort or stress

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What is unstable anagina?

With or without effort, usually progressive leading to MI

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What is prinzmetal/Variant?

at rest due to coronary artery spasm, usually at the same time of day

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what is asympotmatic/silent angina?

Unknown ischemia common in patients with diabetes or neuropathy

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What is BNP?

Brain naturetic peptide. Measures how much the ventricles stretch

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What is claudication?

Pain (usually cramping) with walking or activity in the calf, thigh and/or buttocks

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What does claudication indicate?

Blockages in arteries inhibiting blood supply

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How can you tease out claudication as a diagnosis?

If you can reproduce the pain, it could be claudication

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What are some treatments for HTN?

medications
exercise
stress management
diet

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What is atherosclerosis?

Thickening and hardening of coronary artery walls, decreasing flow. Occurs in the intima layer of the vessel.

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What are risk factors for Atherosclerosis?

Elevated cholesterol and trygliceride levels
High blood pressure
Smoking
Diabetes
Obesity
Sedentary lifesetyle
High fat diet

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What are angina symptoms caused by?

Decreased O2 supply to myocardium

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How is angina described?

chest pain, but can also consist of burning or pressure

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What type of angina is it ok to exercise with?

Stable angina

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What is MI?

Myocardial Infarction-cell death or necrosis of cardiac muscle usually due to artery occlusion

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What are some causes of vascular occlusion?

thrombus, embolus, coronary artery spasm

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What is a Demand MI?

A MI that occurs in patients with underlying cardiac disease with increased systemic stress

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What are the three tissue areas associated with an MI?

Zone of infarction
Zone of injury
Zone of ischemia

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How often are cardiac enzymes drawn after a cardiac event?

every 8 hours

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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