cardio di 1st test Flashcards
cardiac ischemia
2 pathophysiological causes
- decreased blood supply
2. increased metabolic
2 causes of decreased blood supply
- coronary spasm
2. coronary obstruction
causes of coronary spasm
- rupture of coronary plaque
- stress
- endocrine disorders
What causes coronary obstruction?
atherosclerotic plaques or thrombosis
systemic hypertension and hypertrophy are examples of
increased metabolic demand of cardiac muscles
A decreased blood supply =
decreased O2 and Glucose
drop in ATP
A decreased blood supply results in anaerobic respiration creating ______ which activates pain receptors
acidosis
3 steps of decreased blood supply and is the step reversible
- ischemia-reversible
- injury-reversible
- necrosis-irreversible
2 tests for injury and necrosis
- cardiac enzymes
2. ECG
What enzymes are tested for cardiac injury and necrosis?
CK-MB
tropinin 1
CK-MB doesnt change for the first _ hours
4
CK-MB spikes in the first __ hours and returns to normal by ______ hours
24
72
If CK-MB levels do not return to normal a ___________ results
reinfarction
How long does troponin 1 stay elevated after MI?
14 days
first notable rise in troponin 1 levels 3 hours after MI
What shows on an ECG representing cardiac ischemia?
an inverted T wave and/or depression of S-T segment
What shows on an ECG representing cardiac injury?
elevation of S-T segment (above P-Q segment)
What shows on an ECG representing cardiac necrosis (MI)?
abnormalities of Q-wave!!
ascending Q-wave is > 30% of R
chest pain from decreased blood supply is known as?
angina
Heart Failure definition
when the heart can not pump enough blood to systemic circulation (decreased cardiac output
Top five reasons for Heart Failure in US?
- MI
- systemic HTN
- myocarditis
- stenosis of cardiac valves
- regurgitation
Left Sided heart failure has what target organs?
- kidneys
- heart
- brain
Decreased renal blood flow due to LSHF causes what?
- decreased GFR
- increased Angio 2 and aldosterone
- increased NA/H2O
- increased blood pressure
- hepato/splenomegaly
- increased CHP=peripheral edema
- Jugular Venous Distension