CardioPulmonary Pathology Flashcards
Angina Pectoris
- p! in chest, jaw, or L arm 2ndary to temp/localized ischemia (usually from atherosclerosis)
- dyspnea
- indegestion
- dizziness, syncope and anxiety
- Causation: cold/windy weather, PA, stress
- results in changes of left venticular fxn on ECG
- Medications:
- nytroglycerins etc
Coronary Artery DIsease
an atherosclerotic dx process that narrows the lumen of the CA resulting in ischemia to the myocardium (leading cause of death in US today)
- clinical manifestions: ischemia, infarction, sudden death and heart failure
- main syndromes include angina, MI and <3 failure
Cor Pulmonale
Failure or hypertrophy of the R ventricle resulting from disorders of the lungs, pulm vessels or chest wall
- lung pathology produces pulmonary artery HTN that creates a problem for R ventricle
- usually chronic but may be acute and reversible
Congestive Heart Failure
results from failure of the heart to maintain adequate circulation of the blood to meet systemic demands
- decreased CO
- elevated end diastoliv values
- tachycardia
- contractile deficiency (SV, F)
- impaired ventricular function
Treatment
- best rest, diuretics, sodium restriction etc
Medications:
- Digitalis - increase pumping ability, decrease HR
- Diuretics - decrease fluid, pre/afterload, control HTN
Left Sided Heart Failure (forward)
Inadequate L ventricle to pump into system
- undue tachycardia
- intolerance to cold
- increased pulm art pressure/edema
- DOE
- dry cough
- orthopnea, PND
- Pulmonary Rales, wheezing
- fatigue
Right sided Heart Failure (backward)
Inadequate R ventricle reduces venous return
- increased pulm art swelling/edema
- peripheral edema (ankle swelling)
- venous hypertension and stasis
- weight gain
- fullness in abdomen
- fatigue
Myocardial Infarction
Ischemic myocardial necrosis usually resulting from abrupt reduction coronary blood supply (atherosclerosis, thrombus, spasm, cocaine)
- symptoms similar to angina, not relieved w/ medication
- pt usually restless, pale, diaphoretic, and cool
Treatment
- relieve stress, reduce cardiac work
Medications:
- depend on damage
Postural Tachycardia Syndrome
sustained HR increased greater than or equal to 30 bpm within 10 minutes of standing (40 in teenagers)
Ischemic Cardiac Chest Pain
(angina or MI)
- diffuse
- retrosternal
- “tightness”
- achiness
- Anginal Scale 1+ to 4+
- associated w/ dyspnea, syncope, anxiety etc
- can refer to:
- shoulders, back, arms, neck or jaw
- p! from back = AAA
Asthma
increased reactivity of the trachea and bronchi to various stimuli causing widespread narrowing of the airways due to inflammation, smooth muscle constriction, and increased secretions.
Signs/Symptoms:
- wheezing cough
- dry or productive mucoid sputums
- anxiety w/ severe bronchospasm may restrict airflow to the point of no wheezing
- chest wall is symmetrically decreased
Treatments
- bronchodilators prior to exercise/cold exposure
- decreased activity if environment is unfavorable
- medications, oral or IV steriods (prednisone) and nebulizer or inhaler.
Bronchitis
Chronic inflammation of the tracheobronchial tree with cough and sputum production lasting at least 3 months for 2 consecutive years
signs/symptoms
- wheezing or rhonci breath sounds
- productive mucoid or purulent sputum with infection
- may have fever
Treatment
- bronchopulmonary hygiene if indicated
- positions of relaxation
- paced breathing
- endurance exercise
- patient education
- smoking cessation
Cystic Fibrosis
A genetically inherited dx, characterized by thickening of secretions of all exocrine glands, leading to obstruction. May present as obstructive, restrictive or mixed
Signs/symptoms
- frequent infections : staph aureus, pseudomonas aeruginosa
- inability to weight gain
- positive sweat electrolyte test
- rales, wheezing
- productive of large mucoid, mucopurulent or purulent sputum
- may have hemoptysis
Treatment
- percussion, vibration, shaking and postural drainage up to several times per day (acute) or will develop pneumonia
- suction in severe cases
- endurance exercises
Emphysema
Permanent abnormal enlargement and destruction of air spaces distal to terminal bronchioles. May develop following smoking history with chronic cough and sputum production
Signs/Symptoms
- barreled chest
- use of accessory muscles of ventilation
- decreased breath sounds w/w/o wheezing
- dyspnea
Treatment
- pursed lip breathing
- education about disease
- endurance exercises
Restrictive Diseases
- Alterations in pleura
- fibrotic changes w/in pulmonary pleura associated w/:
- idiopathic pulmonary fibrosis
- asbestos
- radiation pneumonitis
- oxygen toxicity
- fibrotic changes w/in pulmonary pleura associated w/:
- Alterations in Chest Wall
- restricted motion of bony thorax:
- ankylosing spondylitis
- arthritis
- scoliosis
- pectus excavatum
- chest wall burns
- scleroderma
- restricted motion of bony thorax:
- Alterations in neuromuscular system
- decreased muscular strength results in an inability to expand rib cage
- MS
- MD
- Parkinson’s
- SCI
- Stroke
- decreased muscular strength results in an inability to expand rib cage
Flail Chest
2(+) fractures in two or more adjacent ribs, usually due to blunt trauma
- Signs/symptoms
- shallow breathing
- crepitation during ventilation over site
- paradoxical mvmnt of flail section
- inspiration: pulled inward
- expiration: moves outward
- treatment
- gentle breathing exercises
- splinting
- pain management
- proper positioning
