Cardiovascular Conditions Flashcards
What is coronary artery disease?
cardiovascular condition, involves narrowing or blockage of coronary arteries due to atherosclerosis.
-impedes blood flow to myocardium, leading to ischemia (with pain: angina pectoris)
-potentially resulting in ACS or MI
What is acute coronary syndrome?
term used to describe a range of conditions associated with sudden, reduced blood flow to the heart.
-3 entities: STEMI, NSTEMI, and unstable angina
What causes ACS?
What is the pathophys?
the rupture of an atherosclerotic plaque in a CA, leading to partial or complete blockage of blood flow
-disruption of plaque triggers platelet aggregation and thrombus formation. results in ischemia and potential necrosis of myocardial tissue. extent of damage depends on duration and severity of ischemic event.
CAD can lead to _________ , or progress to ______.
angina pectoris
ACS
s/s ACS
CP or discomfort that may radiate to shoulders arms, neck, jaw, back.
-described as pressure or squeezing
-dyspnea, diaphoresis, nausa, syncope
Dx of ACS
ECG
cardiac biomarkers
Why ECG for dx ACS?
differentiates between stemi and nstemi/ unstable angina
What does NSTEMI ECG usually show?
ST segment depression or T wave inversion
Cardiac biomarkers for dx ACS
Troponins.
-elevated indicate myocardial necrosis and help differentiate between NSTEMI and unstable anginga
ACS management
pharm:
1. antiplatelet agents (aspirin and P2Y12 inhibitors)
2. anticoagulants
3. beta blockers
4. ACE inhibitors
5. statins
reperfusion therapy:
-PCI
-thromobolysis
What do ST segement elevations signify?
COMPLETE blockage of one or more CAs
(indicates acute transmural ischemia)
Pathophys of STEMI
results from rupture of atherosclerotic plaque followed by thrombosis, leading to occlusion of the CA.
risk fac
Risk Factors of STEMI (preluding one)
- HTN
- HLD
- smoking
- DM
- family hx CAD
clinical manifestations of STEMI
CP (pressure or squeezing) radiating to left arm, neck, or jaw
diaphorsis
dyspnea
nausea
sometimes syncope
post STEMI reperfusion management
- antiplatelet therapy with aspirin and P2Y12 ihibitors (clopidogrel)
- AC with heparin or LMWH
- BB to reduce myocardial oxygen demand
- ACE inhibitors prevent ventricular remodeling
- statins for lipid management
NSTEMI is characterized by
partial blockage of a CA, result is reduced blood flow to heart muscle
How is a NSTEMI identified?
by cardiac biomarkers, such as troponins, indicating myocardial injury
Pathophy of NSTEMI
CA plaque ruptures or erodes, leading to thrombus formation. Not completely obstructied, so some perfusion of myocardium is allowed, BUT insufficient to meet metabolic demands, esp during exertion or stress.
mismatch between o2 supply and demand causes ischemia and myocardial necrosis
clinical manifestations of NSTEMI
similar to other forms of ACS, including CP or discomfort that may radiate to arm, neck, jaw, back. (often pressure like)
dyspnea, diaphoresis, nausea, fatigue
Dx of NSTEMI
- ECG: may show nonspecifc changes (ST depression or T wave inversion)
- cardiac biomarkers ** (Troponin I or T)
Management/ Tx of NSTEMI
Pharm:
1. antiplatelet agents (aspirin and P2Y12 inhibitors)
2. AC (heparin)
3. BB
4. statins
5. nitrates**
procedure (not all cases)
- PCI
What diagnostic tool helps differentiate between NSTEMI and unstable angina?
cardiac biomarkers (Troponin I or T) as they are sensitive indicators of myocardial cell injury
Unstable angina is characterized by_______
and indicates________
unexpected CP or discomfort typically at rest or with minimal exertion.
indicates sudden reduction in blood flow to heart muscle, often due to plaque rupture and subsequent thrombus formation in CA
How do stable and unstable angina differ?
stable: predictable pattern and relieved by rest or nitro
unstable: unexpected. occurring at rest or with minimal exertion