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Patient Care > Cardiovascular Disease > Flashcards

Cardiovascular Disease Flashcards

1
Q

More than – million Americans (about 25% of the population) are estimated to have some form of CVD with about – million having coronary heart disease

A

70

13

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2
Q

Although on the decline, the mortality rate is –% (pre Covid)

A

33%

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3
Q

what is the leading cause of death in the US after age 65?

A

cardiovascular disease

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4
Q

cardiovascular disease is responsible for – million new or recurrent heart attacks annually, of which –% are fatal

A

1.2

40

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5
Q

risk factors for heart disease (4)

A

heredity
sex
race
age

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6
Q

Heredity

A

30% of heart disease risk stems from genetic factors, much more than was previously understood

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7
Q

People with parents or siblings affected by coronary atherosclerotic heart disease are at risk for development of the disease at a younger age than that typical for those

A

without such a history

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8
Q

Sex

A

Men develop heart disease 10 years earlier on average than women, especially with low testosterone. However, women catch up postmenopausal

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9
Q

Race

A

African Americans are more at risk. In part due to being at risk for hypertension. Hispanics living in America are about 25% less likely to die of heart disease than non-Hispanic whites. May be due to lower smoking rate in general

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10
Q

Age

A

Majority of people who die of coronary disease are 65 or older

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11
Q

risk factors for heart disease are factors that can’t be

A

changed

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12
Q

general warning signs and symptoms (8)

A 
Extreme fatigue
Constant dizziness or lightheadedness
A fast heat rate (more than 100 bpm)
A new, irregular heartbeat
Chest pain or discomfort during activity that goes away with rest
Difficulty breathing during regular activities and rest
Nausea and cold sweats
Edema (ankles)
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13
Q

Edema (ankles) may be a sign of

A

venous insufficiency

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14
Q

If you press on a swollen area and an indentation or pit remains, it’s called

A

pitting edema

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15
Q

types of fluid retention with edema (2)

A

mild

severe (pitting)

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16
Q

major risk factors for CV disease (7)

A 
Smoking
Diabetes
Cholesterol 
Hypertension 
Obesity
Sleep apnea
Family hx.
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17
Q

single most modifiable risk

A

smoking

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18
Q

minor risk factors for CV disease (3)

A

excessive alcohol use
stress
age

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19
Q

stenosis

A

narrow or obstruction

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20
Q

where does stenosis usually occur?

A

aortic valve

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21
Q

stenosis can be caused by (3)

A

rheumatic fever
calcification of valve
congenital abnormalities

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22
Q

breathing in dyspnea (3)

A

difficult
labored
uncomfortable

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23
Q

dyspnea is usually due to (2)

A

COPD

asthma

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24
Q

orthopnea

A

difficulty breathing when lying down

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25
Q

causes of orthopnea (4)

A

heart failure
COPD
panic disorder
sleep apnea

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26
Q

Coronary artery disease (CAD)

A

decreased or blocked blood flow to the heart due to plaque (cholesterol) build up

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27
Q

CAD is a leading cause of (2) in patients with diabetes

A

morbidity and mortality

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28
Q

If you have diabetes, you are — as likely to have heart disease or a stroke than someone who doesn’t have diabetes and at a younger age

A

twice

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29
Q

The longer you have diabetes, the more likely you are to have

A

heart disease

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30
Q

ABCs of cardiovascular disease and diabetes

manage your ABCs

A

A: get a regular A1c test aim to stay in your target range
B: try to keep your BP WNR
C: manage your cholesterol levels
s: stop smoking

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31
Q

atherosclerosis

A

progressive clogging of the arteries

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32
Q

where does atherosclerosis occur? (2)

A

large to medium muscular arteries

large elastic arteries

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33
Q

atherosclerosis can lead to (3)

A

thrombosis (blood clot)
infarction
ischemic lesions

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34
Q

ischemic lesions can be of (3)

A

brain
heart
extremities

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35
Q

major risk factor of atherosclerosis (2)

A

Elevation in serum lipid levels

Increased BP

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36
Q

in general, — blood pressure is more strongly related to the incidence of CVD than is — blood pressure, especially in older adults

A

systolic

diastolic

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37
Q

SBP rises throughout life, and DBP tends to level off or decrease after the age of

A

50

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38
Q

what can chest pain cause? (3)

A

angina pectoris
hyperventilation
acute MI

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39
Q

most common cause of chest pain

A

angina pectoris

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40
Q

lease common cause of chest pain

A

acute MI

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41
Q

angina pectoris is usually

A

brief, resulting from temporary ischemia of the myocardium

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42
Q

hyperventilation is

A

common

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43
Q

acute MI pain is usually

A

prolonged

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44
Q

most important symptom of angina pectoris

A

chest pain

45
Q

angina pectoris is usually described as a sensation of (3)

A

aching, heavy, squeezing pressure

46
Q

angina pectoris is tightness in the

A

midchest region

47
Q

Area of discomfort with angina pectoris often is reported to be the size of a fist and may radiate into the (4)

A

left or right arm, neck or mandible

48
Q

Pain of angina pectoris is of brief duration, lasting - to - minutes if the provoking stimulus is stopped

A

5-15

49
Q

cause of angina pectoris

A

Blood supply to the cardiac muscle is insufficient for oxygen demand (atherosclerosis or coronary artery spasm)

50
Q

angina pectoris can be observed in absence of (3)

A

coronary obstruction-anemia, hypoxemia, or profound hypotension

51
Q

Angina episodes may be precipitated by (3)

A

stress, anxiety, or physical activity

52
Q

someone with angina pectoris can have hypertension due to the (2) but vitals are usually normal

A

pain, and possible anxiety

53
Q

Angina is defined in terms of its pattern of

A

symptom stability

54
Q

STABLE Angina

A

is pain that is predictable, reproducible, unchanging, and consistent over time. Pain typically is precipitated by physical effort such as walking or climbing stairs but can occur with eating or stress

55
Q

stable angina may be confused for

A

indigestion

56
Q

Pain of stable angina is relieved by (3)

A

cessation of the precipitating activity, by rest, or the use of nitroglycerin

57
Q

Most patients with chronic stable angina have underlying

A

Coronary Artery Disease. The plaques tends to be slow growing and relatively stable.

58
Q

UNSTABLE ANGINA

A

Is defined as new-onset pain, increasing in frequency, and/or intensity, and is precipitated by less effort than before. It can also occur at rest

59
Q

The pain of unstable angina is not readily relieved by

A

nitroglycerin

60
Q

The key feature of unstable angina is the (2)

A

changing character (increasing intensity, frequency) or pattern of pain

61
Q

Patients with stable angina have a relatively good

A

prognosis

62
Q

Patients with unstable angina have a poorer prognosis and often experience an – – within a short time

A

acute MI

63
Q

SKIPPED

nitroglycerin study example (5)

A

STUDY: 380 patients with documented Coronary AD and angina
At least one risk factor was present in 96% of the patients
Only 46% of the patients had a prescription for SNG
Of those with a prescription for SNG, only 65% were informed by the physician on the proper use
Of those who were routinely carrying SNG, 37% had an expired product

64
Q

nitroglycerin exerts action in

A

2-4 min

65
Q

nitroglycerin duration of action is

A

30 min

66
Q

side effects of nitroglycerin (4)

A

pounding in head
flushing
tachycardia
possible hypotension

67
Q

angina pectoris treatment steps (5)

A 
Stress reduction protocol
Avoid excess vasoconstrictors
Oxygen as necessary
Nitroglycerine tabs
Small bottle (plastic or metal, often keychain case, 1-2 tabs sublingual)
4444 if doesn’t go away
68
Q

with angina pectoris treatment, place patient in what position?

A

sitting-up or semi-sitting position with head elevated

69
Q

why do we put them in this position?

A

Ensure open airway and breathing is adequate

70
Q

what do we check next?

A

vitals

71
Q

Dispense/administer nitroglycerin either tablet or spray sublingually. Repeat every

A

5 minutes up to 3 doses in a 15-minute time period

72
Q

Always check BP between each dose. If the systolic BP drops below 100mm/Hg do not give an additional dose of Nitroglycerin. Do not want to create profound (2)

A

hypotension and reflex tachycardia

73
Q

what life threatening outcome can angina pectoris lead to

A

hypotensive shock

74
Q

If pain is not relieved, (2)

A

give one aspirin 325 mg and call 911

75
Q

Viagra was originally developed by Pfizer for the treatment of (2)

A

hypertension and angina pectoris

76
Q

Women and men report different symptoms of MI, with fewer women experiencing — — but more often experiencing (2)

A

chest pain

fatigue and dyspnea

77
Q

Patients who have experienced an acute MI should be

A

hospitalized or receive emergency treatment as soon as possible

78
Q

Basic management goal is to (2)

A

minimize the size of the infarction and prevent death from lethal arrhythmias

79
Q

Early administration of aspirin is recommended, with 160-325 mg being chewed and swallowed to (2)

A

decrease platelet aggregation and limit thrombus formation

80
Q

signs and symptoms of MI

A

Development of chest pain
Cyanotic, pale, or ashen appearance
Death of cardiac muscle due to inadequate blood oxygen supply
The condition may progress to cardiac arrest
With unresponsive patients-initiate CPR, including use of automated external defibrillator (AED)

81
Q

Development of chest pain, sometimes manifested as a (3) feeling, that is more severe than with angina and lasting longer than 15 minutes; and is not relieved by nitroglycerin in a conscious patient

A

crushing, squeezing or heavy

82
Q

Cyanotic, pale, or ashen appearance

A

weakness, cold sweat, nausea, vomiting, air hunger and sense of ‘impending death’ irregular pulse

83
Q

acute MI is a

A

heart attack

84
Q

acute MI is a lack of

A

O2 to tissues

85
Q

lack of O2 to tissues causes

A

ischemia (damage)

86
Q

what occurs after 4-6 hours of actor MI?

A

permanent damage (necrosis)

87
Q

plaque ruptures can result in

A

thrombus (blood clot) formation

88
Q

Dental treatment of Post-Myocardial Infarction

< 8 weeks out:
> 8 weeks out:

A

< 8 weeks out, No elective Dental Treatment

> 8 weeks out, Elective Dental Treatment possible, need to: Obtain a Medical Consultation-what is the patient’s cardiac status? Is the patient’s cardiac condition stable? What is the patient’s ejection fraction? Does the patient have any degree of heart failure?

89
Q

what should INR be for patients on anticoagulants with MI

A

2-3

90
Q

stress reduction protocol (5)

A 
Short appointments
Early morning appts
Limit vasoconstrictors
Profound anesthesia
Explain everything
91
Q

Limit vasoconstrictors

Generally, less than

A

2 carpules

92
Q

Explain everything

A

“tell, show, do”

93
Q

CHF

A

congestive heart failure

94
Q

CHF is usually called

A

heart failure

95
Q

CHF usually occurs at what age??

A

> 65

96
Q

CHF results from any structural or functional cardiac disorder that impairs the ability of the

A

ventricle to fill with or eject blood

97
Q

complex of symptoms with CHF (2)

A

not an actual diagnosis

end stage of many CV diseases

98
Q

number 1 cause of CHF

A

coronary heart disease

99
Q

number 2 cause of CHF

A

cardiomyopathy

100
Q

SKIPPED

other causes of CHF (5)

A 
Hypertension
Valvular insufficiency
Myocardial infarction 
Infective endocarditis
Pulmonary embolism
101
Q

CHF signs and symptoms (7)

A 
Fatigue and weakness
Ankle swelling (edema) 
Clubbing of the digits
Syncope (fainting)
Angina
Breathing difficulties
Increased urination at night
102
Q

CHF respiration symptoms (4)

A

Dyspnea
Orthopnea
Sleep apnea
“How many pillows do you sleep on?”

103
Q

“How many pillows do you sleep on?” (2)

A

Under the head

>2 pillows = caution

104
Q

INR

A

international normalization ratio

105
Q

CHF risk (3)

A

cardiac arrest
stroke
MI

106
Q

DILATED cardiomyopathy is caused by (2)

A

CAD or poorly controlled hypertension

107
Q

SYSTOLIC cardiomyopathy reduced ejection fractions and is the most common type of

A

heart failure.

108
Q

can dilated and systolic be used interchangeably?

A

yes

109
Q

causes of cardiomyopathy (4)

A

unknown/idopathic (50%)
alcohol abuse
hereditary
viral infections

Patient Care (15 decks)

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