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Cardiovascular Disease (Exam 1) Flashcards

1
Q

Cardiovascular disease definition

A

atheroscleortic process characterized by a thickening in the intimal layer of the blood vessel wall caused by a local build up of lipids

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2
Q

CVC contributers (8)

A
  1. Heredity (genes)
  2. Smoking
  3. HTN
  4. Diabetes
  5. High cholesterol
  6. Age
  7. Endothelial injury
  8. Areas of sheers stress
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3
Q

Fatty streaks

A

asymptomatic; begin at birth

“foam cells”; build on each other and balloon out

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4
Q

plaque

A

elevated lump that thickens& decreases lumen

Can progress to occlude artery

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5
Q

Myocardial Ischemia (MI)

A

Lack of blood flow to the cells (lack of oxygen)

causes pain in heart muscle due to lack of oxygen to myocardium

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6
Q

Angina pectoris definition

A

episodic pain/crushing sensation in the chest caused by reversible MI

reversible by decreasing demand

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7
Q

Contributers to Angina Pectoris (4)

A
  1. Obstruction
  2. Increased metabolic demands that the heart can’t keep up with
  3. low blood hemoglobin (dec. ability to deliver oxygen)
  4. Pulmonary disease
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8
Q

Why are women at an increased risk to die from angina pectoris

A

they have atypical symptoms that are either ignored or misdiagnosed.

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9
Q

Stable Angina definition

A

chronic exertional angina

occurs when flow reserve of 1+ coronary arteries is limited; manifests during increased demand/physiological stress

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10
Q

Stable angina TX

A

rest 5-10 minutes
Nitroglycerine (vasodialator)
RF management

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11
Q

Unstable (pre infarction) angina definition

A

life threatening

Similar to MI, but artery is not completely occluded (80-90%)

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12
Q

Unstable (pre infarction) angina S&Sx

A
  1. crescendo angina
  2. angina w/ minimal exertion/@ rest
  3. angina after recent MI
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13
Q

Unstable angina is a called pre infarction angina because..

A

usually progresses to MI; life threatening if untreated

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14
Q

Unstable angina RX

A

pharmological/surgical intervention

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15
Q

collaterals

A

new vessels created by the body to go around the blockage

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16
Q

Prinzmetal/Variant Angina

A

caused by artery spasm

body becomes abnormally over reactive to vasoconstricting agents; s&sx occurs @ rest and early morning

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17
Q

Prinzmetal/variant angina contributers

A
  1. smoking

2. cocaine

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18
Q

Asymptomatic “Silent” angina definition

A

angina without pain

usually found while investigating some other unrelated symptom

19
Q

Asymptomatic angina TX

A

pharmalogical

  1. nitrates
  2. beta blockers
20
Q

Myocardial Infarction definition

A

death or necrosis of some portion of the cardiac muscle occurs in response to sustained myocardial ischemia

21
Q

Myocardial infarction contributers (5)

A
  1. ischemia (sustained)
  2. atherosclerosis
  3. thombus (moving blood clot)
  4. arterial spasm
  5. hypovolemic shock (massive blood loss)
22
Q

30% of Myocardial infarctions are _______

A

asymptomatic; may be in a small area of tissue that has little to no impact on CO

23
Q

Myocardial Infarction diagnosis

A
  1. Hx
  2. symptoms
  3. serial serum enzymes
  4. ECG changes

(must have + findings in 2 of 3)

24
Q

Myocardial infarction RX

A

rapid management to limit size of infarct and scope of damage

25
Complications of a myocardial infarction (4)
1. Arrythmias 2. heart failure 3. Thrombolytic 4. Heart structure damage
26
Arrythmias & MIs
1. Occur in 90% of post-MI 2. Vary in severity according to damage and location 3. VT, VF and SVT are most probable cause of post-MI deaths
27
Heart failure
abnormality in the effective mechanical performance of heart; decreased/inability to maintain adequate CO
28
Thrombolytic & MIs
1. Venous and mural thrombi may occur 2. occur primarily due to venous stasis 3. can result in pulmonary embolism
29
venous thombi
Thrombus in vessel
30
mural thrombi
Thrombus in wall of heart (usually in left ventricle); S&sx: sudden significant pain, numbness, coldness of extremity TX: surgical emobolectomy
31
venous stasis
blood flow thats not going anywhere
32
Heart structure damage and MIs
1. Papillary muscle rupture 2. intraventricular septal rupture 3. V. aneurysm formation 4-7 days post MIs; RX = surgery
33
Pericarditis & MIs
2-3 days post-MI accumulation of fluid in pericardial sac- if rapid; compressed heart resulting incardiac tamponade (life threat.), increasing pressure restricts diastolic filling and dec. CO & arterial pres. TX: aspiration of fluid, pain killers, steroids, abx
34
Sudden cardiac death definition
unexpected w/o prior symptoms usually in apprently healthy individuals engaging in normal activities
35
Sudden cardiac death RFs
1. v. electrical instability 2. extensive CAD 3. abnormal LV function 4. Ejection fraction <20%
36
Ejection fraction
amt. left in left v. compared to amt. out. Normal is 50-65%
37
Congestive Heart failure definition
inability of heart to maintain adequate CO
38
Types of Congestive Heart failure
1. Acute 2. Chronic 3. Compensated/Uncompensated
39
Acute Congestive heart failure
rapid failure of heart pump
40
Chronic congestive heart failure
develops gradually, chronic retention of fluid and salt by kidneys leading cause of hospitalization >65yrs leads to end organ failure
41
Compensated congestive heart failure
heart adapted to chronic heart failure good enough at rest only, heart maintains adequate CO through compensatory mechs and pharmacological intervention
42
uncompensated congestive heart failure
compensatory mechs at work but cannot maintain CO (pharm intervention can help)
43
Intractable congestive heart failure
heart fails despite the therapies; only rx is heart transplant EF <20% (~5-10%); Low CO

Cardiac Rehab (9 decks)

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