Cardiovascular Diseases and Disorders Flashcards
Coronary Artery Disease (CAD)
ETIOLOGY:
1) risk factors: smoking, stress, obesity, hypertension, diabetes, high cholesterol, sedentary lifestyle, and age
2) atherosclerosis (plaque) OR arteriolosclerosis (degenerative) -> blocked coronary arteries
S/S:
1) asymptomatic -> angina pectoris (chest and left arm pain) -> myocardial infarction (severe chest and left arm pain, nausea)
TREATMENT:
1) ACE inhibitors, ARBs, B-blockers, calcium-channel blockers, thiazide diuretics
2) balloon angioplasty, stent angioplasty, coronary artery bypass graft (CABG) surgery
Angina Pectoris
ETIOLOGY:
1) activity -> increased cardiac O2 demand (if CAD-related), vasospasm, tachycardia -> myocardial ischemia
S/S:
1) chest and left-arm pain, dyspnea, arrhythmia
TREATMENT:
1) nitroglycerin tablets
2) lifestyle changes (exercise, low-salt/low-fat diet)
Myocardial Infarction (MI)
ETIOLOGY:
1) angina pectoris (vasospasm), CAD -> myocardial ischemia -> cardiac muscle death
S/S:
1) severe chest pain, referred left arm pain, dyspnea, arrhythmia, diaphoresis (sweating), nausea
TREATMENT:
1) aspirin (antiplatelet NSAID), thrombolytic drugs
2) stent/balloon angioplasty OR CABG surgery
BONUS FACTS:
1) patient must take daily aspirin or B-blocker for life
Cardiac Arrest
ETIOLOGY:
1) infarction, electrocution, drowning, drug overdose, extreme trauma -> cardiac activity stops
S/S:
1) unresponsive, no pulse, no respiratory effort
TREATMENT:
1) cardiopulmonary resuscitation (CPR) or automated external defibrillator (AED) within 4-6 minutes
2) epinephrine (Adrenalin), lidocaine (antiarrhythmic drug)
Takotsubo Cardiomyopathy (Broken Heart Syndrome
ETIOLOGY
1) emotional or physically-straining event -> excessive adrenaline -> temporary left ventricle hypertrophy
S/S:
1) chest and left arm pain, dyspnea
TREATMENT:
1) hospitalization for a few days
2) ACE inhibitors and B-blockers
Congestive Heart Failure (CHF)
ETIOLOGY
1) MI, CAD, COPD, arrhythmia, valvular damage, cardiomyopathy, hypertension -> impaired perfusion
S/S:
1) right-sided failure -> peripheral edema, hepatomegaly, splenomegaly
2) left-sided failure -> pulmonary congestion, dyspnea,
TREATMENT:
1) ACE inhibitors, ARBs, aldosterone antagonists, diuretics (reduce caricias workload)
BONUS FACTS:
1) best prognosis associated with acute (MI) CHF
Pulmonary Edema
ETIOLOGY:
1) left-sided dysfunction (mitral valve dysfunction, hypertension, arrhythmia, pulmonary emboli) -> excessive pulmonary blood psi
S/S:
1) dyspnea, orthopnea (easier to breath when straight up), tachypnea, bloody sputum
2) tachycardia and possible low blood psi
TREATMENT:
1) bronchodilators
2) nitroglycerin or sodium nitroprusside (IV vasodilators) and diuretics (antihypertensive)
3) Fowler position
Cor Pulmonale
ETIOLOGY:
1) COPD (chronic factor) or pulmonary emboli (acute factor) -> increased pulmonary blood pressure -> increased right-heart workload and hypertrophy
2) *hypoxemia -> BM stimulation -> polycythemia -> higher blood psi
S/S:
1) peripheral edema, distended veins, hepatomegaly and splenomegaly
TREATMENT:
1) treat causative factors
2) oxygen supplementation and bronchodilators
3) diuretics (edema), anticoagulants (prevent thrombosis), and phlebotomy (polycythemia)
Mitral Stenosis
ETIOLOGY:
1) RHD -> hardening of cusps
S/S:
1) dyspnea, palpitations, fatigue, cyanosis
TREATMENT:
1) anticoagulants, digoxin (antiarrhythmic)
2) balloon valvuloplasty or commissurotomy
Mitral Insufficiency
ETIOLOGY
1) MI, mitral valve prolapse, rheumatic fever, endocarditis valve -> mitral valve unable to close
S/S:
1) dyspnea, heart murmur, fatigue
TREATMENT:
1) treat causative factors (antibiotics, antifungals)
2) surgical valvular repair or replacement
Mitral Valve Prolapse (MVP)
ETIOLOGY:
1) abnormally long or short chordae tendineae AND/OR malfunctioning papillary muscles -> mitral valve cusp bulges back when closing
S/S:
1) asymptomatic OR fatigue, dyspnea, syncope
TREATMENT:
1) usually no treatment is needed, lifestyle changes encouraged
2) beta-blockers
Arrhythmia
ETIOLOGY:
1) other cardiac diseases, certain drugs -> electrical impulse error in SA or AV nodes
S/S:
1) tachycardia, bradycardia, heart block (atria/ventricles beat independently), atrial fibrillation, or ventricular fibrillation
2) fatigue, dizziness, syncope
TREATMENT:
1) treat causative factors, cease drug use
2) cardiac ablation if bradycardia
3) implantable cardioverter-defibrillator (ICD) if tachycardia
Cardiomyopathy
ETIOLOGY:
1) Dilated: viral infection, chronic alcoholism, autoimmunity -> myocardial degeneration
2) Hypertrophic: congenital factors -> enlarged ventricles -> obstruction
3) Restricted: myocardial insult -> fibrosis -> stiff myocardium
S/S:
1) dyspnea, fatigue, tachycardia, chest pain
2) (right-sided) peripheral edema, distended veins hepatomegaly, splenomegaly
3) (left-sided) dyspnea, orthopnea, tachypnea, bloody sputum
TREATMENT:
1) ACE inhibitors, B-blockers, CCBs (antihypertensive and antiarrhythmic)
BONUS FACTS:
1) worst prognosis associated with restrictive cardiomyopathy
Pericarditis
ETIOLOGY
1) inflammation or infection (rheumatic fever, bacteria, viruses) -> exudate enters serous fluid, pericardial adhesions, visceral pericardial calcification -> reduced cardiac output
S/S:
1) chest pain, tachycardia, dyspnea, “friction rub” during auscultation
2) fever, malaise, chills
TREATMENT:
1) treat causative factors
2) NSAIDs, antipyretics, analgesics, corticosteroids
3) surgical resection of adhesions or calcifications
Cardiac Tamponade
ETIOLOGY
1) visceral or parietal pericardial blood vessel damaged -> blood fills pericardial sac -> impaired beating of heart
S/S:
1) cyanotic above nipple line
2) (shock) altered state of consciousness, weak and rapid pulse, tachypnea, cold, polydipsia, shakiness, pupil dilation
TREATMENT:
1) pericardiocentesis (needle-shunting blood from sac)
Myocarditis
ETIOLOGY:
1) pathogenic infection (viral, bacterial, fungal, protozoal) or toxic agents (cocaine, chronic alcoholism, radiation) -> myocardial inflammation
S/S:
1) arrhythmia, palpitations, dyspnea
2) fatigue, fever, malaise
TREATMENT:
1) treat causative factor
2) analgesics, NSAIDs, corticosteroids
3) digoxin (antiarrhythmic) and ACE inhibitors
Endocarditis
ETIOLOGY:
1) bacterial (Staphylococcus A, Group A streptococcus, or E. coli) or fungal sepsis -> endocardial and valvular infection -> septic emboli transported through arterial circulation
S/S:
1) fever, fatigue, weakness, chills, night sweats, anorexia
2) ischemia of extremities
TREATMENT:
1) treat causative factors (antifungals, antibiotics)
2) antipyretics, anticoagulants
3) surgical repair of valves
Rheumatic Fever
ETIOLOGY:
1) group A beta-hemolytic Streptococcal infection -> autoantibodies produced -> systemic inflammation (can include cardiac tissues)
S/S:
1) fever, weakness, malaise, weight loss, anorexia, polyarthritis, edema
TREATMENT:
1) complete course of penicillin, antipyretics, anti-inflammatory drugs
Rheumatic Heart Disease (RHD)
ETIOLOGY:
1) group A beta-hemolytic Streptococcal infection -> valvular vegetation/autantibodies produced -> valvular scarring and stenosis
S/S:
1) cardiac murmurs, tachycardia, dyspnea, cough, possible CHF
TREATMENT:
1) prophylactic penicillin
2) surgical valvular repair or replacement
Shock
ETIOLOGY:
1) hypovolemic (hemorrhaging), anaphylactic, septic (bacterial infection), cardiogenic (arrhythmia, MI, valvular disease), neurologic (emotional distress, other insult), or metabolic (acidosis) -> inadequate blood perfusion -> ischemia of vital organs
S/S:
1) altered state of consciousness, weak and rapid pulse, tachypnea, low blood pressure
2) polydipsia, pupil dilation, shakiness
TREATMENT:
1) CABs, control any bleeding (if hemorrhagic), epinephrine (if anaphylactic)
2) place in supine position, elevate legs above heart, keep warm
3) vasodilators OR vasoconstrictive drugs (if cardiogenic)
BONUS FACTS:
1) worse prognosis associated with cardiogenic shock
Essential (Primary) Hypertension
ETIOLOGY:
1) (risk factors) family history, stress, type A personality, high-fat/salt diet, obesity, sedentary lifestyle -> high blood psi -> blood vessel damage
S/S:
1) asymptomatic OR headaches, epistaxis syncope, worsened visual acuity
2) blood pressure >140/90 mmHg
TREATMENT:
1) ACE inhibitors, ARBs, CCBs, thiazide diuretics (antihypertensives)
BONUS FACTS:
1) blood psi of 120-139/80-89 mmHg considered “pre-hypertensive”
Malignant Hypertension
ETIOLOGY:
1) idiopathic OR extreme stress -> extremely high blood psi
S/S:
1) severe headache, syncope, blurry vision
2) blood psi ≥ 200/120 mmHg
TREATMENT:
1) sodium nitroprusside (IV vasodilator)
BONUS FACTS:
1) extreme risk of cerebrovascular accident (CVA)
Thromboangiitis Obliterans (Buerger’s Disease)
ETIOLOGY
1) chronic smoking -> blood vessel inflammation and thrombus -> complete obliteration -> infarction to surrounding areas
S/S:
1) intense pain, possible ulcers or gangrene
TREATMENT:
1) cease smoking, Buerger-Allen exercises
2) amputation of gangrenous tissues
Aneurysm
ETIOLOGY:
1) atherosclerosis, trauma, inflammation, infection -> weakening and dilation of blood vessel
S/S:
1) (before rupture) asymptomatic, possible palpable lump, bruit murmur
2) (if large vessel and ruptures) hemorrhagic shock
TREATMENT:
1) catheter stent graft, artery bypass graft surgery
Phlebitis
ETIOLOGY:
1) linked to obesity, surgery, or trauma
S/S:
1) tenderness, warmth, swelling
TREATMENT:
1) analgesics (just symptomatic)
Thrombophlebetis
ETIOLOGY
1) deep venous phlebitis, hypercoagulable blood disorders, trauma -> formation of thrombus
S/S:
1) tenderness, swelling, edema, chills, fever
TREATMENT:
1) immobilize area,
heparin (anticoagulant)
Emboli
ETIOLOGY:
1) blood clot, air bubble, fat globule, or chunk of tissue -> lodged in vessel -> ischemia to surrounding areas
S/S:
1) (if peripheral artery affected) localized pain, coldness, numbness
2) (if large artery affected) nausea, dizziness, syncope, shock
TREATMENT:
1) streptokinase (thrombolytic drug), heparin (anticoagulant)
Varicose Veins
ETIOLOGY:
1) inactivity -> no milking action of veins -> blood pool (distention) and places stress on veins -> permanent valvular damage
S/S:
1) dull sensation, leg cramps at night -> stabbing pain, noticeably distended veins
TREATMENT:
1) compression stockings, sclerotherapy, ligation, vein stripping, or laser ablation
Atherosclerosis
ETIOLOGY:
1) RISK FACTORS: family history, obesity, sedentary lifestyle, high-fat diet, smoking
2) lipids and cholesterol in blood -> fatty streaks -> atherosclerotic fatty deposit -> risk of thrombus and infarction
S/S:
1) asymptomatic -> high blood pressure, syncope, dyspnea
TREATMENT:
1) lifestyle changes
2) lovastatin (hyperlipidemic drug)
Raynaud’s Disease
ETIOLOGY:
1) cold weather, emotional events, or smoking tobacco -> arteriole vasospasm
S/S:
1) white discoloration (blanching) -> blue discoloration -> red discoloration when circulation restored
2) possible (although uncommon) digital ulceration
TREATMENT:
1) apply warmth
2) vasodilators, alpha-adrenergic blockers, CCBs (side effects may outweigh benefits)
