Cardiovascular Heart Flashcards
1
Q
what are the 4 major coronary arteries
A
- right coronary artery
- left main coronary
- left anterior descending
- left circumflex artery
2
Q
what 2 arteries are considered the “widow makers”
A
- left main coronary
- left anterior descending
3
Q
formula for cardiac output
A
HR x SV = CO
4
Q
what is normal stroke volume
A
60-100ml / beat
5
Q
what is normal heart rate
A
70
6
Q
what is normal Cardiac output
A
4.2-7 L
7
Q
ejection fraction
A
amount of blood pumped out of the ventricle divided by the total amount of blood in the ventricle
8
Q
what is normal ejection fraction
A
62%
9
Q
frank starling law
A
the stroke volume out ot the left ventricle will increase as the left ventricular volume increases due to the myocyte stretch causing a more forceful contraction
10
Q
heart failure effect on frank starling law
A
- decreases contractibility
11
Q
excersize effect on frank starling law
A
- increases contractibility
12
Q
preload
A
stretching of the cardiac muscle at end diastole right before contration
13
Q
decrease in preload effect on cardiac output
A
decreases cardiac output
14
Q
afterload
A
the pressure that the heat must work against to eject blood during systole (ventricular contraction)
15
Q
high afterload effect on CO
A
decreases CO
16
Q
change in the S-T segment indicates
A
damage to the heart
17
Q
ST segment depression indivates
A
ischemia
- cells are low on oxygen
18
Q
ST segemnt elevation indicates
A
infraction
- calls are without oxygen (within 20 mins there will be irreversible damage)
19
Q
Coronary artery disease modifiable risk factors
A
- dyslipidemia
- hypertension
- cigarette smoking
- diabetes melitus
- obestiry
- sedentary lifestyle
- atherogenic diet
20
Q
coronary artery disease non-modifiable risk factors
A
- age
- gender
- family history
21
Q
myocardial Ischemia causes
A
- stable angina
- prinzmetal angina
- silent ischemia
22
Q
stable angina
A
- chronic coronary obstruction
- gradual narrowing
23
Q
Prinzmental angina
A
- caused by spasm
24
Q
Slient ischmia
A
- can be caused from mental stress (induced ischemia)
-can be asymptomatic (1/3)
25
stable angina is activated by
physical exertion or stress
26
stable angina symptoms
substernal chest discomfort
- sensation of heaviness or pressure
- may radiate to neck, lower jaw, left arm and shoulder
Pallor, diaphoresis, dyspnea
27
stable angina symptoms in women
atypical chest pain
28
most women with stable angina do not have CAD they have
microvascular angina
- vasoconstriction of small coronary arteries
29
stable angina risk factors
- uncontrolled diabetes , dyslipidemia, diabetes
- hypertension
- increased LDL; decreased HDL
- sedentry lifestyle
- high BMI
- genetics
30
prinzmental angina is also called
variant angina
31
prinzmetal angina
- unstable, unpredictable, can occur at rest
- vasospasm of coronary artieries with or without atherosclerosis
32
prinzmental angina occurs
- often at rest
- at night between midnight and 6am
33
prinzmetal agnia results from
- decreased vagal activity (facilitates adaptive responses)
- hyperactivity of the SNS
34
prinzmetal angina causes
- cocaine use in younger populations
- other blood vessel issue
- migraines
- raynaulds disease
35
prinzmetal angina is usually a _______ condition
benign
36
prinzmetal angina can cause
dysthrythmias
37
Silent ischemia symptoms
- fatigue, dyspnea, feelings of unease
- asymptomatic
38
stable angina causes
- diabetes mellitus
- surgical denervation during CABG
- cardiac transplant
- Previous MI (local nerve injury)
- mental stress
39
How to evaluate silent ischemia
transient ST segment changes
40
People who experience chest pain related to angina and MI often beleive that the pain is
Indigestion
41
how to rule out if chest pain is indigestion
take ant-acid to rules out
42
signs and symptoms of angina and MI in men
typical symptoms
- sensation of haviness or pressure, may radiate to neck, lower jaw, left arm and shoulder
43
signs and symptoms of angina and MI in women
atypical symptoms
- palpations, anxiety, and fatigue, right side chest pain
44
what is the leading cause of death amongst Canadian women
Heart disease and stoke
45
Acute coronary syndrome process
1. stable angina
2. unstable angina
3. NSTEMI
4. STEMI
46
nSTEMI
- damage is limited to the myocardium directly below the edocardium
- ST wave depression and T wave inversion
47
nSTEMI manifestations on ECG
- ST wave depression and T wave inversion
48
STEMI
- damage extends from the edocardium to the epicardium
- serious risk for complications
49
STEMI manifestations on ECG
- presents with ST elevation
50
how long can cardiac cells withstand ischemic conditions before hypoxic injury occurs
20 mins
51
Mi involves the left ventricle
-pulmonary venous congestion
52
MI invloves the right ventricle
- increase in system venous pressure
53
myocardial infraction diagnosis
history exam, ECG results and increased troponin levels
54
when should troponin levels be drawn after an MI
- immediately
- 6, 12, 24 hours after initial event (can be delayed)
55
valve disfunction
stenosis or regurgitation of all your heart valves
56
stenosis
- valve doesnt open fully so it is hard to get blood past
57
regurgitation
- valve doesnt close properly so blood will leak back into the chamber it has just left
58
what is the most common disorder of the heart valves
aortic stenosis
59
aortic stenosis
- most common disorder of the heart valves
- valve between left ventricle and aorta
60
mitral stenosis
- valve between left atria and left ventricle
61
mitral stenosis is most common in
rheumatic heart disease
62
aortic or mitral regurgitation
- inability of aortic valve to close properly or prolapse of mitral valve
63
aortic or mitral regiritation is a result fo
chronic hypertension, rheumatic heart disease, bacterial endocarditis
64
heart failure
unable to generate an adequate cardiac output
65
heart failure causes
dysfunction of the left ventricle
66
right side heart failure is related to
pulmonary disease
- pleural effusion, pneumothorax putting pressure on the heart
67
heart failure risk factors
ischemic heart disease and hypertension
- age, obesity, diabetes, renal failure, valvular heart disease, cardiomyopathies, myocarditis, congenital heart disease, excessive alcohol disease
68
left sided heart failure signs and symptoms
restlessness, confusion, orthopnea, tachycardia, exertional dyspnea, fatigue, cyanosis, pulmonary congestion (cough, crackles, wheezes, blood-tinged sputum, tachypnea), elevated pulmonary capillary wedge pressure, pulmonary nocturnal dyspnea
69
left sided heart failure is
decreased ejection fraction
70
ejection fraction <40%
inability for the heart to perfuse tissues
71
when can contractibility be decreased
in MI, myocarditis, cardimyopathies
72
right sided heart failure can be caused by
- pulmonary hypertension
- left ventricular failure
73
right sided heart failure
inability to pump blood effectively to the lungs; back up of fluid in the vena cava
74
right sided heart failure signs and symptoms
- fatigue
- increased peripheral venous pressure
- ascites
- enlarged liver and spleen
- distended jugular veins
- anorexia and complaints of GI distress
- weight gain
- dependent edema
75
cor pulmonale
- enlargement, dilation hypertrophy or failure of the right ventricle
76
right sided heart failure occurs without ventricular failure in
COPD, cystic fibrosis, ARDS
77
what is hypovolemic shock
insufficient intravascular fluid volume
78
what is cardiogenic shock
- heart failure
79
what is neurogenic shock
- neural alteration of vascular smooth muscle tone
80
what is anaphylactic shock
immunological process
81
what is septic shock
result of infection
82
what are the 3 types of shock
- hypovolemic
- cardiogenic
- distributive (neurogenic, septic, anaphylactic)
83
shock general symptoms
feeling unwell, weak, dizziness, confused, thirty, hypotension, decrease in respiratory rate (acidosis), cellular edema, cell death
84
hypovolemic shock results from
- loss of whole blood (hemorrhage)
- loss of plasma (burns)
- loss of interstitial fluid (diarrhea, diuresis, diabetes mellitus, diabetes insipidus, emesis)
85
hypovolemic shock effect
heart rate increases, sats decrease, cardiac output decreases
86
hypovolemic shock manifestation
high SVR, poor skin turgor, PALE, COOL, CLAMMY SKIN, thirst, oliguria, low preload, rapid heart rate, thread pulse, mental status deterioration
87
cardiogenic shock is most often caused by
myocardial infraction
88
cardiogenic shock effect
heart rate increases, SATs decrease, cardiac output decreases, weak pulse, decreased blood pressure
89
cardiogenic shock is caused by
myocardial infraction, congenital heart anomalies, cardiomyopathy, myocarditis, arrhythmias, drug toxicity
90
cardiogenic shock manifestations
dyspnea, tachypnea, venous and pulmonary edema, dusky skin color, hypotension, oliguria (scant urine) and ileus (lack of movement in bowel)
91
neurogenic shock effect
cardiac output decreases, heart rate decreases, SATs decrease
92
neurogenic shock can be caused by
- trauma to the spinal cord
- interruption of oxygen to the medulla
- depressive medication, anesthetic agents, severe emotional stress, pain anf other causes
93
relative hypovolemia
inadequate distribution of blood volume between the central and peripheral compartments
94
neurogenic shock
- widespread vasodilation
- overstimulation of parasympathic
- understimulation of sympathetic
- loss of vascular tone = relative hypovolemia
-blood volume is the same - systemic vascular resistance decreases
95
anaphylactic shock
- widespread hypersensitivity
- exposure to antigen
- immune and inflammatory response
- sudden onset
96
anaphylactic shock effect
CO decreases, HR increases, SATs decrease
97
anaphylactic shock symptoms
anxiety, dizziness, difficulty breathing, stridor, wheezing pruritus with hives, swollen lips and tongue, abdominal cramping
98
septic shock effect
CO normal, heart rate increases SATS increases
99
septic shock risk factors
genetics, chronic diseases, immune deficiency state, timeliness of intervention
100
septic shock symptoms
tachycardia, tempurature instability, renal dysfunction, clotting abnormalities, decreased mental status
101
septic shock process
infection --> bacteremia --> systemic inflammatory response syndrome --> sepsis --> severe sepsis --> septic shock --> MODS
