cardiovascular system Flashcards
What diseases are ACS?
STEMI, NSTEMI, unstable angina
What is ACS?
Acute Coronary Syndrome
an umbrella term for multiple ischemic heart diseases
What is ischemia?
a reduction in blood flow, insufficient, due to a blockage
When do MIs happen?
When one of the branches of the coronary arteries becomes occluded, BP decreases leading to ischemia
What is coronary atherosclerosis?
When fatty build-up occurs inside of the arteries narrowing them
Acute MI signs/symptoms?
Chest pain (can be described as squeezing tightening, crushing), referred pain (to jaw, neck, arms), pallor, cold and clammy, nausea, weak thready pulse, dyspnea, tachy, hypotension, pain is not relieved w nitrates (GTN), feeling of impending doom.
How do you manage an MI?
TIME CRITICAL!, (STEMI -> PPCI (can be seen on ECG) NSTEMI -> ED (can’t see on ECG). aspirin (inhibits blood clots), GTN (is a vasodilator, tries to inc blood flow), Clopodogrel (anti-platelet), pain relief, O2 (only if hypoxic), fluids (if marked hypotension)
How to differentiate and identify a STEMI?
happens (L or R) from complete and prolonged occlusion of coronary artery.
Can be seen on ECG
Cardiac biomarker will be present (e.g. troponin)
To determine where happening depends on which ECG lead you can see the ST-elevation
( men <40 2.5mm, >40 2mm, women 1.5mm)
How do you differentiate and identify an NSTEMI?
NSTEMI is due to severe coronary artery narrowing, partial occlusion, microembolisation (small clot), thrombus (fatty build up)
Will not show on ECG
Will show cardiac biomarkers though
How do you identify and differentiate unstable angina?
Will not have cardiac biomarkers
What is angina and what are the two types?
Chest pain due to reduction in blood flow to cardiac muscles,
Unstable angina (ACS) and stable angina.
What is stable angina?
Ischemia! a deficiency in blood flow to cardiac tissue, it is myocardial ischemia that isn’t enough to induce cellular necrosis ( that is an MI).
What are the signs and symptoms of stable angina?
It is predictable, They will typically last 15> mins, caused by physical exertion, constricting discomfort (in neck, jaws, shoulders, arms), will be relieved by rest/GTN (a vasodilator to increase blood flow) (nitrates)
may cause nausea, gastrointestinal discomfort
Will appear on ECG as ST depression
What are the signs and symptoms of unstable angina?
the attacks are the same chest pain due to myocardial ischemia, however they are more unpredictable, they may not have a trigger and can continue while resting.
What is the management of Stable angina?
less stress/ physical exertion
GTN
What factors increase the risk of angina?
Anemia, Chronic stress, diabetes, high fats diet, too much alcohol, Hx of heart diseases, HF, high BP, high cholesterol, inflammation, enlarged heart, long-term exposure to second hand smoke, physical inactivity/obesity, men >45 women >55, smoking, drugs
What is the Heart Failure defined as?
The inability of the heart to pump a sufficient amount of blood to reach metabolic requirements
What are factors that increase likelyhood of HF?
(anything really that makes the heart work harder for a longer period of time). coronary artery disease (plaque build up), hypertension, vascular heart disease (umbrella term for lots of diseases which affect the heart), cardiomyopathy (congenital/viral) , myocarditis (inflammation of the heart), pericarditis (inflammation of lining of the heart), COPD, and systemic diseases, arrhythmia, kidney disease, diabetes, smoking, alcohol, drugs, medications such as cancer drugs (chemo), hypertension, cocaine.
What are the signs and symptoms of HF?
SOB, chest pain, palpitations, fatigue during activity, oedema (in legs, ankles, abdomen), weight gain, needing to urinate while resting at night, dry hacking cough, bloated, loss of appetite, nausea
What are the complications of congestive heart failure?
Irregular heart beat, sudden cardiac arrest, heart valve problems, fluid that collects in lungs, pulmonary hypertension, kidney damage, liver damage, malnutrition
Types of HF?
Left-sided HF, Right-sided HF, High-output HF (rare)
left-sided HF usually occurs first and is often the cause of right-sided HF
Left sided HF
fluid in your lungs