Chapter 23 Cardiovascular Flashcards
Coronary Artery Disease (the most common cause is atherosclerosis)
Any vascular disorder that narrows or occludes the coronary arteries leading to myocardial ischemia (decreased oxygen)
Lipoprotein
refers to lipids particularly cholesterol and triglycerides according to atherosclerosis
LDL vs HDL
LDL is bad cholesterol: < 100
HDL is good cholesterol: 40-60
Total cholesterol should be less than 200
Chylomicrons
mainly composed of triglycerides
Necessary for fat to be absorbed in small intestines
Nonmodifiable vs Modifiable risk factors of coronary artery disease
Nonmodifiable: Increased age, Family history, Male gender or female gender post-menopause
Modifiable: Dyslipidemia: has to do with lipoproteins (LDL and HDL), Hypertension, Cigarette smoking (vasoconstriction–>limiting oxygen supply), Diabetes mellitus, Obesity/sedentary lifestyle, Atherogenic diet
C-reactive protein and ESR
(Nonspecific)made in the liver; measurement of plaque-related information
Indicates there is a lot of inflammation somewhere but doesn’t indicate where
Myocardial ischemia
due to plaques; oxygen content of coronary blood is insufficient to meet the metabolic demands of the myocardial (heart cells) cells, ecludes blood flow to coronary arteries
ischemia
decreased oxygen or lack of
angina (2 types)
chest pain related to cardiac ischemia
Stable Angina vs Prinzmetal Angina
Stable: Gradual luminal narrowing and hardening of arterial walls
-pain radiates, diaphoretic(sweaty), dyspnea, chest pain will go away with meds,
Prinzmetal (unpredictable): due to vasospasm; Unpredictable occurrence and often at rest
Silent ischemia
due to the release of inflammatory mediators but does not show any symptoms
Angina Treatment (MONA)
Treatment seeks to decrease myocardial oxygen demand and increase oxygen supply
Myocardial Infarction (MI: heart attack) (part of heart has died due to lack of O2)
an area of the heart is permanently destroyed caused by decreased blood flow in the coronary artery
SLIDE 27
Signs and Symptoms of MI
-Sudden severe chest pain; may radiate
-Nausea, vomiting
-Diaphoresis
-Dyspnea
Complications: Sudden cardiac arrest due to ischemia, left ventricular dysfunction, and electrical instability
What are disorders of the heart wall?
Acute pericarditis: inflammation of the pericardium Pericardial effusion(effusion means fluid build up): the buildup of fluid in the pericardial sac. Tamponade-fluid accumulates rapidly causing cardiac compression resulting in decreased cardiac output
Signs and Symptoms for pericarditis
fever for a few days, chest pain when lying in recumbent position makes it worse and also when taking deep breaths, the assessment will indicate friction rub of parietal and visceral layers
Cardiomyopathies
enlarged heart
Stenosis
narrowing of valves; reduces or blocks blood flow from heart
Regurgitation
valves do not completely close resulting in too much blood or backflow of blood
Rheumatic Fever
- can be a result of a pharyngeal strep infection
- delayed response starts with fever, joint pain, heart pain as a result of recent infection
Rheumatic Fever Contin.
- Systemic, inflammatory disease caused by a delayed immune response to pharyngeal infection by the group A beta-hemolytic streptococci (usually 1-4 weeks later)
- Febrile illness
- Inflammation of the joints, skin, nervous system, and heart - If left untreated, rheumatic fever causes damage to valves, rheumatic heart disease
- Can be prevented with antibiotic treatment of the strep throat
Infective Endocarditis (pg 630–> risk factors)
systemic: Infection and inflammation of the endocardium
The main cause is bacteria
Could be due to a prosthetic valve or a person with a history of IV drug use
Must have prophylactic antibiotic before any dental procedure is conducted to prevent any further infection from occurring
What are the skin lesions specific to Infective Endocarditis and what are other sign and symptoms
Osler nodes: painful erythematous nodules on the pads of the fingers and toes)
and Janeway lesions: nonpainful hemorrhagic lesions on the palms and soles
*Fever, New or changed cardiac murmur, Petechial lesions of the skin, conjunctiva, and oral mucosa
Dysrhythmias (Arrhythmias)
the heart is out of its normal rate and rhythm
Heart Failure Pg. 632
results in inadequate perfusion of the tissues.
ventricles cant pump blood out resulting in decreased cardiac output and leftover blood in the ventricles that shouldn’t be there
Remodeling
refers to changes in the size, shape, structure, and function of the heart. This can happen as a result of exercise (physiological remodeling) or after an injury to the heart muscle (pathological remodeling).
The ventricle is unable to pump blood effectively resulting in a decreased cardiac output
Left Sided heart failure deals with what type of symptoms
Those that are related to the lungs, not enough blood is being ejected from the left ventricle leaving a backup of blood
Ex: shortness of breath(dyspnea), frothy, foamy sputum that is tinted pink, orthopnea(lying flat and unable to breathe; must be elevated), swelling, oliguria(decreased urine output), pulmonary edema, paroxysmal nocturnal dyspnea
Right-Sided Heart Failure
Severe peripheral edema
Ascites: swelling in the abdomen
what does decreased contractility correlate to
decreased cardiac output
Shock
The cardiovascular system fails to perfuse the tissues adequately; rest of the body is unable to get enough oxygen
–Leads to impaired cellular metabolism
Impaired oxygen use
Impaired glucose use
–Manifestations vary based on stage but often include hypotension, tachycardia, increased respiratory rate
Types of Shock
–Cardiogenic
Decreased cardiac output and evidence of tissue
hypoxia in the presence of adequate intravascular
volume, usually follow MI
–Hypovolemic (low volume)
-The person who is losing a lot of fluids
-Caused by loss of whole blood (hemorrhage), plasma
(burns), or interstitial fluid in large amounts
–Neurogenic (vasogenic)
-Result of widespread and massive vasodilatation that
results from parasympathetic overstimulation and
sympathetic under-stimulation may be seen in trauma
to the spinal cord or medulla
-heart rate will go down and so may blood pressure
and cardiac output may be normal or could be really
high
Types of Shock (Pg 643, 651)
–Cardiogenic
Decreased cardiac output and evidence of tissue
hypoxia in the presence of adequate intravascular
volume, usually follow MI
–Hypovolemic (low volume)
-The person who is losing a lot of fluids
-Caused by loss of whole blood (hemorrhage), plasma
(burns), or interstitial fluid in large amounts
–Neurogenic (vasogenic) (spinal cord injury)
-Result of widespread and massive vasodilatation that
results from parasympathetic overstimulation and
sympathetic under-stimulation may be seen in trauma
to the spinal cord or medulla
-heart rate will go down and so may blood pressure
and cardiac output may be normal or could be really
high
decreased blood pressure and increased heart rate what does that mean
A patient is a high risk for hypovolemic shock
Types of Shock Contin..
- -Anaphylactic: Results from widespread hypersensitivity reaction (anaphylaxis)
- -Septic: Begins with an infection that progresses to bacteremia, then systemic inflammatory response syndrome (SIRS) with sepsis, then severe sepsis, then septic shock
What is Multiple Organ Dysfunction Syndrome?
Progressive dysfunction of two or more organ systems resulting from an uncontrolled inflammatory response to severe illness or injury
