Coronary Artery Disease Flashcards

1
Q

Coronary Artery Disease

A

Blocked area of HE, narrowing of artery, blocked of blood flow to the heart

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2
Q

what does coronary artery disease cause

A

Causes Heart attack - myocardium infarction, angina, chest pain

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3
Q

what causes coronary artery disease

A

• Due to plaque build up in wall of coronary or blockage - Atherosclerosis plaque / Atheroma, - cause atherosclerosis

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4
Q

Angina

A

• Angina is not a heart attack - excess stress, physical effort, too much food, temperature.

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5
Q

atherosclerosis,

A

degenerative changes in the small arterioles
artery has a very rough elevated surface with loose pieces of plaque and through the openings to ranching arteries are locked

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6
Q

What causes atherosclerosis

A

It occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques.

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7
Q

What are the symptoms of atherosclerosis

A

pain

effects brain kidneys and legs

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8
Q

Plaques form primarily where

A

aorta, carotid, coronary, iliac arteries

at points of bifurcation, where turbulent blood flow may encourage the development of these plaques

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9
Q

During inflammation, how does an atherosclerosis form?

A

Monocytes conglomerate through the lining of the endothelium, collect CHO & fatty material. the artery wall thickens and bulges into artery

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10
Q

List some risk factors of developing athersclerosis

A

smoking, elivated CHO, High BP, Diabetes, Obesity, inactivity, diet, alchohol, high homocysteine levels

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11
Q

•High-Density Lipoprotein (HDL)

A
  • High-Density Lipoprotein (HDL) is the “good” lipoprotein; it has low lipid content and is used to transport cholesterol away from the peripheral cells to the liver where it undergoes catabolism and excretion
    • Good kind - HDL - transport CHO from tissues to LIVER to degregate
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12
Q

•Low-Density Lipoprotein (LDL)

A
  • Low-Density Lipoprotein (LDL) has high lipid content and transports cholesterol from the liver to cells. It is considered the “bad” lipoprotein that promotes plaque formation
    • CHO from Liver to cells
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13
Q

What can an athersclerosis develop into

A

thrombus, embolus, or aneurysm

angina, myocardial infarction

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14
Q

________ of aortic aneurysm develop in the abdomen Abdominal aortic anerysm’s

A

75%

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15
Q

•Besides formation of thrombus and embolus the plaque also damages the arterial wall, weakening the structure and may lead to _____________

A

an aneurysm

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16
Q

What are non-modifiable risk factors that will increase the likeliness of an atheroscerosis?

A

Age, more common after 40 yrs
Males more likely
Genetic - familial hypercholesterolemia

17
Q

What are modifiable risk factors that will increase the likeliness of an atheroscerosis?

A
obesity
Diet
Exercise
smoking
diabeties
hypertension
18
Q

how does smoking increase the risk of atherosclerosis

A

Smoking - most effect able - directly related to the amount used, decreases good CHO and increases bad. Increasing levels of arteries to narrow, vassoconstricting, clot forming

19
Q

How does one check for atherosclerosis

A

ECG - can identify cardiac blockages
CBD’s - blood levels of CHO - ratio
CRP - C reative protein - inflammation marker
Exercise stress test

20
Q

Treatments for atherosclerosis

A
Weight loss
Diet - reduce salt intake, lowering fat intake
control of diabeties and hypertension
Quit smoking
Exercise
Anticoagulant
Percutaneous transluminal coronary angioplasty (PTCA)
Coronary Artery Bypass Graft (CABG)
21
Q

Coronary Artery Bypass Graft (CABG)

A

surgical procedure to relieve angina and decrease the risk of death from CAD. Graft to reroute the blockage through the new graft.

22
Q

Percutaneous transluminal coronary angioplasty (PTCA)

A

minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart.

23
Q

Angina Pectoris

A

Angina, or chest pain, occurs when there is a deficit of oxygen to the heart muscle
• Relieved by rest

24
Q

cause of angina pectoris

A

blood or oxygen supply to the myocardium is impaired,

the heart is working harder than usual (needs more oxygen) or a combination of both

25
Q

cause of angina

A

Spasm in artery, drugs, cold exposure, smoking, stress, partial blockage

26
Q

Classic or exertional angina

A

Pain on Exertion
Also called stable angina. Episodes of pain or discomfort are provoked by similar or consistent amounts of activity or stress. Heavy meals, smoking, emotional
○ Develops when HE is working harder - predictable, similar to previous, less than 5 min, disappears with rest / time or medication

27
Q

Variant angina

A

(occurs at rest). Results from a spasm of one of the large coronary arteries on the surface of the heart.
○ Caused by a spasm of HE vessels
○ Happens when Resting,
○ Can be relieved by medication

28
Q

Unstable angina

A

(refers to prolonged pain at rest and of recent onset).
○ Unstable Angina is a more serious form. This may precede a myocardial infarction
○ Variable cause - more severe and long lasting 30 min, may not reduce due to
○ Not relieved by rest, nor medication
○ Gets worse - impending Heart attack -

29
Q

signs and symptoms of angina

A
  • Angina occurs as recurrent, intermittent brief episodes of substernal chest pain
    • Pain is described as a tightness or pressure in the chest and may radiate to the neck and left arm
    • Pallor, diaphoresis and nausea are present

Attacks vary in severity and last a few seconds or minutes

30
Q

treatment of angina

A
  • Usually relieved by rest and administration of coronary vasodilators such as nitroglycerin
    • Nitroglycerin is give sublingually - vasodilator,
    • Asprin - reduces clotting factors
    • If chest pain persists, it is important to seek hospital care
    • Avoidance of sudden physical exertion
    • Anxiety and stress reduction
    • Angioplasty, lifestyle,
31
Q

what is the most common cause of myocardial infarction

A

The most common cause is atherosclerosis with thrombus

32
Q

In which three ways may an infarction develop?

A
  1. The thrombus may build up to obstruct the artery
    1. Vasospasm may occur in the presence of a partial occlusion by a plaque leading to total obstruction
    2. Part of the thrombus may break away, forming an embolus that flows freely until it gets lodged in a smaller vessel
      ○ The size and location of the infarct determine the severity of the damage
33
Q

• With cell destruction, specific enzymes are released from the myocardium into tissue fluid and blood-___________________________________ - used as cardiac markers to see if there has been damage, elevated several hours after the attack

A

creatinine phosphokinase (CPK) and troponin

34
Q

____________ is the most specific indication for cardiac muscle damage

A

Troponin

35
Q

signs and symptoms of myocardial infarction

A
  • Hallmark: acute onset, substernal chestpain of crushing or squeezing nature
    • Pallor and diaphoresis
    • Nausea, dizziness, weakness and dyspnea
    • Hypotension
    • Pulse is rapid and weak
    • Low grade fever
    • Can experience no symptoms at all! 25% silent - diabeties patients more prevalent
36
Q

Diagnostic tests for myocardial infarction

A

ECG
serum enzymes CPK, Troponin
Electrolytes abnormal
Leukocytosis

37
Q

Treatment for myocardial infarction

A
  • Analgesics (morphine)
    • Oxygen via mask
    • Nitroglycerine
    • Anticoagulants (thrombolytic agents such as streptokinase, urokinase or tissue plasminogen activator may be administered immediately to reduce the clot in the first few hours)
    • Depending on the individual circumstances: medication to reduce arrythmias, defibrillation or a pacemaker
    • Drugs, such as Digoxin, support the heart function
    • Specific measures may be required if shock or congestive heart failure develops

Bypass surgery may be performed