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CardioPulm > Coronary Artery Disease > Flashcards

Coronary Artery Disease Flashcards

1
Q

Outer Layer

A

Adventitia

Basic support structure

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2
Q

Middle Layer

A

Media
Multiple layers of smooth muscle cells
Makes adjustments to luminal diameter

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3
Q

Inner Layer

A

Intima

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4
Q

Intima

A

endothelial layer, basement membrane, smooth muscle cells

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5
Q

What is the primary driving force moving blood into myocardial tissue?

A

diastolic BP

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6
Q

What plays a role in determining volume of blood passed along to tissue?

A

vasomotor tone

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7
Q

Left ventricular end-diastolic pressure

A

the pressure within the ventricle at end diastole

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8
Q

Atherosis

A

Fatty streak that consists of lipid-laden macrophages and smooth muscle cells

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9
Q

Sclerosis

A

Responsible for reduction of blood vessel compliance

Organization of “fibrous cap” of thrombi over advanced plaques that have developed on endothelial lining

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10
Q

Lesions of Atherosclerosis

A

Fatty Streak
Raised Fibrous Plaque
Complicated Plaque

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11
Q

Vasospasm

A

Hyperplasia of intimal smooth muscle cells is hallmark of advanced atherosclerosis creating a coronary artery that is prone to spasm

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12
Q

Prinzmetal angina

A

variant angina associated with ST-segment elevation, at rest, and not associated with any preceding increase in myocardial oxygen demand

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13
Q

Modifiable risk factors:

A

Cigarette/tobacco smoking
High blood pressure (over 140/90)
High blood cholesterol levels – best predictor is ratio of total cholesterol to HDL
Physical inactivity

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14
Q

Nonmodifiable risk factors:

A

Heredity
Male sex
Increased age

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15
Q

Classic stable angina:

A

tightness, pressure, indigestion anywhere above the waist that develops with exertional activity and relieved with NTG

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16
Q

Unstable angina:

A

chest discomfort that is accelerating in frequency or severity and may occur while at rest but does not result in myocardial necrosis
-acute MI

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17
Q

Pericarditis:

A

pain at rest, may worsen with activity,but is not relieved with rest or NTG, responds to anti inflammatory meds.

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18
Q

Factors that Contribute to Unstable Angina

A

Circadian variations in catecholamine levels
Increases in plasma viscosity
Increases in platelet activation
Pathological changes in atherosclerotic plaques

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19
Q

Printzmetal’s variant angina (vasospasm)

A

supply ischemia

20
Q

Chronic stable angina (fixed stenosis)

A

demand ischemia

21
Q

Unstable angina (thrombus)

A

supply ischemia

22
Q

STEMI

A

develops a Q wave on ECG in subsequent 24 to 48 hrs (transmural infaction)

23
Q

Non-STEMI

A

does not develop a Q wave on ECG (referred to nontransmural or subendocardial region infarction)

24
Q

Right coronary artery infarction

A

increased risk of AV block and/or arrhythmia

50% have right ventricular infarct

25
Q

Left main artery infarction:

A

pump dysfunction or failure

26
Q

Left anterior descending (LAD) infarction

A

pump dysfunction or failure

27
Q

Circumflex infarction

A

non specific

28
Q

Abnormal contraction patterns

A

Dyssynchrony
Hypokinesis
Akinesis
Dyskinesis

29
Q

Dyssynchrony

A

uncoordinated contraction with adjacent segments

30
Q

Hypokinesis

A

reduction in the strength of contraction

31
Q

Akinesis

A

no contraction

32
Q

Dyskinesis

A

abnormal movement during contraction

33
Q

Factors that affect remodeling

A

Size of infarct
Ventricular load
increased pressure or increased volume will increase load
Patency of the artery that was infarcted

34
Q

Hypertensive Heart Disease

A

Produces a pressure overload on left ventricle

Diastolic dysfunction with impairment of LV relaxation develops early

35
Q

Systolic Dysfunction:

A

an impairment in ventricular contraction, resulting in decrease in stroke volume and decrease in ejection fraction (less than 40%). An increase in end systolic volume will also occur. Now called heart failure with reduced ejection fraction or HFREF.

36
Q

Prehypertension Systolic

A

120-139

37
Q

Prehypertension Diastolic

A

80-89

38
Q

Stage 1 hypertension systolic

A

140-159

39
Q

Stage 1 hypertension diastolic

A

90-99

40
Q

Stage 2 hypertension systolic

A

greater than 159

41
Q

Stage 2 hypertension diastolic

A

greater than 99

42
Q

Dystolic Dysfunction:

A

Changes in ventricular diastolic properties that lead to an impairment in ventricular filling and an impairment in ventricular relaxation.

43
Q

Medical clearance needed:

A

SBP >180 mmHg & DBP >110 mmHg) pt’s must have medial clearance & prescribed medication for HTN

44
Q

Exercise testing should be terminated if

A

SBP >250mmHg or DBP >115 mmHg

45
Q

Orthostatic hypotension

A

SBP dop of >20mmHg or DBP drop >10mmHg

46
Q

Refer to physician if resting BP is

A

(SBP >200 mm Hg or DBP >100 mm Hg)

47
Q

Exercise recommendations for PAD:

A

short intervals (1-5 mins) with frequent rest breaks (gradually increase)
walking
longer warm up times in colder environments
sensory exam
footwear and foot hygiene

CardioPulm (22 decks)

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