Coronary Artery Disease Flashcards
What is another name for Coronary Artery Disease?
Ischemic Heart Disease
What is the leading cause death in the US?
CV disease of both genders of all races and ethnic groups
Why do 60% of patients die in the first hour of experiencing an MI?
Most people are in Denial
What is Arteriosclerosis?
Thickening and reduced elasticity of arterial walls
What is Atherosclerosis?
is the abnormal accumulation of lipid deposits (LDL) and fibrous tissue within arterial walls and lumen
it is a type of arteriosclerosis – most common culprit of CAD
Most common place is in the vessels that supply the heart
What is Coronary Atherosclerosis?
blockages and narrowing reduce blood flow to myocardium
Where does plaque tend to accumulate?
The bifurcations in the coronary arteries
What are Nonmodifiable risk factors for CAD?
Advancing Age, male gender, genetics
What are modifiable risk factors for CAD?
Hypertension Obesity Smoking Stress Physical Inactivity Diabetes Mellitus Hyperlipidemia
Is salt with iodide important in diet?
YES it is VERY important
What are emerging risk factors of CAD?
Elevated homocysteine
Elevated C-reactive protein
Metabolic Syndrome
What are risk factors specific to women?
Premature menopause
Oral Contraceptives
Hormone replacement
What are general risk factors for CAD?
Fasting glucose> 100
Elevated Triglycerides
Elevated C-reactive Protein
What is blood flow regulated by?
Aortic pressure
Heart Rate
Collateral Circulation
Atherosclerosis-most common cause
In relation to Ischemia, what increases oxygen demand?
Exercise Eating Exposure to cold Emotions Hypertension Sexual Activity
In relation to Ischemia, what signifies inadequate oxygen supply?
Coronary Artery Spasm CAD Anemia Smoking Hypotension or Dysrhythmia
What is Angina Pectoris?
Temporary, reversible imbalance between supply and demand.
Transient, substernal chest, jaw, arm, shoulder, or neck pain or pressure caused by insufficient coronary blood blood flow.
Described as burning, squeezing, suffocating, heaviness or pressure.
Sometimes experience a feeling of sudden death
Do Women have different symptoms than men?
Yes, women may experience nausea, vomiting, fatigue, upperback pain
What is the most common cause of Angina?
Exercise
What are the categories of Angina
Stable
Unstable
Prinzmetal’s
What is Stable Angina?
Usually brought on by exercise
What is unstable Angina?
Angina felt during rest
What is Prinzmetal’s Angina?
Usually at rest and during the middle of the night
What are some nursing interventions?
Ask if they have a history of smoking
Give them nitro under the tongue and should be sitting or laying down
Administer O2
Assess VS, Respiratory Distress, and Heart and Lung sounds
What are diagnostic tests?
12 lead ECG Cardiac specific Troponin and Myoglobin Full Lipid Profile CBC C-reactive protein Chest X-ray Echocardiogram Coronary Angiography
What is involved in Angina Pectoris management?
Rest, Nitro sublingual, and oxygen
Medication
Reperfussion: PTCA and CABG
Conservative management of Angina Pectoris
Smoking Cessation
Diet=Reduce Fat, Lower LDL levels, Moderate alcohol intake, lose weight if overweight.
Decrease Sodium
Exercise
What are the meds used in treatment of Coronary Artery Disease?
Nitroglycerin Calcium Channel Blockers Beta-Adrenergic Blockers Drugs used to lower cholesterol Antiplatelet
Clinical manifestations of Angina
Chest pain substernal may radiate
Pain typically occurs after precipitating event: exercise, stress, heavy meal
Relieving Factors: Rest, NTG
Activity, Pain, Rest, Relief
Clinical manifestations of MI
Chest pain lasting more than 15-20 minutes, dyspnea, tachycardia, anxiety, diaphoresis, N/V, decreased LOC
Unrelieved by NTG and Rest
Women-Atypical pain
Where do most occlusions occur?
The widowmaker the Left anterior descending artery
What is MONAB
Morphine, Oxygen, Nitroglycerin, Aspirin, Beta blockers
What are the treatment goals when collaborating with other professionals?
Relieve chest pain Reduce extent of myocardial damage Re-perfuse myocardium Maintain cardiovascular stability Decrease Cardiac Workload
What are diagnostic tests of MI?
ECG Cardiac Markers such as Creatine Kinase which shows cardiac muscle damage Troponins T and I Myoglobin if negative no damage T wave inversion usually shows ischemia Bizarre Q wave
Elevation of what segment indicates an MI?
ST segment and only needs to be a 1mm elevation to indicate MI
What is used for management of MI?
Aspirin and ECG and Nitro
Fibrinolytics can only be given in a short time frame
12 lead ECG
ACEI, antidysrhytmics
What are the revascularization procedures?
PTCA CABG -90% totally relieved -Heart Stopped during surgery -Heart is stopped and blood flow is maintained by machine
