Coronary Artery Disease Flashcards
What is coronary artery disease also known as?
Ischemic heart disease
What can coronary artery disease be described as?
Impaired blood flow to myocardium
What is the leading cause of death in the United States for men and women of all racial and ethnic groups?
Cardiovascular disease
What is the percentage of deaths after an MI within the first hour?
60%
What is the percentage of death after an MI before hospitalization?
40%
What is arteriosclerosis?
Thickening and reduced elasticity of arterial walls
Atherosclerosis is a type of what?
Arteriosclerosis
What is the most common culprit of CAD?
Atherosclerosis
How is atherosclerosis described?
The abnormal accumulation of lipid deposits (LDL) and fibrous tissue within arterial walls and lumen
Where is the most common place for arteriosclerosis?
Vessels of heart
What is the usual first sign of coronary atherosclerosis?
Angina
What is occurring in coronary atherosclerosis?
Blockages and narrowing of the coronary vessels reduce blood flow to the myocardium
What is the most prevalent cardiovascular disease in adults?
Coronary artery disease (CAD)
True or False:
CAD is typically symptomatic that leads to sudden death?
False:
It is asymptomatic to sudden death
What deposits on plaque and initiates clot formation?
Platelets and fibrin
Where do blockages due to coronary artery disease mostly occur?
In the branching of the coronary arteries
What are the non-modifiable risk factors associated with coronary artery disease?
Advanced age
Male gender
Genetics
What are the three modifiable diseases a patient can have that increases their risks for coronary artery disease?
Hypertension
Diabetes mellitus
Hyperlipidemia
What are the four modifiable risk factors that increases a patients risk for coronary artery disease?
Cigarette smoking
Obesity (diet)
Physical inactivity
Stress
What are the three emerging risk factors for coronary artery disease?
Elevated levels of homocysteine
Inflammatory processes
Metabolic syndrome
What is the protein associated with inflammatory processes?
C-reactive protein
What are the three risk factors for coronary artery disease that is unique to women?
- Premature menopause
- Oral contraceptive use
- Hormone replacement therapy
What are the four things that blood flow is regulated by?
- Aortic pressure
- Heart Rate
- Collateral circulation
- Atherosclerosis
What type things can cause ischemia?
Increases oxygen demand
Inadequate oxygen supply
How is angina pectoris described?
A temporary and reversible imbalance between supply and demand of oxygen
What are the typical symptoms of angina?
- Transient pain or pressure due to insufficient coronary blood flow
- Tachycardia
- Hypo or hyper -tension
- Pallor and cool or clammy skin
What are the three categories of angina?
- Stable
- Unstable
- Prinzmetal
What 5 factors do you need to assess for angina?
- Description of symptoms
- Info about history of CAD
- Sex
- Age
- Number of risk factors present
What is the first nursing intervention you need to do for a patient complaining of angina?
Administer oxygen
What type of EKG should you conduct if a patient is experiencing angina pain?
12 lead
Other than oxygen- what should you administer to a patient experiencing angina pain?
Nitrates and narcotics
What do most patients say they were doing when they began experiencing angina pain?
Some sort of exercise
What could you see on an ECG that would indicate a patient is experiencing an angina episode?
ST segment depression and T wave inversion
What labs do you draw in a patient experiencing angina?
Cardiac specific troponin and myoglobin Coagulation studies Full lipid profile C-reactive protein Homocysteine levels
When do most people experience stable angina?
During exercise
When do most people experience unstable angina?
During relaxation
When does Prinzmetal angina typically occur?
In younger people, at rest, typically in the middle of the night
What other diagnostic tests do you do for a patient experiencing angina?
- Chest X-ray
- Echocardiogram
- MRI
- Coronary computed tomographic angiography
- Stress test
- Invasice coronary angiography
What is the main goal of treatment for angina?
Decrease myocardial oxygen demand and increase oxygen supply
What are the two types of repercussion therapy?
- Percutaneous transluminal coronary angioplasty (PTCA)
- Coronary artery bypass graft (CABG)
What does PTCA stand for?
Percutaneous Transluminal Coronary Angioplasty
What does CABG stand for?
Coronary artery bypass graft
What should you always assess for I’m a patient that just had a PTCA?
Swelling, bleeding, and hematoma around the incision site
Upon sheath removal what could occur as a vasovagal response?
Decrease heart rate with hypertension
How long do you hold pressure to the incision site after sheath removal?
Minimum of 5 minutes
What happens during a PTCA?
A balloon tipped catheter is threaded through the arteries. The plaque that is causing the occlusion gets smashed against the vessel. A stent can then be placed if necessary.
What are the five conservative managements recommended for a patient with angina pectoris?
Smoking cessation Diet change Exercise Hypertension control Diabetes control
What medication are prescribed to patients with angina pectoris?
Nitroglycerin Beta-adrenergic blocking agents Calcium channel blocking agents Drugs used to lower cholesterol Antiplate/anticoagulant drugs
What is the main difference occurring in the heart when comparing angina and myocardial infarction?
Heart muscle damage
Angina typically has none and MI typically has damage
True or False:
A patient who is experiencing angina should expect to have pain relief after resting and taking nitroglycerin
True
How is acute myocardial infarction described?
Chest pain that is sudden and not relieved by rest or nitroglycerin
What could cause a myocardial infarction?
Unstable angina
What is the definition of myocardial infarction?
Acute cardiac ischemia leading to cardiac tissue death. May lead to cardiac failure and ultimately death if lead untreated.
What is a STEMI?
ST elevation myocardial infarction
Where do more MIs occur?
In the Left anterior deceasing artery
AKA widow maker
What are the five things you need to administer NOW to a patient experiencing an MI?
MONA: Morphine Oxygen Nitroglycerin Aspirin
What are the cardiac makers tested in a patient experiencing a myocardial infarction?
AKA A cardiac injury panel:
Creatine kinase MB: CK-MB
Troponin I and T
Myoglobin
What typically happens to a patient ECG when they are experiencing a myocardial infarction?
ST elevation, T wave inversion, and new bizarre looking Q wave.
What are the type main side effects of nitroglycerin?
Headache and dizziness
After a patient has a undergone a heart catheterization- how frequently should you assess their vital signs?
Every 15 minutes
What occurs during a CABG?
A bypass of the occluded artery is surgically done. A vein taking from a leg is connected to the Aorta and a place in the heart to bypass the occluded artery.
Why would a patient who is experiencing an acute myocardial infarction have decreased urine output?
Due to the kidneys not getting enough blood flow
What are the two nursing diagnoses associated with an acute myocardial infarction?
Ineffective tissue perfusion and Deficient Knowledge.
What are the two lifestyle changes that a patient needs to enact once they experience a myocardial infarction?
Diet (reduction of salt and cholesterol)
Exercise
