Coronary Vascular Disease Pt 1 Flashcards
What is Coronary Vascular Disease?
umbrella term for all diseases that affect the heart or blood vessels
What diseases are included when thinking of coronary vascular disease?
- coronary heart disease (clogged arteries) which can cause:
- heart attacks
- stroke
- congenital heart defects
- peripheral artery disease
What does coronary atherosclerosis affect?
The vessels that supply the heart with blood
Coronary Atherosclerosis is usually caused by what?
Atherosclerosis-a buildup of plaque-fatty substance inside the artery wall
Atherosclerosis leads to what?
a blockage/narrowing of arteries that supply blood to the myocardium (cardiac muscle)
Behavioral Risk Factors for CVD
- tobacco
- sedentary lifestyle
- diet high in fat and calories
- alcohol
Metabolic Risk Factors for CVD
- HTN
- diabetes
- hyperlipidemia
- obesity
General Risk Factors for CVD
- age
- gender
- race
- family history
- stress
Metabolic Syndrome
cluster of conditions that occur together, increasing the risk of heart disease, stroke, and type 2 diabetes
How many risk factors must a person have to be considered to have metabolic syndrome?
3
Risk Factors for Metabolic Syndrome
- large waist-35 in for women/40 in for men
- high triglyceride level < 150
- reduced “good”/HDL cholesterol
- increased BP 130/85 or higher
- elevated fasting BG < 110
- elevated serum CRP/fibrinogen
S/S of CVD
- may be progressive secondary to worsening of obstruct blood flow
- angina
- arrhythmias
- MI
Symptoms of CVD are directly r/t what?
location and degree of narrowing
Normal Total Cholesterol
< 200
HDL or Good Cholesterol
- < 50 women 35-80
- < 50 in men 35-65
- transports LDL to liver where it is broken down and excreted
LDL or Bad cholesterol
- Normal < 130
- transports cholesterol particles throughout the body
- small particles easily build up in the walls of arteries, making them hard and narrow
Triglycerides
- norm < 150
- fat that comes primarily from food
- body also produces it when it converts excess calories to fat for storage
Primary Treatment for CVD
Diet and Activity
Diet for CVD
- heart healthy
- control portion sizes
- increase intake of fruits and vegetables
- eat more whole grains
- limited saturated fats/avoid trans fats
- low fat protein sources
- low sodium
Activity Requirements for CVD
- increased physical activity
- 2.5 hrs of moderate exercise each week
- 75 mins of vigorous exercise each week
Secondary CVD Treatment
Lipid Lowering meds
-Statins
Types of Statins
- atorvastatin/Lipitor
- pravastatin/Pravachol
- simvastatin/Zocor
Rules for Statins
- contraindicated w/ liver disease
- use cautiously w/ kidney disease
- may cause rhabdomyolysis
- interactions w/ multiple meds
BP and CVD
- hypertension puts added force against artery walls/makes them hard and stiff
- extra pressure damages arteries making more vulnerable to narrowing/plaque build up
- increases workload of left ventricle
Hypertension w/ CVD can treated how?
- through early detection and treatment
- smoking cessation
- weight control
- alcohol avoidance
- decreased sodium intake
- increased exercise
- meds
What disease can increase the clients risk for a cardiac event?
Diabetes
Diabetes Control
- eat 3 meals a day at regular times
- healthy carbs
- avoid/limit simple and complex carbs
- meds
What type of angina occurs when the heart must work harder usually during physical exertion?
Stable Angina
Can stable angina be stopped/relieved?
Yes by rest or meds
Stable Angina
- doesn’t come as surprise; all episodes are similar
- lasts a short time
- feels like gas/indigestion
- may feel like chest pain that spreads to arms, back, or other areas
What are possible triggers of stable angina?
- emotional stress
- exposure to very hot/cold temps
- heavy metals
- smoking
Unstable angina often occurs when?
While resting, sleeping, or w/ little physical exertion
Unstable Angina
- comes as surprise
- rest or meds do not help relieve it
- may get worse over time
- can lead to heart attack
- more frequent, severe in nature, lasts longer
Unstable angina is also known as what?
Acute coronary syndrome
Assessment of Angina Position
- left or right chest
- sub sternal
- epigastric
- mid back
- generalized
Provocation of Angina
Cold
Heat
Stress
Quality of Angina
- discomfort
- burning
- sharp
- aching
Radiation of Angina
- left/right arm
- neck
- jaw
- anywhere
S/S of Heart Attack
- N/V
- diaphoresis
- anxiety
- SOB
- dizziness
Nitrates (Nitroglycerin)
- vasodilator
- increase O2 supply
- monitor HR and BP prior to administration
- contraindicated w/ hypotension
- may be administered SL q 1-5 mins up to 3 times
How often should the patient replace their nitroglycerin?
q 6 months
When should nitroglycerine be taken?
before “expected” pain w/ stable angina
When should the patient go to the hospital after taking nitroglycerin?
If pain is unrelieved after 5 mins / 3 doses
Nitroglycerin may cause what?
- intense throbbing headache
- tachycardia
- hypotension
What are some examples of beta blockers?
- metoprolol/Toprol
- atenolol/Tenormin
Beta Blockers
- reduce demand for O2
- reduce HR and BP
- decreases imbalanced O2 needs during activity
Abrupt withdrawal from a beta blocker could cause what?
- palpations
- hypertensive crisis
- angina
- MI
Examples of calcium channel blockers
Norvasc
Cardizem
Calcium Channel Blockers
- decrease demand and increase supply of O2
- decrease HR and BP
- grapefruit juice alters absorption
What should you avoid while taking calcium channel blockers?
Grapefruit juice
Examples of Antiplatelet/Anticoagulants
- aspirin
- Plavix
- heparin
Anticoagulants/Antiplatelet
- prevent thrombus formation
- monitor for s/s of bleeding
- assess H&H
How long does it take for antiplatelet to take effect?
up to 7 days
Symptoms of Heart attack
- acute onset of pressure, tightness, pain, or squeezing
- n/v, indigestion, heartburn, abdominal pain
- SOB
- cold sweat/diaphoresis
- extreme fatigue
- lightheaded/dizzy
What can a heart attack be like for a woman?
May experience generalized CP w/ or w/o the other symptoms
Elderly patients may experience what w/ a heart attack?
Silent ischemia-no symptoms/abnormal EKG
