CV 10

Question 1

Why does ischemia lead to shortness of breath?

Answer 1

Ventricles have less ability to contract
Body has less oxygen
Can also get SOB if you have pulmonary congestion

Question 2

Diaphoresis

Answer 2

A type of thicker sweat

Question 3

Why do you get nausea and diaphoresis with a heart attack?

Answer 3

Sympathetic NS is active
Trying to increase the force of contraction and increase HR to maintain CO
Also arteriole resistance to tissue vascular resistance
Causes sweating and nausea

Question 4

Would BP increase or decrease during a heart attack?

Answer 4

Decrease
Because the heart isnt pumping as well
But watch for people with hypertension, might be harder to spot what a decrease BP is for them

Question 5

3 things that happen during clot formation

Answer 5

Platelet aggregation
Thrombus formation
Vasoconstriction

Question 6

Non-STEMI

Answer 6

ST elevation myocardial infarction
Some cells are dying and they’re near the subendocardium
Ischemia doesnt go all the way through the wall
Would see ST depression

Question 7

STEMI

Answer 7

ST elevatin myocardial infarction
Transmural ischemic damage and necrosis
More extensive ischemia
Will see ST elevation

Question 8

Coronary steal

Answer 8

If you give NO to someone with an occluded artery, then all vessels will dilate
But the resistance is lower in the non occluded vessel, so blood will flow that way

Question 9

2 outcomes from coronary thrombus

Answer 9

1. Healed rupture with narrowed lumen (more blood supply disruption)
2. Acute coronary event (permanent damage to heart muscle)

Question 10

Coronary collateral circulation

Answer 10

Usually compressed
Question over if they develop naturally or only during chronic conditions
Can feed the area downstream from an occlusion

Question 11

What leads would you look at for an inferior MI?

What artery is damaged?

Answer 11

Leads 2, 3 and aVF

Damage to right coronary

Question 12

What leads would you look at for an anterior MI?

What artery is damaged?

Answer 12

V1, V2, V3, V4

Damage to LAD

Question 13

What leads would you look at for an lateral MI?

What artery is damaged?

Answer 13

Lead 1, aVL, V5, V6

Left circumflex

Question 14

How can you tell someone has necrotic tissue in their heart (from a past MI)?

Answer 14

Q wave

Deep negative wave before the positive R wave

Question 15

PCI

Answer 15

Percutaneous transluminal coronary intervention

Place balloon and stent into occluded artery

Question 16

5 treatments for ischemia and heart attacks

Answer 16

Anti-ischemic medications (nitrates, beta blockers, Ca channel blockers)
Anti-clotting medications (aspirin, clopidogrel, heparin)
Fibrinolytic drugs
PCI
Coronary artery bypass graft