CV Flashcards
What are the signs/symptoms of PAD?
- pain with walking, stops at rest — intermittent claudication (pain and cramping in legs)
- pain with increased speed, workload, incline
- diminished pulses, cool limb, pallor
What is peripheral artery disease (PAD)?
- same as CAD, just blocking blood flow in periphery
- atherosclerosis - plaque builds up in peripheral arteries and occludes blood flow
When severe, what is PAD considered?
An occlusive disease
What are chronic changes in occlusive diseases? (Due to decreased blood flow)
- thick nail beds, dry skin, muscle atrophy, decreased sensation, and decreased strength
What is one type of severe occlusive disease?
Critical limb ischemia
Characteristics of critical limb ischemia?
- more likely to have this if have diabetes
- ulcerations, gangrene, pain, decreased functional capacity
What is commonly used to diagnose PAD?
Ankle brachial index (ABI)
How is ABI found?
Systolic pressure in ankle pulse divided by systolic pressure in arm
What are the categories for ABI?
1-1.29 --- Normal 0.91-0.99 --- borderline 0.41-0.9 --- mild/mod PAD 0-0.4 --- severe PAD *anything below 0.91 have some arterial occlusion
PAD treatment
- risk factor modification
- decrease CV risk
- PROGRESSIVE EXERCISE
- foot care — any small would could cause problems due to not being able to heal bc of lack of blood flow
- angioplasty, bypass surgery, amputation
What is an aneurysm?
- cardiac condition where vessel wall is weakened
- localized dilation or out pocketing of arterial wall
- as out pocketing increases, get increased wall tension and thrombi
True vs false aneurysm
True – deterioration of media
False – blood accumulates, disrupts vessel layers
What is a possible issue for aneurysm?
Longstanding HTN
Aneurysm characteristics
- asymptomatic - first sign usually death or unrelenting pain in back in thoracic spine and in brain
- palpable out pocketing in LE
- severe abdominal back pain
- rupture – poor prognosis
Treatments for aneurysm
- monitor size and location
- grafting – resect aneurysm, graft
DVT
- blood clot in venous system
What are the parts of the Virchow Triad?
- Stasis of blood flow - limits muscular pump, immobility
- Endothelial injury - trauma
- Hypercoagulability of blood - oncologic disease
DVT characteristics
- can be asymptomatic
- unilateral swelling distal to occlusion
- pain and warmth from blood stuck in extremity
- erythema
- if bilateral may be systemic issue
Thromboembolic disease risks
- dehydration
- malignancy
- surgery/trauma
- pregnancy
- obesity
- transatlantic flight
What are treatments for DVT?
- anticoagulation - blood thinners
- filters - IVC filter prevents clot from moving
- prevention – mobility, compression stockings (help prevent DVT post surgery and decrease pain)
Pulmonary Vasculature disorders examples
- PE – blood clot in pulmonary artery blocks blood supply
- DVT - blood clot in venous system - cause embolism from air, tumor, bone marrow
Risks of pulmonary Vasculature disorders
- virchows triad
- > 60 yrs old
- cigarettes
- obesity
Pulmonary Vasculature disorders prognosis
- 10% die within one hour
- favorable for survivors
Thrombus
- travels and becomes an embolus - if embolus is large, can cause death
Pulmonary embolism - where do they come from?
- almost always come from DVTs
- clot broke off and traveled up to the heart to pulmonary artery and clogged
What are symptoms of PE?
- chest wall tight
- shoulder pain
- hemoptysis (throw up blood)
- dyspnea
- occur in 20% of pop
PE tests
- search for clot - Doppler
- V/Q scan
- chest CT
PE Treatment
- anticoagulation, fibrinolytics, compression garments, oxygen, mobility
What is congenital heart disease?
- heart defect in-utero
- usually occurs in 1st trimester
- not common in children (8/1000)
Congenital heart disease etiology
- 10% have genetic defect
- other causes - alcohol, diabetes, viruses, hypoxemia, premature
What are the two main types of congenital defects?
- cyanotic and acyanotic
Cyanotic congenital heart disease
- affects oxygen levels
- impaired blood flow to lungs, mix of oxygenated and deoxygenated blood
Acyanotic defects
- no oxygen problems
- shunt blood from left side of heart to right side
Cyanotic defects
- transposition of great vessels
- tetralogy of fallot
- tricuspid atresia
Acyanotic defects
- ventricular septal defect (VSD)
- atrial septal defect (ASD)
- coarctation of aorta
- PATENT DUCTUS ARTERIOSIS (PDA)
Patent ductus arteriosis
- acyanotic
- in fetus, ductus arteries is connects pulmonary a. to aorta
- blood bypass lungs
- goes from high (aorta) to low (pulmonary a.) pressure
- oxygenated blood
- right to left shunt
What are signs and symptoms of congenital heart disease?
- respiratory distress
- cyanosis
- grunting/wheezing
- failure to thrive
- signs of HF
- SOB
What are the diagnosis options for congenital heart disease?
- prenatal scree - genetic disorders
- ultrasound
- echocardiogram
- often occurs with other NM, MS, or organ issues
PT Implications for congenital heart disease
- assess activity tolerance
- breathing patterns
- HR response
- posture
- developmental milestones
