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Med Conditions > CV pathology > Flashcards

CV pathology Flashcards

1
Q

what are the 3 main aspects of a chest x ray?

A
  • heart size and shape
  • surface anatomy
  • lungs and pulm vasculature
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2
Q

what is the surface anatomy of the heart

A 
sup and inf vena cava
RA
RV
LV
aorta
pulm trunk
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3
Q

what is the cardiac origin of chest pain?

A
  • angina
  • MI
  • pericarditis
  • aortic aneurysm
  • aortic stenosis
  • cor pulmonale
  • mitral valve prolapse
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4
Q

what is the non-cardiac origin of chest pain pulmonary?

A
  • pleurisy
  • pneumothorax
  • pulmonary emoblism
  • pneumona
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5
Q

what is the non-cardiac origin of chest pain GI?

A
  • gastroesophagel reflux disease (GERD)
  • peptic ulcer disease (PUD)
  • pancreatitits
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6
Q

what is the non-cardiac origin of chest pain musculoskeletal?

A
  • fibromyalgia
  • costochondritis
  • rib fracture
  • cervical/horacic radiculopathy
  • TOS
  • shoulder disorders
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7
Q

what is the non-cardiac origin of chest pain neuro?

A
  • anxiety

- panic

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8
Q

what is the non-cardiac origin of chest pain other?

A
  • metastases

- herpes

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9
Q

what is angina pectoris?

A

discomfort in the chest associated with myocardial ischemia but WITHOUT necrosis

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10
Q

what is MI?

A

local arrest or sudden insufficnecy of arterial blood supply thta produces an area of necrosis in the heart

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11
Q

what happens when the oxygen demand is greater than the oxygen supply?

A

heart attack

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12
Q

what happens with CAD?

A

there is a flow limit and the coronary artreries do not dilate well

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13
Q

what is atheroscelerosis?

A

plaque that develops is underneath the intima so inside vessel is fibro, fatty, muscular plaque

-endothelial lining can burst and then the blood is exposed to the plaque=instantatnoues coagulation

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14
Q

what is acute coronary syndrome (ACS)?

A

due to a sudden decrease in coronary arteries blood flow leading to cardiac dysfunction and possibly necrosis

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15
Q

what are the complications of MI?

A
  • impaired contractility
  • tissue necrosis
  • electrical instability
  • pericardial inflammation
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16
Q

what are the pain patterns of myocardial ischemia?

A
  • squeezing, burning, pressure, choking
  • diffuse, nonfocal
  • typically 1-3 minutes
  • angina equivalents: SOB/DOE, nausea/vomit, weakness/lethargic
17
Q

what are aggravating factors for myocardial ischemia?

A

-demand>supply
physical exertion, emotional stress, early AM(bc increase in sympathetic activity and circadian rhythym)

-no impact:
body position/ROM
-palpation
-deep breathing/coughing
-eat/drinking
18
Q

what are relieving factors for myocardial ischemia?

A

-decreased demand
rest, medications:NTG

  • increased supply
    medications: anticoagulations, thrombolytics, aspiring

-surgery: PCI or CABG

19
Q

what is chronic stable angina?

A
  • established level of onset
  • consistent angina threshold: workload that will elicit symptoms
  • usual pain pattern
  • as CV demand goes up, hit repetitive threshold
20
Q

what is unstable angina pectoris?

A
  • change in a pre-exisitng angina pattern
  • decrease angina threshold/loss of cardiac reserve/ decresae exercise reserve

should call doctor bc impending MI

it increases morbidity and mortality
should not return to PT until stable

21
Q

what is angiography/ventriculography?

A

-invasive procedure
-catheter is passed into artery and advanced to heart
usually fem artery
-radio opaque contrast medium injected

information gathered:
-patency of coronary arteries; location and severity of lesions
-intracardiac volumes and intracardiac pressures
direct measurement of CO/SV/EF

22
Q

what is the treatment of myocardial ischemia?

A
  • risk factor reduction
  • cardiac rehab
  • pharamcologic therapy
  • surgery: angiopalsty and bypass surgery
23
Q

what are the typical sternal precautions

A
  • 6-8 weeks
  • weight restriction of 5-10 lbs
  • UE ROM: shoulder elevation< 90 degrees and horz abduction
  • driving 6-8 weeks post op

consider pain management, pulmonary hygeine, bracing with cough

24
Q

what are some common concerns post CV surgery?

A
  • pulmonary complications: atelectasis(alveolar collapse), weak/poor cough, decreased inspiration, increased risk of pneumonia
  • infections (incisions, lines/tubes)
  • dysrhytmias- A fib, PVCs
  • Cardiopulm bypass: post-perfusion syndrome when transietn decline in attention, memroy, fine motor function and speed of rsponses
  • HTN
  • hyperglycemia
  • post op MI
  • abnormal lab values
  • pain
  • depression- motrality rates sky rocket
25
Q

what is the cause of essential/primary HTN?

A

-unknown etiology
-risk factors: genetic predisposition, environmental factors (obesity, stress, sodium intake)
account for 90% of all HTN cases

26
Q

what is the cause of secondary HTN

A

renal disease
endocrine disease
10% of all HTN cases

HTN= primarily an abnormality of TPR

27
Q

what are the complications of prolonged, uncontrolled HTN?

A

-changes in vessel wall lead to vascular damage/trauma, arterioscelerosis and atheroscleroisis

-complications arise due to target organis impacted:
CV system: CAD/MI, aneursysms
renal: renal insufficinecy and failure 
NS: stroke, vascular dementia
eyes: aneyrysms and blindness
28
Q

what is HF

A

inability of the heart to supply adequate blood flow and oxygen delivery to peripheral tissues and organs

  • fluid backs up
  • someone who has had an MI will likely end up with HF eventually
29
Q

what happens with a lower afterload?

A

function gets better= better SV and output

30
Q

what is the systolic HF classification?

A

pump failure
-heart failure with reduced ejection fraction
EF <40%

31
Q

what is the diastolic HF classifcation?

A

filling failure
-heart failure with preserved ejection fraction
EF> 50%

32
Q

what is echocardiography?

A
  • use of reflected US to assess cardiac function
  • info gathered: size and thickness, valve function, vnetricular wall motion, SV and CO, EF, R and L pressures
  • noninvasive
  • air, bone and adipose decrease image quality
  • to improve image quality: transesophageal echocardiogprahy or doppler
33
Q

what is transesophageal echocardiography TEE?

A

transducer inserted directly into esophagus
requires sedation and invasive

improves image quality

34
Q

what is a normal EF?

A

55-70%

35
Q

why is EF important?

A

important in regards to lifespan

36
Q

what is the relationship between EF and Vo2?

A

EF can NOT predict how pt performs

37
Q

what other organ systems/problems exist wtih HF?

A

-abnormal vent reserve and regulation
-obesity
-anemia
-impaied autonomic reg
-systolic dysfunction
-decrease skeletal muscle mass
-decrease oxidative caapcty
etccccc

Med Conditions (20 decks)

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