CV System Part 3 Flashcards
Angioplasty is the mechanical widening of
Narrow or obstructed arteries
If angioplasty is performed 10 time then
Bypass surgery
Percutaneous Transluminal Coronary Angioplasty (PTCA) is associated with
Stenosis (women)
Percutaneous Transluminal Coronary Angioplasty (PTCA) has a balloon at its tip which is inflated and deflated to stretch the narrowing and improve the
Passage for blood flow
Can be done by laser
Coronary Artery Bypass Graft (CABG) involves taking a portion of artery or vein from the
Leg, chest, arm and grafting it onto the coronary artery
CABG most used arteries
Mammary and radial arteries
Saphenous vein
Mammary has least amount of sclerosis with time
Angina Pectoris
With narrowed arteries, blood flow to the heart is
Compromised
Ischemia
Results in ______
Described as ______
Can radiate to ________
Usually only lasts for _______
Cardiac workload > O2 supply
Angina
Squeezing or crushing pressure
Areas of the body
A few minutes (stable angina)
4 known triggers for angina include
Exertion (walking, stairs)
Emotional stress/attachment
Exposure to cold or wind
A large meal
Not as common but can happen
Sleep
Sex
Rest
Stable angina definition
Ceases with
Artery has accumulated deposits that narrow it
Ceases with rest or nitroglycerin
Unstable angina caused by
Blood clot in the blood vessels
15 min or more
Unstable angina is predictable and not related to the usual demand for
Myocardial O2
Doesn’t go away with rest
Variant angina is _______ and due to ______
Transient ischemia, coronary spasm
Variant angina occurs at ______ and is often relieved with ______
Rest, minor activity
Pain patterns associated with angina
Left shoulder/arm
Ulnar nerve
Jaw
Scapula
Diagnosis of Angina Pectoris
Suspected with history and response to nitroglycerin
The Zone of Infarction
Area of myocardium that was completely deprived of O2 resulting in cell death
Elevated ST Segment
The zone of hypoxic injury
Immediately surrounds the area of Infarction
Will recover if blood flow is restored quickly
The adjacent zone of ischemia
Drop in T wave
Usually reversible
Hyperacute (elevated T waves)
Only seen early after the onset of the MI
ST segment elevation
may persist for some days
ST Depression
myocardial ischemia
Cardiac troponin
better indicator of MI
Complications Post-MI
Can include
Arrhythmias
Pericarditis
Congestive Heart Failure
Sudden Death
MI
Activities that increase intra abdominal pressure can lead to
Bradycardia (contraindicated)
6 weeks post MI avoid anything
hot
Congenital Cardiomyopathy
Muscular Dystrophy
Acquired Cardiomyopathy
Myocarditis
Cardiomyopathy
Affects heart muscle itself (fibrous tissue) so contraction and relaxation phases are
Impaired
- Cardiomyopathy Classifications
- Dilated
Ventricle wall: very thin
Most common
Mostly affect contraction
Cardiomyopathy Classifications
Hypertrophic
Young athletes
Most common cause of death in young athletes
Effect relaxation
Cardiomyopathy Classifications
Restrictive
Effect relaxation
Clinical manifestations
Dilated
Fatigue and weakness with normal or low BP
Clinical Manifestations
Hypertrophic
Frequently asymptomatic, with sudden death being a presenting sign
Dyspnea is common
Clinical Manifestations
Restrictive
Decreased Cardiac Output (CO) leading to intra ventricular pressure and signs of CHF
Cardiomyopathy
Avoid
strenuous exercise
alcohol
Congestive Heart Failure
Compensatory Mechanisms
Low blood pressure releases ADH
SNS
Renin-Angiotensin system activation
Increased HR
Myocardial Hypertrophy
CHF Risk Factors
Ischemic Heart Disease
Cigarette Smoking
HTN
Obesity
Diabetes
Valvular Heart Disease (much higher in older populations)
The number of patients with each form is approximately 60% with ______ and 40% with ____
Systolic failure and diastolic failure
Patients with systolic heart failure have a low
Left ventricular ejection fraction
Patients with diastolic heart failure have a normal
LV ejection fraction but abnormal LV elasticity and abnormal diastolic function
Left Sided HF
- Dyspnea
Exertional
Paroxysmal Nocturnal Dyspnea
Orthopnea - Productive Cough
- Daytime upright posture decreases blood flow to kidney resulting in Oliguria (pee less than normal)
- Nocturia
- Hypoxia, fatigue, muscle weakness
- sleep disturbance
Right Sided Heart Failure
Cyanosis
Jugular Vein distention
Hepatomegaly
Ascites
Dependent Edema (pitting edema)
Anxiety
Right sided HF Other
Splenomegaly
Pitting edema in ankles and sacrum
RUQ pain
In right sided HF, if Gain 2 or more pounds per day or 5 or more per week
Contact physician immediately
Right sided HF, ACSM recommends
Moderate intensity 2-6 min exercise
2 minute rest
