Disorders of Cardiac Function Flashcards
Acute coronary syndrome
a spectrum of acute ischemic heart disease ranging from unstable ischemia to acute MI based on the presence of ECG changes
Unstable Angina
causes unexpected chest pain, and usually occurs while resting → most common cause is reduced blood flow caused by atherosclerosis → unstable plaque → which can rupture → blood clot which blocks the flow of blood to the heart muscle – heart cells are not dying
Stable angina
thick fibrous cap
cardiac marker
Troponin: they have had an MI
pathophysiology of MI
- Complete obstruction of coronary artery → infarction
- Area affected become necrotic → death of myocardium → replaced by fibrous tissue
s/s of MI
- Chest pain radiating to left arm/neck
- Severe, crushing, constrictive or like heartburn
- GI distress, nausea, vomiting
- Tachycardia and vasoconstriction
- Anxiety, restlessness
- dizziness , weakness in the arms and legs
Main cause of death for MI
cardiac arrhythmias/dysrhythmias
complications of MI
- Heart failure
- Cardiogenic shock
- Pericarditis
- Thromboemboli
- Rupture of the heart
- Ventricular aneurysms
treatment from MI
- rest, oxygen therapy and analesics
- Anticoagulants
- thrombolytic agents
- Low dose ASA therapy
- Coronary bypass surgery
- Percutaneous coronary intervention
In what type of patient do you see ST wave elevation
acute myocardial infarction
In what type of patient do you see ST wave depression
chronic ischemic heart disease
chronic stable angina
- thick fibrous cap
- fixed coronary obstruction → stable plaque
- Imbalance between blood flow and metabolic demand
- Pain when the heart’s oxygen demand increases
- Physical exertion
- Emotional stress
- Relieved by nitroglycerin
sign and symptoms for stable angina
- Chest pain or discomfort (pressure, tightness, squeezing)
- May radiate to the left arm, shoulder, jaw or back.
- Shortness of breath
- These symptoms occur with exertion
sign and symptoms of unstable Angina
- Chest pain or discomfort that is new or worsening
- Pain that lasts longer than usual
- Pain that occurs at rest
- Shortness of breath
- This is considered a medical emergency
treatment from angina
- Directed towards symptoms relief
- Lifestyle changes
- Drugs
- Nitrates
- Beta blockers
- Calcium channel blockers
stenosis
- the valve will not open all the way
- It is harder to force blood through it
- Will hear murmur of blood shooting through the narrow opening when the valve is open
regurgitation
- the valve will not close all the way
- It leaks when “closed”
- Will hear a murmur of blood leaking back through when the valve should be closed
Silent myocardial ischemia
- Myocardial ischemia without pain
- Factors associated are same as those responsible for angina
variant/vasospastic angina
- Pain when coronary arteries spasm
- Occurs at rest or with minimal activity
Cardiac effusion
is when fluid surrounds the heart slowly and has few to no symptoms
Cardiac tamponade
is when fluid surrounds the heart quickly and results in compressing the heart
Consequences of cardiac effusion/cardiac tamponade
- Restricts heart expansion
- Left and right ventricle cannot accept enough blood
- Decreased cardiac output
- Decreased blood pressure and shock
- Increased venous pressure
- Jugular distension
Hypertrophic cardiomyopathy
- Genetic
- Defects in contractile proteins make cells too weak
- Cells hypertrophy to do the same amount of work as normal cells
- Need more oxygen and perform less efficiently, so the person is prone to heart failure and may suffer sudden death during exertion
- Most common cause of sudden cardiac death
Dilated cardiomyopathy
- Progressive cardiac dilation → the heart is enlarged 2-3x normal
- All 4 chambers involved, thinning walls
- Easy for blood to enter not exit
- Heart loses contractile function
s/s of dilated cardiomyopathy
- dyspnea
- orthopnea
- exercise intolerance
treatment of dilated cardiomyopathy
- beta blockers
- diuretics
- ACE inhibitors
- heart transplant
Restrictive cardiomyopathy
- Restricted cardiac filling → heart is “stiff” so it can’t fill properly
- Heart does not expand when blood is going in
symptoms of restrictive cardiomyopathy
- Dyspnea
- PND
- Orthopnea
- Peripheral edema
Peripartum cardiomyopathy
- Dilated cardiomyopathy that occurs in the last month of pregnancy or within 5 months after delivery
- Half of the women recover with no loss of cardiac function
