exam 1 cardiovascular Flashcards by Jackie O'Donnell

no underlying cause of hypertension

primary

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developed as a result of underlying disease

secondary

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clinical manifestations

Head in AM 
blurred vision
nose bleeds 
edema
nocturia
lethargy

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hypertension medication

Thiazides
ACE inhibitors
CCB

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Complications of hypertension

TIA
Stroke 
Retinopathy 
Peripheral vascular disease 
Renal failure 
LVH
CHD
HF

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Post-prandial drops in BP

BP drops after eating
Greatest 1 hour after eating
Last up to 3-4 hours

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Medication that can lead to loss of BP control and heart failure

NSAIDs

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Generic designation for many different conditions involving obstructed blood flow through coronary arteries

Coronary artery disease

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Oxygen and nutrients still supplied to myocardium until blockage is

70%

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What should total cholesterol be at

less than 200 mg/dL

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what should LDL be at

less than 100 mg/dL

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what should HDL be at

60 mg/dL and above

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what should triglycerides be at

less than 150 mg/dL

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What percent should total calories of total fat be

25-35%

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what percent should total calories of saturated fats be

less than 7%

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what percent should total calories of polyunsaturated fats be

up to 10%

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what percent should total calories of monounsaturated fats be

up to 20%

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what percent should total calories of carbs be

50-60 %

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what percent should total calories of dietary fiber be

20-30%

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What percent should total calories of protein be

15%

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how much cholesterol should you have a day

200mg/ day

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is chest pain or discomfort that most often occurs with activity or emotional stress

stable angina

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is chest pain that happens suddenly and becomes worse over time
Plaque disruption causes it

unstable angina

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is condition characterized by debilitating chest pain despite being on prescribed medication plan

intractable or refractory angina

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is a syndrome typically consisting of angina at rest that occurs in cycles

Varient (Prinzmetal) angina

have objective findings suggestive of myocardial ischemia that is not associated with angina

Silent ischemia

Side effects of Nitroglycerin

Headache Hypotension Tachycardia Orthostatic hypotension

medication used in Prinzmetal angina

CCB

medication that is used if there is a history of angina

anti-platelet

an umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked

Acute Coronary Syndrome

Pericarditis and fever within 4-6 weeks esp. after cardiac surgery Ag-ab reaction to the necrotic myocardium Pain fever, a friction rub, pericardial effusion, arthralgia

Dresslers syndrome

caused by complete obstruction of coronary artery with fibrous clot causes myocardial ischemia distal to clot

Acute myocardial infarction

CK-MB elevation time and peak

3-9 hrs elevation | 12-18 hrs peak

when does serum Troponin levels rise and how long do they last

rises in 3 hrs | lasts 7-10 days

serum myoglobin elevation and peak time

1 hr elevation | 4-6 hrs peak

when does LDH rise

rises in 8-24 hours

what rises 1st week after infarct

ERS

for patients with recurring symptoms to monitor heart structure and function

Cardiac cath

given as standard of care within 6 hours of AMI onset if PCI not available: lysis of occluding clot

Thrombolytics

Morphine sulfate drug of choice, vasodilates and decreases preload

analgesics

how much morphine do you give for AMI

1-5 mg IVP

how much oxygen do you give for AMI

how much nitro do you give for AMI

.4 SL | 5X3

how much ASA do you give during AMI

160-325mg

how much beta blockers do you give during AMI

5mg IV | 5-15min X3

goal of MONA B

increase O2 supply and decrease O2 demand

Decrease myocardial O2 demand by decreasing force of contraction, slowing heart rate, and slowing impulse conduction

Beta blockers

ballon inserted into descending thoracic artery and inflating during diastole

Intraaortic ballon pump

sheath inserted into femoral artery and cath is guided through arteries to aorta and radiopaque dye is inserted into coronary arteries

Coronary angioplasty

cath with ballon inserted and positioned central to blockage then inflated to reconfigure blockage Stent may be inserted to prevent restenosis

intracoronary stent

internal mammary artery or saphenous vein grafted to coronary artery beyond the point of blockage to reestablish blood flow Not curative since grafts can occlude

Coronary artery bypass Graft

occurs if a valve doesnt close tightly | Blood leaks back into the chambers rather than flowing forward through the heart or into an artery

Regurgitation

is when the flaps of the valve flop or bulge back into an upper heart chamber during a heartbeat

prolapse

occurs if the flaps of a valve thicken, stiffen, or fuse together this prevents the heart valve from fully opening

stenosis

common, can lead to atrial fibrillation, LLSB radiated to axilla, low pitched

mitral regurgitation

high pitched, RSB best heard | Radiated up neck, sounds musical

aortic stenosis

complications of mechanical valves

throboemboli | need to be on coumadin

is an acute, immunologically mediated, multisystem inflammatory disease that occurs a few weeks following an episode of group A streptococcal pharyngitis

Rheumatic fever

Major criteria for Rheumatic fever | JONES

``` Joint involvement O looks like a heart=myocarditis Nodules, subcutaneous Erythema marginatum Sydenham chorea ```

Minor criteria | CAFE PAL

``` CRP increased Arthralgia Fever Elevated ESR Prolonged PR interval Anamnesis of rheumatism Leukocytosis ```

is inflammation fo the pericardium, the fibroserous sec that surrounds the heart can be acute or chronic

Pericarditis