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Acute and Chronic > Exam 2 Coronary Artery Disease > Flashcards

Exam 2 Coronary Artery Disease Flashcards

1
Q

Abnormal accumulation of lipid, or fatty substances, and fibrous tissue in lining of arterial blood vessel walls
Block and narrow vessels- reduce blood flow to heart muscle
Progresses over many years- build up of plaque narrowing walls
Atherosclerotic lesions most often occur where vessels branch

A

Atherosclerosis

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2
Q

Abnormal ______________of lipid, or fatty substances, and _________tissue in lining of arterial blood vessel walls

A

Abnormal accumulation of lipid, or fatty substances, and fibrous tissue in lining of arterial blood vessel walls

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3
Q

Block and narrow vessels- __________blood flow to heart ______

A

Block and narrow vessels- reduce blood flow to heart muscle

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4
Q

Progresses over ______years- build up of plaque _________walls

A

Progresses over many years- build up of plaque narrowing walls

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5
Q

Atherosclerotic ________most often occur where ________branch

A

Atherosclerotic lesions most often occur where vessels branch

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6
Q

Lipids and fatty tissues build up and narrow and reduce blood flow to the heart this is what causes systems like angina or they don’t have an s/s and will come in and have an MI

Plaque buildup in the vessels

Most will have symptoms and take meds for angina and then have an MI

A

Atherosclerosis

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7
Q

If thrombus forms and obstructs blood flow leads to _____ coronary syndrome which may lead to MI

A

If thrombus forms and obstructs blood flow leads to Acute coronary syndrome which may lead to MI

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8
Q

According to site and degree of narrowing as well as obstruction of blood flow
Blood flow decrease is usually progressive causing inadequate blood supply to heart muscle- Ischemia- causes Angina Pectoris
Angina is usually caused by significant atherosclerosis
If blood supply decrease is enough and for long enough irreversible damage and cell death may occur.
Over time damaged heart tissue is replaced by scar tissue and there are levels of dysfunction.
May result in low cardiac output and heart failure may occur
Decrease in blood supply may even cause heart to abruptly stop beating (sudden cardiac death)

A

Clinical manifestations

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9
Q

According to site and _______ of narrowing as well as __________ of blood flow

A

According to site and degree of narrowing as well as obstruction of blood flow

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10
Q

Blood flow decrease is usually ___________causing inadequate blood supply to heart muscle- Ischemia- causes ________Pectoris

A

Blood flow decrease is usually progresses causing inadequate blood supply to heart muscle- Ischemia- causes Angina Pectoris

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11
Q

_________is usually caused by significant atherosclerosis

A

Angina is usually caused by significant atherosclerosis

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12
Q

If blood supply ________ enough and for long enough _____________ damage and cell death may occur.

A

If blood supply decrease is enough and for long enough irreversible damage and cell death may occur.

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13
Q

Over time __________heart tissue is replaced by ____ tissue and there are levels of dysfunction.

A

Over time damaged heart tissue is replaced by scar tissue and there are levels of dysfunction.

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14
Q

May result in ________cardiac output and heart failure may occur

A

May result in low cardiac output and heart failure may occur

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15
Q

____________in blood supply may even cause heart to abruptly stop beating (sudden cardiac death)

A

Decrease in blood supply may even cause heart to abruptly stop beating (sudden cardiac death)

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16
Q

Chest pain cuz blood flow is decreased
Angina is caused by insignificant buildup

Once tissues dies it will not work anymore

Heart failure my occur with atherosclerosis

A

Clinical manifestations

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17
Q

Most common- chest pain
Some are totally asymptomatic
May present with varying sx other than chest pain- epigastric distress, pain in jaw, left arm
Dyspnea
Nausea, palpitations, numbness
May just have sudden cardiac event

A

Clinical manifestations for not getting enough oxygen to the heart

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18
Q

Clinical manifestations for not getting enough oxygen to the heart

A

Most common- chest pain
Some are totally asymptomatic
May present with varying sx other than chest pain- epigastric distress, pain in jaw, left arm
Dyspnea
Nausea, palpitations, numbness
May just have sudden cardiac event

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19
Q

Widow maker – no s/s and then they have a mi and ppl don’t come back

Some are asymptomatic

Elderly will have different signs

A

Clinical manifestations for not getting enough oxygen to the heart

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20
Q

Family history- woman before 65 or man before 55
Increasing age
Gender (men earlier than women)
Race (higher in African American)

A

Risk factors Non modifiable:

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21
Q

Risk factors

A

Non modifiable:
Family history- woman before 65 or man before 55
Increasing age
Gender (men earlier than women)
Race (higher in African American)

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22
Q

Hyperlipidemia
Tobacco use
Diabetes
HTN
Obesity
Physical inactivity
Metabolic syndrome
Alcohol

A

Modifiable Risk factors

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23
Q

Modifiable Risk factors

A

Hyperlipidemia
Tobacco use
Diabetes
HTN
Obesity
Physical inactivity
Metabolic syndrome
Alcohol

24
Q

High lipids can change

Ldl – low density lipoprotein are the bad clo.

If total is elevated you are also at a higher risk

A

risk factors

25
Q

Control cholesterol
HDL good cholesterol over 40 for males/ over 50 for females
LDL bad cholesterol under 100 (less than 70 for very high risk patients)
Total cholesterol of less than 200
Triglycerides less than 150

Exercise and diet can help control these levels

Stop the smoking affects the arteries

A

Prevention

26
Q

Prevention

A

Control cholesterol
HDL good cholesterol over 40 for males/ over 50 for females
LDL bad cholesterol under 100 (less than 70 for very high risk patients)
Total cholesterol of less than 200
Triglycerides less than 150

Exercise and diet can help control these levels

Stop the smoking affects the arteries

27
Q

Diet
Weight loss
Cessation of tobacco use
Increased physical activity
Manage HTN

Before they get to the angina point start get up and walk around to help prevent

A

Cholesterol

28
Q

cholesterol

A

Diet
Weight loss
Cessation of tobacco use
Increased physical activity
Manage HTN

Before they get to the angina point start get up and walk around to help prevent

29
Q

a wide variety offruits and vegetables
whole grains and products made up mostly of whole grains
healthy sources of protein (mostly plants such as legumes and nuts; fish and seafood; low-fat or nonfat dairy; and, if you eat meat and poultry, ensuring it is lean and unprocessed)
liquidnon-tropical vegetable oils
minimally processed foods
minimized intake of added sugars
foods prepared with little or no salt
limited or preferably no alcohol intake

A

heart diet

30
Q

heart diet

A

a wide variety offruits and vegetables
whole grains and products made up mostly of whole grains
healthy sources of protein (mostly plants such as legumes and nuts; fish and seafood; low-fat or nonfat dairy; and, if you eat meat and poultry, ensuring it is lean and unprocessed)
liquidnon-tropical vegetable oils
minimally processed foods
minimized intake of added sugars
foods prepared with little or no salt
limited or preferably no alcohol intake

31
Q

Fish oil capsules – otc
Zocor (simvastatin)
Lipitor (atorvastatin)

A

Cholesterol lowering agents

32
Q

Cholesterol lowering agents

A

Fish oil capsules – otc
Zocor (simvastatin)
Lipitor (atorvastatin)

33
Q

inflammatory marker for cardiovascular risk. Liver produces this protein to stimulus such as injury. People with diabetes and those who are likely to have cardiac event may have high levels.
Increase when there is inflammation somewhere in the body

A

crp

34
Q

crp

A

inflammatory marker for cardiovascular risk. Liver produces this protein to stimulus such as injury. People with diabetes and those who are likely to have cardiac event may have high levels.
Increase when there is inflammation somewhere in the body

35
Q

Troponinis a type of protein found in the muscles of your heart.
Troponinisn’t normally found in the blood.

Elevates in 2- 6 hours – might change after labs are drawn
Peaks within 12

A

Troponin I

36
Q

troponin I

A

Troponinis a type of protein found in the muscles of your heart.
Troponinisn’t normally found in the blood.

Elevates in 2- 6 hours – might change after labs are drawn
Peaks within 12

37
Q

Found in heart not blood but if heart function ____________ then troponin will be found in blood

A

Found in heart not blood but if heart function decreases then troponin will be found in blood

38
Q

Other isoenzymes that are measured in blood test- elevate after MI

A

CK and CK-MB

39
Q

CK and CK-MB

A

Other isoenzymes that are measured in blood test- elevate after MI

40
Q

_______– metabolic profile – are enterocytes
CBC – will tell them if something else is going on
CXR – always do a chest _______to see heart and lungs

A

BMP – metabolic profile – are enterocytes
CBC – will tell them if something else is going on
CXR – always do a chest xray to see heart and lungs

41
Q

Episodes of pain or pressure in chest
Need exceeds demand
Discomfort- agonizing
ANGINA SUBSIDES WITH NITROGLYCERIN OR REST
NITRO X 3 one every 5 minutes for chest pain if unrelieved call 911

A

Angina

42
Q

Angina

A

Episodes of pain or pressure in chest
Need exceeds demand
Discomfort- agonizing
ANGINA SUBSIDES WITH NITROGLYCERIN OR REST
NITRO X 3 one every 5 minutes for chest pain if unrelieved call 911

43
Q

Chest pain sit down put legs up and take three times and 5 mins in-between

True angina it will go away with rest and nitro

Elderly don’t have same s/s might be short of breath or confusion

Elderly don’t feel the same way as younger patient

A

Angina

44
Q

Angina

A

Chest pain sit down put legs up and take three times and 5 mins in-between

True angina it will go away with rest and nitro

Elderly don’t have same s/s might be short of breath or confusion

Elderly don’t feel the same way as younger patient

45
Q

May not exhibit typical pain
Dyspnea may be presenting symptom
Sometimes no symptoms
Medications used cautiously in elderly due to increased risk of adverse reactions

A

Elderly

46
Q

Elderly

A

May not exhibit typical pain
Dyspnea may be presenting symptom
Sometimes no symptoms
Medications used cautiously in elderly due to increased risk of adverse reactions

47
Q

Patient history
Ecg showing ischemia (t wave inversion)
Stress test – stress heart and see response

A

Diagnosis of angina

48
Q

Diagnosis of angina

A

Patient history
Ecg showing ischemia (t wave inversion)
Stress test – stress heart and see response

49
Q

Objectives- decrease 02 demand and increase 02 supply
Stents/ CABG – going in and opening back up
Medications:
Nitroglycerin- sl tab or spray under tongue or in cheek should ideally relieve pain in 3 minutes for PRN use. Different routes including capsules, topical patches, IV.

A

Medical Management of Angina/CAD

50
Q

Medical Management of Angina/CAD

A

Objectives- decrease 02 demand and increase 02 supply
Stents/ CABG – going in and opening back up
Medications:
Nitroglycerin- sl tab or spray under tongue or in cheek should ideally relieve pain in 3 minutes for PRN use. Different routes including capsules, topical patches, IV.

51
Q

Beta blocker: metoprolol- reduce incidence of recurrent angina, infarction and mortality.
Calcium channel blocker- Norvasc- used for patients not responsive to beta blockers
Antiplatelets- prevention of platelet aggregation Anticoagulants- prevention of thrombus formation
Aspirin: 81-325 mg daily
Lovenox: LMWH- sq monitor for s/s of internal bleeding.
Oxygen: to meet demands

A

Medical Management of Angina/CAD

52
Q

Medical Management of Angina/CAD

A

Beta blocker: metoprolol- reduce incidence of recurrent angina, infarction and mortality.
Calcium channel blocker- Norvasc- used for patients not responsive to beta blockers
Antiplatelets- prevention of platelet aggregation Anticoagulants- prevention of thrombus formation
Aspirin: 81-325 mg daily
Lovenox: LMWH- sq monitor for s/s of internal bleeding.
Oxygen: to meet demands

53
Q

_______ Obtain a 12-lead ECG within 10 minutes of report of chest pain.

A

ecg

54
Q

Oxygen
Pain assessment
Vital signs, pulse ox PQRST (find out what the patient was doing when pain came on)
continuous heart monitoring and pulse ox
EKG (ECG)
Chest xray
Saline lock (often 2)
NTG prior to arrival x how many and did it work?
Labs (troponin, CK, CKMB, BMP, CBC, CRP

A

ER monitoring management/ unknown chest pain

55
Q

ER monitoring management/ unknown chest pain

A

Oxygen
Pain assessment
Vital signs, pulse ox PQRST (find out what the patient was doing when pain came on)
continuous heart monitoring and pulse ox
EKG (ECG)
Chest xray
Saline lock (often 2)
NTG prior to arrival x how many and did it work?
Labs (troponin, CK, CKMB, BMP, CBC, CRP

Acute and Chronic (15 decks)

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