Exam 5 Module 10 Flashcards
Pathway of atherosclerosis
- Initial endothelial injury
- Fatty streak (lipids depositing)
- Fibrous plaque and deposit growth
- Complicated plaque rupture
Coronary artery disease
Atherosclerosis impacting vessels of the heart
Risk factors for coronary artery disease (modifiable and non-modifiable)
Modifiable:
High cholesterol, high low density lipoproteins (LDL)
Not exercising
Hypertension
Diabetes
Smoking
Obesity
Non-modifiable
Age
Genetics (family history)
Male> female
Stable Angina
Chest pain/discomfort or tightness
Exercise induced
Resolves with rest
Ischemia = NO cell death= NO troponin
Unstable angina
Chest pain that occurs at rest
Increases in frequency/severity over time
Unpredictable
Unstable fibrous plaque
Ischemia = NO cell death = NO troponin
NSTEMI
Partial, severe occlusion
Ischemia » damage/death
Partial thickness (subendocardial tissue)
Damage occurs after 20 minutes of ischemia
Troponin detected
STEMI
Total vessel occlusion
Full thickness damage of muscle
Troponin present
Elevated ST wave
Sudden cardiac death
1 cause is ventricular arrhythmia
Difference between cardiac arrest and heart attack
Cardiac arrest is an electrical problem
Heart attack is a circulation problem
Causes of Right sided heart failure
Left heart failure (most common)
Elevated PA pressure
COPD
Pulmonary fibrosis
PE
Pulmonary hypertension
MI
S/S of right sided heart failure
Peripheral edema
Hepatomegaly
Splenomegaly
Abdominal pain
GI/indegestion
JVD
Ascites
Weightgain
Left sided heart failure causes
Systolic heart failure, floppy heart (most common)
MI, Systemic hypertension
Coronary artery disease
Cardiomyopathy
Valvular abnormalities
S/S of lift sided heart failure
Pulmonary edema
Shortness of breath
Paroxysmal nocturnal dyspnea/tachypnea
Activity intolerance
Confusion
Tachycardia
Hypoxia
Diastolic heart failure
Failure during ventricular relaxation
thickened myocardium (reduced chamber size)
Decreased filing ability (decreased preload)
Diastolic heart failure causes
Chronic hypertension » hypertrophy and cardiomyopathy
Results of diastolic heart failure
Back up of fluid into lungs
Decreased CO, EF
Adequate contractions, decreased chamber size
Systolic heart heart failure
Ventricular failure during contraction
Weak, floppy myocardium
I
Causes of systolic heart failure
Chronic hypertension, ischemic heart disease (MI)
Results of systolic heart failure
Decreased CO and EF
Non-cyanotic congenital defects
Left » right shunt
• ventricular septal defect
• atrial septal defect
• patent ductus ateriosus
Cyanotic heart defects
right shunt » left
•tetralogy
Tetralogy of fallot
Right to left shunt causing cyanosis
Defects that can cause tetralogy of fallot
Ventricular septal defect
Pulmonary valve stenosis
Displaced aorta
Right ventricular hypertrophy
Rheumatic heart disease
Untreated strep infection causes inflammation of endocardium, myocardium and pericardium.
NOT an issue of bacteria on valves
Inflammation » stenosis, leaking (regurgitation), and vegetation (scarring)
• heart failure, endocarditis, thrombi/clot
Infective endocarditis
Inflammation of the heart due to bacteria
Most commonly impacts tricuspid valve
Risk factors of infective endocarditis
IV drug use
Prior heart damage/failure
Dental procedures
Cardiac surgery
Indwelling IV lines
S/S of infective endocarditis
Fever
Chills
New heart murmur
Night sweats
Fatigue,
Shortness of breath
Chest pain
Emboli
Complication of infective endocarditis
Congestive heart failure, MI, Glomerulonephritis
Myocarditis
Inflammation of heart muscle
Caused by viral infection
Complications: heart failure, arrhythmia, sudden death
Pericarditis and s/s
Inflammation of the outer lining of the heart
Sharp stabbing chest pain that radiates along arm
Self resolving
Pericardial effusion
Accumulation of fluid in pericardial sac
sounds: pericardial friction rub, muffled heart, tachycardia
S/S of pericardial effusion
Chest pain
Shortness of breath
Light headed
Dizzy
Pericardial tamponade
Fluid compresses heart (R side)
Causes hemodynamic instability
S/S of pericardial tamponade
Becks triad
Weakness
Syncope
Dizziness
Becks triad
Muffled heart sounds
Hypotension
JVD
Mitral stenosis
Narrowing of mitral valve, impeding blood flow from left atrium into left ventricle
Causes decreased cardiac output, pulmonary edema
Mitral regurgitation
Insufficient valvular closing causes backflow of blood into left atrium during systole
Causes decreased cardiac output, pulmonary edema
Emboli of infective endocarditis
Emboli can cause: splinter hemorrhages (under nails)
Roth spots (retina
Osler nodes (hands/feet)
