gen med conditions- cardio conditions Flashcards
Angina Pectoris
Description: chest discomfort associated with myocardial ischemia and left ventricular dysfunction
Most common manifestation of CAD
Unchanged for 60 days = stable angina
Increases in frequency, lasts longer, provoked by less exertu=ion = unstable angina
Causes: Anemia, Valvular heart disease, Hyperthyroidism
Risk Factors: Hypertension, Dyslipidemia, Diabetes mellitus, Family history of CAD, smoking
Presentation: Chest pressure, Chest tightness from exercise or emotional stress, Resolve w/ sublingual nitroglycerin
Diagnosis: EKG and stress testing. Cardiac enzyme blood tests to rule out heart attack
Management: long-acting nitrates, beta-blockers, calcium-channel blockers, aspirin.
Bypass graft surgery if symptoms continue.
Atrial Fibrillation (A-Fib)
Description: twitching of the heart muscle that causes an arrhythmia (irregular hear beat) and it becomes faster. Blood remains in the atria rather than being fully pumped out of heart to go to the body.
This blood can pool and possibly cause clot formation.
Clot can be pumped out of heart and into body and can even be logged into an artery (typically goes to brain and causes stroke)
Causes: Heart attack, CAD, HBP, pericarditis, myocarditis, pulmonary embolism, pneumonia, obesity, disease of mitral valves, stimulants, excessive alch,
Clinical presentation: Chest pain, palpitations, shortness of breath, confussion, dizziness, fainting, weakness
Management: medications (beta-blockers, calcium-blockers, digoxin)
Electrical cardio version- shock to reset heart rhythm
surgery, pacemaker
Anticoagulation
Prevention: Low-fat & low-cholesterol diet, regular exercise, avoid smoking,
Coronary Artery Disease
Also known as: CHD, heart disease, atherosclerosis
Description: CAD is when plaque (fatty substances) build up inside coronary arteries. Coronary arteries bring oxygenated blood back to heart. Blockage can lead to heart attack
Causes: dyslipidemia (elevated cholesterol & fatty substanes in blood), hypertension, diabetes, obesity, age, Fam hx, sedentary life, high-fat diet
Clinical presentation: some can be asymptomatic. Other show conditions where heart is stressed, like with exercise
Symptoms: chest pain/discomfort, shortness breath, heart attack, nausea, increased sweating, racing heartbeat
Diagnosis: EKG, exercise stress test, cardiac catheterization, coronary angiography
Management: lifestyle changes (diet, exercise, no smoking)
Meds (lipid-lowering agents, antihypertensives, supplements-omega3, fish oils)
Cardiac catheterization with severe cases
Deep Vein Thrombosis
Also known as DVT, blood clot
Description: DVT blood clot that has formed in a deep vein (normally in lower ext/ pelvis). If it dislosges and goes to lunges it is called pulmonary embolism.
Causes: poor circulation, ineffective or abnormal clotting of blood
Risk Factors: history of DVT, prolonged inactivity/surgery, fam hx, pregancy, cancer, smoking, obesity, pacemaker, oral contraceptives
Clinical presentation: often no signs or symptoms but can present with:
Pain/cramping in extremity, redness, swelling, increased warmth, positive homan’s sign
Diagnosis: Venous ultrasound scanning
Management: elevation of extremity, compression stockings, anticoagulants & thrombolytics
Dyslipidemia
Description: contributes to buildup of plaque in arteries. Elevated levels or triglycerides, total plasma cholesterol, low-density lipoprotein (LDL)
Causes: genetics, sedentary lifestyle, high-fat & cholesterol diet, diabetes, kidney disease, cirrhosis
Presentation: no signs or symptoms
Management: lifestyle changes (healthy diet & exercise), omega3 & fish oil, fiber, nuts, Lipid-lowering meds (statins, vibrates, niacin)
Hypertension
Also known as HBP
Description: elevation in BP; Normal= 120/80 Pre-Hypertension= 135/85 Hypertension= 140/90 most cases it has no known cause, other 5% secondary to other conditions such as renal vascular disease, cushing's syndrome (high cholestrol long time: skinny legs and weight gain in mid second& thyroid) Many meds can raise BP: decongestants, nonsterodial anti-inflammatories, appetite suppressants
Causes: family hx, obesity, excess salt in diet, smoking, sedentary lifestyle, stress, poor diet, oral contraceptives
Clinical presentation: often no signs or symptoms: in cases with extreme elevation: headache, blurred vision can exist
Untreated or poorly controlled hypertension can lead to a stroke, congestive heart failure, CAD, renal insufficiency
Management: lifestyle changes to healthier choices & exercise, avoid smoking & increase fluid intake
When diet and exercise fail-medacations are necessary: diuretics, angiotensin converting enzyme (ACE) inhibitors, beta-blockers, calcium-channel blockers, angiotensin-receptor blockers
Hypotension
Also known as Low Blood Pressure (LBP)
Description: could consider hypotensive when his or her blood pressure is consistently below 90/60 and remains asymptomatic. Not considered dangerous unless the individual becomes symptomatic
Causes: Extended bed rest, trauma with extensive blood loss, serious burns, anaphylaxis, septic shock, prego, cancer, dehydration, meds
Presentation: lightheadedness, dizzieness, blurred vision, fatigue, shortness breath, confusion
Management: treatment is warranted if an individual becomes symptomatic. Managed by increasing dietary sodium intake, adequate hydration & wearing compression stockings.
Myocardial Infraction
Also known as a heart attack
Description: MI is death of heart muscle tissue due to lack of blood supply
Causes: Coronary artery vasospasm, ventricular hypertrophy, coronary artery emboli, cocaine use, arteritis, other coronary artery abnormalities
Risk factors: age, male gender, smoking, dyslipidemia, diabetes, hypertension, fam hx, sedentary life
Presentation: angina, anxiety, cough, diaphoresis (not normal sweating), dyspnea (difficult breathing), lightheadedness, nasuea, pain arms, back & neck, syncope.
Management: MI is a medical emergency. Treatment is oxygen therapy, aspirin, nitroglycerin, beta blockers, heparin, morphine. Further: angiography with stent placement & coronary artery bypass.
Prevention: healthy low-fat diet, healthy weight, no smoking, exercise, low cholesterol, BP, and control blood sugar
Palpitations
Description: heart beats that feel abnormally rapid or unusual. “beating out of my chest”
Causes: exercise, anxiety, fever, stimulants, overactive thyroid, anemia, hyperventilation, MVP, heart disease, meds
Presentation: varying heart beat speeds & feelings (rapid, racing, fluttered)
Call 911 if: angina, dizziness, syncope
Management: treat underlying cause
Prevention: stress management, healthy low-fat diet, avoid smoking, exercise
Peripheral Arterial Disease
Also known as PAD, arthrosclerotic peripheral arterial disease, peripheral vascular disease (PVD) or hardening of arteries
Description: circulatory disease with narrowing of BV leads to reduced blood flow in affected arteries
Causes: Atherosclerosis, blood clots, infection
Risk Factors: high cholesterol, obesity, smoking, age, diabetes, fam hx, hypertension
Presentation: cramping in extremities (calf muscles), coldness in extremities, numbness in extremities, reduced hair growth on extremities, skin discoloration, poor toe/fingernail growth
Management: exercise, healthy diet and exercise, good levels of blood sugar, BP& cholesterol, avoid smoking
Medical procedures: angioplasty, bypass surgery, thrombolytic therapy
Diagnostic tests: physical exam, ankle-brachial-index (ABI), ultrasound, angiography, blood test
If not taken care of, PAD can result in gangere, stroke, heart attack
Shock
A decrease in adequate perfusion of oxygenated blood in the body. Life threatening& medical emergency
Causes:
Hypovolemic-> low circulating blood volume
Hemorrhagic-> severe hemorrhage
Neurogenic-> impairment of nerve conviction, inability to control blood vessels diameter, causing systemic vasodilation
Cardiogenic-> impaired cardiac output as in myocardial infarction
Anaphylactic-> allergic reaction
Septic-> massive system infection
Clinical presentation: anxiety, cool, clammy skin (septic may be warm/moist), diaphoresis, fatigue, hyoptension, pale skin, priapism (neurogenic shock), rapid shallow breathing, thirst, weak rapid pulse,
Anaohytactic shock is different: difficulty breathing, narrowing of air way, swelling of face, urticaria (hives), warm flushed skin
Management: laying on back with feet elevated 8-12 inches and maintain normal body temp. In anaphylactic shock administer epinephrine.
Shock cannot be reversed without advanced care, but it can be prevented
Supraventricular tachycardia
Paroxysmal supraventricular tachycardia (PSVT), paroxysmal artrial tachycardia (PAT)
Description: Tachycardia heart beats in excess of 100 b/min. SVT is when tachycardia originates above the ventricles. PSVT tachycardic rhythm that involves an accessory pathway in electrical conduction of the heart
Causes: hyperthyroidsm, stimulants, alch, meds, COPD, pneumonia
Presentation: angina, dizzieness, labored breathing, lightheadedness, LOC, palpitations
Management: meds (beta-blockers, calcium-blockers, antitiarhymic agents) vagal maneuvers (coughing or gain), electrical cardio version, catheter ablation
Diagnosis is made by EKG
Prevention: limit alch, no smoking, limit caffeine, stress management, avoid over-the counter depressants
Ventricular Fibrillation
V-Fib; Ventricles of heart beat irregularly and rapidly and do not reproduce coordinated contractions. Potentially fatal cardiac arrhythmia. V-fib=cardiac arrest
Presentation: unresponsiveness, lack of carotid pulse, respiratory arrest
Management: cardiopulmonary resusciataion, defib, Acanced cardiac life suppost (ACLS)
Ventricular Tachycardia
V-tach; 3 or more ectopic ventricular complexes with heart rate over 100 b/min. Sustained ventricular tachycardia for more than 30secs can lead to cardiac arrest
Causes: previous heart disease, electrolyte imbalance, meds, over-counter-decongestants
Presentation: chest pain & discomfort, dyspnea, palpitations, syncope
Management: ACLS, defibrillator, implantable cardioveterter defib (ICD), antiarrhythmic meds
Diagnosis is confirmed with EKG
