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Cardiopulmonary > Ischemic Cardiac Conditions > Flashcards

Ischemic Cardiac Conditions Flashcards

1
Q

What are the three layers of an arterial wall, starting from outer layer in?

A

adventitia, media, and intima

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2
Q

Describe how fluid dynamics rules impact myocardial perfusion?

A

all fluids flow from areas of high pressure to low pressure, and all fluids follow the path of least resistance so if there is an obstruction, they will take the least resistive path around it-> causes blood flow to decrease more distally

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3
Q

What are the 4 major determinants of myocardial blood flow?

A
  1. diastolic blood pressure is the primary driving force moving blood into myocardial tissue
  2. vasomotor tone plays a role in determining volume of blood passed along to tissue
  3. resistance to flow is commonly caused by atherosclerosis
  4. LVEDP- the pressure in the L ventricle at the end of diastole, can put an occlusive force on the capillary beds
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4
Q

Which term describes the presence of obstruction but does NOT inhibit heart muscle function?

A

coronary artery disease

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5
Q

Which term describes obstruction that causes permanent damage to muscle downstream, inhibiting muscle function?

A

coronary heart disease

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6
Q

What are the modifiable risk factors for heart disease?

A

smoking, high blood pressure, proper diet, diabetes, high blood cholesterol, physical inactivity, obesity

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7
Q

What are the non-modifiable risk factors for heart disease?

A

heredity, male sex (earlier age MI risk), increased age (greater than 65 years old)

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8
Q

What can occur in about half the patients with CHD within one hour of symptoms?

A

sudden cardiac death

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9
Q

Fill in the blank: chronic stable angina is associated with ______

A

atherosclerosis

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10
Q

Which condition is described as tightness/pressure/ indigestion above the waist that develops with exertional activity and diminishes with rest or nitroglycerin?

A

chronic stable angina

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11
Q

What is angina?

A

imbalance in supply and demand of myocardial oxygen

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12
Q

What are the three types of acute coronary syndrome?

A

unstable angina, acute MI- STEMI AND NON-STEMI

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13
Q

What are clinical clues or signs that would indicate unstable angina?

A

angina at rest, pts typical angina now occurring at a lower level of activity, deterioration of a previously stable pattern

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14
Q

What is the difference between a STEMI and a Non-STEMI?

A

stemi is totally occluded due to thrombus or plaque and can be seen as a ST segment elevation on the EKG, a non-stemi is not completely blocked

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15
Q

How long does it take for necrosis to develop in a MI?

A

15-20 minutes

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16
Q

What are the common sx of MI?

A

pressure, chest pain that can spread up towards neck, back, jaw, or shoulders, dizzyness, sweating, pallor, SOB, not relieved by nitroglycerin or rest

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17
Q

What condition occurs at rest and is due to a spasm in the coronary arteries due to exposure to the cold weather, stress or smoking?

A

prinzmetal angina

18
Q

What condition has pain at rest that worsens with activity, is NOT relieved with nitroglycerin or rest, and responds to anti-inflammatory medications?

A

pericarditis

19
Q

How can you differentiate between MI chest pain versus MSK chest pain?

A

MSK can be palpated, MI cannot

20
Q

What condition is due to an increased thickness of the connective tissue and decreased compliance of collagen and elastic connective tissue in the vessels?

A

arteriosclerosis

21
Q

What condition is an increased in blood flow that increases BP due to a buildup of plaques?

A

atherosclerosis

22
Q

What is the gold standard to diagnosis an MI and what is the normal range?

A

troponin, 0-3.0 is normal

23
Q

How can you diagnose an MI?

A

EKG, troponin and creatine kinase levels

24
Q

Which creatine kinase isoenzyme is the most conclusive of all the CK isoenzymes and what is the abnormal range?

A

CKMB, abnormal if it is greater than 3%

25
Q

If you find myoglobin in a pts result, can you be sure that is due to cardiac injury?

A

no, need to rule out skeletal muscle injury

26
Q

What does an MI infarction need within the first 3 hours of onset?

A

fibrinolysis and PTCA

27
Q

What is the main concern with an MI?

A

main concern is to re-perfuse the area of the heart not receiving enough blood and oxygen

28
Q

What is a way to help prevent an MI?

A

baby aspirin daily (75-325 mg/day)

29
Q

What are some exercise parameters acute post MI (4-6 weeks)?

A

HR should not exceed 120, exercise should only be 20-30 bpm above the resting HR, if resting HR above 100- contact MD to clear for exercise, SBP: should increase 20-30mmHg above resting, DBP should be within +/-10mmHg, RR SHOULD NOT DOUBLE, RPE: 11-13

30
Q

You have a pt with a systolic BP of 130 and another one with a BP of 160, what categories would each be in?

A

pre-hypertensive and stage 2

31
Q

t/f, 90-95% of those with HTN have primary HTN with no discernible cause

A

true, the other 5-10% have secondary HTN which do have identifiable medical conditions

32
Q

Who is most likely to be at risk for hypertension?

A

overweight, African American male

33
Q

What are some hypertension medications?

A

beta blockers, calcium channel blockers, ACE inhibitors, diuretics

34
Q

What is the biggest takeaway of someone with cardiac issues in how we treat as PTs (what do we make sure we do?)?

A

TAKE VITALS

35
Q

What is the most important factor to help reduce the risk of stroke?

A

reduction in blood pressure

36
Q

What is the name for the pain patients feel with peripheral arterial disease?

A

intermittent claudication

37
Q

What is the best way to exercise for someone with peripheral artery disease?

A

walking, for short intervals alternating rest periods

38
Q

t/f, compression stockings would be helpful for someone with peripheral artery disease?

A

false! would completely obstruct blood flow then

39
Q

What ABI would indicate a severe arterial occlusive disease?

A

0.5 (1.0-1.4 is normal)

40
Q

You have a pt with thin and shiny skin with loss of hair on the ankle and foot. They have an ulcer with minimal exudate and it looks pale and deep wound bed with even margins, what type of ulcer is it?

A

arterial ulcer

Cardiopulmonary (25 decks)

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