Ischemic Heart Disease Flashcards
ischemia
condition in which blood flow is restricted or reduced in or to a part of the body
hypoxemia
- low oxygen content in the blood
- low O2 saturation
hypoxia
- body or a region of the body is deprived of adequate oxygen supply at the tissue level
- fully saturated blood but not getting to area needed
acute coronary syndrome
- umbrella term for a range of symptoms associated with sudden, reduced blood flow to the heart
what does acute coronary syndrome include
MI unstable angina ST segment elevation non-ST segment elevation myocardial infarction or heart attack
is ACS a diagnosis?
yes
patient history for someone with ACS
chest or left arm pain, hx of CAD
examination of someone with ACS
- hypotension, diaphoresis
- pulmonary edema, rales
- ECG changes
- elevated cardiac biomarkers
ischemic heart disease
- coronary heart disease
- coronary artery disease
- atherosclerotic heart disease
what does ischemic heart disease include
heart attacks/MI
angina: stable or unstable
what is the most common specific diagnosis under ACS
ischemic heart disease (IHD)
causes of IHD
- atherosclerosis of the coronary arteries
- coronary thrombus or emboli
- coronary spasm
- complications of connective tissue disorders
- lupus
- RA
risk factors IHD
age HTN diabetes gender smoking physical inactivity hypercholestermia/hyperlipidemia high levels of stress family history poor diet obesity
symptoms of IHD
- chest pain
- pain in arms, jaw, neck, back or stomach
- SOB
- lightheaded
- nausea
- sweating
- females present diff than males
how can IHD be diagnosed
blood testing
- cardiac enzymes, troponin, ANP & BNP are gold standard
- CRP
plaque rupture
- exposes thrombogenic lipids to the blood
- stimulates localized thrombus formation with ischemic outcome
occlusion event
damage is dependent on coronary involved
cardiomyopathy
disease of the heart muscle
ischemic cardiomyopathy
- heart is chronically ischemic
- chronic narrowing of the coronary arteries which in turn, diminishes blood supply to the heart
- most common type of dilated cardiomyopathy
what causes ischemic cardiomyopathy
CAD which causes an insufficient blood flow to the heart resulting in myocyte ischemia
the damage from the myocyte ischemia when you have ischemic cardiomyopathy causes what?
- cardiac remodeling
- myocardial fibrosis
- arrhythmias
- possible cardia conduction system impairments
- cell death
- left ventricular enlargement and dilation
what is a precursor for ischemic cardiomyopathy
worsening CAD
pt’s with ischemic cardiomyopathy develop what
- congestive heart failure
- most common presentation
prognosis for ischemic cardiomyopathy
determined by myocardial viability (number of functioning myocytes)
rheumatoid arthritis
- immune mediate chronic inflammatory disease
- morning stiffness, arthralgias, arthritis
rheumatoid arthritis can appear as
pericarditis myocarditis valvular heart disease atherosclerotic CAD coronary arteritis aortitis cor pulmonale conduction disturbances
rheumatoid arthritis is a primary pathogenic factor for what
premature development of atherosclerosis –> pulmonary HTN –> cor pulmonale
angina pectoris
intermittent chest pain caused by transient, reversible myocardial ischemia
angina leads to what
MI
sudden cardiac death
ischemic cardiomyopathy
stable angina
- mismatch between O2 delivery and O2 need
- heart wants to pump blood but no O2 available so presents as angina
how is stable angina brought on
- by exertion or other form of stress and reduces with reduced stress
- occurs at a predictable HR
unstable angina
- brought on by exertion or other form of stress
- onset is unpredictable
what is the prognosis for unstable angina
- poor
- no exercise as treatment
myocardial infarction
- due to sufficiently long ischemic insult
- time is tissue
- risk increases with age
reperfusion injury
- tissue damage caused when the blood supply returns to tissue after a period of ischemia or lack of oxygen
what is reperfusion injury associated with
- microvascular injury
- due to increased permeability of capillaries and arterioles that lead to an increase in diffusion and fluid filtration to tissues
sudden cardiac death
- natural unexpected death secondary to cardiac causes with rapid loss of consciousness
- some cardiac issues that lead to this
- can survive
