Ischemic Heart Disease Flashcards
An obstruction in what artery impacts heart function?
Coronary
List the main coronary arteries
Left
Right
Branches (circumflex, LAD)
List the determinates of Myocardial Blood Flow
Diastolic BP
Resistance
Vasomotor Tone
LV End-Diastolic pressure
Equation of Blood Pressure
BP = (Cardiac Output) X (Total Peripheral Resistance)
What is the most powerful contributor to cardiovascular disease?
Hypertension
At what BP vital should you STOP exercise?
-SBP > 250 mmHg OR DBP > 115mmHg
-BP drops 20 mmHg
- SBP drops 10 mmHg AND DBP drops 10 mmHg
At what BP vital should you get medical clearance for exercise?
- Resting SBP > 200 mmHg
- DBP > 105 mmHg
List side effects for taking BP medications
Orthostatic hypotension
Drop in BP during activity
Uncontrolled hypertension can lead to what effect in the brain?
Cerebral aneurysm
Hemorrhagic CVA (stroke)
Uncontrolled hypertension can lead to what effect in th eyes?
Retinopathy
Uncontrolled hypertension can lead to what in the heart?
Congestive heart failure
Atherosclerosis
Angina
Myocardial infarction
Uncontrolled hypertension can lead to what in the kidney?
Nephrosclerosis
Chronic renal failure
Signs and symptoms for heart attack in men/general
Radiating pain (jaw or left side)
Crushing pain
“elephant is sitting on my chest”
“hard to breathe”
Signs and symptoms for heart attack in women
Unusual fatigue
Sleep disturbances
SOB
Indigestion
Anxiety
Chest discomfrt
Atypical signs and symptoms for heart attack
Indigestion
LV dysfunction
Arrhythmia
Syncope
Silent
Precipitating factors of heart attack
Cold
Exertion
Anxiety
Heavy meals
Tachycardia
Hypoglycemia
What factors can relieve heart attack temporarily?
Rest
NTG (nitroglycerin)
How can we determine myocardial oxygen demand? (equation)
Rate pressure product = HR x SBP
How many days without change is categorized as stable angina?
60 days
How is stable angina characterized?
Chest pain
How does stable angina typically present?
Tachycardia
Hypoxia
How is stable angina relieved?
Rest
Sublingual nitroglycerin
How is unstable angina characterized?
Sign/symptoms of inadequate blood supply to myocardium
BIG sign/symptom of unstable angina?
Chest pain at rest
When should a physician/nurse be notified when unstable angina suspected?
Angina at rest
Angina at lower exertion
Deterioration of previously stable pattern
Drop in HR or BP w/ exercise
How is prinzmetal angina characterized?
unusual syndrome of cardiac pain secondary to MI
What type of angina is exclusively at rest?
Prinzmetal angina
What type of angina is secondary to increased coronary vasomotor tone or vasospasm?
Prinzmetal angina
What pharmacological drugs are used to treat prinzmetal angina?
Nitrates
Calcium Channel Blockers
Name two types of acute MI’s
Transmural
Non-transmural (subednocardial)
What does a STEMI indicate?
Occlusion in a large vessel and a large area is at risk
ST elevation
Is a STEMI an emergency?
Yes! Requires thrombolytic therapy or immediate cardiac catheterization
What does an NSTEMI indicate?
High grade lesion, without total occlusion to a smaller area (most of the time)
List treatment/interventions of MI (acute coronary syndrome)
Morphine sulfate
Beta blockers
Aspirin
EKG
Blood draw for cardiac makers
