Ischemic Heart Disease

Question 1

Coronary Artery Disease (CAD): Definition

Answer 1

arteries become CLOGGED d/t atherosclerosis

coronary arteries branch from the aorta

Question 2

Which artery is typically the most problematic in CAD (sometimes termed the “widow-maker”?)

Answer 2

left anterior descending artery

Question 3

3 Main Problems with the Heart that Contribute to Issues:

Answer 3

electrical (conduction)
plumbing (ARTERY BLOCKAGE, spasm, or valve issues)
pump (heart muscle)

Question 4

CAD Causes What? (1)

Answer 4

heart attacks

Question 5

CAD: Stats/Misc.

Answer 5

1 in 7 deaths in the US
other terms: coronary heart disease, heart disease
umbrella term: people often group heart attacks under CAD (not everyone with CAD has had a heart attack)

Question 6

CAD: NON-Modifiable Risk Factors (5)

Answer 6

-age (the older–> the more likely)
-family history
-gender (males earlier in life, once women hit after menopause, same likelihood)
-ethnicity (Black or African Americans, Hispanics, Native Americans or Indigenous peoples are much more likely than White or Asian Pacific Islanders)
-genetics

Question 7

CAD: Modifiable Risk Factors (9)

Answer 7

HTN (2 to 3 fold)
cigarette smoking
diabetes
obesity
inactivity
diet
HLD!
depression
stress

Question 8

Ischemic Heart Problems: Etiology

Answer 8

“a plumbing issue”
atherosclerosis develops in the arteries supplying the myocardium= ARTERY BLOCKAGE
-the blockage causes decreased tissue perfusion
-causes ENDOTHELIAL DYSFUNCTION
-the heart must work harder to pump the blood

Question 9

Endothelial Dysfunction: Definition

Answer 9

vessels aren’t necessarily blocked but become narrowed when they are supposed to dilate

Question 10

Endothelial Dysfunction: Causes (4)

Answer 10

diabetes
HTN
HLD
smoking

when combined with plaque filled arteries–> not good! (narrow and blockage as well)

Question 11

CAD: Symptoms (9)

Answer 11

may be asymptomatic
-eventually as arteries continue to narrow, the decreased blood flow may cause chest pain
chest pain
heartburn
irregular heart rate
dizziness
burning sensation
nausea
weakness
anxiety
cold sweat

Question 12

What will a complete occlusion in the artery cause?

Answer 12

myocardial infarction

Question 13

CAD: MAIN symptom

Answer 13

Angina

Question 14

Angina: Definition

Answer 14

chest pain
stable vs. unstable angina

Question 15

STABLE Angina: Definition/Characteristics

Answer 15

-coronary blood flow is diminished but NOT blocked
-there is an imbalance between oxygen supply and demand
-episodic
-crescendo-decrescendo
-is brought on by exertion
-is relieved with rest
-usually only lasts 2-5 minutes

Question 16

STABLE angina: MOST common cause

Answer 16

atherosclerosis

Question 17

UNSTABLE angina: Characteristics

Answer 17

-severe and of new onset
-crescendo pattern
-occurs at rest
-lasts >10 minutes

Question 18

Cardiac Chest Pain: Symptoms/Characteristic

Answer 18

-“pressure, or tightness”
-diffuse, poorly localized
-associated with physical exertion or other stress
-relieved with rest, usually within minutes
-prolonged symptoms may represent an acute coronary syndrome (MI)

Question 19

Non-Cardiac Chest Pain: Symptoms/Characteristic

Answer 19

-“sharp, or stabbing”
-focal, well localized
-may be positional, spontaneous at rest
-no predictable relation to physical exertion
-may last from seconds to even days at a time

Question 20

NON-Cardiac Chest Pain: Causes (8)

Answer 20

GERD
muscle problems
ulcer
lung disorders
bone disorders
deep breath
emotional disorder
esophageal rupture
it is important to exclude the heart being the cause of the chest pain BEFORE exploring non-cardiac causes

Question 21

Atypical Angina in Women: Symptoms

Answer 21

*usually presents differently than it does in men
hot or burning
tenderness
NOT always in the chest
indigestion
heart burn
nausea
fatigue/weakness
lightheadedness
dyspnea

Question 22

Pain with Myocardial Infarction

Answer 22

chest pain not brought on by exertion
pain not relieved in 2-5 mins
pain may radiate to other areas
often accompanied by N/V, SOA, diaphoresis

Question 23

Where may chest pain radiate to with a MI? (5)

Answer 23

neck
jaw
upper abdomen
shoulders
arm

Question 24

What do we do with STABLE angina?

Answer 24

EDUCATION: rest and relaxation
-decrease oxygen demand on the heart
Nitrates
Prevent/treat further atherosclerosis
TEACH about myocardial infarctions