Ischemic Heart Disease Flashcards
Coronary Artery Disease (CAD): Definition
arteries become CLOGGED d/t atherosclerosis
coronary arteries branch from the aorta
Which artery is typically the most problematic in CAD (sometimes termed the “widow-maker”?)
left anterior descending artery
3 Main Problems with the Heart that Contribute to Issues:
electrical (conduction)
plumbing (ARTERY BLOCKAGE, spasm, or valve issues)
pump (heart muscle)
CAD Causes What? (1)
heart attacks
CAD: Stats/Misc.
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)
CAD: NON-Modifiable Risk Factors (5)
-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
CAD: Modifiable Risk Factors (9)
HTN (2 to 3 fold)
cigarette smoking
diabetes
obesity
inactivity
diet
HLD!
depression
stress
Ischemic Heart Problems: Etiology
“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
Endothelial Dysfunction: Definition
vessels aren’t necessarily blocked but become narrowed when they are supposed to dilate
Endothelial Dysfunction: Causes (4)
diabetes
HTN
HLD
smoking
when combined with plaque filled arteries–> not good! (narrow and blockage as well)
CAD: Symptoms (9)
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
What will a complete occlusion in the artery cause?
myocardial infarction
CAD: MAIN symptom
Angina
Angina: Definition
chest pain
stable vs. unstable angina
STABLE Angina: Definition/Characteristics
-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
STABLE angina: MOST common cause
atherosclerosis
UNSTABLE angina: Characteristics
-severe and of new onset
-crescendo pattern
-occurs at rest
-lasts >10 minutes
Cardiac Chest Pain: Symptoms/Characteristic
-“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)
Non-Cardiac Chest Pain: Symptoms/Characteristic
-“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
NON-Cardiac Chest Pain: Causes (8)
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
Atypical Angina in Women: Symptoms
*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
Pain with Myocardial Infarction
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
Where may chest pain radiate to with a MI? (5)
neck
jaw
upper abdomen
shoulders
arm
What do we do with STABLE angina?
EDUCATION: rest and relaxation
-decrease oxygen demand on the heart
Nitrates
Prevent/treat further atherosclerosis
TEACH about myocardial infarctions
