Ischemic Heart Disease Flashcards
What is the general problem in diastolic heart failure?
Heart cannot sufficiently fill with blood (Ventricle is stiff and cannot relax enough)
What is the general problem in systolic heart failure?
Heart cannot pump/eject blood sufficiently to meet demands of the body
Low ejection fraction
What is a normal ejection fraction?
What is the ejection fraction in a patient with systolic heart failure?
Normal is 60-70%
Systolic heart failure - lower EF (40% or even lower)
What are some of the compensatory mechanisms that act during CHF?
Frank Starling
Adrenergic nervous system
Renin-angiotensin-aldosterone
Cardiac remodeling
List some of the consequences of L sided heart failure
Less peripheral blood flow
Blood pools in the pulmonary circulation
Symptoms: SOB, orthopnea, ischemic changes and symptoms in the pulmonary circulation
What are some symptoms that could lead to L sided heart failure?
Ischemia
HTN
Aortic/mitral valve disease
What are some consequences of R sided heart failure?
Systemic and portal venous circulation engorgement
Peripheral edema (increased pressure in capillaries and veins)
Ascites
What is the top cause of R sided heart failure?
L sided heart failure
What is it called when the R side of the heart is failing, but not the L side?
Cor pulmonale
List the three types of angina pectoris
Stable Angina
Unstable Angina
Prinzmetal Angina
Describe how a person develops stable angina
Growth of atherosclerotic plaques in the lumen of the blood vessel over many years. Over 75% of the original lumen becomes obstructed and the person feels substernal chest pain when they have increased cardiac demand.
Their coronaries cannot meet the needs of increased cardiac demand
How should a person relieve symptoms of stable angina?
Rest
Vasodilators (like nitroglycerin)
Describe the pathogenesis of unstable angina
Atherosclerotic plaque disruption in the coronary arteries. Fissure or ulceration of the atheromatous plaque causes platelets to activate and aggregate. Thrombus forms and it PARTIALLY occludes the blood vessel, causing chest pain
How do the symptoms of unstable angina differ from stable angina?
Unstable angina has frequent chest pain that occurs with less effort (or at rest) and with longer duration
What causes Prinzmetal Variant Angina?
Coronary artery spasm
NOT related to HR, blood pressure, or physical activity