Ischemic Heart Disease III - Exam 2 Flashcards
What is Dressler’s Syndrome? What is the underlying cause? What is the associated time frame?
A type of pericarditis that occurs post MI or CABG
Believed to be caused by an immune system mediated inflammatory response following damage to heart tissue or the pericardium
occurs between 1 to 12 weeks post-MI
**How does a right ventricular infarction present? Present in 1/3 of patients with ______
**Presents as hypotension with relatively preserved LV function
inferior wall infarction
**What kind of MI is NTG CI? Why?
**inferior wall MIs
because it will make the hypotension worse
What is the tx for hypotension associated with right ventricular infarction?
Treat the hypotension with IV normal saline (bolus then continuous infusion) or inotropic agents if necessary
**Where are ventricular free-wall rupture the MC? What pt population are they associated with? When do they MC occur?
Most common in the anterior or lateral wall of LV
elderly patients who are having their first MI
most commonly in first 24 hours
How do ventricular free-wall ruptures present?
May present as a pericardial effusion post-MI or pulseless electrical activity (PEA)
What is a Post-MI Ventricular Septal Defect (VSD)? When does it occur? What type of MI is it associated with? What is the tx?
hole that connects both ventricles
Rare post-MI complication occurring a few days following initial cardiac event
transmural MI that involves the septum
Mortality rate is high without surgical intervention
How does an acute mitral regurgitation from ruptured papillary muscle present? What is the tx?
Presents as sudden onset decompensated heart failure
Mortality high without surgical intervention
What are the 4 changes that need to occur with regards to the pt’s lifestyle following a cardiac event?
Dietary changes
Implementation of an exercise regimen
Addition of appropriate medications
Increased frequency/number of follow up care visits
When should f/u appts be made with cardio and PCP for an uncomplicated MI? severe MI?
f/u in 4-6 weeks for uncomplicated MI
severe MI: 1-2 weeks
What 4 f/u should be scheduled and 1 referral need to be scheduled/placed following an MI?
AMI clinic
CHF clinic
PCP
Cario
refer: to cardiac rehab and consider dietitian
What are the exercise instructions for a post-MI pt?
Should include at least 150 minutes of moderate intensity exercise per week or 75 minutes of high intensity exercise per wee
need to monitor intensity and duration of exercise, so cardiac rehab is very important!
What are the “cardiac blues?” What does it put the pt at an increased risk for?
Depression after an MI leads to emotional distress and suffering
an increased risk of having another MI or dying over the ensuing months and years
What are the considerations for sexual activity for an uncomplicated post- MI? complicated?
Sexual activity is reasonable ≥ 1 week after uncomplicated MI if the patient is without cardiac symptoms during mild to moderate physical activity
aka need to be able to walk up a flight of stairs without s/s in order to be cleared for sex
2 to 3 weeks is recommended, as long as asymptomatic
What cardiac medication is CI with ED drugs? How long do you need to wait in between doses?
NTG and PDE-5 inhibitors are CI
need to wait at least 24 hours in between NTG and PDE-5 inhibitors
