Lecture 4 Exam 2 Flashcards
What is Coronary Artery Disease (CAD)
*Also known as mycocardial ischemia
A pathologic condition caused by lack of oxygen to the tissue
Chest pain of cardiac origin is most often the result of?
Coronary Heart Disease
Ischemic Heart Disease
Atherosclerotic Heart Disease
What are the Risk factors of Coronary Artery Disease (CAD)?
- Gender
- Age
*Heredity - Obesity
- Physcial inactivity
- Tobacco
- High BP
- High Cholesterol
Who does CAD affects?
- Affects men more than females
- Most likely due to hormonal status in women
- Postmenopausal women are at higher risk
- Hormone replacement therapy can reduce risk
With age CAD is?
- Greater risk factor
- Result of progressive atherosclerosis
- Onset occurs after age 65
CAD- Heredity including race results in?
- Family history
- African Americans higher CAD mortality rate
- Middle -aged Black men highes mortality rate
- Non-hispanic whites have second highest mortality rate
- Black women are more at risk than nonhispanic women.
CAD with tobacco use equals?
- Smokers 2-4x to develop CAD
- Speeds up the development of coronary plaques and promotes rupture and coronary thrombosis.
With hypertension, who are more at risk for CHD?
Over 50, with systolic more than 140mmHg.
What is Hypercholesterolemia?
- Cholesterol- waxy fatlike substance made in liver
- Too much results in atherosclerosis and CHD
What are the complications of Diabetes?
- CAD due to atherosclerosis
- Atherisclerosis speeds up and becomes more severe in diabetics.
*
What is the percentage of diabetics die from some form if CAD or complication?
75%
What are the obesity and physical activity risk factors ?
- Risk factor for CAD
- Leads to type 2 diabetes
Weight Control diet and excersise can reduce ?
Hypertension and Hypercholesterolemia
What is angina pectoris?
- Inadequate supply of oxygen to the heart
- caused by atherosclerosis
- Common medical emergency within dental office
What is Atherosclerosis ?
A build up of plaques on inner walls of large and medium sized arteries.
What to administer for Angina Pectoris?
Nitroglycerin
What is Stable Angina?
- Known as typical, chronic, classic or exertional.
- Induced by excerise or stress
- Chest pain lasting 1-15min
- No Change in frequency, etiology or duration of symptoms in the last 60 days
Can Pt with Angina be treated?
Yes but appointments should be short and minimally stressful
What is Unstable Angina
- Pt with unstable angina should recieve minial or emergency dental care after consultation
- Meds maynot relieve pain
- Higher risk for MI
- Vasoconstrictor contraindicated
What is Variant Angina ?
- Occurs spontanteously usually while person at rest and at odd hours of the day or night
- more common in women under 50 and at low risk for CAD
What are the signs and symptoms of stable Angina ?
- Generalized chest discomfort: Pressure, burning, heaviness, squeezing, or choking
- Radiates to left shoulder, arm, neck, lower jaw or tongue
- Diaphoresis/Sweating
- Pallor
- Nausea
- Vary in intensity
- last 1-15 min
- Increased pulse and BP
What are the signs and symptoms of unstable Angina ?
- Same symptoms as stable, but may occur for no apparent reason
- Intensity may be more acute
- Last up to 30 min
Signs and Symptoms of Variant Angina ?
Same as stable Angina
Palpitations synscope and dyspnea
More likely to occur at rest
What are the treatment of angina ?
- Terminate dental treatment
- Semisupine or upright
- Assess CABs
- Administer Oxygen 3-6 liters/minute
- Monitor VS
- Nitroglycerine
- If uses tablet, use every 5 minutes up to 3 doses- alleviates 2-4 minutes
- If no improvement after 2nd dose call 911
If patient presents with no history of angina hisotry but chest pain occurs what to do?
EMS should be called, and follow steps for angina to treat pt.
What is Acute Myocardial Infraction (AMI)?
Necrosis of a portion of the myocardium due to total or partial occlusion of a coronary artery
What can occur with Myocardial infraction?
- Cardiac dysrhythmia- may occur after MI and is a high risk for death.
- Bradycardia
- Ventricular tachycardia
- Ventricular fibrillation
- Asystole
What are the signs and symptoms of AMI ?
Classic Symptom- Chest pain 20 min or more
* Pressure, tightness,heaviness
* Burning
* squeezing
* Crushing sensation in middle of chest and or lower one third of epigastrium
* Pain radiates down arms, shoulder, jaw or back
What are the sympotoms women show if they have AMI?
- Atypical discomfort
- Upper abdominal pain
- Shortness of breath
- Fatigue
What happens to diabetics with MI?
They suffer silent MI
What is the treatment for AMI ?
- Terminate procedure
- if Hx of Angina follow protocol
- Upright or semisupine
- Oxygen 4-6L
- Monitor vitals
- Administer nitroglycerine- 3 doses over 15 min
- Administer asprin chewed 325mg
- Manage pain- N2o
When treating a patient with syptoms of AMI or Angina you administer nitrogycerine and the pain diminishes and then returns it is most likey ?
(AMI)
Acute Myocardial Infraction
