Med Nursing 2 Flashcards
Coronary Artery Disease
Caused by the buildup of plaque in the wall of the coronary arteries
The major blood vessels that supply the heart (coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart muscle. Cholesterol deposits (plaques) in the heart arteries and inflammation are usually the cause of coronary artery disease
myocardial ischemia
caused from an increased demand for oxygen or a decreased supply of oxygen
Chronic Stable Angina
- Occurs intermittently over a long period with the same pattern of onset, duration, and intensity of symptoms
- Rarely sharp or stabbing
- Pain usually lasts 3-5 minutes
- Drug therapy: goal: ↓ O2 demand and/or ↑ O2 supply
- If Ischemia continues and is not reversed, acute coronary syndrome (ACS) develops
Myocardial Infarction
“heart attack,” is caused by decreased or complete cessation of blood flow to a portion of the myocardium
The symptoms of MI include chest pain, which travels from left arm to neck, shortness of breath, sweating, nausea, vomiting, abnormal heart beating, anxiety, fatigue, weakness, stress
Acute Coronary Syndrome
- ACS encompasses the spectrum of
unstable angina - non–ST-segment–elevation myocardial infarction (NSTEMI)
- ST-segment–elevation myocardial infarction (STEMI)
- Deterioration of once-stable plaque –> Rupture –> Platelet aggregation –> Thrombus
Unstable Angina
- Chest pain that is new in onset, occurs at rest, or has a worsening pattern.
- Unstable angina is unpredictable and represents an emergency.
Automaticity
ability ad initiation of an impulse
Atrial Fibrillation
- Total disorganization of atrial electrical activity due to multiple ectopic foci, resulting in loss of effective atrial contraction
- Most common dysrhythmia
- Can result in decrease in CO due to ineffective atrial contractions (loss of atrial kick) and rapid ventricular response
- Thrombi may form in the atria as a result of blood stasis.
Contractility
the way the heart responds to the impulse by contracting
Conductivity
how the impulse is transmitted
Excitability
the way it’s electrically stimulated
Sinus Bradycardia
- Slow but regular heart rate because sinus node discharges at rate <60 beats per minutes
- Can be normal, especially in athletes
Sinus Tachycardia
Fast but regular heart rate because sinus node discharges at rate >100 beats per minutes
Ventricular Tachycardia
- Ventricular rate 100 to 250 beats per minute
- Associated with MI, CAD, electrolyte imbalance, CNS disorders, etc
- Life threatening
Atrial flutter
- Atria of heart contracting rapidly in characteristic flutter waves
- Atria rate is 250 -350 beats/minute. * The ventricular rate varies according to the conduction rate.
- High ventricular rates (>100) and loss of the atrial “kick” can decrease CO and precipitate HF, angina
- Risk for stroke due to risk of thrombus formation in the atria
Stroke
Stroke occurs when ischemia or hemorrhage into the brain results in death of brain cells.
Ventricular Fibrillation
- Disorganized ventricle electrical activity without coordination and without effective contractions ineffective “quivering’ of ventricles
- Occurs in acute MI, CAD, cardiomyopathy
- Requires CPR, ACLS, defibrillation
- If untreated leads to death
Ischemic stroke
inadequate blood flow to the brain from partial or complete occlusion of an artery.
Asystole
Absence of contractions of the heart
Flat line in an EKG
2 types of Ischemic stroke
Thrombolytic stroke + Embolic stroke
Hemorrhagic stroke
a burst blood vessel may allow blood to seep into and damage brain tissues until clotting shuts off the leak
Thrombolytic stroke
- the process of clot formation results in a narrowing of the lumen, which blocks the passage of blood through the artery
- Thrombosis occurs in relation to injury to a blood vessel wall and formation of a blood clot.
- Result of thrombosis or narrowing of the blood vessel
Embolic stroke
- an embolus is a blood clot or other debris circulating in the blood. When it reaches an artery in the brain that is too narrow to pass through it lodges there and blocks the flow of blood
- Occurs when an embolus lodges in and occludes a cerebral artery
- Results in infarction and edema of the area supplied by the involved vessel
Transient ischemic attack
Transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction of the brain
Symptoms last <1 hour.
a precursor to ischemic stroke
