Medical and Surgical Management of Cardiovascular Disease Flashcards
Ace inhibitors
inhibit conversion of angiotensin 1 to angiotensin II
decrease Na retention and peripheral VC to DEC BP
Angiotensin II receptor blocker (ARBs)
DEC BP
Nitrates
dec preload through peripheral VD
reduce myocardial oxygen demand
reduce chest discomfort
might dilate coronary arteries helping coronary blood flow
Beta adrenergic blocking agents
DEC HR and contractility
control arrhythmias, chest pain
DEC BP
Ca channel blockers
Dec HR
dec contractility
dilate coronary arteries
DEC BP
Antiarrythmias
Restore normal heart rhythm
improve CO
Digitalis
increase contractility
DEC HR
Diuretics
Dec myocardial work (reduce pre and afterload)
Control BP
Aspirin
dec platelet aggregation
might prevent MI
Tranquilizers
dec anxiety, sympathetic effects
Hypolipidemic agents
Cholesterol lowering drugs
reduce serum lipid levels
Activity restriction - acute MI
once acute MI has stopped, activity can increase but should be limited to 5 METs or 70% of age predicted HR max for 4 to 6 wks following MI
Activity restriction - Acute heart failure
oxygen demand should not be increased in pt in acute or decompensated failure
activity can be gradually inc once not showing signs of decompensation
Surgical intervention - Percutaneous transluminal coronary angioplasty
under fluroscopy - surgical dilation of BV using small balloon tipped catheter inlated inside the lumen
Improved coronary blood flow
Surgical intervention - intravascular stents
endoprosthesis (wire mesh) implanted postangioplasty to prevent restenosis and occlusion in artery
Surgical intervention - Coronary artery bypass graft (CABG)
using anastamosing graft
improved coronary blood flow
Surgical interventions - Transplant
used in end stage myocardial disease
Surgical interventions - Transplant - Heteroptics
Involves leaving the natural heart and piggybacking the donor heart
Surgical interventions - Transplant - Orthotopic
involves removing the diseased heart and replacing it with the donor heart
Surgical interventions - Transplant - Heart and lung transplantation
Involves removing both organs and replacing them with donor organs