Module 3 Flashcards by Allyssa Sy

Describe the pathophysiology of stable angina

occurs when the heart cannot support the increasing O2 myocardial demands

How well did you know this?

Not at all

Perfectly

What are the clinical manifestations of stable angina?

tightness, squeezing, clenched fist over the chest
often increases with activity or exertion
decreases in discomfort during rest
short duration, <3min

How well did you know this?

Not at all

Perfectly

What are the treatment options of stable angina

short term nitroglycerin sprays or SL tablets to be taken 5 min prior to activity
long acting nitrates also an option
beta blockers-good effect and decreases mortality
antiplatelets

How well did you know this?

Not at all

Perfectly

Describe how you would manage stable angina and when it is appropriate to refer to ER

medication treatment

refer to ER if ongoing pain despite usage of short term nitrates and beta blockers

How well did you know this?

Not at all

Perfectly

Describe unstable angina and progression into NSTEMI

worsening chest pain
no oxygen to supply heart
NSTEMI is less concerning than a STEMI

How well did you know this?

Not at all

Perfectly

NSTEMI vs. STEMI

similar in characteristics; ECG ST waves will be depressed or elevated.
increased ST wave= potential myocardial infarction due to rupture of plaque causing blockage

How well did you know this?

Not at all

Perfectly

Clinical presentation of myocardial infarction

racing heart, increasing chest pain, nausea/vomiting, radiating chest pain to shoulder or jaw
women present differently

How well did you know this?

Not at all

Perfectly

Describe the etiology of CHF

heart is unable to meet the demands of the body
usually caused by a structural concern of the heart (valve problems, poor ventricular filling, ejection fraction)
can be caused by other factors such as HTN, a fib, cardiomyopathy
abnormal vessels of the heart trigger the RAAS because there is not enough demand on the heart

How well did you know this?

Not at all

Perfectly

What are some clinical findings of CHF/

SOB, fluid overload, edema, fatigue, nausea/vomiting loss of appetite, impaired mental status, anemia, tachycardia/bradycardia

How well did you know this?

Not at all

Perfectly

What are the diagostic tools used for CHF?

not one good diagnostic
echocardiography- looks at the structures of the heart and how it flows
CXR
MRI
CT scan
labs - BNP (brain nautureitic peptide)

How well did you know this?

Not at all

Perfectly

What is the management of CHF? (dependent on stages)

stage A- no structural changes treat underlying condition ie a fib, HTN
stage b- structural abnormality but mild, asymptomatic, treat underlying condition plus beta blocker
stage c- structural abnormalities plus symptoms; meds and symptom management inc. fluid restrictions, decrease sodium intake
stage d- LVAD, surgical intervention, end of life care

How well did you know this?

Not at all

Perfectly

DEscribe the etiology of A fib

common, irregular electrical impluses
greater risk of stroke
valvular and non valvular a fib (structural heart changes/ mechanical heart valve vs. opposite of that)

How well did you know this?

Not at all

Perfectly

what are the clinical findings of a fib?

palpitations, irregular HR, rapid, may be induced by exercise

How well did you know this?

Not at all

Perfectly

What is the diagnostic evaluation for afib?

ECG
echocardiogram -show size of the hart
holter
stress test

How well did you know this?

Not at all

Perfectly

Describe the management of a fib

unstable? - to ER
stable- may not be needed in asymptomatic individuals <65 years of age and asymptomatic
may consider an anticoagulant if hx of other cardiac concerns
valvular afib- treat with warfarin only
non valvular a fib- warfarin or NOAC

How well did you know this?

Not at all

Perfectly

Describe the etiology of HTN

increased pressure to the vessels causes the blood to flow harder, cardiac output is affected due to straining and stretching of the vessels
rks factors: obesity, smoking, diet, sedentary lifestyle
Primary vs. secondary (primary-idiopathic) secondary- due to disease process

What are the clinical manifestations of HTN?

often asymptomatic

assess for other things- sleep apnea, headache, family hx and lifestyle

What is the managgement of HTN?

often clinic BPs higher, consider looking at home BPs bfore starting meds
start with thiazide, acei or arb depending on pt factors, cost, and renal function

What is the patho behind dyslipidema?

elevateed cholesterol, LDL, or low HDL = potentially causes coronary artery disease

What are the diagnostic tools for dylipidemia and management?

dx tools= bloodwork (complete lipid profile), usually screening done in pts that have increased family hx of CV risl
DM or prev. CV concerns warrant testing
framingham score

What is the management for dyslipdemia?

statins for secondary reasons (prev. MI, HTN, DM) are useful in preventing plaque buildup
no real reason to use in primary prevention or just based on LDL levels
diet, smoking cessation

Common side effects of statins

increased risk of DM
increased risk of muscle pains
increased risk of GI effects
rhabdomylosis or myositis as severe side effects

Alternative options to statins for treatment of dyslipidemia

niacin
resins
ezetimibe

What is the risk of high blood triglyercerides?

unknown patho but can cause increased risk of pancreatitis

diet modification, restricting fatty foods

S/s of aortic dissection

patho- tears in the intima of the aortic wall, blood enters the aortic space causes a secondary pathway for blood flow hypertension is a risk factor and is an emergency severe chest pain with a ripping or tearing quality radiating down back or anterior chest hypertension, paralysis, kidney failure or injury, ischemia to the lower peripherals

S/S of abdominal aortic aneurysm

patho- dilation of renal aorta to >5cm, unable to handle pressure causing possible rupture hypotension, pulsing abdoiminal mass (caused by acute rupture) pain that radiates from abdomen to the back, could be asymptomatic, fevers, chills

S/S of DVT

patho- triad of virchow (venous stasis, venous injury, hypercoagulation) asymptomatic unilateral leg pain with or without mass tender to touch, hot to touch edema PE- SOB, chest pain, cough, tachycardia, syncope - ER

define anemia

decrease in hgb or hemtocrit, women <120, men <135

describe the types of different anemia (microcytic, normocytic, macrocytic)

micro- iron deficiency (most common), thalassemia, inflammation or infection normo - sickle cell anemia, aplastic anemia macro - vitamin b12 or folic deficiency

Describe the causes, management and treatment of iron deficiency

microcytic anemia- most common causes: mennstrual loss, pregnancy, trauma, malabsorption clinical findings: fatigue, tachycardia, palpitations, pallor, headaches, pica treatment: parentarel or oral iron (empty stomach, vitamin c faciliatates absoprtion)

Describe the causes, management and treatment of thalassemia

genetic disorder, more common in asians, changes in the genetic makeup of the RBCs clinical findings: may depend on the severity of the condition (similar to iron deficiency anemia), more severe - requires iron transfusions frequently

Describe the causes, management and treatment of vitamin b12 deficiency

primary care of macrocytic anemia, needed for development of DNA usually because of dietary restrictions or those who cannot absorb vitamin b12 more common in vegans clinical findings: anemia traits, fatigue, tiredness, palpiations, brain fog, neurological defects if severe (parasthesias, ataxia, loss of sensory vibration, romberg may be pos. sore mouth, loss of taste) treatment: oral vitamin b12, injectable vitamin b12 , may require transfusion if severe

Describe the causes, management and treatment of folate deficiency

causes- dietary, pregnancy needs to increase during pregnancy, occurs in those who can't absorb folate clinical findings: often absent, may have anemia type symptoms management: daily folate, increase dose during pregnancy

Describe the difference between stable and unstable angina

stable angina- relieved by rest, short term nitrates | unstable- cardiac chest pain that is unrelieved with rest or medications

What is the management for unstable angina

refer to ER- o2, nitro, antiplatement | long term beta blocker or statin

Describe the difference between type A and type B aortic dissection

type A- worse prognosis, involves aortic arch | Type B- proximal descending arch

Module 3 Flashcards

Cardiology