Oct. 21, 2019 Flashcards
What is the literal definition of the word SUBENDOCARDIAL (break it up)
SUB - under
ENDOCARDIAL - cardiac wall
In a SUBENDO, is it a DISTAL or PROXIMAL OCCLUSION?
DISTAL OCCLU
What BVs does a DISTAL OCCLUSION affect?
The smaller BVs
What portion of the HEART’S wall does SUBENDOCARDIAL MI affect?
The inner 1/3 - 1/2 of the wall
T or F:
SUBENDOCARDIAL is STEMI
F, it is NSTEMI
Is the ST elevated or depressed in a SUBENDOCARDIAL MI?
Depressed
4 MNFTS of SUBENDOCARDIAL MI:
1) Acute, severe, radiating chest pain
2) Tachycardia
3) Nausea and vomiting
4) Anxiety
Why is tachycardia associated with MI?
Whenever there is HYPOXIA, the NS will detect this and inc the HR in an attempt to oxygenate the tissue
Why can nausea and vomiting occur from extreme pain?
Simply put, the vomit center in the brain is located close to the pain center so action potentials may affect both
Who usually presents MNFTs for an MI atypically?
Women, more likely to have an absence of pain or back pain
Important diagnostics for MI:
1) ECG
2) ANGIOGRAM
3) SERUM MARKERS
What will an ECG detect?
This will monitor the waves of the heart:
- ST elevation/depression
- T inversion
- no R wave (are ventricles contracting?)
- Abn Q wave
What is the main purpose of an ANGIOGRAM?
To track the flow of B by injecting dye into the coronary BVs and checking for disrupted flow
What are the pros and cons of an ANGIOGRAM?
Pro - An extremely valuable diagnostic tool for occlusions
Con - Invasive
Tx for SUBENDOCARDIAL MI
- Thrombolytic
- Anticoag
- Antiarryth
- Morphine PRN
- O2
What 3 drugs would you give post-stabilization and why?
1) IV diuretic - Dec B vol, therefore dec workload for heart
2) NEGATIVE INOTROP - Dec contractility of the heart, therefore dec workload
3) VASODIL - to make B passage through BVs easier (?)
What are 3 examples of revascularization Sx that may be used to prevent MI?
1) Inserting a STENT (metal mesh to open vessel)
2) ELUTING STENT ( “ but it releases meds)
3) BYPASS (take vein and create new vessel to bypass the occluded one
In a simple statement, what is CARDIOMYOPATHY?
Defective cardiac muscle
What are the distinguishing factors that are used to identify which type of CARDIOMYOPATHY a pt has?
Size, shape, Fx of HEART and it’s muscles
What are the 3 types of CARDIMYOPATHY?
1) HYPERTROPHIC
2) DILATED aka CONGESTED
3) RESTRICTIVE
What happens to the HEART walls in HYPERTRO? How does this affect Fx?
HEART muscle in walls get much thicker, this results in smaller chambers that are unable to properly fill or empty
How does a thickened septum affect the AORTA?
It will impede B flow to the AORTA
T or F:
In most cases HYPERTRO is AUTOSOMAL DOMINANT
F, in most cases it is idiopathic, 50% AUTOSOMAL DOMINANT
Are most HYPERTROs symptomatic or asymtomatic?
Asymptomatic w a normal systolic Fx
What are some symptoms/mnfts that may manifest w HYPERTRO?
- Dyspnea
- ANGINA
- Syncope
- PALPITATIONS
- Sudden death
What is the relationship between HYPOXIA and dyspnea?
Whenever there is HYPOXIA, it is almost always accompanied by dyspnea
Tx for HYPERTRO:
- Negative INOTROPE
- Sx
- Chemical ABLATION
What is chemical ABLATION?
Uses chemicals to get rid of excess tissue in the HEART
Characteristics of CONGESTED CARDIOMYOPATHY
- All of HEART is enlarged (atria, vents, etc)
- Dec recoil
How does dec recoil contribute to CONGESTED CARDIMYOPATHY
Dec recoil = inadeq ability to empty chambers = pooling of B in chambers
T or F:
CONGEST is an idiopathic disease
F, it is a GENETIC disease
What other factors might contribute to CONGEST?
- Alcohol abuse
- Viral infct
- Drugs
MNFTs of CONGEST?
- Poor contractility = dec EF
- Cardiac failure
What would be ideal pharma interventions for CONGEST?
- DIURETICS (dec B vol = dec workload)
- Beta blockers (neg INOTROPE = dec contractility = dec workload)
What is the most uncommon form of CARDIOMYOPATHY?
RESTRICTIVE CARDIOMYOPATHY
Explain RESTRICTIVE:
- dec elasticity and inc rigidity = inadeq filling = dec CO = CONGESTIVE HEART FAILURE
