Pathophysiology - Cardiology Flashcards
test 2
What is the circulatory system?
- Transports oxygen and nutrients for metabolic process
- Carries waster products
- Circulates electrolytes and hormones
What is the number one cause of morbidity and mortality in the US?
Cardiovascular disease
Common signs and symptoms of cardiovascular disorders
Chest pain, edema, shock, fever, kidney disorders, circulation problems, breathing problems, bluish skin discoloration, fainting, fatigue, coughing, heat palpation, dyspnea, cardiac syncope, vasovagal syncope
What is dyspnea?
Shortness of breath
What are types of dyspnea?
- Paroxysmal nocturnal dyspnea: sudden episodes while sleeping
- orthopnea: breathless while laying down
What is cardiac syncope?
Heart cannot pump enough blood leadings to low BP
What is the cause of cardiac syncope?
Arrhythmias, aortic dissection, orthostatic hypotension, CAD, hypertrophic cardiomyopathy, hypoglycemia, vertebral artery insufficiency
Risks of cardiac syncope
Alcohol, lower BMI, DM, elevated plasma, glucose
What is vasovagal syncope?
Strong parasympathetic response that leads to vasodilation from prolonged standing
What can occur because of fear of needles or blood transfusion
vasovagal syncope
Common signs and symptoms of CVD
fatigue, coughing, cyanosis, peripheral edema, ascites, claudication
T or F?
Cyanosis is the lack of blood and oxygen to nail beds and lips
True (cyan = blue)
T or F?
Ascites are abdominal distention
True
What is a Electrocardiogram (ECG)?
Machine with electrodes that amplify electrical impulses from the heart
What is ausculation?
stethoscope used to detect valvular abnormalities and murmurs
What is a stress test?
Assess cardiovascular function and check for exercise induced problems
What do chest x-rays show?
Heart shape, size, and possible pulmonary congestion
What are positron emission tomography scans (PET)?
Imaging that produce 3D body imaging
What is cardiac catheterization?
A catheter through a blood vessel into a ventricle to determine a heart function
What is a coronary angiography?
X-ray visualization of blood vessels, looking at blood flow and obstructions
What is a doppler ultrasound?
Assess blood flow through sound waves
What is arterial blood gas deermination?
- to check oxygen, CO2, and PH levels
- determines how well lungs are moving oxygen in the blood and removing CO2
What is coronary artery disease?
Affected arteries that are marked by atherosclerotic deposits with thrombus blocking them
Signs and symptoms of Coronary Artery Disease?
First symptom of angina pectoris (chest pain), leading to a burning, squeezing, crushing pain
What is the etiology of CAD?
- arteries narrow and develop atherosclerosis (plaque) because of fat substance plaque
- arteriosclerosis (hardening)
Risk factors of CAD?
Genetic predisposition, over 40 yo, male, postmenopausal, white race, smoking, diabetes, obesity, stress, elevated cholesterol
Tx of CAD
Restore adequate blood flow to myocardium, beta blockers, coronary artery bypass surgery, angioplasty
What is coronary artery bypass graft?
removal of venous tissue from LE and transplanted to the heart
Prognosis of CAD
depends on tx response, diet, exercise
What is angina pectoris?
chest pain after exertion from reduced oxygen supply to myocardium
Three types of angina pectoris
- stable (exertional) angina: most common, due to plaque build up
- unstable anginaL requires emergency treatment because it is unrelieved by rest or medication
- prinzmetal/variants angina: rare, caused by spasms that narrow the artery
Signs and symptoms of angina pectoris
sudden onset of left sided chest pain, dyspnea, increased BP, arrhythmias
Difference between heartburn and cardiac problems
heartburn: slight pain and radiate outward
cardiac problems: sudden pressure, tightening, squeezing, crushing, chest pain
Etiology of angina pectoris
- vessels cannot supply enough due to atherosclerosis
- coronary artery spasms
-cardiac ischemia
dx of angina pectoris
prior hx of chest pain, ECG confirmation if ischemia
tx of angina pectoris
end strenuous activity, nitroglycerin tablets (vasodilator)
prognosis of angina pectoris
depends on the arterial blockage, diet, exercise, lifestyle
What is myocardial infraction (heart attack)?
Sudden death of segment of the heart muscle due to an abrupt interruption of the blood flow to the heart
T or F?
After taking nitroglycerin three times and symptoms are not relieved it becomes and emergency
True
Signs and symptoms of myocardial infraction
crushing pain, left sided chest constriction, radiating pain left arm, back, and jaw
Etiology of myocardial infraction
insufficient oxygen supply
dx of myocardial infractions
administeroxygen, morphine, aspirin
prognosis of myocardial infraction
65% in the first hour, late death depends on if there were complications
What is arrythmia?
Deviation of a normal heartbeat
What is congestive heart failure?
Inability of the heart to pump enough blood to meet the body’s homeostasis
Signs and symptoms of congestive heart failure
dyspnea, anxiety, R side liver and spleen enlarged, L side increased pulmonary congestion and respiratory problems
What is cardiac arrest?
Sudden cessation of cardiac activity
Prognosis of cardiac arrest
Depends on resuscitation time
T or F?
Brain cells begin to die in cardiac arrest after 4-6 minutes and brain death at 10 minutes
True
What is cardimyopathy?
Non inflammatory disease of cardiac muscle leading to enlargement of the myocardium and ventricular dysfunction
T or F?
Cardiomyopathy is the most common direct cause of sudden death
False - it is the second most common direct cause of sudden death
Signs and symptoms of cardiomyopathy
dyspnea, fatigue, palpitations, tachycardia, chest pain, hepatic congestion, peripheral edema, cardiac murmurs
Cardiomyopathy etiology
Usually unknown
Dx of cardiomyopathy
pt hx, physical exam, x-ray, biopsy, cardiac catheterization
Cardiomyopathy prognosis
Better with medication, can be fatal
What is carditis?
Inflammation of the heart tissue due to infection or immune system problems
Three forms of carditis?
- Pericarditis (pericardium)
- Myocarditis (muscular walls of the heart)
- Endocarditis (lining and valves of the heart)
Signs and symptoms of pericarditis
fever, malaise, chest pain, dyspnea, chills
Myocarditis signs and symptoms
Palpitations, fatigue, dyspnea, fever, arrhythmia, chest tenderness
Endocarditis signs and symptoms
Fever, chills, night sweats, weakness, anorexia, fatigue
Etiology of carditis (three types)
- Pericarditis: idiopathic or infection
- Myocarditis: complication of diseases
- Endocarditis: drug use, rheumatic disease
What is valvular heart disease?
Harming of any of the heart valves
T or F?
The mitral valve is most affected in valvular heart disease
True
Signs and symptoms of valvular heart disease
Fatigue, cough, palpation, hemoptysis, cyanosis, heart murmur, apical pulse, diastolic murmur
Etiology of valvular heart disease
- mitral stenosis: rheumatic heart disease
- aortic insufficiency: aortic valve abnormalities
dx of valvular heart disease
heart murmur, pt hx, cardiac catheterization, doppler echocardiography, chest x-ray
tx of valvular heart disease
limit sodium intake, oxygen therapy, diuretics
What is rheumatic heart disease?
Damage to the heart from rheumatic fever, systemic inflammatory, and autoimmune disease that involves joint and cardiac tissue
Signs and symptoms of rheumatic heart disease
sore throat, rheumatic fever, valve damage, tachycardia, edema, dyspnea
dx of rheumatic heart disease
chest x-ray, ECG, lab testing, rheumatic fever, cardiac murmur
tx of rheumatic heart disease
penicillin
What is hypertension?
Abnormally high BP
Signs and symptoms of hypertension
epistaxis (nosebleed), headache, lightheadedness, syncope
Etiology of hypertenstion
Unknown. Could be related to stress, age, hx, type A personalities, lifestyle
Hypertension tx
beta blockers, lifestyle change, diuretics
T or F?
Malignant hypertension is the sagest hypertension
False, malignant hypertension is life threatening where BP is 200/120
What is orthostatic hypotension?
- aka postural hypotension
- systolic decrease of 20 or 10 in both diastolic and systolic
- increased pulse of 15 from sitting to standing
Who is most at risk to get orthostatic hypotension?
Older adults
What is shock?
Low BP leading to decreased tissue, organ profusion, not getting enough oxygen
Look at shock table 14-5 on pg 302
Signs and symptoms of shock
cold, clammy, cyanosis, tachycardia, altered mental status, anuria, olguria
dx of shock
medical hx, physical exam, BP < 90/50
tx of shock
laying on back, providing warms, elevating legs
Types of shock (5)
anaphylactic, cardiogenic, hypovolemic, neurogenic, septic
What is an aneurysm?
Weakening and dilation of the wall of an artery
Types of aneurysm (3)
saccular, fusiform, dissecting
Saccular aneurysm
increased arterial pressure that bulges on one artery side
Fusiform aneurysm
Weakened arterial wall that creates a spindle shape
Dissecting aneurysm
Blood forced through arterial wall that separates and creates false lumen
What is the most common aneurysm?
Abdominal aortic aneurysm, pt can show back pain
Etiology of aneurysm
Build up of atherosclerotic plaque, trauma, inflammation
dx of aneurysm
CT, MRI, ultrasound, radiographic
What is vasculitis?
Destroys blood vessels by inflammation
Dx of vasculitis
Lab tests
Tx of vasculitis
Stopping inflammation and suppressing immune system (usually through steroids)
What is plebitis?
Inflammation of a vein
- mainly in the leg
What is thrombophlebitis?
Inflammation of a vein and formation of thrombus (clot) in the vessel wall
T or F?
In thrombophlebitis you will see the same edema amount in each leg
False - one has extreme edema compared to the other
Intervention of thrombophelbitis
immediate, heparin, antibiotic, surgery
T or F?
Arterial thrombosis can lead to heart attacks or strokes
True
Deep vein thrombosis affects…
lower leg, thighs, pelvis - with clots in femoral and pelvic veins
What is a pulmonary embolism?
Lodging of blood clot in pulmonary arter
Signs and symptoms of pulmonary embolism
dyspnea, chest pain, anxiety, rales, tachycardia, fever
T or F?
Pulmonary embolism always has to have symptoms
False - can show no symptoms and be cardiac arrest
Pulmonary embolism etiology
DVT (deep vein thrombosis)
Dx of pulmonary embolism
d-dimer test, screening, pulse ox, chest x-ray (CT scan!! with contrast)
tx of pulmonary embolism
oxygen, vasopressors, heparin, anticoagulants, continual monitoring for complications
T or F?
Pulmonary embolism prognosis is good
False - depends on amt of lung tissue affected (infraction?)
What are varicose veins?
swollen, twisted, knotted veins, can cause cramps
What is Raynauds disease?
Vasospstic condition that bilaterally affects the hands, or feet with exposure to cold or stress
What is buergers disease?
aka thromboangiitis obliterans
- inflammation of the peripheral arteries and veins of extremities with formation of clots
How can buergers disease be presented?
Pain in affected area of cold, cyanosis, numb feet from reduced blood flow, red, tingles
Incidence of buergers disease
age 20-40 and smoke heavily
Tx of buergers disease
smoking cessation, ambulation, surgery, amputation
