Test 2 artherosclerosis Flashcards
Relationship btw HTN & Artherosclerosis
- Pressure exerted traumatizes endothelial lining repair with inflammation – also put down fibrous tissue, calcium, and lipids; occluded this vessel somewhat have to increase pressure to get past occlusion; damages inner wall of vessel = more plague so have to up pressure; vicious circle; High BP means plaque and plague means up the pressure
Risk Factors for Artherosclerosis
Cigaretts, Diabetes, Obesity, age (40+),Race (African American), Family, Gender (Post-Menopausal women most likely, Men more likely overall), HTN & Hyperlipidemia
How do Cigarettes effect Artherosclerosis
risk seems to be more with number of cigarettes smoked rather than length of time smoked. increase in Carbon Monoxide in tissue, so blood thinks no oxygen is getting to tissue, so heart pumps faster to perfuse with oxygen; nicotine constricts vessels; increases BP
what is a sign of CO2 poisioning
– bright cherry, pink color in nail bed Normal is red/purple
How does Diabetes effect Artherosclerosis
Type 1 Mostly; high sugar levels damage vessels and trigger the inflammation response like HTN
how does Obesity effect Artherosclerosis
Every 10 pounds overweight = 1 extra mile of bv Lose weight=lose bv=lower bp
Ischemia
Aerobic metabolism to Anaerobic metabolism= Lactic Acid = ↓pH (acid)=k+up This decreases the ability to repolarize
What do you see on the EKG with Ischemia
T wave inversion St Segment depression
What is the point of no return with Ischemia
30-45 min then there is irreversible damage to myocardial tissue and it is called a MI
Where is the ischemia most likely to happen in heart?
Left Ventricle
Transmural infarction
all the way from endocardium to epicardium; full thickness of all myocardial muscle
subendocardial infarction
goes about ½ way through myocardial tissue
relationship of enzymes to infarction
indirect way of assessing how much tissue is damaged; greater enzyme level, greater tissue damaged
When do you measure for enzymes
Blood test q8hrs at least 3 times
ck-mb enzyme
indirect way of assessing how much tissue is damaged; greater enzyme level, greater tissue damaged
Troponin
Protien that mediates CA, it is not an enzyme, its a protein marker. It rises 4-6 hrs after MI takes 10 days to go down.
CRP
elevated CRP r/t MI “there’s a fire, how hot it is, but have no idea where it is.
MI EKG
Pronounced Q wave, elevated ST segment, inverted Twave, ST seg and T wave will return to normal.
Congestive heart failure
static circulatory situation; things aren’t moving; “congested” traffic or blood; location of congestion depends on which ventricle we’re talking about
Type of Congestive Heart failure in left ventricle
pulmonary venous congestion
Type of Congestive Heart failure in right ventricle
systemic venous congestion
Cardiogenic Shock
greater than 40%loss all at once (can’t perfuse); do get pulmonary venous congestion 80-90%death rate
Ventricular septal defects
Complication of an MI. Septum that separates R & L ventricle. If septum gets necrotic b/c of injury pt. will have multiple vessel occlusions.
Septal rupture
Pressure difference btw ventricles and L is >. Pressure difference causes hole in septum b/c all that is holding it together is the mesh created in inflammation. These are most common in children.
Most common complication of MI
Dysrhythmia 90% Cardiac pt have some degree of dysrhythmia.
how does tachycardia effect CO=HRxSV
HR > 150, can’t fill up ventricle before it compresses, compromised because of SV
how does bradycardia effect CO=HRxSV
t contract often enough. Not beating fast enoug to keep perfusion
Premature Beat
electrical system has been activated from somewhere other than SA node; somewhere in travel another firing fires prematurely before SA firing completely finished its route
Ventricular Fibrillation
just quivering, not filling or contracting; defibrillate – turning off electrical activity of heart/shutting down electrical activity;