test 3 Flashcards
why is CHD most common cause of death in the US?
obesity
what is atherosclerosis? what is it caused by?
build up of plaque in vessels, caused by obesity, hypertension, dyslipidemia
what are the risk factors for increased atherogenesis? why?
endothelial injury, inflammatory response, tobacco smoke, LDL, hypertension
monocyte
white blood cell response
fibromuscular plaque
leads to arterial remodeling, thrombus
what occurs in a myocardial infarction
chest pain lasting > 30 mins, ECG shows ST segment or t-wave changes
What are some of the pharmaceutical drugs used to treat cardiac problems?
supplemental oxygen, nitroglycerin, beta blocker, ACE blocker, aspirin, anticoagulant, percutaneous coronary intervention, coronary artery bypass graft surgery
What is meant by the ischemic cascade? What are the different stages and what occurs in each?
stiffening of left ventricle, systolic emptying of left ventricle becomes impaired, left ventricular ejection fraction decreases, ECG abnormalities may occur (ST segments), angina pectoris develops
Does an occlusion = immediate infarction? Why or why not?
not necessarily because there may not be enough blockage
What are the differences in CABS, and PTCA?
CABS are meant for people who have already done PTCA or are no longer candidates for angioplasty
people feel really good after angioplasty- effects retention models, post-surgery of any kind individuals are on beta blockers and it makes it difficult to use HR for intensity
What is meant by revascularization surgery?
surgery to provide new or additional blood supply to body part or organ
What is the difference between HFREF, HFPEF their causes, symptoms, physiology
HFPEF: heart failure with preserved ejection fraction (preserved flow, still volume of blood due to diastolic dysfunction)
HFREF: heart failure with reduced ejection fraction (reduced flow)
What are some anticipated responses in those with HF? Why does exercise capacity decrease?
increased norepi and catecholamine response, decreased dilation lowering blood flow to muscles. lower power output, lower cardiac output, lower HR, lower exercise capacity, VO2 is 8-21 ml/kg/min
What is meant by PAD?
blockage of the leg arteries by plaque-results in stenosis or occlusion
What populations are at higher risk for PAD? Why?
obese or smokers
What is meant by hemodynamic testing with the ABI test?
determine the amount of blood flow in extremities at a given time. ABI: changes in blood flow or blood pressure
When is a cardiac transplant recommended? What complications or changes in terms of heart regulation do you see?
1-3 years is 85-78% survival rates, all cardiac autonomic fibers are severed (only parasympathetic fibers left) after transplant, exercise intolerance is normal, see no increase in HR at rest due to no sympathetic stim, HR increases slowly due to increased NE blood
What other hemodynamic test can be done to determine claudication or risk for IC-
segmental limb pressure, transcutaneous oxygen pressure, CT, MRI
What are the signs and symptoms of PAD
asymptomatic, mild claudication, moderate to severe claudication
How are the symptoms described or scaled?
Fontaine and rutherford
What is the function of cilostazol?
phosphodiesterase inhibitor (inhibits platelet aggregation and direct arterial vasodilator)
What are common locations where claudication occurs?
legs, butt region
What is the overall exercise recommendation for those with IC?
walking up to 50 minutes combining rest and exercise- avoid high intensity to avoid IC
What is the purpose of the pacemaker and why is it needed? What are the common indications for a pacemaker?
maintains a normal heart rate when sympathetic/parasympathetic nervous intervention is no longer good enough. HR that is too slow due to SA node dysfunction, blood in AV node
what are the risk factors for atherosclerosis
tobacco use, dyslipidemia, hypertension, sedenstary lifestyle, obesity, diabetes mellitus
what are the 3 causes of ischemia? what do they mean ? what causes them? why do they occur
thrombosis, embolism, reduction in blood flow
what is angina/unstable angina why does it happen what does it mean what causes it?
probably a result of transient vessel occlusion followed by spontaneous thrombolysis, and vasorelaxation
treatment mechanisms for coronary syndrome
anti-ischemic therapy (nitroglycerin, beta blockers), oral and intravenous antiplatelet therapy
what is meant by ischemic cascade. what are the causes?
stiffening of left ventricle, systolic emptying of left ventricle becomes impaired, left ventricular ejection fraction decreases, ECG abnormalities may occur, angina pectoris
infarction and ischemia? stenosis and occlusion?
infarction is the necrosis of cardiac myocytes resulting from prolonged ischemia. ischemia. ischemia is where a body part doesn’t receive enough blood flow, and leads to tissue damage. stenosis: narrowing of a vessel. occlusion: blockage of a vessel.
what is meant by CABS and PTCA?
CABS: coronary artery bypass surgery
PTCA: precutaneous transluminal coronary angioplasty
what are the symptoms of HF
shortness of breath, swelling, weight gain, fatigue, palpitations, confusion
