Topic 4: CAD, Chronic Stable Angina, HTN Flashcards
perfusion
The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries.
oxygenation
The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.
coronary artery disease
atherosclerosis of the coronary arteries that reduces the blood supply to the heart muscle
Stages of Atherosclerosis
- Endothelial injury
- Fatty streak
- Fibrous plaque
- Complicated lesion (thrombus formation)
collateral circulation
circulation formed by smaller blood vessels branching off from or near larger, occluded blood vessels
Nonmodifiable risk factors for CAD
Age
Gender
Ethnicity
Family history
Genetic predisposition
Modifiable risk factors for CAD
Smoking, HTN, DM, obesity, diet, activity level, hyperlipidemia
angina
chest pain; caused by either an increased demand for oxygen or a decreased supply of oxygen.
chronic stable angina
*Intermittent chest pain that occurs over a long period with same pattern of onset, duration, and intensity of symptoms
chronic stable angina EKG
*ST segment depression and/or T-wave inversion
how do patients oftern describe chronic stable angina as
pressure, heaviness, or discomfort in the chest. squeezing, heavy, tight, or suffocating sensation
what is chronic stable angina often provoked by
*physical exertion, stress, or emotional upset
chonic stable
*with exercise or when stress happens, relieved with rest or nitroglycerin
Prinzmetal’s Angina (variant angina)
*occurs anytime, including at rest - caused by coronary artery spasms
Microvascular angina
*distal coronary arteries, ADLs, more common in women
unstable angina
*rupture of plaque, with exercise or rest, increases with severity/frequency/duration over time, not relieved with rest/nitro, lasts longer than 10 min
If Angina is not treated promptly, it can progress into a
myocardial infarction
what are the common locations and patternd of angina and MI
-most substernal, may radiate to other locations, including the jaw, neck, shoulders, and/or arms.
-complain of indigestion or a burning sensation in the epigastric region.
-between the shoulder blades.
what will the client complain of with angina and MI
-Squeezing in the chest
-Pressure, an elephant sitting on the chest
-Pain from chest radiating to jaw, neck, left arm
-Anxiety, sense of impending doom
-Nausea, vomiting
-Dizziness
-Pale, cool, & clammy skin, diaphoresis
-Tachycardia, palpitations
-Tachypnea & shortness of breath
-Decreasing LOC
lab tests for MI/angina
Myoglobin
CK-MB
Troponins
Lipids
CBC, BMP, CRP
ECG
coagulation labs
(PT/INR, aPTT) - the amount of time it takes for different parts of the clotting system to form a clot.
cardiac enzymes labs
(CK-MBs, Troponins, BNP) - enzyme(s) excreted by the heart when it’s in distress
lipid panel
(Cholesterol, Triglycerides, HDL, LDL) - measures the different types of fat that float around in our blood
digoxin level labs
this measures the amount of a medication, Digoxin, that is in the blood to determine if the amount is too high or too low
D-dimer labs
this measures fragments of fibrin that are left over after a clot has formed
CRP labs
C Reactive Protein tells us about inflammation in general
What medication affects the aPTT lab value?
heparin
What is the antidote to heparin?
protamine sulfate
What medication affects the PT/INR lab value?
warfarin