Unit 2 Module 1: Cardiovascular Flashcards
Heart failure: which side?
shortness of breath
left
How is an MI diagnosed?
- EKG changes
- Cardiac enzymes: troponin elevated
Heart failure: which side?
dyspnea on exertion
left
t/f: HTN can lead to blindness
true
HTN can lead to retinopathy, which can eventually lead to blindness.
t/f: Dysfunction of the sympathetic nervous system, RAAS (renin, angiotensin, aldosterone system) adducin and naturietic peptides can result in increased peripheral vascular resistance and increased blood volume; two main causes of sustained hypertension.
true
Heart failure: which side?
2+ ankle edema
right
What are the 4 psychological symptoms of myocardial infarction?
- impending doom
- anxiety
- fatigue
- restlessness
According to American Heart Association (AHA) and American College of Cardiology (ACC), designate the following as normal or hypertensive (includes stage 1,stage 2 and hypertensive crisis).
BP 188/92
hypertensive
AHA/ACC designate “normal” as less than 120/80 and the stages of HTN start with any reading over 130/80
According to American Heart Association (AHA) and American College of Cardiology (ACC), designate the following as normal or hypertensive (includes stage 1,stage 2 and hypertensive crisis).
BP 132/78
hypertensive
AHA/ACC designate “normal” as less than 120/80 and the stages of HTN start with any reading over 130/80
Serena Williams, an international tennis star underwent a series of serious health problems. It started in Fall, 2010 when she cut her foot on a piece of glass at a restaurant. She underwent 2 operations to repair the foot. She had limited movement for 20 weeks first with a cast, followed by a walking boot for 10 weeks. In February, 2011 she was hospitalized for pulmonary embolisms (PE) in both lungs.
Which part of Vichow’s triad put Serena at risk for a DVT and PE?
vascular wall injury
What are the 4 physiological symptoms of myocardial infarction?
- chest pain
- shortness of breath
- GI complaints
- diaphoresis (sweating)
According to American Heart Association (AHA) and American College of Cardiology (ACC), designate the following as normal or hypertensive (includes stage 1,stage 2 and hypertensive crisis).
BP 90/50
normal
AHA/ACC designate “normal” as less than 120/80 and the stages of HTN start with any reading over 130/80
Is this patient hypertensive or normal?
An 89-year-old with a BP of 182/90
hypertensive
Per JNC 8: Patients under the age of 60 should have a BP less than 140/90. If over the age of 60 then less than 150/90. If one of the two numbers is elevated, then the person is considered to have HTN.
Heart failure: which side?
orthopnea
left
t/f: When a patient says “I was told I have 4 vessel occlusion” he is referring to atherosclerosis in his coronary arteries.
true
A plaque from atherosclerosis can result in:
1) progressive narrowing of the vessel resulting in occlusion (like in this example)
2) sudden vessel obstruction from plaque hemorrhage or rupture.
3) thrombois and formation of emboli
4) aneurysm formation caused by weak blood vessel walls.
The formula for arterial blood pressure is ___ x peripheral vascular resistance
cardiac output
Cardiac output X PVR= arterial pressure. You can take it a step further an look at what makes up cardiac output and what influences PVR.
Heart failure: which side?
hepatomegaly
right
The body tries to “fix” the problem of heart failure by compensatory mechanisms. How does the body compensate?
The body tries a lot of compensatory mechanisms without any improvement. Strategies include: activating RAAS (water and Na retention), increased HR, increased peripheral vascular resistance.
Is this patient hypertensive or normal?
A 72-year-old with a BP of 145/92
hypertensive
Per JNC 8: Patients under the age of 60 should have a BP less than 140/90. If over the age of 60 then less than 150/90. If one of the two numbers is elevated, then the person is considered to have HTN.
What are this pt’s risk factors for heart disease?
John Jacob Jingleheimer Smidht is a 68 year old male. He presents to the outpatient clinic with complaints of occasional chest pain. He is concerned because his Dad died from heart problems at an early age. He has a history of hypertension and “sugar diabetes” but doesn’t take any medications for them because he doesn’t feel like he needs them. He smokes 1/2 pack a day of cigarettes and has since he was 12 years old. “Hard to quit, when I’ve been doing it for so long”. He was told he needs to watch what he eats as his cholesterol was high the last time it was checked. On physical exam, you note that he is considered “obese” based on his body mass index and he has a waist circumference of 44 inches.
Family history, diabetes, smoker, high waist circumference
A patient arrives in the emergency room with chest pain and is diagnosed with a STEMI. Which of the following findings are expected?
A patient with a STEMI is in a life-threatening situation since the myocardium has injury from the endocardium to the epicardium. There are increased cardiac enzymes, EKG changes (ST elevation and Q wave) and the patient should be very symptomatic, not just chest pain.
Emily Sparks is a 39-year old female who has end stage renal disease (CKD stage 5) and is on dialysis. She was recently diagnosed with HTN. The nurse recognizes that she most likely has what type of HTN?
secondary
Heart failure: which side?
weight gain of 3 lbs overnight
right
What are the symptoms of a DVT?
- erythema at the area of thrombosis
- swelling in one leg
- elevated temperature
- slightly elevated WBC
- calf tenderness
- general malaise
A patient complains of angina whenever he takes his morning walk with the dog. He tells his provider that his pain in his chest always come on when he reaches “Elm St”. The provider recognizes what is the underlying pathology in this situation?
This situation is characteristic of stable angina, which would be related to a fibrous plaque which is causing a decreased diameter in the blood vessel. It is predictable as the demand on the heart increases, the pain appears.. Stable angina is relieved by rest and/or nitroglycerin.
Heart failure: which side?
cough of pink frothy sputum
left
What is the most serious risk for a patient with a DVT?
pulmonary embolism
Order these from least to most serious
- STEMI
- unstable angina
- non-STEMI
- stable angina
stable angina–unstable angina—non-STEMI (non Q wave MI)——-STEMI (Q wave MI)
t/f: Kidney failure can cause HTN, but HTN can not cause kidney failure.
false
Kidney failure can cause HTN because of fluid volume overload and HTN can cause nephropathy and increased pressure in the kidney causing dysfunction in the glomerulus and difficulty with filtration.
In heart failure, the heart is likely to be [overstretched/understretched], so that the diameter of the heart [increases/decreases].
overstretched/increases
Is this patient hypertensive or normal?
An 18-year-old with a BP of 118/72
normal
Per JNC 8: Patients under the age of 60 should have a BP less than 140/90. If over the age of 60 then less than 150/90. If one of the two numbers is elevated, then the person is considered to have HTN.
Is this patient hypertensive or normal?
A 65-year-old with a BP of 122/86
normal
Per JNC 8: Patients under the age of 60 should have a BP less than 140/90. If over the age of 60 then less than 150/90. If one of the two numbers is elevated, then the person is considered to have HTN.
Heart failure: which side?
paroxysmal nocturnal dyspnea
left
What are the non-modifiable risk factors for hypertension
family history, age, genetics, gender, race (African American individuals at highest risk).
Heart failure: which side?
anorexia
right
Sustained hypertension for years can lead to which cardiac problems?
MI, heart failure, hypertrophy of the left ventricle, angina
Put the following in order from least pathogenic (1) to the most pathogenic (4).
- fibrous plaque
- fatty streak
- foam cells
- complicated lesion
The foam cells turn into fatty streaks, which develop into fibrous plaques, which have the potential to become a complicated lesion if the plaque ruptures.
According to American Heart Association (AHA) and American College of Cardiology (ACC), designate the following as normal or hypertensive (includes stage 1,stage 2 and hypertensive crisis).
BP 128/86
hypertensive
AHA/ACC designate “normal” as less than 120/80 and the stages of HTN start with any reading over 130/80
Systolic heart failure, the heart has a problem with [ejection/relaxation] . As a result, the ejection fraction [increases/decreases] . A normal ejection fraction (EF) is 65%.
ejection | decreases
Systolic heart failure, the heart has a problem with ejection. As a result, the ejection fraction decreases. A normal ejection fraction (EF) is 65%. Systolic heart failure is the most common. Patients with systolic heart failure can have an EF in the teens.
What are the symptoms of unstable angina?
- chest pain at rest
- > 20 minutes
- new/severe or prolonged/more frequent
- no cardiac marker elevations
What are the modifiable risk factors for hypertension
diet high in Na and low in vitamin D, Ca, Mg, K; excessive alcohol use, tobacco use like cigarette smoking, obesity, physical inactivity and drug use (illicit and prescribed such as oral contraceptive use).
What is an example of high output heart failure?
High output heat failure is not very common. Examples include severe anemia and thyrotoxicosis. Low output heart failure is much more common.
After ___ minutes without oxygen, the cellular damage to the heart is irreversible.
20 minutes
