Unit 2_Additional Cardiovascular Conditions and Peripheral Vascular Disease Flashcards
What is known as a drop in SBP > 20 mmHg and/or drop in DBP > 10 mmHg, with reflexive increase in HR (10-20%) as individual transitions from supine or sitting to a standing position?
Causes:
Autonomic dysfunction
Volume depletion/dehydration
Prolonged immobility
Venous pooling
Medications
Starvation/malnutrition
Note:
–more common in older adults
Orthostatic Hypotension
What cardiovascular condition should you advise caution when transitioning from supine to sit and from sit to stand, especially if patient has been immobile for extended period
Guard against falls from lightheadedness – “dizziness”?
Possible treatments to consider:
Abdominal binders and elastic stockings may aid venous return
Repetitive large muscle contractions in each stage of transfer transition to promote venous return (supine, sitting, standing)
Precautions
Caution with warm water exposure
Emphasize post-exercise cool-down period
Avoid prolonged stationary standing
Rehabilitation Considerations for Orthostatic Hypotension
What is known as idiopathic development of cardiac muscle fibers to inability to contract and/or relax?
Classifications:
Dilated (most common)
Hypertrophic
Restrictive
Additional diagnoses you may encounter (less common)
Left Ventricular Non-Compaction Cardiomyopathy (LVNC)
Arrhythmogenic Right Ventricular Dysplasia (ARVD)
Idiopathic Cardiomyopathy
What cardiovascular condition has the following partial list of risk factors:
Familial/genetic predisposition – common
Radiation therapy
Chemotherapeutic agents
Rheumatic fever
Viral illness
Alcohol abuse
Sarcoidosis
Obesity
Hypertension
Smoking
Idiopathic Cardiomyopathy
What is known as inflammation of the pericardium (“membrane sack surrounding the heart”)?
May lead to cardiac tamponade and with resulting heart failure.
Causes:
Idiopathic (85%)
Viral/bacterial infections (pathogens)
Acute MI
Cardiac trauma
Treatment: -
Antibiotics (correct the underlying cause)
Pericardiocentesis (drain fluid)
Pericarditis
What is known as abnormal stretching of the wall of an artery, vein, or the heart, with the diameter being at least 50% greater than normal
(“Ballooning or outpouching”)?
Risk factors:
Increased age
Smoking
Atherosclerosis
Male
Family History (genetics)
Treatment
Surgical – clip (brain) or graft (peripheral)
Rupture is catastrophic
Aneurysm
What is known as anatomic defect in the heart that is present at birth?
Incidence:
About 8 per 1000 babies born will have some form of congenital hear disease
Symptoms:
Cyanosis
Chronic heart failure
Congenital Conditions
What congenital condition includes left-to-right shunts and outflow obstruction?
Acyanotic
What congenital condition includes Teralogy of Fallot and transposition of the great arteries?
Cyanotic
What is known as pathologic conditions of blood vessels supplying the extremities and major abdominal organs (“outside of the heart and brain”)?
There are a wide variety conditions across 3 categories:
Occlusive
Inflammatory
Vasomotor
Affects the legs more frequently than the arms
Atherosclerosis is a common underlying cause for PVD affecting the legs. It can result in ischemic pain referred to as “claudication”
Peripheral Vascular Diseases (PVD)
What are most cases of hypertension considered?
PRIMARY Hypertension
What type of hypertension results from another system?
Example: Renal hypertension
SECONDARY Hypertension
What are the result of hypertension and/or hyperlipidemia?
Occlusive Peripheral disorders
What is essential in the body?
Functions include:
Component of cell membranes
Provides insulation around nerve cells
Used in the manufacture of certain hormones
Low-Density Lipoproteins (LDL)
Elevated levels associated with increased risk of atherosclerosis
Dietary modification is helpful in reducing LDL’s (reduced saturated fat and simple sugars in the diet)
“statin” medications prescribed to reduce total cholesterol and LDL HDL’s
High-Density Lipoprotein (HDL)
Returns LDL to the Liver
Increase HDL by:
Aerobic Exercise
Weight loss
Omega-3 fatty acids (fish, nuts, beans)
Cholesterol
What occurs when atherosclerotic changes occludes blood flow to the lower extremity skeletal muscles?
Clinical Signs and Symptoms (all distal to the occlusion)
Ischemic induced pain (”cramping, tightness”) distal to the occlusion
Reduced pulses
Cyanosis
Symptoms start at a reproducible threshold of physical activity and resolve with rest.
Rehabilitation is prescribed at the threshold just below what causes claudication. Treatment should not be prescribed at levels that induce claudication.
Occlusive Peripheral Vascular Disease
What inflammatory peripheral vascular disease includes acute and chronic inflammation of veins and arteries in the hands and feet?
Occurrence:
5:1 Males vs Females
Highest Incidence in Smokers
May lead to need for amputation
Thromboangiitis Obliterans (“Buerger’s Disease”)
What vasomotor peripheral vascular disease affects small vessels of the digits?
Pathology - Exposure to cold, smoking, emotional distress triggers small vessels in the digits to constrict via spasm. This creates short term ischemia that is resolved with the stimulus is removed.
Persons will have pallor, possible pain, and gangrene (if not resolved).
Resolution is accompanied by a hyperemic response.
Intermittent Vasospastic disorder
What Involves the middle layer (“media”) of large arteries, especially the aorta?
Characterized by medial necrosis/degeneration
Loss of muscle and elastic fibers
Cystic Medial Necrosis
What Cystic Medial Necrosis disorder is a connective tissue disorder?
Fibrillin-1 deficiency (“fibrillin is a connective tissue protein”)
Elastin is not maintained
Dilation of the aorta often leads to aneurysm.
Marfan’s Syndrome
