Unit 4 Cardio Screen Flashcards
What are the S/S of Cardiovascular Disease?
- Chest pain
- Palpitation
- Dyspnea
- Syncope
- Fatigue
- Cough
- Cyanosis
- Edema/Claudication (Leg pain)
- Pain/Discomfort
- Abnormal vital signs
What are different Cardiac Diseases that affect the Heart Muscles?
- Coronary Artery Disease
- Myocardial Infart
- Pericarditis
- Congestive heart failure
- Aneurysms
What are different Cardiac Diseases that affect the Heart Valves?
- Rheumatic Fever
- Endocarditis
- Mitral Valve Prolapse
- Congenital Deformities
What are different Cardiac Diseases that affect the Cardiac Nervous System?
- Arrhythmias
- Tachycardia
- Bradycardia
What is the Pathophysiology of the Heart?
- Hyperlipidemia
- Coronary Artery Disease
- Angina
- Myocardial Infarction
- Pericarditis
- Congestive Heart Failure
- Aneurysm
What is Hyperlipidemia?
- Elevated serum total cholesterol (hypercholesterolemia)
- Elevated low-density lipoproteins (LDL)
- Elevated triglycerides (hypertriglyceridemia)
- Decreased high-density lipoproteins
These abnormalities are the primary risk factors for atherosclerosis and cardiovascular disease (CAD)
What can cause Coronary Heart Disease?
Atherosclerosis: This is a disease process of hardening of the arteries making plaque. It is a progressive process that may begin in childhood. It can occur in any artery in the body, but it is most common in medium- sized arteries such as those of the heart, brain, kidneys, and legs.
Thrombus: A clot (thrombus) form on the plaque
Spasm: Sudden constriction of a coronary artery because the blood flow to that part of the heart is cut off or decreased
plaque, is made up of fats, calcium, and fibrous scar tissue and lines the usually supple arterial walls, progressively narrowing the arteries
What are the Modifiable Risk Factors for Coronary Artery Disease?
- Physical Inactivity
- Tobacco smoking
- Elevated serum
- Cholesterol
- High BP
- Diabetes
- Obesity
What are the Non-Modifiable Risk-Factors for Coronary Artery Disease?
- Advancing age (65 years or older)
- Male Gender
- Family hx
- Race
- Postmenopausal (female)
Wha are contributing factors for Coronary Artery Disease?
- Response to stress
- Personality
- Peripheral Vascular Disease
- Hormonal Status
- Alcohol consumption
- Obesity
What is Angina?
- Acute pain in the chest, called Angina Pectoris, results from the imbalance between cardiac workload and oxygen supply to myocardial tissue.
- Angina is a symptom of obstructed or decreased blood supply to the heart muscle primarily from atherosclerosis
What is the Pain Pattern with Angina? How is pain typically described?
- Pain pattern is usually projected to the left shoulder and arm over the distribution of the ulnar nerve
- Pain is usually mild or moderate. Rarely is the pain described as severe
What is Myocardial Infarction (MI)?
Also known as, Heart Attack, coronary occlusion is the development of ischemia and necrosis of myocardial tissue. It results from a sudden decrease in coronary perfusion or an increase in myocardial oxygen demand without adequate blood supply
What are the Clinical S/S of MI in women?
These were the ones highlighted, theres more
- Weakness and lethargy (unusual fatigue, that may interfere with ADLs)
- Indigestion, heartburn, or stomach pain; may be mistakenly diagnosed or assumed to have GERD
- Isolated, continuous midthoracic or interscapular back pain
- Symptoms may be relieved by antacids
What is Pericarditis?
This is inflammation of the pericardium, the sac-like covering of the heart.
- Specifically, it affects the parietal pericardium, (the fluid like membrane between the fibrous pericardium and the epicardium) and the visceral pericardium
What is Congestive Heart Failure/Heart Failure?
- Also called Cardiac decompensation and Cardiac Insufficiency
- The physiological state in which the heart is unable to pump enough blood to meet the metabolic needs of the body (determined as O2 consumption) at rest or during exercise, even though filling pressures are adequate
What are the Clinical S/S of Left Ventricular Failure
What are the Clinical S/S of Right Ventricular Failure?
What is an Aneurysm?
An abnormal dilation (commonly a sac-like) formation in the wall of the artery, vein, or the heart. Aneurysms occur when the vessel or heart wall becomes weakened by trauma, congenita vascular disease, infection, or atherosclerosis
What is an Abdominal Aortic Aneurysm?
- When there is a palpable, pulsating mass (in the abdomen space)
- When there is an abdominal “heartbeat” felt by the client when lying down
- There is typically a dull ache in the mid-abdominal left flank or low back
- There could be hip, groin, scrotal (men), buttock, and/or leg pain (posterior thigh)
Where are most Aortic Aneurysms located?
Where are Peripheral Aneurysms located and what can they cause?
The most common site for peripheral arterial aneurysms is the popliteal space in the LE.
- Popliteal aneurysms cause ischemic symptoms in the lower limbs and an easily palpable pulse of larger amplitude. An enlarged area behind the knee may be present, seldom with discomfort
What are the Main S/S of MI?
Severe chest pain described as “Crushing Pain” lasting more than 30 or more minutes
What are the Main S/S of Pericarditis?
Pain aggravated by movement associated with deep breathing and cough
What are the Main S/S of Congestive Heart Failure (CHF)?
LE edema, Symptoms develop gradually
What are the Main S/S of Abdominal Aortic Aneurysm?
Awareness of a pulsating mass in the abdomen, with or without pain, followed by abdominal pain and back pain
What are the Main S/S of Cardiac Valvular Conditions?
Easy fatigue, dyspnea, palpitation when become symptomatic
What are the Main S/S of Sinus Tachycardia/Bradycardia?
Palpitations/reduced pulse rate
What is Mitral Valve Prolapse (MVP)?
Characterized by mitral leaflet thickness with increased extensibility, decreased stiffness, and decreased strength compared with normal valves
What are the Clinical S/S of Mitral Valve Prolapse?
- Profound fatigue; low exercise tolerance
- Chest pain; arm, back, or shoulder discomfort
- Palpitations or irregular heartbeat
- Tachycardia
- Migraine HA
- Anxiety, depression, panic attacks, dyspnea
What are Arrhythmias? What can they cause?
Also called dysrhythmias, are disorders of the heart rate and rhythm caused by disturbances in the conductions system
- Arrhythmias may cause the heart to beat to quickly (Tachycardia), too slowly (Bradycardia), or with extra beats and fibrillations
During an MI, damaged heart muscles cells, deprived of O2, can release small electrical impulses that may disrupt the heart’s normal conduction pathway. These Fibrillation impulses can occur in the atria or the ventricles
What are 4 different Cardiovascular Disorders?
- Hypertension
- Transient Ischemic Attack (TIA)
- Orthostatic Hypotension
- Venous Disorders - Deep Vein Thrombosis (DVT)
What is Hypertension usually a sign of? What can it cause?
High blood pressure is usually a sign that the vessels cannot relax fully and remain somewhat constricted, requiring the heart to work harder to pump blood through the vessels
- Over time the extra effort can cause the heart muscle to become enlarged and eventually weakened. - The force of blood pumped at high pressure can also produce small tears in the lining of the arteries, weakening that arterial vessels
- Hypertension is a major cardiovascular risk factor, associated with elevated risks of CVDs, especially MI, Stroke, PVD, and cardiovascular death
For adults, what is considered Normal BP?
90-119 / 60-79
For adults, what is considered Pre-hypertensive BP?
120-139 / 80-89
For adults, what is considered Stage 1 Hypertensive?
140-159 / 90-99
For adults, what is considered Stage 2 Hypertensive?
> /160 / >/ 100
What is Transient Ischemic Attack (TIA)?
This occurs when the blood supply to part of the brain has been temporarily disrupted. These ischemic episodes last from 5 to 20 min, although they may last as long as 24 hours
- Considered by some as a progression of cerebrovascular disease and may be referred to as “ministrokes”
What is Orthostatic Hypotension?
An excessive fall in BP of 15mmHG or more in systolic BP or a drop of at least 7mmHG or more of diastolic BP on assumption of an erect position (within 3 minutes of standing from a sitting or supine position)
- Orthostatic Hypotension is not a disease but a manifestation of abnormalities in normal BP regulation
With Peripheral Vascular Disorders, what is Arterial Disease?
Vascular disorder secondary to occlusive arterial disease usually have an underlying atherosclerotic process that causes disturbances in the circulating to the extremities and can result in significant loss of function of either the UE or LE
With Peripheral Vascular Disorders, what are Venous Disorders?
Venous disorders can be separated into acute an chronic conditions. Acute venous disorders include thromboembolism (DVT). Chronic venous disorders can be separated further into varicose vein formation and chronic venous insufficiency
How may a patient with DVT present?
- Unilateral tenderness or leg pain
- Unilateral swelling (>3 cm difference in leg circumference)
- Warmth
- Discoloration
What is Life’s Simple 7?
- Be active
- Check BP
- Check sugar
- Check cholesterol
- Eat better
- Manage weight
- Quite smoking
When should PT refer patient out?
- Systemic and abnormal vital signs
–Difference of more than 40mmHG between Systolic and diastolic
–Hypertension (>/160 / 100 mmHG)
–Tachycardia or Bradycardia - Palpitation lasting for hours or with associate symptoms
- Extreme fatigue and SOB
- Neurologic patients with arrhythmias
What are the guidelines for immediate Medical Attention?
- Worsening of intermittent claudication
- Anginal pain that does not improve when stopping exercise (3 to 5 min) or by taking nitroglycerin (20 min) - Syncope
- Transient Ischemic Attack (TIA)
What is a 0 in the Pulse Palpation scale?
No Palpable pulse
What is a 1+ in the Pulse Palpation scale?
Faint but detectable pulse
What is a 2+ in the Pulse Palpation scale?
Normal
What is a 3+ in the Pulse Palpation scale?
Increased or full
What is a 4+ in the Pulse Palpation scale?
Bouncing pulse
What is a 1+ in the Pitting Edema scale?
No pitting,; mild indentation of skin (2mm)
What is a 2+ in the Pitting Edema scale?
Moderate pitting that indents 4mm; disappears within 10-15 seconds
What is a 3+ in the Pitting Edema scale?
Deep pitting that indents 6mm; remains indented >1 minute; dependent extremity is visible swollen
What is a 4+ in the Pitting Edema scale?
Very deep pitting that indents 8mm; remains 2-5 minutes; dependent leg is grossly distorted
What is the Ankle Brachial Index (ABI)?
ABI values are strong independent predictors of cardiovascular morbidity and mortality
Patient is supine when testing
- Place BP cuffs over the brachial artery and above each malleolus
- Rapidly inflate to 20 mmHG above when the audible systolic BP disappears in each arm and deflate at
2 mm per second
1.00 - 1.4 is normal anything below is abnormal
