Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Concepts 2 > Unit 5 - MI/Angina/HF/CAD/atherosclerosis > Flashcards

Unit 5 - MI/Angina/HF/CAD/atherosclerosis Flashcards

1
Q

define angina

A
  • Pain radiating in the arms, shoulders, jaw, neck, and / or back
  • Shortness of breath
    Weakness and / or fatigue
  • typically occurs in response to exertion and is relieved by rest.
  • usually lasts no more than a few minutes
  • Often worse when exertion follows a meal.
  • Emotional stress may also cause or worsen angina.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

causes of angina

A
  • usually occurs when the heart’s workload and need for oxygen exceeds the ability of the coronary arteries to supply.
  • Coronary blood flow can be limited when the arteries are narrowed by atherosclerosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

stable angina

A
  • chest pain or discomfort that typically occurs with activity or stress.
  • Episodes of pain or discomfort are provoked by similar or consistent amounts of activity or stress.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

unstable angina

A
  • refers to angina in which the pattern of symptoms changes.
  • Because the characteristics of angina in a particular person usually remain constant, any change—such as more severe pain, more frequent attacks, or attacks occurring with less exertion or during rest—is serious.
  • Such change usually reflects a sudden narrowing of a coronary artery because an atheroma has ruptured or a clot has formed.
  • The risk of a heart attack is high.
    Unstable angina is considered an acute coronary syndrome.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is angina diagnosed

A
  • A complete medical history
  • Electrocardiogram (ECG)
  • Continuous ECG monitoring with a Holter monitor
  • Stress test (patient walks on a treadmill or pedals a stationary bicycle with ECG attached).
  • Echocardiography
  • Electron beam computed tomography (CT)
  • Cardiac catheterization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is Echocardiography

A

Echocardiography uses ultrasound waves to produce images of the heart (echocardiograms). This procedure shows heart size, movement of the heart muscle, blood flow through the heart valves, and valve function. Electrocardiography is done during rest and exercise. When ischemia is present, the pumping motion of the left ventricle is abnormal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is Electron beam computed tomography (CT) scan

A

detect the amount of calcium deposits in the coronary arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment of angina

A
  • Attempts to slow or reverse the progression of coronary artery disease by dealing with risk factors (hypertension, high cholesterol)
  • quitting smoking is crucial
  • A low-fat, varied diet that is low in carbohydrates and exercise are recommended for most people.
  • weight loss if needed
  • nitrates (nitroglycerin spray) - viagra/cialis must be avoided while taking nitrates
  • beta-blockers, calcium channel blockers
  • anti platelet drugs (aspirin, ticlopidine, clopidogrel)
  • Percutaneous coronary intervention(balloon angioplasty & stent insertion)
  • Coronary artery bypass graft surgery (CABG)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define myocardial infarctions

A
  • the death of heart muscle from the sudden blockage of a coronary artery by a blood clot.
  • Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen.
  • Blockage of a coronary artery deprives the heart muscle of blood and oxygen, causing injury to the heart muscle. Injury to the heart muscle causes chest pain and chest pressure sensation.
  • If blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

leading causes of death in Canada

A
  • Heart disease & stroke
  • estimated 70,000 heart attacks each year in Canada. That is one heart attack every 7 minutes
  • Almost 16,000 Canadians die of heart attacks each year
  • Most of the deaths from heart attacks are caused by ventricular fibrillation of the heart that occurs before the victim of the heart attack can reach an emergency room
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

survival rate of MI

A
  • Those who reach the emergency room have an excellent prognosis; survival from a heart attack with modern treatment should exceed 90%.
  • The 1% to 10% of heart attack victims who die later include those victims who suffer major damage to the heart muscle initially or who suffer additional damage at a later time.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

heart attack symptoms

A
  • vary among individuals, and even a person who has had a previous heart attack may have different symptoms in a subsequent heart attack.
  • chest pain or pressure is the most common symptom of a heart attack, heart attack victims may experience a diversity of symptoms that include:
    *Pain, fullness, and/or squeezing sensation of the
    chest
    *Jaw pain, toothache, headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

causes of a heart attack

A
  • ## Atherosclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is Atherosclerosis

A
  • a gradual process by which plaques (collections) of cholesterol are deposited in the walls of arteries.
  • Cholesterol plaques cause hardening of the arterial walls and narrowing of the inner channel (lumen) of the artery.
  • Arteries that are narrowed by atherosclerosis cannot deliver enough blood to maintain normal function of the parts of the body they supply
  • can remain silent (causing no symptoms or health problems) for years or decades
  • can begin as early as the teenage years, but symptoms or health problems usually do not arise until later in adulthood when the arterial narrowing becomes severe.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

risk factors of atherosclerosis

A
  • Smoking cigarettes, high blood pressure, elevated cholesterol, and diabetes mellitus can accelerate atherosclerosis and lead to the earlier onset of symptoms and complications, particularly in those people who have a family history of early atherosclerosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does atherosclerosis cause an MI

A

the surface of a cholesterol plaque in a coronary artery may rupture, and a blood clot forms on the surface of the plaque.

The clot blocks the flow of blood through the artery and results in a heart attack.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The cause of rupture that leads to the formation of a clot

A
  • unknown
  • contributing factors may include cigarette smoking or other nicotine exposure, elevated LDL cholesterol, elevated levels of blood catecholamines (adrenaline), high blood pressure, and other mechanical and biochemical forces.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

most common time for heart attacks to occur

A
  • between 4:00 A.M. and 10:00 A.M. because of the higher blood levels of adrenaline released from the adrenal glands during the morning hours.
    (Increased adrenaline may contribute to rupture of cholesterol plaques)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

symptoms of a heart attack

A
  • chest pain or pressure is the most common symptom
  • Jaw pain, toothache, headache

*Shortness of breath

*Nausea, vomiting, and/or general epigastric (upper middle abdomen) discomfort

*Sweating

*Heartburn and/or indigestion

*Arm pain (more commonly the left arm, but may be either arm)

*Upper back pain

*General malaise (vague feeling of illness)

*No symptoms (Silent heart attacks are especially common among patients with diabetes mellitus.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

heart attack symptoms in women

A
  • neck and shoulder pain
  • abdominal pain
  • nausea
  • vomiting
  • fatigue
  • SOB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

complications of a heart attack

A
  • heart failure
  • When a large amount of heart muscle dies, the ability of the heart to pump blood to the rest of the body is diminished, and this can result in heart failure.
  • The body retains fluid, and organs (e.g. the kidneys) begin to fail.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

risk factors for atherosclerosis and heart attack

A

Smoking tobacco, high blood pressure, elevated cholesterol, diabetes mellitus, male gender, family history of heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

define high blood cholesterol

A
  • hyperlipidemia
  • A high level of cholesterol in the blood is associated with an increased risk of heart attack because cholesterol is the major component of the plaques deposited in arterial walls.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

bad cholesterol

A

The cholesterol that is combined with low-density lipoproteins (LDL cholesterol) is the “bad” cholesterol that deposits cholesterol in arterial plaques. Thus, elevated levels of LDL cholesterol are associated with an increased risk of heart attack.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

good cholesterol

A

The cholesterol that is combined with HDL (HDL cholesterol) is the “good” cholesterol that removes cholesterol from arterial plaques. Thus, low levels of HDL cholesterol are associated with an increased risk of heart attacks.

26
Q

how is a heart attack diagnosed

A
  • When there is severe chest pain, suspicion that a heart attack is occurring usually is high, and tests can be performed quickly that will confirm the heart attack.
  • ECG (recording of the electrical activity of the heart) - Abnormalities in the electrical activity usually occur with heart attacks and can identify the areas of heart muscle that are deprived of oxygen and/or areas of muscle that have died.
27
Q

how is a heart attack diagnosed

A
  • When there is severe chest pain, suspicion that a heart attack is occurring usually is high, and tests can be performed quickly that will confirm the heart attack.
  • ECG (recording of the electrical activity of the heart) - Abnormalities in the electrical activity usually occur with heart attacks and can identify the areas of heart muscle that are deprived of oxygen and/or areas of muscle that have died.
28
Q

Treatment for Heart Attack

A
  • chew 2 aspirin tablet -this improves the chances of survival by reducing the size of the clot (if present) in the coronary artery. - People with an allergy to aspirin may be given clopidogrel instead
  • decreasing the heart’s workload - (a beta-blocker is usually given to slow the heart rate enabling the heart to work less and reduces the area of damaged tissue)
  • give an anticoagulant drug, such as heparin, to help prevent the formation of additional blood clots.
  • O2 thru nasal prongs (Providing more oxygen to the heart helps keep heart tissue damage to a minimum)
  • morphine for severe discomfort - This drug has a calming effect and reduces the workload of the heart.
  • nitroglycerin, which relieves pain by reducing the workload of the heart and possibly by dilating arteries
29
Q

symptoms of heart failure

A
  • coughing
  • tiredness, SOB
  • pleural effusion
  • swelling in the abdomen
  • pulmonary edema
  • pumping action of heart weakens
30
Q

define heart failure

A
  • The term heart failure means the heart is not working efficiently
  • occurs when the heart muscle becomes weak & can’t pump enough blood to meet the body’s needs
  • As a result there is not enough blood flow to provide the body’s organs with oxygen & nutrients
31
Q

cause of heart failure

A
  • heart muscle becomes weak & can’t pump enough blood to meet the body’s needs
  • As a result there is not enough blood flow to provide the body’s organs with oxygen & nutrients
  • Initially the heart tries to compensate for its weakness by beating faster or more forcefully
  • Eventually these mechanisms fail & the heart becomes more & more impaired
  • HF usually results from a condition that forces the heart to work harder & faster to keep blood flowing
  • Such a condition may involve the heart’s right side, left side or both
32
Q

two basic problems in HF

A
  • Systolic dysfunction- occurs when the heart can’t pump enough blood to supply all the body’s needs
  • Diastolic dysfunction- occurs when the heart cannot accept all the blood being sent to it
  • Many people have both systolic & diastolic HF
33
Q

heart failure is usually the result of

A

other heart problems:

  • Coronary Artery Disease (CAD)-a condition that causes narrowing of arteries that supply the heart with blood, can damage & weaken
    areas of the heart
  • Persistent Hypertension (HTN) –forces the heart to pump against higher pressure, which causes it to weaken over time. People with uncontrolled HTN are more likely to develop HF than those with normal BP
34
Q

HF result of

A
  • CAD
  • HTN
  • heart attack (damages heart muscle)
  • diabetes
  • arrhythmias (abnormal heart rhythms cause heart to pump inefficiently)
  • heart valve disease (may be cause by abnormalities)
  • heart valve damage (may be caused by rheumatic disease or infection)
  • viral infection (of heart muscle can weaken heart)
  • an enlarged wall between the heart chambers
  • certain kidney conditions (that increase BP & fluid build-up can increase risk of HF by putting more stress on heart)
  • smoking, obesity
35
Q

prevalence of HF

A
  • affects over 6 million people in North America & is the most common cause of hospitalization for people over 65 years of age
  • men slightly more at risk than women
  • People of African descent are considerably more at risk than those of European descent & also have a higher risk of death
36
Q

heart compensates for HF in 3 ways

A
  • Dilating (enlarging) to form a bigger pump
  • Adding new muscle tissue to pump harder
  • Beating at a faster rate
37
Q

symptoms of HF

A
  • The heart cannot pump well enough to pump the blood through the body & back to the heart again
  • Blood then backs up into the legs & the lungs, causing fluid build up.
  • This causes visible edema (swelling) of the ankles & legs & shortness of breath (due to pulmonary edema)
38
Q

Right-Sided HF

A
  • blood backs up into your body
  • This causes:
  • edema of the feet, ankles & legs.
  • It may lead to frequent urination at night
  • sudden weight gain
  • weakness, vertigo (dizziness)
  • painful stomach bloating
39
Q

Left-Sided HF

A
  • pulmonary edema can cause breathing problems, such as shortness of breath (SOB), dyspnea (difficulty breathing), especially when lying down, wheezing, coughing up blood tinged mucus, a dry, hacking cough
  • It may also produce weakness, chest pain, & a rapid pulse
  • Most patients with HF have both right-sided & left-side HF, so they have symptoms of both.
40
Q

diagnosing HF

A
  • An exam will be completed checking for edema of the legs & fluid in the lungs
  • The doctor will order blood & urine tests & ECG or chest x-ray- which can show excess fluid in the lungs
  • echocardiogram (ultrasound of the heart - tells how much of the blood in the heart is actually being pumped out to the rest of the body)
41
Q

treating and preventing HF

A
  • usually managed with lifestyle adjustments & medications
42
Q

Lifestyle adjustments for treating HF

A
  • Cutting back on fluids- a daily weight is often necessary to help adjust fluid intake & medications
  • Staying active, but avoiding triggering HF symptoms
  • lower sodium intake to 2.3 g daily or less
  • Wearing special elastic stockings reduce swelling in the legs caused by fluid retention
  • weight management program (if needed)
43
Q

medical interventions for HF

A
  • ace inhibitors (expand blood vessels, allowing blood to flow more easily & making the heart’s work easier or more efficient)
  • Angiotensin Receptor Blockers (may be useful in place of ACE inhibitors when they cannot be used or sometimes in addition to ACE inhibitors)
  • Certain Beta-Blockers (e.g. bisoprolol, carvedilol, metoprolol) have been proven to help improve heart function
  • Digoxin increases the force of the pumping action of the heart
  • Diuretics (help the body eliminate excess salt & water. The diuretic spironolactone also maintains potassium stores)
  • Hydralazine & nitrates (be useful in place of ACE inhibitors or ARBs when they cannot be used, or sometimes in addition to other therapies when symptoms are still present)
  • In some cases surgery may be necessary to improve heart function
44
Q

Ways to maintain/improve heart health

A
  • Control hypertension
  • Eat a healthy diet
  • Exercise
  • Maintain blood sugar control if diabetic
  • Maintain healthy cholesterol levels
  • Quit smoking
45
Q

define coronary artery disease

A
  • a type of blood vessel disorder that occurs when fatty deposits calledplaques build up inside the coronary arteries (atherosclerosis).
46
Q

major cause of CAD

A

Atherosclerosis

47
Q

Modifiable risk factors for CAD

A
  • High blood pressure
  • High blood cholesterol and triglycerides
  • Diabetes
  • Unhealthy weight
  • Unhealthy diet
  • Too much alcohol
  • Not enough physical activity
  • Smoking or chewing tobacco
  • Stress
48
Q

Nonmodifiable risk factors for CAD

A
  • Age – with age increases risk of CAD
  • Sex –heart disease and stroke increases after menopause.
  • Family history –close relative who has experienced heart disease at an early age, increases risk.
  • Women who have had pre-eclampsia during pregnancy have an increased risk.
  • Indigenous, South Asian and African heritage – are more likely to have high blood pressure and diabetes.
  • Socioeconomic status- This includes things such as access to healthy food, safe drinking water, health services and social services.
49
Q

Signs and Symptoms of CAD

A
  • Angina-A squeezing, suffocating or burning feeling in the chest that tends to start in the centre of your chest but may move to arm, neck, back, throat or jaw.
  • Shortness of breath
  • Fatigue
  • Pain
  • Dizziness
  • heart attack
50
Q

non-traditional signs and Symptoms of CAD in women

A
  • Vague chest discomfort
  • Fatigue
  • Sleep difficulties
  • Indigestion
  • Anxiety
51
Q

How is CAD Diagnosed

A
  • Full medical history including a doing a full physical assessment
  • chest xray
  • angiography
  • echocardiogram
  • ECG
  • stress test
52
Q

Treatment for CAD

A

There is no cure for CAD, but there are many treatments, including medications, surgery and lifestyle changes, that can slow down its progress

53
Q

medical interventions of CAD

A

Medications
Anti-platelets
ACE inhibitors
Beta-blockers
Calcium channel blockers
Nitrates (Nitroglycerin)
Surgical and non-surgical procedures
Your doctor may also suggest these procedures:
Percutaneous coronary intervention (PCI or angioplasty with stent)
Coronary artery bypass surgery

54
Q

define acute coronary syndrome

A
  • results from a sudden blockage of a coronary artery
  • This blockage causes unstable angina or heart attack, depending on the location and amount of blockage
55
Q

signs and symptoms of acute coronary syndrome

A
  • chest pressure or ache, shortness of breath, and fatigue
  • pain in upper abdomen
  • sweating
  • nausea
  • pain in back, neck, jaw or arm
  • ## Loss of consciousness
56
Q

how to diagnose acute coronary syndrome

A
  • Symptomology
  • Bloodwork
  • Full physical assessment
  • Electrocardiogram (ECG)
57
Q

What is a STEMI

A
  • ST elevation myocardial infarction
  • ST segment elevation on pt ECG who generally have cardiac biomarkers (i.e. elevated troponin levels) which indicate necrosis of heart muscle
58
Q

management of STEMI

A

early repercussion therapy either by thrombolytic therapy or revascularization with percutaneous coronary intervention (PCI)

59
Q

NSTEACS

A
  • Non ST segment elevation acute coronary syndrome
  • refers to symptomatic individuals whose first ECG shows no ST elevation.
60
Q

NSTEMI

A
  • Non ST elevation myocardial infarction
  • refers to those people who have not had ST elevation on their ECG, however, subsequent cardiac biomarkers are elevated.
  • Up to 50% of patients diagnosed as NSTEMI have an ECG that is normal or only show minor changes.
61
Q

how is unstable angina distinguished from NSTEMI

A
  • Unstable anginais an accelerated pattern of angina with or without ECG changes
  • It is distinguished from NSTEMI by the absence of elevated cardiac biomarker
62
Q

tx of unstable angina

A
  • Medications- Nitroglycerin
  • Antiplatelet therapy- (i.e. ASA)
  • Anticoagulant therapy- (i.e. Heparin)
  • Percutaneous coronary intervention (PCI)- (angioplasty with stent) is a non-surgical procedure that uses a catheter (a thin flexible tube) to place a small structure called a stent to open up blood vessels in the heart

Concepts 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions