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MS4 ADRN.210 - rotation 2 > week 1 - cardiac + HTN > Flashcards

week 1 - cardiac + HTN Flashcards

1
Q

What is Acute Coronary Syndrome (ACS)?

A

-prolonged ischemia that is not immediately reversed, which includes:

~NSTEMI
~STEMI
~unstable angina

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2
Q

angina pectoris is chest pain due to what?

A

myocardial ischemia

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3
Q

what is atheroma AKA plaque?

A

caps of smooth muscle cells that form over lipid deposits in arterial vessels

-protrude into the lumen of the vessel
-lumen becomes narrowed
-blood flow is obstructed

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4
Q

atherosclerosis is the most common cause of CVD, what is it?

A

abnormal accumulation of lipid deposits + fibrous tissue in arterial walls + lumen

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5
Q

what is a coronary artery bypass graft (CABG)?

A

-surgical procedure
-a blood vessel from another part of the body is grafted onto the occluded coronary artery below/ after the occlusion so that blood flow can bypass the block

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6
Q

what are high density lipoproteins (HDL)?

A

-higher proportion of protein
-a lipid that transports cholesterol to liver for secretion through the bile
-good protein
-benefits the arterial wall

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7
Q

what is ischemia?

A

insufficient tissue oxygenation/ obstructed blood flow

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8
Q

what are low density lipoproteins (LDL)?

A

-lower proportion of protein
-a lipid that transports cholesterol to the body tissue
-harmful to the arterial wall

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9
Q

what is metabolic syndrome?

A

a cluster of metabolic abnormalities that increase risk of cardiovascular disease
-insulin resistance
-obesity
-dyslipidemia/ hyperlipidemia
-hypertension

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10
Q

what is MI?

A

-heart tissue death
-lack of oxygenated blood flow

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11
Q

what is percutaneous coronary intervention (PCI)?

A

when a catheter is placed in the coronary artery to reduce blockage

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12
Q

what is percutaneous transluminal coronary angioplasty (PTCA)?

A

a balloon is inflated in the coronary artery to break an atheroma, open the vessel lumen + improve blood flow

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13
Q

what is a stent?

A

metal mesh that provides structural support to a coronary vessel to prevent collapse/ closure

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14
Q

what is sudden cardiac death?

A

abrupt cessation of effective heart/ cardiac activity

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15
Q

what do thrombolytics do?

A

they break down blood clots

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16
Q

what is the cardiac muscle biomarker, troponin?

A

an indicator of heart muscle injury

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17
Q

CAD is the disease of the heart due to decreased blood supply from the narrowing + obstruction from:

A

atherosclerosis

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18
Q

What are 6 of the modifiable risk factors of CAD?

A

-DM
-obesity
-smoking
-HTN
-high cholesterol
-physical inactivity

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19
Q

What are some things that put women, specifically, at risk of CAD? (4)

A

-anemia (during pregnancy)
-early menopause
-Endometriosis
-hormonal birth control

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20
Q

Lipitor is the brand name for AtorvaSTATIN - these drugs are used to lower cholesterol + reduce risk of MI, stroke etc. what are some side effects of -statin drugs?

LIPITOR

A

-Liver issues
-Increased blood sugar
-Pain in the muscles
-Impaired memory
-Tiredness/ fatigue
-Other (headaches)
-Rhabdomyolysis

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21
Q

What is PTCA and how does it restore blood supply to the heart with an obstructed artery?

A

Percutaneous Transluminal Coronary Angioplasty - a balloon tipped catheter is inserted into the artery and is inflated several times to reopen the artery

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22
Q

How would you describe Directional Coronary Atherectomy to unblock an artery to promote unblocked blood flow?

A

this procedure uses a rotating blade that is inserted into the artery, and it shaves down the plaque and removes it

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23
Q

Laser Ablation is another procedure used to restore blood flow from a blocked artery. It is a burst of laser radiation that ________ the plaque.

A

vaporizes

24
Q

What kind of diet should a patient with CAD be on? A diet LOW in _____.

A

fat

25
Q

What are 4 things that usually induce angina?

A

-stress
-extreme cold temperatures
-eating a heavy meal
-physical exertion

26
Q

Stable angina is predictable + consistent pain upon exertion that is relieved by _______ or ___________.

A

rest or nitroglycerin

27
Q

Unstable angina is characterized by symptoms increasing in ________ + _______. And it is NOT relieved by rest or nitroglycerin.

A

frequency and severity

28
Q

What kind of angina is defined as “severe, incapacitating chest pain?”

A

intractable or refractory angina

29
Q

What are the characteristics of Prinz metal’s Angina? (4)

A

-chest pain at rest
-reversable ST-segment elevation
-from coronary vasospasm
-seen in patients with a history w/ migraines + Raynaud’s Phenomenon

aka variant angina

30
Q

True or false?
Silent ischemia is the objective evidence of ischemia (i.e. ECG), but the patient has no reports of pain or other symptoms.

A

true

31
Q

Chronic stable angina is intermittent chest pain occurring for a long period of time with the same pattern of: (3)

A

-onset
-intensity
-duration

32
Q

Will chronic stable angina show ST-segment elevation or depression?

A

depression

33
Q

What 2 health issues is silent ischemia associated with?

A

DM + HTN

34
Q

Angina Decubitus is chest pain that occurs while _____ ____, that is relieved by sitting or standing up.

A

Lying down

34
Q

Nocturnal Angina is characterized by chest pain at ______, but you don’t necessarily have to be sleeping.

A

night

34
Q

what is something that may relieve Prinz Metal’s Angina?

A

Exercise

35
Q

ACS occurs when ischemia is prolonged and not immediately reversed. ACS includes what 3 cardiac problems?

A

-unstable angina
-NSTEMI
-STEMI

36
Q

MI is ischemia longer than 20 minutes, causing irreversible cell death aka _______.

A

necrosis of the myocardial tissue

37
Q

During an MI, your sympathetic nervous system is stimulated, this results in the:
-release of ______
-diaphoresis
-________ of peripheral blood vessels
-skin is ashen, cool + clammy

A

-glycogen
-vasoconstriction

38
Q

What are 6 clinical manifestations of an MI?

A

-increased HR + BP (but then BP decreases)
-Crackles
-JVD
-abnormal heart sounds
-N/V
-fever

39
Q

How long after an MI is the scar tissue still weak and vulnerable to stress?

A

10 -14 days.

by week 6 post MI, scar tissue should have fully replaced the necrotic tissue

40
Q

After an MI, what does the myocardium do to try and compensate for the infarcted muscle?

A

it will hypertrophy and dilate

enlarging to try and increase the number of cells

41
Q

True or false?
The most common complication of an MI are dysrhythmias.

A

true

42
Q

Cardiogenic shock is the failure of which ventricle? - which means tissues are not being supplied with adequate nutrients + oxygen.

A

The left

43
Q

Papillary muscles are located in the heart ventricles, after an MI they can dysfunction. What does this cause you to hear while listening to the mitral valve?

A

regurgitation

44
Q

A _________ aneurysm occurs after an MI from the infarcted myocardial wall becoming thin and bulging out during contraction?

A

ventricular

45
Q

Acute pericarditis is another complication associated with MI. It is the inflammation of the pericardium, it results in cardiac compression (cardiac tamponade). What will you hear on auscultation?

A

pericardial friction - a high pitched grating or creaking sound

46
Q

Dressler Syndrome is pericarditis with:
-effusion
-fever
-chest pain
-pericardial friction
-arthralgia

occurring how many weeks post MI?

A

4-6

46
Q

What are the cardiac markers looked at with an MI or unstable angina?

A

-troponin
-CK-MB
-myoglobin

47
Q

How is a coronary angiography used to examine the hearts blood vessels?

A

a catheter inserts dye into the artery and x-ray’s are taken to see how it moves through the heart

this shows how blood is moving through the heart

48
Q

What are the 2 emergent PCI procedures used to treat after the confirmation of an MI?

A

drug eluding stents and angioplasty

49
Q

Fibrinolytic therapy is another PCI used to treat MI, this is used to dissolve blood clots. What is the biggest risk/complication of using this method?

A

Bleeding

50
Q

If you have ACS, what are the 3 things that should be very low in your diet?

A

-saturated fat
-salt
-cholesterol

51
Q

What are 3 reasons a patient would need surgical intervention even after a PCI was performed?

A

-presence of LMCAD or 3 vessel CAD
-patient isn’t a candidate for PCI (lesions aren’t accessible)
-PCI failed + patient is still having chest pain

52
Q

What are 3 complications related to cardiopulmonary bypass?

A

-bleeding + anemia
-fluid + electrolyte imbalances
-hypothermia

MS4 ADRN.210 - rotation 2 (7 decks)

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