week 1 - cardiac + HTN Flashcards
What is Acute Coronary Syndrome (ACS)?
-prolonged ischemia that is not immediately reversed, which includes:
~NSTEMI
~STEMI
~unstable angina
angina pectoris is chest pain due to what?
myocardial ischemia
what is atheroma AKA plaque?
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
atherosclerosis is the most common cause of CVD, what is it?
abnormal accumulation of lipid deposits + fibrous tissue in arterial walls + lumen
what is a coronary artery bypass graft (CABG)?
-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
what are high density lipoproteins (HDL)?
-higher proportion of protein
-a lipid that transports cholesterol to liver for secretion through the bile
-good protein
-benefits the arterial wall
what is ischemia?
insufficient tissue oxygenation/ obstructed blood flow
what are low density lipoproteins (LDL)?
-lower proportion of protein
-a lipid that transports cholesterol to the body tissue
-harmful to the arterial wall
what is metabolic syndrome?
a cluster of metabolic abnormalities that increase risk of cardiovascular disease
-insulin resistance
-obesity
-dyslipidemia/ hyperlipidemia
-hypertension
what is MI?
-heart tissue death
-lack of oxygenated blood flow
what is percutaneous coronary intervention (PCI)?
when a catheter is placed in the coronary artery to reduce blockage
what is percutaneous transluminal coronary angioplasty (PTCA)?
a balloon is inflated in the coronary artery to break an atheroma, open the vessel lumen + improve blood flow
what is a stent?
metal mesh that provides structural support to a coronary vessel to prevent collapse/ closure
what is sudden cardiac death?
abrupt cessation of effective heart/ cardiac activity
what do thrombolytics do?
they break down blood clots
what is the cardiac muscle biomarker, troponin?
an indicator of heart muscle injury
CAD is the disease of the heart due to decreased blood supply from the narrowing + obstruction from:
atherosclerosis
What are 6 of the modifiable risk factors of CAD?
-DM
-obesity
-smoking
-HTN
-high cholesterol
-physical inactivity
What are some things that put women, specifically, at risk of CAD? (4)
-anemia (during pregnancy)
-early menopause
-Endometriosis
-hormonal birth control
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
-Liver issues
-Increased blood sugar
-Pain in the muscles
-Impaired memory
-Tiredness/ fatigue
-Other (headaches)
-Rhabdomyolysis
What is PTCA and how does it restore blood supply to the heart with an obstructed artery?
Percutaneous Transluminal Coronary Angioplasty - a balloon tipped catheter is inserted into the artery and is inflated several times to reopen the artery
How would you describe Directional Coronary Atherectomy to unblock an artery to promote unblocked blood flow?
this procedure uses a rotating blade that is inserted into the artery, and it shaves down the plaque and removes it
Laser Ablation is another procedure used to restore blood flow from a blocked artery. It is a burst of laser radiation that ________ the plaque.
vaporizes
What kind of diet should a patient with CAD be on? A diet LOW in _____.
fat
What are 4 things that usually induce angina?
-stress
-extreme cold temperatures
-eating a heavy meal
-physical exertion
Stable angina is predictable + consistent pain upon exertion that is relieved by _______ or ___________.
rest or nitroglycerin
Unstable angina is characterized by symptoms increasing in ________ + _______. And it is NOT relieved by rest or nitroglycerin.
frequency and severity
What kind of angina is defined as “severe, incapacitating chest pain?”
intractable or refractory angina
What are the characteristics of Prinz metal’s Angina? (4)
-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
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.
true
Chronic stable angina is intermittent chest pain occurring for a long period of time with the same pattern of: (3)
-onset
-intensity
-duration
Will chronic stable angina show ST-segment elevation or depression?
depression
What 2 health issues is silent ischemia associated with?
DM + HTN
Angina Decubitus is chest pain that occurs while _____ ____, that is relieved by sitting or standing up.
Lying down
Nocturnal Angina is characterized by chest pain at ______, but you don’t necessarily have to be sleeping.
night
what is something that may relieve Prinz Metal’s Angina?
Exercise
ACS occurs when ischemia is prolonged and not immediately reversed. ACS includes what 3 cardiac problems?
-unstable angina
-NSTEMI
-STEMI
MI is ischemia longer than 20 minutes, causing irreversible cell death aka _______.
necrosis of the myocardial tissue
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
-glycogen
-vasoconstriction
What are 6 clinical manifestations of an MI?
-increased HR + BP (but then BP decreases)
-Crackles
-JVD
-abnormal heart sounds
-N/V
-fever
How long after an MI is the scar tissue still weak and vulnerable to stress?
10 -14 days.
by week 6 post MI, scar tissue should have fully replaced the necrotic tissue
After an MI, what does the myocardium do to try and compensate for the infarcted muscle?
it will hypertrophy and dilate
enlarging to try and increase the number of cells
True or false?
The most common complication of an MI are dysrhythmias.
true
Cardiogenic shock is the failure of which ventricle? - which means tissues are not being supplied with adequate nutrients + oxygen.
The left
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?
regurgitation
A _________ aneurysm occurs after an MI from the infarcted myocardial wall becoming thin and bulging out during contraction?
ventricular
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?
pericardial friction - a high pitched grating or creaking sound
Dressler Syndrome is pericarditis with:
-effusion
-fever
-chest pain
-pericardial friction
-arthralgia
occurring how many weeks post MI?
4-6
What are the cardiac markers looked at with an MI or unstable angina?
-troponin
-CK-MB
-myoglobin
How is a coronary angiography used to examine the hearts blood vessels?
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
What are the 2 emergent PCI procedures used to treat after the confirmation of an MI?
drug eluding stents and angioplasty
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?
Bleeding
If you have ACS, what are the 3 things that should be very low in your diet?
-saturated fat
-salt
-cholesterol
What are 3 reasons a patient would need surgical intervention even after a PCI was performed?
-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
What are 3 complications related to cardiopulmonary bypass?
-bleeding + anemia
-fluid + electrolyte imbalances
-hypothermia
