Week 3: Coronary Artery Syndrome & Gerontology Flashcards
How is coronary ischemia pain typically described?
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- Pressure
- Squeezing
- Radiation (to L shoulder, down L arm, to neck & lower jaw)
How is the pain associated with an aortic disection typically described?
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TEARING
* may migrate to arms, abdomen, back, or legs
How is the pain associated with a pulmonary embolism typically described?
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Stabbing pain
- gripping
- moderate to severe
- radiiates to neck & shoulders
- may be asymptomatic
How is the pain associated with a pneumothorax typically described?
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Sudden onset of pain
- SEVERE chest pain
- lateral thorax radiating to ipsilateral shoulder
- sharp or tearing
How is the pain associated with pneumonia typically described?
Pain evolves with breathing
- burning or stabbing pain
- associated with a cough
Leads II, III, & AVF can show which type of MI?
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Inferior wall MI
Leads V2, V3, & V4 can show what type of MI?
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Anterior wall MI
What can new onset of S3 gallop / sound lead to?
KNOW THIS!!!
- Heart Failure
- Cardiogenic Shock
Nutritional intervention for a patient with a myocardial infarction (MI) includes which action?
a.) Remove all caffeine from the patient’s diet.
b.) Place the patient on a low-protein diet.
c.) Provide the patient with frequent small snacks.
d.) Ensure the patient’s meals are very hot.
c.) Provide the patient with frequent small snacks
small meals place less demands on circulatory system
Which conditions are responsible for older adult patients having a greater risk of drug toxicity? (Select all that apply)
a.) Polypharmacy.
b.) Decreased absorption rates in the GI tract.
c.) Decreased creatinine levels.
d.) Increased respiratoyr reserves.
e.) Increased potential for dehydration.
a.) Polypharmacy
e.) Increased potential for dehydration
- Taking multiple drugs increases the risk of toxicity & drug interactions
- Thirst mechanisms in older patients are impaired, leading to an increased potential for dehydration & drug toxicity
A patient presents with a thirty minute history of substernal chest pain that radiates to his left jaw. Which of the following EKG changes would you expect in this patient if his troponin level came back positive?
a.) QT prolongation
b.) PR shortening
c.) ST elevation
d.) PR widening
e.) ST depression
c.) ST elevation
Substernal chest pain with radiation to the jaw is a classic symptom / sign of mycardial infarction (MI)
List the non-modifiable risk factors associated with Acute Coronary Syndrome.
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- Age
- Heredity
- Race
- Sex
List the modifiable risk factors associated with Acute Coronary Syndrome.
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- Cigarette smoking
- High cholesterol (hypercholesterolemia)
- Hypertension
- Physical inactivity
- Obesity
- Diabetes mellitus
Which cardiac biomarker is the most specific? How long does it take for this biomarker to initially elevate?
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Troponin; takes 2-4 hours to elevate
- recheck troponin every 4 - 6 hours
Pneumonic for Assessing Pain
OPQRST
- Onset
- Provocation / Palliative / Precipitating
- Quality
- Region / Radiation / Referral
- Severity / Scale (0 - 10)
- Timing
What is stable angina?
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stable chest pain pattern relieved by rest or NGT
What is unstable angina?
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Increase in frequency or duration of chest pain
What is variant angina?
KNOW THIS!!!
Chest pain associated with coronary artery spasm
What is an acute myocardial infarction (MI)?
KNOW THIS!!!
Any chest pain exceeding 15 minutes & unrelieved by rest or NGT should be presumed as an infarction until proven otherwise.
Match the following symptoms with the description of coronary artery disease (CAD).
- Chest pain associated with coronary artery spasm.
- Stable chest pattern relieved by rest or NGT.
- Any chest pain exceeding 15 minutes & unrelieved by rest or NGT should be presumed as an infarciton until proven otherwise.
- Increase in frequency or duration of chest pain.
a.) Stable angina
b.) Unstable angina
c.) Variant angina
d.) Myocardial infarction (MI)
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a.) Stable angina = Stable chest pain pattern relieved by rest or NGT
b.) Unstable angina = Increase in frequency or duration of chest pain
c.) Variant angina = Chest pain associated with coronary artery spasm
d.) Myocardial infarction (MI) = Any chest pain exceeding 15 minutes & unrelieved by rest or NGT should be presumed as an infarction until proven otherwise
What is the difference in a Type 1 & Type 2 Myocardial Infarction?
Type 1: due to acute coronary obstruction (plaque)
Type 2: due to oxygen supply demand mismatch without acute coronary obstruction (issue with oxygen supply/demand; NO plaque)
What is Type 1 Myocardial Infarction?
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Due to coronary artery obstruction (plaque build up)
What is Type 2 Myocardial infarction?
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Due to oxygen supply/demand mismatch without acute coronary obstruction (issue with oxygen supply/demand; NO plaque)
What is Type 3 myocardial infarction?
KNOW THIS!!!
Sudden cardiac death due to ischemia which is detected by autopsy.
