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30 Cards in this Set

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angina pectoris
acute pain in chest upon physical/emotional exertion

caused by inadequate oxygen supply to myocardium
build-up of fatty, fibrous plaque in walls of arteries

elasticity of arterial walls diminished
cerebrovascular accident (CVA)
(a.k.a. stroke & brain attack)
acute condition of a blood clot or bleeding in a vessel in the brain
coronary arteries
vessels that bring oxygen and nutrients to the myocardium
coronary arterial bypass graft (CABG)
involves use of a surgically implanted vein graft to bypass obstructed area in coronary artery

uses a section of the saphenous vein or internal mammary artery
hemorrhagic stroke
caused by bleeding from a blood vessel in the brain

accounts for about 20% of strokes

S/S: blindness - paralysis - speech problems - coma - dementia
myocardial infarction
sudden blockage of coronary artery

primary cause is advanced coronary artery disease
myocardial ischemia
reduced blood supply to cardiac muscle cells
percutaneous transluminal coronary angioplasty (PTCA)
procedure for pts with arterial narrowing due to atherosclerosis

plaque is pressed against sides of artery wall using balloon catheter/laser
fatty, fibrous material that builds up on walls of arteries

accumulation may lead to hypertension, stroke, MI, or angina
reflex tachycardia
temporary increase in heart rate occuring when bp falls
stable angina
chest pain that is predictable in duration and frequency

pain occurs with physical exertion or emotional stress
thrombotic stroke
caused by blood clot blocking an artery in the brain
unstable angina
frequent/severe chest pain occuring while at rest
variant angina
chest pain caused by spasm of a coronary artery
The classic presenation of angina pectoris is sharp pain in the 1_____ region, often moving to the 2_____ side of the neck and lower jaw and down the left 3_____. Most often this pain is preceded by 4_____ 4_____ or 5_____ 5_____. With rest, anginal pain usually subsides in less than 6_____ minutes.
1 heart
2 left
3 arm
4 physical exertion
5 emotional excitement
6 15
Lifestyle changes that may lessen the frequency of angina episodes include . . .
- ceasing tobacco use
- limit sodium
- increase potassium & magnesium intake (banana, beans, spinach, & tomatoes)
- limit alcohol
- implement a medically supervised exercise plan
- reduce stress
- reduce dietary saturated fats
The two treatment goals for angina are . . .
1. reduce the frequency of angina episodes

2. terminate acute anginal pain in progress
AKA: Nitrostat - Nitro-Dur
CLASS: organic nitrates
ACTION: converts nitrate (NO2) to nitric oxide (NO)- dilates both arterial and venous blood vessels - reduces work required of heart & lowers myocardial oxygen demand
A/E: headache - reflex tachycardia
organic nitrates
AKA: Tenormin
CLASS: beta-adrenergic blocker
ACTION: selectively blocks beta1 receptors - reduces rate & force of cardiac contractions - slows heart rate (neg. chronotropic effect) - reduces contractility (neg inotropic effect)
A/E: fatigue - weakness - hypotension
beta-adrenergic blocker
AKA: Cardizem - Dilacor - Triazac
CLASS: calcium channel blocker
ACTION: inhibits transport of calcium ions into myocardial cells - dilates coronary arteries - decreases coronary artery spasm
A/E: headache - dizziness - edema (ankles/feet) - possible serious drug/drug interaction with digoxin or beta-adrenergic blockers
calcium channel blocker
AKA: Retavase
CLASS: thrombolytic
ACTION: dissolves blood clots by activating plasminogen - restores circulation to injured/occluded blood vessels
A/E: contraidicated in pts w/active bleeding

* most effective if given w/i 30 min but not later than 12 hrs after onset of MI s/s
AKA: Lopressor - Toprol
CLASS: beta-adrenergic blocker
ACTION: selective beta1 antagonist - reduces myocardial oxygen demand - following acute MI, is infused slowly until target heart rate reached (usually 60 - 90 bpm)
A/E: bradycardia - hypotension
beta-adrenergic blocker
Drug therapy of stable angina is usually begun with _____ _____.
organic nitrates
Long-acting nitrates are often delivered through a _____ _____ to decrease the frequency and severity of anginal episodes.
transdermal patch
Which of the following best explains the mechanism by which organic nitrates terminate acute anginal attacks?
a. direct vasodilation of coronary arteries
b. slowing heart rate
c. stronger force of myocardial contraction
d. dilation of peripheral veins, reducing preload
d. dilation of peripheral veins, reducing preload
The primary mechanism by which calcium channel blockers decrease the frequency of angina attacks is:
a. slowing conduction through the SA node
b. increasing the heart rate
c. increasing the strength of contraction of the myocardium
d. reducing cardiac workload
d. reducing cardiac workload
Captopril (Capoten) or lisinopril (Prinivil) are sometimes given to MI pts to:
a. restore blood supply to the damaged myocardium
b. increase myocardial oxygen demand
c. reduce post-MI mortality
d. reduce acute pain associated with MI
c. reduce post-MI mortality
Calcium channel blockers are only effective against _____ dysrhythmias.
A blockade of sodium channels in myocardial cells will:
a. slow the spread of impulse conduction
b. speed up the spread of impulse conduction
c. stop the spread of impulse conduction
d. worsen a dysrhythmia
a. slow the spread of impuls conduction