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28 Cards in this Set
- Front
- Back
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Coronary Artery Disease |
occurs with artheroscleorisis where fatty plaque deposits from in the arterial walls - not a specific disease but a syndrome |
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Myocardial Infarction |
Occurs with blood flow through the coronary arteries to the myocardium is completely blocked - irritating one side of the heart leading to stretching, overworking the heart |
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Ischemia |
A blockage in any of the coronary arteries that leads to an area of the heart dying and becoming necrotic |
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Traditional risk factors for Coronary Heart Disease |
Unmodifiable - age, gender, ethnicity, race Modifiable - lifestyle choices |
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Non-traditional risk factors for Coronary Heart Disease |
C-reactive protein - means that you are at risk for developing blood clots (von Willebrand factor concentration) Hypehomocysteinemia - genetic disorder with a lack of enzyme that breaks down homocysteine (high levels of homocysteine leads to heart attack) |
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Artherosclerosis |
considered to be an endothelial injury - fatty streak - fibrous plaque builds up and narrows the lumen of vessels - Thrombus formation that breaks apart and causes ischemia/infarction |
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Types of Angina (3) |
1. Stable Angina 2. Unstable Angina 3. Prinzmetal Angina |
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Stable Angina |
Occurs by physical exertion or stress - Subsides after 15 minutes - Chronic - Commonly intense and commonly in men - Blood goes to the STOMACH and not the HEART |
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Unstable Angina |
Considered to be early stage of progressive CAD - pain increases in severity and frequency - may occur even when patient is at rest - aka crescendo angina |
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Prinzmetal Angina |
- aka vasospatic angina - smooth muscle spazzes out in the artherosclerotic coronary arteries - occurs at rest and without a cause - usually occurs at the same time of day (routine) |
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Which drugs are good for prinzmetal angina? (vasospatic angina) |
Calcium channel blockers!
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Acute Coronary Syndrome (ACS) |
sudden obstruction of coronary blood flow O2 demands > O2 supply |
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What are women symptoms? |
Women have back pain, flu-like symptoms, vomiting, shortness of breath |
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What are men symptoms? |
Men have chest pain, angina, flu-like symptoms, vomiting, shortness of breath |
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Why is time so important for myocardial infarctions? |
Once the blood is blocked in the heart for longer than 20 minutes, the effects (cellular death and tissue necrosis) are irreversible - TIME IS MUSCLE |
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What are the results of myocardial infarctions? |
Scar tissue forms, loss of contractibility, changes in cardiac pressure and volume - dysrhythmias and congestive heart failure |
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What drugs do you use for angina? |
1. Nitrates and Nitrites 2. Calcium Channel Blockers 3. Beta blockers |
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Nitrates/Nitrites |
Relaxes smooth muscle/dilates coronary arteries - brings O2 to heart by dilating arteries - affects PRELOAD by reducing venous return - used for prevention of angina |
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Types of nitrates/nitrites |
Sublingual, tablets, capsules, IV solutions, transdermal patches, ointments, translingual sprays - includes rapid-acting and long-lasting |
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Rapid-acting forms of nitrites/nitrates |
are used for acute angina
- sublingual tablets, IVs |
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Long-acting forms |
used for PREVENTING anginal episodes |
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Nitroglycerin |
In oral form, they bypass the first-pass effect - for symptomatic treatments - IV for BP control, treatment of CHF, ischemic pain, pulmonary edema |
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Adverse affects for Nitrates/Nitrites |
headaches (most common) - reflex tachycardia (rebound tachycardia) - postural hypotension - Tolerance may develop |
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Patients should report.. |
Blurred vision, persistent headaches, dry mouth, edema, fainting episodes, weight gain, dyspnea |
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Instruct your patients to avoid... |
- Alcohol - Changing positions too quickly - Hot baths/whirlpools |
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Why shouldn't you expose Nitrates to light? |
Chemical changes in the medication! |
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What to teach patients using Beta Blockers? |
Monitor for pulse less than 60 beats. - Do not stop medications quickly. - Long-term prevention |
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What to teach patients using Calcium Channel Blockers? |
Constipation is a common problem! - Tell them to eat high in fiber foods |
