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148 Cards in this Set

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refers to the loss of elasticity of the artery. Rubberband theory.
arteriosclerosis
refers to the accumulation of fatty deposits chiefly composed of cholesterol on the walls of the artery. Athere- fatty mush. Skerlos- hard
atherosclerosis
Loss of o2 to tissues
ischemia/hypoxia
this disease is the narrowing of the coronary arteries sufficiently to prevent adequate blood supply to the myocardium
Coronary artery disease
narrowing, which is usually a result of atherosclerosis, may progress to the point where the heart muscle is damaged due to ____blood supply
lack
Non-modifiable risks factors. Things we ____ change.
can't. age, gender, ethnicity, family
women don't develop CAD as early as men because ____ gives proteins to the heart
estrogen
Modifiable risk factors of CAD are things we ____ change. Risk factors include?
can.
hypertension, elevated serum lipids, obesity, tobacco use, physical inactivity
Name the the stats of hypertension?
120/80 normal
121-139/81-89 pre
140-159/90-99 hyper
>160/100 very hypertensive
the stress of constant elevated bp increases atherosclerosis. Because it damages _____ cells of the coronary arteries, which in turn causes hypertrophy of LV. If we catch this BP early can help decrease atherosclerosis
endothelial cells
Modifiable risk factors of CAD is things we ___ control
can.
hypertension, elevated serum lipids, obesity, tobacco use, physical inactivity
Elevated serum lipids is > ___ is bad. Fasting tyrglycerides is > ___is bad
200, 150
IN regards to CAD, obesity mortality rate is greater in obese with CAD BMI >___. Hypertension is more likely to develop 3x higher in obese. Individual who stores fat in ___. At a higher risk for cad.
30, abdomen
If you use tobacco, there is a 2-6x higher of devloping ____. Smoking has been linked to decreasing ___ levels in women. Estrogen protects the ____***… This puts premenpausal women at greater risk. The more you smoke the greater risk. Pipe and cigar still has increase. Nicotine releases _____and norepinephrine
CAD, women, heart, epinephrine
physical inactivity- lack of activity on regular basis. ___minutes at a time. is recommeneded. 5x a week. Physical active people increases ___. Collateral circulation increases with exercise
30, HDLs
Personality in regards to CAD. Type _ are anal and more prone to get CAD and type __ are more laid back
A, B
A complete lipid provile is suggested at the age of __ and to draw up every _ years
20, 5
Cholesterol lowering drug therapy. These drugs are the most widely used and studied lipid-lowering drugs.
Statin Durgs
i. mevacor (lovastatin)
ii. Lipitor (atovastatin)
iii. crestor (rosuvastatin)

Statin, cholesterol absorption inhibitor, bile acid sequestrants
statin
These meds inhibit the synthesis of cholesterol in the liver. This inhibition causes an increased in hepatic LDL receptors which allows the liver to remove more LDLs from the blood. A small increase in HDLs is also seen

Statin, cholesterol absorption inhibitor, bile acid sequestrants
statin
Drugs that increase lipoprotein removal

Statin, cholesterol absorption inhibitor, bile acid sequestrants
bile-acid sequestrants
i. Questran (cholestyramine)
ii. colestid (colestipol)

Statin, cholesterol absorption inhibitor, bile acid sequestrants
Bile-acid sequestrants
meds binds with bile acids in the intestine, forming insoluble complex and excreted in feces. Binding results in removal of LDL and cholesterol. Liver takes cholesterol into bile acids and then out thru poop. Can have some GI symptoms show up. This can lower LDls by as much as 20%. Effective and safe for Long term use. Side effects will eventually go away. This can interfere with Dig and Coumadin, vancomyacin, and thiazide diuretics.

Statin, cholesterol absorption inhibitor, bile acid sequestrants
bile-acid sequestrants
drugs that decrease cholesterol absorption

Zetia. Inhibits the absorption of dietary and biliary cholesterol across the intestinal wall. It is used as an adjunct to dietary changes. When combined with statin, even greater reducting in LDLs

Statin, cholesterol absorption inhibitor, bile acid sequestrants
Cholesterol absorption inhibitor
i. Garlic used for high cholesterol, triglycerides.
ii. omega-3 fatty acids used for ↑ triglycerides and CVD prevention
iii. Niacin- used for ↑ cholesterol
iv. Soy used for ↑ cholesterol.
v. Red yeast rice ↑ cholesterol
Info
Name the stages in orderof CAD:
Foam cell
fatty streak
atheroma
fibrous plaque
Complicated lesion/rupture
CAD stages. macrophages and smooth muscle cells, which have accumulated LDLs in them. Fat started to collect. 1st cells found at a fatty streak
Foam cell
Cad Stages. lipid filled muscle cells. Earliest leasion of atherosclerosis
Takes on yellow appearance. Have been observed at age 15
Fatty streak
CAD stages. fatty deposits. At this stage fat is being laid down.
atheroma
CAD stages.the fatty streak is covered with collagen. Collagen is laid down which makes more of a lesion... This is the most dangerous stage. As fibrous plaque is growing causes complication, platelets catch on here and further occlude the artery and form a thrombus.
Complicated lesion/rupture
when occlusion occurs in the coronary arteries, this type of circulation allows blood flow. Vessels grow to bypass this occlusion.. So the heart grows these vessels to prevent blood stoppage.
collateral circulation
This refers to chest pain that occurs intermittenlty over a long period with the same pattern of onset, duration, and intensity of symptoms.
Chronic stable angina
The 1st clinical signs of and MI is ____/chest pain
angina
In angina, pain is described as pressure or ache in the ___, constrictive, squeesing, heavy, choking suffocating sensation. Pain can raidate to neck, __, shoulders and arm
chest, jaw
In angina attacks, temperature can cause angina becase cold ____ the blood vessels. emotion can be a factor because of the ____ or ____ sympathetic nervous system. Consumption of heavy meals can ____ workload of heart because blood is shunted to the GI. Tobacco increases the work load of hte heart because ______ is released from the tobacco stimulants. Also cocain and methamphetamines increase the heart rate too.
cold, fight or flight, increase, epinephrine.
Name this type of angina:
occurs only at night but not necessarily when the person is in recumbent position of during sleep
nocturnal, decubitus, Prinzmetals
nocturnal
this type of angina occurs only while the person is lying down.
nocturnal, decubitus, Prinzmetals
decubitis
this angina often occurs at rest and may be result of a coronary artery spasm.

nocturnal, decubitus, Prinzmetals
prinzmetals
Chest pain that is new in onset occurs at rest or has a worsening pattern. It is unpredictable and represents an emergency
unstable angina
Drugs therapy for angina. This is a short acting nitrate.
Nitroglycerine
This is a long acting nitrate?

isordil, lopressor, calan
isordil
This drug therapy for angina decreases myocardial contractility, decreases heart rate and lowers BP.

inderal ( propanolol), lopressor (metoprolol), Corgard (nadolol), Ternormin (atenolol)
Beta blockers
This drug therapy for angina causes smooth muscle relaxation and vasodilatation of the coronary artersy by blocking the binding of calcium to its receptors.

Procardia (nifedipine), Calan (verapamil), Cardizem (diltiazem)
CCB
Guidelines for Nitrol, Keep pills in a ___ bottle, Remove the ____ from the bottle. The pills are good from _to _ months once the bottle is open. You know the stuff is good if it causes a ____ sensation.
colored. Cotton, 3-6. tingle sensation
Adverse affects of Nitro is it can cause a throbbing ___ but last no longer than 20 minutes. Can give tylenol to relieve pain. Try to put the ointment on a place that is free of ___. as a nurse always ___ placement of nitro patch, date, time and name
h/a, hair, switch
Left side cath goes through an ____.
artery
Right side cath goes through an ____
vein
This is when you put a catheter into a artery and it increases the size of the lumen. It is a balloon,
angioplasty
This is used to open up an coronary arter and it stays in place with in that artery.
Stent
Stents can cause a ____, which is bulid of plaque and stationary, when something breaks off it is called an ____
thrombus, Emboli
These are stents that slowly release medication to prevent overgrowth of tissue.
Drug eluding stents
Most serious complication of stents are ____ that can initiate an acute MI and a coronary spasm. can cause heart arrhythmias
emboli
This occurs as a result of sustained ischemia, causing irreversible myocardial cell death ( necrosis)
MI
cardiac cells can withstand ischemic conditions for approximately ___ minutes before cellular death begins
20
__ to __% of myocardial infarction are secondary to thrombus formation.
80 90
Almost all MI involves the __ venticle. Because it is the ___ important ventricle. The first tissue of the heart that becomes ichemic is the _____. It takes approximately _ to _ hours for the heart to become fully necrosed.
Left. Most. endocardium. 4-6
The infarctions are described by ___ of damage. The Doctor will classify the MI. Damage can occur in more than one locaiton
location
Myocardial infarctions usually occur in the ____.
morning
The first thing that happens in an MI is ___ is number 1. Then the sympathetic nervous system releases epi and noraepi to the body resulting in a ____, and the body ____ all the blood to the heart.
pain, vasoconstriction, shunts
Cardiovascular manifestations of an MI: Initially BP & HR is ___ because of the adrenaline released. The BP will eventually ___, crackles will be heard in the lungs because the ___ is being backed up causing _____ edema. This is because the blood is being backed up due to __ ___ not pumping out the blood. Soon this will back flow into the _ ____, and then the _ ____ cuasing _____ vein distention in the neck. Liver enlarment, and edema in the extremities.
elevated. drop, blood, pulmonary, left ventricle, right atrium, right venticle, juglar
Clinical manifestations of mi:
pain, sympathatetic nervous system stim, cardiovascular manifestations, N/V, fever
in an MI, temperature can increase the first 24 hours and get up to ___ degrees resulting from the inflammation of heart cells dying.
102
Healing process of MI: within leukocytes infiltrate the area. Enzymes are rleased form the dead cardiac cells and are important in diagnostic indicators of MI. Macrophages remove all necrotic tissues. There is accue tissue degeneration, The infarct is soft and necrotic. THE PT IS VERY PRONE TO DYSRHYTHMIAS.. which day?

Onset to 3rd day, 4 to 7th day, 8 to 10th day, 12 day, 3 to 4 weeks, 2 to 3 months.
ONSET TO 3RD DAY
Softening of the infarcted area is the greatest. Danger for aneurysm formation on the ventricle wall. Ventricular wall may balloon out during systole.
healing process of MI

Onset to 3rd day, 4 to 7th day, 8 to 10th day, 12 day, 3 to 4 weeks, 2 to 3 months.
4th to 7th day
Rupture of the ventricle will almost always lead to ____
Healing process of Mi
death
Newly formed capillaries develop around the infarct. It takes 2 to 3 weeks before ther is proper circulation
Healing process of MI

Onset to 3rd day, 4 to 7th day, 8 to 10th day, 12 day, 3 to 4 weeks, 2 to 3 months.
8th to 10th day
Collage fibers begin to form around this time. Collagen fibers are insoluble proteins that help in healing process
Healing process of MI.

Onset to 3rd day, 4 to 7th day, 8 to 10th day, 12 day, 3 to 4 weeks, 2 to 3 months.
12th day
The scar begins to gro firm
Healing process of Mi

Onset to 3rd day, 4 to 7th day, 8 to 10th day, 12 day, 3 to 4 weeks, 2 to 3 months.
3 to 4 weeks
Complications of MI: Dys____, heart failure, _____ shock, ____ muscle dysfunction
rhytmias, cardiogenic, papillary
This is a type of shock that decreased pumping ability of the left side of the heart to deliver o2 and nutrients to the body.
Cardiogenic
The muscles around the valves of the heart
Papillary
The function of the papillary muscle is so that blood doesn't seep ____
backwards
This is the blowing up of you vessels on the left side of your heart
ventricular aneurysm
this can develop with 2 to 3 days after Heart attack. Pain can change from breathing and not breathing. to diagnose 12lead ekg. Common complication. Inflammation of the outside of the heart.
Pericarditis
pericarditis that develops 4 to 6 weeks after a Heart attack. This is because the cells were dying this is an autoimmune response, not very common. It is a syndrome
dresslers syndrome
The p-wave indicates _____ contraction, QRS indicates ____ the T wave indicates _____, the U wave indicates.
atrial contraction, ventricular contraction, repolarization of the ventricle, U wave is repoloarization of the perkindje fibers
An early sign of an MI is when the ___ segement of ekg has a degree of increase. NOt all heart attacks have this.
ST
Diagnostic studies of the heart: angiogram, stress test, stress test with medicine, echocardiogram, doplar
info
In MI's it is exrtremly important to ___ quickly
diagnose
This is a therapy to disolve the clot quickly. Aimed at stopping hte MI, by opening the coronary artery. given with in 1st hour. Bleeding is a complication in this therapy.
fibrinolytic terhapy
Heart failure is divided into two subgroups: primary chronic causes: CAD, hypertension, Bacterial endocarditis. Acute: pumoanry emboli, myocarditis
info
the ___ heart failure is the most common. Meds that are good to decrease the heart workload and improves circulation is ____, diuretics, and vasodilators
dig
this is right sided heart failure an elargment of the right ventricle due to high blood prressure exerted by the lungs. You will see edema, acites, jugular veing distension, elarged liver
Cor Pulmonale
in edema < 5 mm
2+
in eema 5-10mm
3+4
in edema >10mm
4+
accumulation of fludin in the alveoli. Most common cause is of this is left sided heart failure
pulmonary edema
This is when the whole heart is not working properly. The heart is already damaged. Death rate is between 50 to 80% when it reaches this far.
Cardiogenic shock
This balloon pump coordinates with heart beat, this is a temporary means to keep blood flowing. Sometimes you can put the heart at rest.. The machine takes over.
Intraaortic balloon pump
Mechanical valves are ___ made, they are more ___ then biological valves but the trouble with these valves are the ____ risk of blood clots. Blood thinners are a must
man, durable, increase
Biological valve is from a cow called ___, and pig called ___
bovine, porcine
The biological doesn't last long compared to the mechanical because of ____
calcification
If you have a biological valve you won't need _____ ____
blood thinners
Prego women prefer___ valves, younger people prefer ___ valves
biological, mechanical
This is when you take a graft from the saphenous bein and put it in the heart
coronary artery bypass graft
Another graft they can use for the coronary artery bypass is this artery. 90% of the people who use this graft lasts 10 years
mammary
this is the dilatation of the arterial wall out pouching
aneurysm
Of true aortic aneurysms, ___ are in the abdominal area and __ is in the thoracic areay
abdominal, thoracic
Aortic aneurysms are usually deteced on a ____ physical examination
routine
If aneurysmms are ___ mmthe go in and take care of it
5.5
If an aneurysm ruptures __% mortality rate
94
T or F malignant tumors in he heart are rare?
true
The rare tumor that occurs is a metastatic tumor
True
Malignant tumors grow____, benign grow ___
faster, slower
Cancer of the heart
cardiac neoplasia
This is when the heart sac swells with fluid
periocarditis
Drawing fluid out of sac around the heart
pericardiocentesis
This is an artificial heart that uses air to help circulate blood. till a new heart arrives. just the atrial part of the heart remains.. This replaces the ventricles
cardiowest total
another artificial heart is called the
abiocor implantable replacement heart
The artificical hearts are called the___- driver and the ____ driver. The ___ driver is not yet improved for use in the use
blue, freedom
This device makes little channels where the coronary arteries feed on down to myocardium and the rengenertaions of vessels go into the myocardium
Transmyocardial laser revascularization
This is inflammation of the vein cuased by a blood clot. Usually find this in legs or arms they are tender warm to touch, painful is the s/s.. infection follows the vein affected, red,
superficial thrombophlebitis
This occurs many times in the leg, whereever there is a deep vein it clogged up by the valve of the vein. tenderness edema, mild to moderate pain, deep reddish color over the tissue
DVT
Risk factors for a DVT: Venous _____, ______damage, ______ of blood
stasis, Endothelial, hypercoagulability of blood
This is a risk factor for dvt:
advanced age, atrial fibrillation, chornic heart failure, orthopedic surgery, pregnancy, prolonged immobility, stroke, varicose veins

Venous stasis, endothelial damage, hypercoagulability of blood
venous stasis
This is a risk factor for dvt:
abdominal and and pelvic surgery, fractures of the pelvis, hip or leg, history of DVT, trauma.

Venous stasis, endothelial damage, hypercoagulability of blood
endothelial
This is a risk factor for dvt:
cigs, dehydration, oral contraceptives, postapartum period, prego, sepsis, malignancies.

Venous stasis, endothelial damage, hypercoagulability of blood
hypercoagulability
To help with a DVT: ___ irritant, use ___ hose, if these aren't present you can use an __ ___
remove, ted, ace wrap
The whole prupose of useing anticoagulant therapy is to to keep more clots from ____. Use blood thinners. The body ____ clots.
forming, dissolves
This is a little medical device that is in the inferior vena cave and it catches blood clots
greefield filter
This is incompetent veins/valves. Engorged torturous veins. Increases venous pressure because blood is not getting back to the heart. so this causes engorgement and may cause edema.
varicose veins
a ____ is stationary and an____ travels
thrombus. Embolus
Which thrombosis is this?
i extremity suddenly become white, cold and extremely painful
ii. numbness and tingling will be present
iii. cramping may be present
iv. eventually wil have a loss of sensation and inability to move the affected area
v. absence of pulse below the occlusion
Arterial
what type of thrombosis
i. may be asymptomatic if deep and very small vein
ii. edema
iii. warmth and tnedernes over the affected area
iv. can experience calf pai or dosiflexion (Postive homans sign)
v. pain may be relieved by elevation of the xtremity
vi. skin warm, red or reddish blue with severe edema, skin cool and cyanotic
vii. pulses normal or diminished
Venouns
a. results from inadequate or poor circulation in the legs
b. ulceration of the tissues of the legs most commonly is due to an indadequate arterial or venous blood supply to an extremity
c. this results in ischemia and ultimately necrosis of the tissues
leg ulcers
Two types of hypertension. this is idiopathic. cause is unknown in 90-95% of the cases
primary
Type of hypertension that is due to a known cause
secondary
Hypertension Target organ diseases occur most frequently in the, heart, ____, peripheral vasculature, _____, eyes
brain, kidney
Weight loss of 10 kg may decrease SBC by approx _ to__ mm hg.
5-20
Dietary sodium restriction in hypertension is < ___ g of soidum a day
2.4
In hypertension, men should not consum no more than _ drinks/ day and women _ drink/ day
2, 1
The most important goal of MIs is to ___ the quality of life and promote health
improve
An enzyme present in heart muscle, skeletal muscle and brain tissue
Creatine Kinase MB
______ levels rise after 4-6 hours after symptom onset, Peak 18-24 hours and return to baseline within 3 days after MI.
Ck-MB
This ia a myocardial muslce protein released into circulation after injury
cardiac-specific troponin
Normally there is ____ circulating troponin so rise in its level is diagnositc witing 1 hour of MI. peaks within 12 hours
no
A low-molecular heme protein found in cardiac and skeletal muscle. Elevation is a sensitive indicator of early myocardial injury
Myoglobin
Serum elevations levels occur with 30 to 60 minues afte injury but decline rapidly after 7 hours
myoglobin
< 6 cardiac marker testing
myo
ck-mb
troponin
6-36 hours
myo
ck-mb
trop 1
>36 hours
cardiac markers
ck mb, myoglobin, troponin
ck-mb
trop 1
These are proteins in the blood whose main purpose is to transport cholesterol, tryglycerides and other insoluble fats.
lipoproteins
These lipoprotiens are carriers of chlolesterol. There sole purpose is to remove cholesterol from the peripheral tissues and transport them to the liver for excretion. Goo Cholesterol within the blood
HDLs
We want this lipoprotein to be >60
HDL
This is the bad cholesterol
LDL
These markers carry cholestoral and deposit them into the peripheral tissue. The level of this marker should be <100
LDL
This lipid marker are the predominant carriers of blood triglycerides.
VDLS
The main component of LDL and HDLs is
cholesterol