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29 Cards in this Set
- Front
- Back
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What is coronary artery disease?
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It is the build up of plaque in the artery. You could wait until 70% occlusion to get signs and symptoms.
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What is a typical sign of coronary artery disease?
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Angina - pain in the chest wall that radiates from left arm. It is a heavy pain.
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When does Angina occur?
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When blood flow does not match metabolic need of vessels. This occurs during physical activity.
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Why does angina occur during physical activity?
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The heart is working hard and the muscle cannot get enough profusion because of occluded vessels
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What are typical and atypical angina signs?
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Typical - pain in chest wall, pain goes down Left arm and sometimes up to jaw
Atypical signs - shortness of breath, ingestion, fatigue. |
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Who are prone to atypical angina signs?
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Women, elderly, people with diabetes
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T/F Heart attack is never the first sign of coronary artery disease.
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False
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How do you manage angina?
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You want to try to correct the imbalance between BF and metabolic need.
1. Nitrate Drugs are powerful vaso-dilators 2. Ca blocker promotes vasodilation by blocking contraction of smooth muscle 3. Beta Blockers - block smpathetics (which make heart work harder) so heart works less. Decreases metabolic need 4. Anti-platelet agents block platelets from sticking to plaque |
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What is an example of an anti-platelet agent?
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Aspirin
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What happens with myocardial infarction on cardiac output?
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MI leads to sudden acute effect of decrease in cardiac output
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What might result from a Myocardial Infarction?
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Syncopy or heart goes into fibrulation, decrease in arterial pressures, immediate response increases sympathetic nervous system -activity to vasoconstrict and venoconstrict increase heart rate and contractility, activation of renal body fluid mechanisms
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What happens on graph when stroke volume decreases rapidly?
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SNS causes sympathetic response that increases it. Renal responses to increase body fluid with ADH and RAAS.
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What is the problem when there is chronic elevation of SNS hormones, ADH, and RAAS?
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Toxic -> large weak re-modeled heart results. "Pathologic hypertrophy" Heart Failure
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What is heart failure?
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Pathophysiological state where heart cannot pump blood so it can no longer eject enough CO to meet metabolic needs
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When does heart failure occur?
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At elevated filling pressures -> heart gets bigger and weak
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What are causes of heart failure in the US?
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Result of CAD -> MI
Hypertension - chronic Cardiac myopathy |
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What is the difference between Systolic and Diastolic Heart Failure?
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Systolic heart failure has a decrease in contractility. Diastolic heart failure has decrease in compliance, so stiff that it cannot relax and fill
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What happens with Left sided heart failure?
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Right keeps pumping and blood backs up into atria causing a increase in atria pressure and a bulge. Blood packs up into pulmonary vasculature to pulmonary capillaries causing increase in hydrostatic pressure in lungs and edema in lungs. This leads to lung congestion and edema
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What happens with Right side heart failure?
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There is back up pressures in Right ventricle into Right atria and backup into systemic circulation. This leads to dependent edema usually in extremities
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What is the most common cause of Right Sided Heart Failure?
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Left Sided Heart Failure
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What are some treatment methods to the Right and Left Sided Heart Failure and edema caused by it?
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Beta Blocker - blocks chronic sympathetic effect of heart disease
ACE Inhibitor or Angiotensin Receptor Blockade blocks RAAS pathway Diuretics decrease fluid overload Cardiac Glycosides - digitalis and ionotropic |
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Of the four classes of heart failure 1,2, and 3 benefit from what?
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Aerobic exercise
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What is circulatory shock?
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Decreased profusion to tissues
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What is hypovolemic shock?
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Loss in blood volume.
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What is cardiogenic shock?
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Acute heart attach
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What is neurogenic shock?
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Block SNS leads to profound vasodilation
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What is septic shock?
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High state of metabolic need, cytokines storm causing overwhelming vasiodilation.
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What is a common cause of septic shock?.
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Perferating GI tract or tampons
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What is low resistance shock?
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It is a tremendous decrease in vascular tone
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