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84 Cards in this Set
- Front
- Back
_______coronary artery supplies blood to the SA and AV nodes |
Right |
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Blockage in the right coronary artery more likely to cause_______ |
Arrhythmias |
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______coronary artery supplies blood to left ventricle |
Left |
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Blockage of left coronary artery may impair pumping capability and cause_______ |
CHF Congestive Heart Failure |
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HEART DISORDER Coronary Artery Disease CAD |
-Arteriosclerosis and -Angina Pectoris -Myocardial Ifarction MI |
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HEART DISORDERS |
-Coronary Artery Disease CAD -Cardiac Arrhythmias -Congestive Heart Failure CHF -Congenital Heart Defects -Inflammation and Infection |
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HEART DISORDERS Inflammation and Infection |
-Rheumatic Fever and Rheumatic Heart Disease |
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*General term for all types of degenerative arterial changes *Usually in terms of degenerative changes in small arteries and arterioles *Elasticity is lost, walls become thick and hard, lumen narrows, becomes occluded *Insufficient O2 ensues and leads to Ischemia, necrosis in brain, kidneys, heart and other tissues |
CORONARY ARTERY DISEASE CAD -Arteriosclerosis |
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*Different in that "atheromas" or plaques are formed *Plaques consist of lipids, cells, fibrin and cell debris *They often include attached "thrombi" on the vessel walls *They form primarily in large arteries |
CORONARY ARTERY DISEASE CAD -Athrosclerosis |
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"bad" cholesterol -High cholesterol content -transports cholesterol from the liver to the cells -binds to receptors on cell membranes (smooth muscle) and enters cell |
LDL low density lipids (Atherosclerosis) |
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"good" cholesterol -Has a lower cholesterol content -Transports cholesterol away from cells to liver where it is catabolized and excreted |
HDL high density lipids (Atherosclerosis) |
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Major factor in atheroma formation_____ |
"bad" Cholesterol (LDL) |
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Non-Modifiable Risk Factors of Athrosclerosis |
*Age (after 40) *Gender (more in men) -Women have higher HDL levels until after menopause when estrogen levels decrease *Genetic factors |
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Modifiable Risk Factors of Athrosclerosis |
*Obesity *Smoking *Sedentary lifestyle *Hypertension & Diabetes that is not controlled *Oral contraceptives combined with smoking |
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Diets high in cholesterol, especially LDL |
Obesity |
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-Decreases HDL -Increases LDL -Promotes platelet adhesion, clot (thrombus) formation and vasoconstriction |
Smoking |
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-Slow blood flow -Exercise reduces blood pressure, stress, and increases HDL, Lowers LDL |
Sedentary lifestyle |
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-Tendency to endothelial degeneration |
Hypertension & Uncontrolled Diabetes |
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*chest pain -occurs due to lack of oxygen in heart muscle, usually when demand is sudden *Can be due to impairment, exertion or a combination *Heart usually adapts to oxygen need by vasodilation (autoregulation) of coronary arteries *If there is arterial damage (atherosclerosis, vasospasm) blood supply is decreased |
Angina Pectoris - CAD |
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Angina may occur in various patterns |
-Classic angina -Variant angina -Unstable angina |
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This type of angina occurs upon exertion |
Classic angina |
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This type of angina occurs at rest due to vasospasms |
Variant angina |
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This is a more serious type of angina with prolonged pain at rest |
Unstable angina |
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In most cases permanent damage does not result from angina, unless episodes are _______ and prolonged |
Frequent |
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Etiology of Angina Pectoris |
-Atherosclerosis, Arteriosclerosis and Vasospasm -Myocardial hypertrophy, severe anemias, Tachycardia and respiratory disease -May be precipitated by overexertion, cold weather, overeating |
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Signs/Symptoms Angina Pectoris |
-Recurrent, intermittent episodes of substernal chest pain lasting seconds to minutes -Usually triggered by exertion, stress -Pain described as "tightness or pressure" which may radiate to neck and left arm -Pallor, diaphoresis, nausea -Attacks vary in severity, can last seconds to minutes |
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Treatment Angina Pectoris |
-Rest, stop activity, sit upright, check pulse/respiration -Nitroglycerine (vasodilator) sublingual (if patient is known to have angina) -Give second dose if pain lasts more than 5 min -911 if no relief after three doses in ten minutes * without a history of angina call after 2 min -Give oxygen if available -Avoid precipitating factors |
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Primary cause of death in American men and women |
Myocardial Infarction MI |
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After first ______ there is a greater risk for a second, CHF or stroke |
MI |
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MI or a _______ occurs when there is prolonged ischemia to heart muscle (myocardium) which leads to cell death or "_______" |
Heart attack "infarction" |
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Most common cause of MI is ________ usually with thrombus |
Atherosclerosis |
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Myocardial infartion develops in three ways |
-Thrombus -Vasospasm -Embolism |
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May build up and obstruct artery |
thrombus |
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occurs with partial occlusion by atheroma |
vasospasm |
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Thrombus breaks away(_______) lodges elsewhere |
embolism |
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Most infarctions are "________" (involve all three heart layers) and occur in left ventricle |
transmural |
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____ and ___ of infarct determine severity |
Size, location |
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At the point of obstruction tissue becomes necrotic and _____ and _____ develop |
injury, inflammation |
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Warning signs of MI (may be intermittent) |
*Pressure, heaviness, burning in chest *shortness of breath (SOB), sweating, fatigue *Nausea and indigestion *Anxiety, fear |
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The sooner medical care is rendered for MI the ____ the outcome |
better |
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Sudden substernal pain radiating to left arm and neck that is severe, ____________ with no relief upon rest or vasodilators (nitro) MI signs/symptoms |
steady and crushing |
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In women MI pain is milder more like indigestion or _________ |
silent |
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Signs/symptoms MI |
*pallor, sweating (diaphoresis), nausea, dizziness, dyspnea, marked anxiety and fear *Hypotension, Weak/rapid pulse *Low grade fever |
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High blood levels of _________ indicate a marked inflammatory response and more severe attack (MI) |
C-reactive protein |
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Diagnostics MI |
Blood gases, Blood pressure |
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CHF occurs when the heart is unable to pump blood in sufficient quantities to meet ______ needs |
metabolic |
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CHF usually occurs as a complication _______ to another condition (usually chronic) such as infartion, valve defect, hypertension or lung disease |
secondary |
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One side of heart usually fails first depending on cause of CHF -________ in left ventricle or _______ effects left ventricle first |
infarction, hypertension |
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One side of heart usually fails first depending on cause of CHF -______ or ______ effects right ventricle first |
pulmonary valve stenosis, pulmonary disease |
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Two effects of CHF |
Backup effect, and forward effect |
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Backup effect -______ develops behind the affected ventricle *output is less than inflow of blood |
Congestion |
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Backup effect -_________ CHF's backup effect is pulmonary congestion (edema) |
Left-sided |
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Backup effect -_______ CHF's backup effect is congestion in systemic circulation (legs, feet, digestive organs) |
Right-sided |
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______ disease is the leading cause of CHF |
Coronary artery |
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Etiology of CHF |
*Coronary artery disease *Infarction (right or left) *Valve defects (stenosis) *Hypertension *Congenital heart defects, pulmonary disease |
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Essential _______ causes an increase in diastolic pressure and an increase amount of work necessary for the left ventricle |
hypertension |
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Right-sided CHF due to pulmonary disease is called ______ |
Cor pulmonale |
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Forward effects CHF-from either side are |
*General hypoxia *Fatigue, weakness *Dizziness, Dyspnea *SOB, Intolerance to cold and exercise |
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Compensatory CHF mechanisms |
*Tachycardia, pallor *Oliguria (decrease urine) |
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Backup effects CHF left-side |
*Related to pulmonary congestion -dyspnea, orthopnea -cough, edema, hemoptysis *Rapid, weak pulse, cool moist skin |
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Backup effects CHF right-side |
*Systemic edema *Hepatomegaly, Splenomegaly *Ascites (fluid in peritoneum, abdominal distension) *Flushed face, distended veins, HA, Visual disturbances |
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"silent killer" |
Hypertension |
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Unknown cause HTN |
Primary (essential) |
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HTN From renal or endocrine disease |
Secondary |
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Severe and progresses rapidly HTN |
Malignant |
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_______ exists where blood pressure is elevated |
prehypertension |
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HTN may be classified as "____" of "____" due to which measure is elevated |
systolic, diastolic |
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Essential hypertension develops with consistent pressure above |
140/90 |
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Diastolic pressure is important because it measures degree of resistance and work load on ________ |
left ventricle |
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HTN Usually an increase in arteriolar vasoconstriction and an increase in _________ |
peripheral resistance |
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-Abnormality in the arteries or veins outside the heart -Most common sites of atheromas in peripheral circulation -abdominal aorta -femoral and iliac arteries |
Peripheral vascular disease PVD |
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Signs/ Symptoms PVD |
*Increased fatigue and weakness in legs as blood flow decreases *Intermittent claudication -leg pain associated with exercise due to muscle ischemia |
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Common in young women and is considered idiopathic |
Raynaud's syndrome |
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Vasopastic condition, in which periodic temporary but severe vasoconstriction occurs in the arterioles and small arteries in the superficial tissues of the fingers or toes |
Raynaud's syndrome |
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Raynaud's vasospasm causes |
-temporary ischemia, with pallor, numbness and cyanosis -followed by vasodilation, redness and throbbing pain |
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Raynaud's episodes are triggered by exposure to: |
Cold Stress Smoking |
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*Development of a thrombus in a vein *Inflammation is present *Platelets adhere to the inflamed site and a thrombus develops |
Thrombophlebitis |
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*Thrombus forms spontaneously in a vein without prior inflammation *Inflammation may develop secondarily in response to thrombosis *Clot is less firmly attached |
Phlebothrombosis |
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Results from a decreased circulating blood volume, leading to decreased tissue perfusion and general hypoxia |
Shock (hypotension) |
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*loss of blood or plasma *Hemorrhage, burns, dehydration, peritonitis, pancreatitis |
Hypovolemic shock |
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*Decreased pumping capability *MI of left ventricle, Cardiac arrhythmia, pulmonary embolus, cardiac tamponade |
Cardiogenic shock |
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*Vasodilation due to loss of sympathetic and vasomotor tone *Pain, fear, spinal cord injury, hypoglycemia (insulin shock) |
Vasogenic shock (neurogenic) |
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*Systemic vasodilation and increased permeability due to severe allergic reaction *Insect stings, drugs, nuts, shellfish |
Anaphylactic shock |
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*Vasodialtion due to severe infection, often with gram-negative bacteria *Virulent microorganisms (gram-negative bacteria) or Multiple infections |
Septic (endotoxic) shock |