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84 Cards in this Set

  • Front
  • Back

_______coronary artery supplies blood to the SA and AV nodes

Right

Blockage in the right coronary artery more likely to cause_______

Arrhythmias

______coronary artery supplies blood to left ventricle

Left

Blockage of left coronary artery may impair pumping capability and cause_______

CHF Congestive Heart Failure

HEART DISORDER


Coronary Artery Disease CAD

-Arteriosclerosis and


-Angina Pectoris


-Myocardial Ifarction MI

HEART DISORDERS

-Coronary Artery Disease CAD


-Cardiac Arrhythmias


-Congestive Heart Failure CHF


-Congenital Heart Defects


-Inflammation and Infection

HEART DISORDERS


Inflammation and Infection

-Rheumatic Fever and Rheumatic Heart Disease

*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

*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

"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)

"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)

Major factor in atheroma formation_____

"bad" Cholesterol (LDL)

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

Modifiable Risk Factors of Athrosclerosis

*Obesity


*Smoking


*Sedentary lifestyle


*Hypertension & Diabetes that is not controlled


*Oral contraceptives combined with smoking

Diets high in cholesterol, especially LDL

Obesity

-Decreases HDL


-Increases LDL


-Promotes platelet adhesion, clot (thrombus) formation and vasoconstriction

Smoking

-Slow blood flow


-Exercise reduces blood pressure, stress, and increases HDL, Lowers LDL

Sedentary lifestyle

-Tendency to endothelial degeneration

Hypertension & Uncontrolled Diabetes

*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

Angina may occur in various patterns

-Classic angina


-Variant angina


-Unstable angina

This type of angina occurs upon exertion

Classic angina

This type of angina occurs at rest due to vasospasms

Variant angina

This is a more serious type of angina with prolonged pain at rest

Unstable angina

In most cases permanent damage does not result from angina, unless episodes are _______ and prolonged

Frequent

Etiology of Angina Pectoris

-Atherosclerosis, Arteriosclerosis and Vasospasm


-Myocardial hypertrophy, severe anemias, Tachycardia and respiratory disease


-May be precipitated by overexertion, cold weather, overeating

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

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

Primary cause of death in American men and women

Myocardial Infarction MI

After first ______ there is a greater risk for a second, CHF or stroke

MI

MI or a _______ occurs when there is prolonged ischemia to heart muscle (myocardium) which leads to cell death or "_______"

Heart attack


"infarction"

Most common cause of MI is ________ usually with thrombus

Atherosclerosis

Myocardial infartion develops in three ways

-Thrombus


-Vasospasm


-Embolism

May build up and obstruct artery

thrombus

occurs with partial occlusion by atheroma

vasospasm

Thrombus breaks away(_______) lodges elsewhere

embolism

Most infarctions are "________" (involve all three heart layers) and occur in left ventricle

transmural

____ and ___ of infarct determine severity

Size, location

At the point of obstruction tissue becomes necrotic and _____ and _____ develop

injury, inflammation

Warning signs of MI (may be intermittent)

*Pressure, heaviness, burning in chest


*shortness of breath (SOB), sweating, fatigue


*Nausea and indigestion


*Anxiety, fear

The sooner medical care is rendered for MI the ____ the outcome

better

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

In women MI pain is milder more like indigestion or _________

silent

Signs/symptoms MI

*pallor, sweating (diaphoresis), nausea, dizziness, dyspnea, marked anxiety and fear


*Hypotension, Weak/rapid pulse


*Low grade fever

High blood levels of _________ indicate a marked inflammatory response and more severe attack (MI)

C-reactive protein

Diagnostics MI

Blood gases, Blood pressure

CHF occurs when the heart is unable to pump blood in sufficient quantities to meet ______ needs

metabolic

CHF usually occurs as a complication _______ to another condition (usually chronic) such as infartion, valve defect, hypertension or lung disease

secondary

One side of heart usually fails first depending on cause of CHF


-________ in left ventricle or _______ effects left ventricle first

infarction, hypertension

One side of heart usually fails first depending on cause of CHF


-______ or ______ effects right ventricle first

pulmonary valve stenosis, pulmonary disease

Two effects of CHF

Backup effect, and forward effect

Backup effect


-______ develops behind the affected ventricle


*output is less than inflow of blood

Congestion



Backup effect


-_________ CHF's backup effect is pulmonary congestion (edema)

Left-sided

Backup effect


-_______ CHF's backup effect is congestion in systemic circulation (legs, feet, digestive organs)

Right-sided

______ disease is the leading cause of CHF

Coronary artery

Etiology of CHF

*Coronary artery disease


*Infarction (right or left)


*Valve defects (stenosis)


*Hypertension


*Congenital heart defects, pulmonary disease



Essential _______ causes an increase in diastolic pressure and an increase amount of work necessary for the left ventricle

hypertension

Right-sided CHF due to pulmonary disease is called ______

Cor pulmonale

Forward effects CHF-from either side are

*General hypoxia


*Fatigue, weakness


*Dizziness, Dyspnea


*SOB, Intolerance to cold and exercise

Compensatory CHF mechanisms

*Tachycardia, pallor


*Oliguria (decrease urine)

Backup effects CHF left-side

*Related to pulmonary congestion


-dyspnea, orthopnea


-cough, edema, hemoptysis


*Rapid, weak pulse, cool moist skin

Backup effects CHF right-side

*Systemic edema


*Hepatomegaly, Splenomegaly


*Ascites (fluid in peritoneum, abdominal distension)


*Flushed face, distended veins, HA, Visual disturbances

"silent killer"

Hypertension

Unknown cause HTN

Primary (essential)

HTN From renal or endocrine disease

Secondary

Severe and progresses rapidly HTN

Malignant

_______ exists where blood pressure is elevated

prehypertension

HTN may be classified as "____" of "____" due to which measure is elevated

systolic, diastolic

Essential hypertension develops with consistent pressure above

140/90

Diastolic pressure is important because it measures degree of resistance and work load on ________

left ventricle

HTN Usually an increase in arteriolar vasoconstriction and an increase in _________

peripheral resistance

-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

Signs/ Symptoms PVD

*Increased fatigue and weakness in legs as blood flow decreases


*Intermittent claudication


-leg pain associated with exercise due to muscle ischemia

Common in young women and is considered idiopathic

Raynaud's syndrome

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

Raynaud's vasospasm causes

-temporary ischemia, with pallor, numbness and cyanosis


-followed by vasodilation, redness and throbbing pain

Raynaud's episodes are triggered by exposure to:

Cold


Stress


Smoking

*Development of a thrombus in a vein


*Inflammation is present


*Platelets adhere to the inflamed site and a thrombus develops

Thrombophlebitis

*Thrombus forms spontaneously in a vein without prior inflammation


*Inflammation may develop secondarily in response to thrombosis


*Clot is less firmly attached

Phlebothrombosis

Results from a decreased circulating blood volume, leading to decreased tissue perfusion and general hypoxia

Shock (hypotension)

*loss of blood or plasma


*Hemorrhage, burns, dehydration, peritonitis, pancreatitis

Hypovolemic shock

*Decreased pumping capability


*MI of left ventricle, Cardiac arrhythmia, pulmonary embolus, cardiac tamponade

Cardiogenic shock

*Vasodilation due to loss of sympathetic and vasomotor tone


*Pain, fear, spinal cord injury, hypoglycemia (insulin shock)

Vasogenic shock (neurogenic)

*Systemic vasodilation and increased permeability due to severe allergic reaction


*Insect stings, drugs, nuts, shellfish

Anaphylactic shock

*Vasodialtion due to severe infection, often with gram-negative bacteria


*Virulent microorganisms (gram-negative bacteria) or Multiple infections

Septic (endotoxic) shock