Atherosclerosis

Question 1

What is atherosclerosis?

Answer 1

Build up and deposition of fatty plaques in the vessel’s inner walls.

Question 2

Name 3 variations of Atherosclerotic disease that affect differing areas of the body?

Answer 2

Coronary Disease, Cerebrovascular Disease, Peripheral Arterial Disease

Question 3

What is the number one cause of death worldwide?

Answer 3

Heart disease

Question 4

Name some cardiovascular risk factors

Answer 4

Cigarette Smoking
Abnormal Lipid Levels
Hypertension
Diabetes
Obesity
Stress

Question 5

Name some cardioprotective factors

Answer 5

Fruit/Veggies
Exercise
Moderate Alchohol (Red Wine)

Question 6

Physical measures of cardiovascular risk factors include 5 measures..

Answer 6

BMI, waist circum, BP, HR, Blood Test (Lipid Levels)

Question 7

What contributes MOST to acute myocardial infarction?

Answer 7

Abnormal Lipid levels and smoking

Question 8

What is the major difference between NSTEMI and STEMI

Answer 8

STEMI has full occlusion of an artery, while NSTEMI is a partial occlusion of an artery

Question 9

Is artherosclerosis an acute or progressive disease?

What are the consequences of having it?

Answer 9

Progressive

Narrow diameter of vessel
Blockage
Stiffness (not as reactive)

Question 10

Name 3 layers of the arterial walls ( Outside to inside order)

Answer 10

Tunica adventitia (collagen) –> Tunica Media (Smooth Muscle) –> Tunica Intima (Endothelium lining lumen)

Question 11

Initial process of artherosclerosis has excess levels of what penetrate blood vessels, becoming trapped?

Answer 11

LDL

Question 12

As LDL is trapped, what happens to it?

Answer 12

It oxidizes, releasing anions

Question 13

Macrophages consume oxidized LDL, creating what kind of cell?

Answer 13

Foam Cell. Indicator of high cholesterol levels

Question 14

Macrophages were previously what type of cell before chemical and adhesion factors attracted them?

Answer 14

Monocytes

Question 15

Foam cells hold primarily what?

Answer 15

Free cholesterol

Question 16

What does the smooth muscle do to foam cells and lipids?

Answer 16

Engulfs it, creating a fibrofatty atheroma in the vessel

Question 17

What is the difference between a stable plaque and an unstable plaque?

Answer 17

Stable plaque has a thick cap and smaller fatty core. Is the primary cause of hardened and narrowed arteries.

Unstable plaque has thin cap with LARGE fat core, more likely to rupture –> heart attack or stroke possibility

Question 18

When does myocardial perfusion occur?

Answer 18

During muscle relaxation (diastole)

Question 19

What is ischemia?

Answer 19

Imbalance of supply and demand of O2

Question 20

What results from increased myocardial demand?

Answer 20

Increase HR, Increased Contractile state, Increased systolic tension (HTN, Cold)

Question 21

What are some gender specific symptoms of chest pain in males?

Answer 21

Crushing Pain, Elephant on Chest feeling, Nausea, Left arm pain, Jaw pain

Question 22

What are some gender specific symptoms of chest pains in women?

Answer 22

Nausea/Vomiting, Fatigue, Anxiety, mid back tightness and discomfort

Question 23

Stable angina is what?

Answer 23

Chest pain associated with increase in physical activity, relieved by rest.

Substernal chest pain radiating to elbow.

Crushing pain, or pressure feeling.
PREDICTABLE!

Question 24

Define Rate Pressure Product

Answer 24

Myocardial oxygen consumption (O2 demand of heart)

Question 25

What is the formula for Rate Pressure Product (RPP)?

Answer 25

HR x SBP EX: 70 x 100 = 7000 RPP

Question 26

Unstable Angina occurs when?

Answer 26

Randomly, without pattern. @ rest @ lower level of exercise than usual @ varying patterns of activity Blood pressure decreases with same amount of activity

Question 27

What can happen to tissues if the supply of O2 does not meet the O2 demands?

Answer 27

Death of myocardial tissue

Question 28

What is myocardial infarction and what does it result in?

Answer 28

Heart attack from prolonged period of ischemia, death of myocardial tissues

Question 29

What are 2 common EKG changes during an MI?

Answer 29

ST elevation, and Q wave abnormality

Question 30

When does an ST elevation occur?

Answer 30

During full occlusion of an artery in an instance of an acute MI. AN INJURY (EX: HEART ATTACK)

Question 31

When does ST depression occur?

Answer 31

Due to ischemia

Question 32

Q wave abnormality results from what?

Answer 32

Absence of electrical forces, an indicator of an MI or history of

Question 33

Exercise testing for diagnosing CAD evaluates what?

Answer 33

HR/BP EKG Limiting symptoms and signs Gas exchange or ventilatory response (VO2Max)

Question 34

What is an indicator of myocardial ischemia?

Answer 34

ST depression

Question 35

What is an indicator of an MI?

Answer 35

ST elevation with Q wave abnormality

Question 36

What drop in blood pressure is indicative of exertional hypotension?

Answer 36

SBP drop of 10 mmhg

Question 37

What happens in PCI (percutaneous coronary intervention)?

Answer 37

aka angioplasty, where a stent is placed in the affected artery and a balloon is then expanded. The plaque is then compressed and widened.

Question 38

Another common procedure other than PCI for occluded arteries is what?

Answer 38

A CABG (coronary artery bypass graft) uses the saphenous vein.

Question 39

An oral medication often used for angina , or CAD is what?

Answer 39

Nitroglycerin

Question 40

Name 2 red flags as a PT for CAD/ischemia?

Answer 40

Angina, Nitroglycerin usage

Question 41

Does chest pain need to be evaluated before physical therapy starts?

Answer 41

Duh.

Question 42

What is peripheral artery disease?

Answer 42

Decreased blood flow to legs

Question 43

What is a common symptom of PAD?

Answer 43

claudication pain (cramping angina in legs)

Question 44

PAD does not increase risk of MI and stroke (TRUE OR FALSE)

Answer 44

False

Question 45

PAD is increased by smoking and diabetes? ( Yes or no)

Answer 45

Yes. These are MAIN RISK FACTORS

Question 46

What is the Ankle Brachial Index?

Answer 46

Checks risk for PAD, using brachial artery and the highest BP of either dorsalis pedis or posterior tibial artery A low ABI indicates narrowing of the arteries in the legs. ABI > 0.90 is normal Formula is ankle systolic/arm systolic

Question 47

Main 2 risk factors for PAD?

Answer 47

Smoking and diabetes

Question 48

What are signs of intermittent claudication?

Answer 48

Achy, cramping legs Pain during exercise Decreases pain in rest Onset of pain is PREDICTABLE

Question 49

Patient needs to be in what position to compare blood pressure in legs/arms?

Answer 49

Supine