- develops quickly, causes organ damage, very hard to control even with meds - most often seen in middle aged black men - involves target organ damage including papilledema

cardio diseases Flashcards by victoria williams

the silent killer

HTN

How well did you know this?

Not at all

Perfectly

BP formula

BP =SVRxCO

How well did you know this?

Not at all

Perfectly

how to be diagnosed with HTN

persistently high BP/current use of HTN meds
based on 2 or more BP readings on 2 or more office visits

How well did you know this?

Not at all

Perfectly

normal BP range

<120 and <80

How well did you know this?

Not at all

Perfectly

elevated (pre-hypertension) range

120-129 and <80

How well did you know this?

Not at all

Perfectly

HTN stage 1 range

130-139 or 80-89

How well did you know this?

Not at all

Perfectly

HTN stage 2 range

> 140 or >90

How well did you know this?

Not at all

Perfectly

primary HTN

AKA: idiopathic, essential
- 90-95% of all cases
- persistently elevated SVR
- usually reversable

How well did you know this?

Not at all

Perfectly

how to diagnose white coat HTN

ambulatory BP monitoring

How well did you know this?

Not at all

Perfectly

secondary HTN

5-10% of cases
- caused by another medical condition

How well did you know this?

Not at all

Perfectly

sources of tyramine

aged food such as wine and cheese

How well did you know this?

Not at all

Perfectly

S&S of HTN

freq. asymptomatic
- fatigue
- dizziness
- angina

How well did you know this?

Not at all

Perfectly

what to be careful of with tyramine

eating tyramine on a MAO-I can fatally increase BP

How well did you know this?

Not at all

Perfectly

target organ complications (5 main ones)

heart: CAD, LVH, HF
brain: TIA, CVA
blood vessels: PVD
kidneys: CKD
eyes: retinopathy

How well did you know this?

Not at all

Perfectly

BP considered a HTN crisis

SBP>180
DBP>120

How well did you know this?

Not at all

Perfectly

hypertensive urgency

severe HTN but no target organ damage
- develops over hours to days

How well did you know this?

Not at all

Perfectly

what is hypertensive emergency and 4 causes of it

severe HTN plus target organ damage
- pre-eclampsia
- not taking meds
- head injuries
- aortic dissections

How well did you know this?

Not at all

Perfectly

malignant HTN

develops quickly, causes organ damage, very hard to control even with meds
most often seen in middle aged black men
involves target organ damage including papilledema

How well did you know this?

Not at all

Perfectly

3 main complications of HTN crisis

HTN encephalopathy
renal insufficiency
aortic dissection

How well did you know this?

Not at all

Perfectly

aortic dissection

tearing and shearing of endothelial lining
- chest pain, reduced pulses

How well did you know this?

Not at all

Perfectly

what is metabolic syndrome

group of risk factors that increase a persons chance of developing CV disease, stroke, and DM

How well did you know this?

Not at all

Perfectly

3 of what 5 problems are needed for dx of metabolic syndrome

abdominal obesity
high triglycerides
low LDL cholesterol
high BP
high FBS

How well did you know this?

Not at all

Perfectly

what is considered abdominal obesity

men: waist greater than 40”
women: waist greater than 35”

How well did you know this?

Not at all

Perfectly

high triglycerides = ?

over 150mg/dL or on drug tx

How well did you know this?

Not at all

Perfectly

low LDL = ?

men: less than 40 women: less than 50 or on drug tx

"high bp" = ?

SBP greater than or equal to 130 DBP greater than or equal to 85 or on drug tx

*** jumping to 2.25 material and on, here

what is considered a high fasting blood sugar

greater than or equal to 100mg/dL

name for when lipids accumulate and migrate into smooth muscle cells

fatty streak

fibrous plaque

collagen convers the fatty streak - vessel lumen is narrowed

complicated lesion

- plaque rupture - thrombus formation - further narrowing or total occlusion of vessel

collateral circulation

chronic ischemia leading to angiogenesis

CRP indicates? normal range?

indicates weak blood vessels - normal <0.5mg/dL

goal for LDL level

less than 100 good less than 70 best

HDL goal range

>45 good >60 best

fibrinogen good range

200-400mg/dL

two causes of angina

- too much demand - not enough supply

vessel is at least what % blocked for angina to occur

70%

what causes stable angina

myocardial ischemia in large coronary arteries

what makes stable angina worse

- strong temps - strong emotions - smoking - drinking

S&S of stable angina and tx

pain on exertion lasting from 5-15 mins - rest, NTG

what causes prinzmetals angina and what probs is it related to

coronary vasospasm - heavy smokers - chronic migraines - raynauds

prinzmetals may occur...?

at rest

tx for prinzmetals

NTG, CCB, and moderate exercise may help to open vessels back up

microvascular angina is from what part of the heart

myocardial ischemia in the small branches of coronary arteries

who usually has microvascular angina

most menopausal women

triggers and tx for microvascular angina

triggered by ADLS tx: NTG, same as CAD

what is silent ischemia and who does it often occur in

- myocardial ischemia without pain - diabetics d/t neuropathy

most common way to find out about silent ischemia

EKG changes

unstable angina

rupture of thickened plaque - part of ACS (heart attack) - occurs at rest - NTG does not relieve pain

angina S&S

chest pain (exclusions apply) tachycardia anxiety SOB (main SX for elderly) syncope hypotension

S&S in women for angina

fatigue **most prominent epigastric pain "indigestion" SOB throat pain LFA pain

short acting nitrates

SL NTG tab or spray - decrease myocardial O2 needs/preload

can you keep NTG in a childproof bottle

how often to change bottle of NTG

Q6mo

when is it recommended to take NTG as prophylaxis

before exertion or exercise

sign that the NTG is working

you feel tingling

three long acting nitrates

isosorbide dinitrate isosorbide mononitrate NTG paste or patch

what are BB DOC for what kind of angina

long term management, not acute probs

what is a last resort drug to try for angina

ranolazine (ranexa)

what does ranolazine do

prolongs QT interval

what progresses to ACS

CAD

common term for acute coronary syndrome

heart attacks

what is the severity of the ACS based on

amount of blockage and O2 demand

what does unrelieved ischemia lead to

myocardial necrosis

what 3 things are considered ACS

unstable angina NSTEMI STEMI

if pt has chest pain....

ALWAYS figure out cause

what is a serial EKG

EKG taken every couple hours to diagnose ACS

sign of ischemia on an EKG

inverted T wave or ST depression (can be there even after an MI is resolved)

sign of injury on an EKG

ST elevation - looks like fireman's hat or grave stone-> EMERGENCY

sign of infarction on EKG

ST elevation, T wave inversion, pathologic Q wave

what labs are included in serial cardiac enzymes

troponins creatine kinase myoglobin LDH

levels of troponin

increase in 4-6 hours peak in 10-12 hours return to normal in 24-36 hours

levels of creatine kinase

increase in 6 hours peak in 18 hours return to normal in 24-36 hours

myoglobin levels

rises within 2 hours peaks in 3-15 hours no end time can be misleading as this is released simply from injured muscles

LDH (late sign)

increases 7-14 days after cardiac event

immediate tx for heart probs

MONA morphine Oxygen NTG ASA (asprin)

immediate tx for STEMI

emergent PCI within 90 mins - thrombotics within 30 mins if no cath lab

how many chest tubes does a CABG pt usually have

vessels commonly harvested for CABG

saphenous vein is most common - R or L. internal mammary artery

8 AMI core measures

1. ASA at arrival 2. ASA for d/c 3. ACE-I or ARB for LVSD (LV EF <40%) 4. smoking cessation counseling 5. BB for d/c 6. fibrinolytics within 30 mins if no cath lab 7. PCI within 90 mins 8. statin for d/c

MONA, Be A Special Friend Please

- morphine - oxygen - NTG - ASA - BB - ACE or ARB - statin/smoking cessation - fibrinolytics - PCI

fast five for chest pain

stay with pt quick cardiac assessment get help STAT get VS apply O2 if needed

3 age related cardiac changes

decreased cardiac output loss of vessel elasticity less efficient valves in the veins

cardio diseases Flashcards

(84 cards)