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Flashcards in Cardiovascular Deck (14):

Coronary artery disease pathology

• Myocardium receives blood from coronary arteries
• Characterised by reduced myocardial perfusion caused by atherosclerotic changes to coronary arteries
• Atherosclerosis progressive chronic inflammatory disease of endothelium- formation of plaque occurs, narrowing arteries >> restricting blood flow to myocardium


acute myocardial infarction pathology

• Heart attack
• Interruption of blood supply to heart muscle, causing damage or death to tissue
• Often due to blockage in coronary arteries- often caused by rupture of atherosclerotic plaque
• Results in ischemia- if it persists, necrosis or infarction occurs
• If not rapidly reversed, scar tissue forms in place
• Scar tissue


Diagnostic tests for AMI

• ECG- ST segment
• Echocardiography
• Cardiac MRI
• Blood test


Surgery for CAD/AMI

• Angiogram- insert dye, locate blockage
• Angioplasty- balloon inserted into narrowed artery- inflated to mechanically widen artery
• Coronary bypass- done when patient is stable- open heart surgery = post surgery concerns


Other management for CAD/AMI

• Medication- antihypertensive’s, statins, anticoagulants, antianginal
• Lifestyle changes



Bradycardia- slow heart beat- slow signal from sinus node
• Tachycardia- fast heart beat- mediated by SNS on sinus node
• Fibrillation- irregular heart beat- Atrial or ventricle- VF life threatening >> effective pumping stops, cause clots >> pulmonary embolism, stroke
• ECG used to detect- monitors electrical activity of the heart over time


Cardiac arrest pathology

• Cessation of normal blood flow- differs to heart attack which is impaired flow
• Brain damage occurs after 5 mins of not receiving oxygenated blood
• Symptoms include- unconsciousness, cessation of breathing, lack of circulation


Cardiac arrest causes

• Coronary heart disease
• Complication in AMI
• Electrolyte imbalance- K+
• Cardiac diseases/conditions
• Trauma
• Internal bleeding
• Overdose
• Drowning
• Pulmonary embolism


Management for cardiac arrest

• CPR 1st responders
• Defibrillation & oxygen
• Medications
• Treatment of cause


What is chronic heart failure

Cardiac pump can’t maintain adequate output OR can’t manage venous return


Chronic heart failure causes

• IHD, AMI, cardiomyopathy
• Hypertension, aortic stenosis (narrowing aortic valve opening)
• Valve incompetence
• Pericardial disease
• Congenital


Symptoms of chronic heart failure

• Failure on left = SOB, fatigue, cough, frothy sputum
• Right = swollen legs, abdomen, raised venous pressure
• Can occur concurrently- congestive cardiac failure


Management of chronic heart failure

• Meds- ACE inhibitors, diuretics, rhythm management
• Lifestyle- fluids, salt, activity
• Surgically modifiable?


Physiotherapy role post-cardiovascular surgery

• Pain management
• Case note interpretations
• Working with med team
• Exercise tolerance
• Monitor signs & symptoms
• Monitor BP, HR, O2 as required
• Chest physiotherapy for airway management
• Exercise rehab for coronary heart disease
• Test improvements in HR or O2 consumption- 6 minute walk test, timed up and go test, modified treadmill tests
• Guide exercise prescription