Chapter 19 Flashcards
(64 cards)
What is pericarditis? What is acute?
Inflammatory process of the pericardium
- Signs and symptoms of <2 weeks
In pericarditis, inflammation increases ____________ which means theres an ____________. During healing there is a ____________________.
- capillary permeability
- increase in fluid
- deposition of scar tissue
What are the causes of pericarditis?
- viral, bacterial, uremia (kidney failure), neoplastic, radiation, trauma, drug toxicity
What are the manifestations of pericarditis?
- Decreased CO
- pericardial rub
- Chest pain (abrupt onset, sharp, radiates, scapula pain d/t irritation of the phrenic nerve, increases with deep breathing coughing, relief when sitting and leaning forward)
- ECG changes
What are complications of pericarditis?
- pericardial effusion
- cardiac tamponade
- dressler syndrome (happens after a heart attack)
What is pericardial effusion? What are the causes?
Fluid build up in the pericardial space which causes compression of heart cambers
- inflammation of pericardium, neoplasms, trauma, cardiac surgery
Pericardial effusion can lead to cardiac tamponade. What is cardiac tamponade? What are the causes?
Fluid/blood accumulation in the pericardial sac which causes compression
-trauma, heart rupture post MI, cardiac surgery, aortic dissection
What are the manifestations of cardiac tamponade? State the diagnosis/ treatment.
Manifestions depend on amount and rapidity (limits Stroke volume and CO= low SBP)
- change in mentation, dsypnea, tachycardia, chest pain, elevated central and jugular venous pressure = cardiac shock
Diagnosis: muffled heart sounds, pulsus paradoxes, ECG, CT, MRI
Treatment: pericardiocentesis, NSAIDS, corticoster.
What is coronary artery disease?
Heart disease caused by impaired coronary blood flow
Describe the blood flow in coronary circulation and relate to the metabolic needs of the heart.
dsadsa
What assists coronary artery flow? What impairs it?
Assist: endothelia cells lining arteries (selective permeability barrier), diastolic pressure in aorta, time is diastole
Impairs: atherosclerosis in common
What are the non-modifiable and modifiable risks for CAD?
NM: sex (post menopausal women), age, ethnicity, genetics
M: HT, hyperlipidemia, tabacco, diabetes, obesity, sedentary lifestyle, inactivity, ability to cope with stress
What are the 3 types of chronic Ischemia heart disease?
- Stable angina pectoris
- Silent myocardial ischemia
- Varient/prinzmental (vasospastic) angina
Explain stable angina pectoris. (what? location? provokes? relief?)
Chest pain or pressure sensation d/t transient ischemia (often a fixed coronary narrowing/obstruction)
- pain is constricting, squeezing, suffocating
- location: precordial/substernal (may radiate and cause epigastric discomfort)
- occurs with exercise, physical exertion, cold, emotions)
- relieved with rest and nitroglycerine
Explain silent myocardial ischema.
- occurs in the absence of anginal pain
- impaired blood flow from the effects of coronary atherosclerosis and vasospasm
- the reason for no pain may be due to: the attack being shorter and not involving as much myocardial tissue, or the person having defects in pain threshold/transmission
Explain variant/ Prinzmental angina.
-caused by coronary artery spasms
- cause is unclear
- often at night (nocturnally), during rest, minimal exercise
- variable symptoms (arrhythmias, ECG changes)
Note: more in elderly, neuropathy, hypoten., low temp, stroke like symptoms
What is acute coronary syndrome? and what are its risks classified on?
Sudden decrease in blood flow to the heart (all caused by an imbalance in myocardial oxygen supply and demand)
- ECG changes (unstable angina, NSTEMI, STEMI)
Causes of acute coronary syndrome?
- unstable plaque that forms a clot
- coronary vasospasm (decrease in 02)
- atherosclerosis/ narrowing
- inflammation/ infection
- secondary (anemia, fever, hypoemia)
Explain unstable angina/ NSTEMI?
- You will get one of these depending on how severe the ischemia is
- is biomarkers are elevated= NSTEMI
- occurs with rest or minimal exertion
- lasts more than 20 mins
- severe, and frequent pain
What is STEMI? (ST elevation myocardial infar.) What are typical manifestations?
- ischemic death of myocardial tissue
- crushing/ constricting chest pain which is abrupt (may radiate), epigastric discomfort, nausea, vomiting, palpitations, cool clammy skin, SOB, anxiety, tachycardia, elevated HR, BP changes, decre. O2
Is STEMI relieved with rest?
NO
in STEMI how long does cell death take? ____________and_____________ can prevent necrosis
Note: ischema and necrosis = stunned myocardium, transmural Q wave
- 15-20 mins
- early perfusion and revascularization
What does myocardial ischemia and necrosis result in ?
- decreased contractile force (decr. CO, coronary artery perfusion, incr. vasculature pressure)
- interruption of conduction (dysrhythmias)
Why are symptoms in STEMI and NSTEMI so variable?
It depends on where the damage is