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Cardiovascular Pathologies > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

Angina Pectoris

A
  • Acute ischemic (holding back blood flow) in chest pain

- insufficient blood flow to the heart muscle from narrowing of coronary artery

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2
Q

Eitology of Angina Pectoris

A

-ischemia to the myocardium from arteriosclerotic (plaque formation)disease

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3
Q

Signs and Symptoms of Angina Pectoris

A
  • sudden onset of severe and sharp pain usually in the chest, neck, shoulder or left arm
  • often occurs from overexertion, emotional stress or extreme weather exposure
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4
Q

Medical Intervention for Angina Pectoris

A
  • Nitroglycerin pills (vasodilators)
  • Nitroglycerin patch (continuous dose) ex. Unstable angina
  • CABG (Coronary Artery Bypass Graft)
  • Angioplasty
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5
Q

Physical Therapy for Angina Pectoris

A

-if angina occurs during treatment, patient must be asked to rest and inform the PT or nurse

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6
Q

Aortic Atherosclerosis

A
  • build up of plaque in aorta
  • a “silent disease” (no symptoms)
  • hardening of the wall of the aorta
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7
Q

Etiology of Aortic Atherosclerosis

A

-familial tendency

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8
Q

Signs and Symptoms of Aortic Atherosclerosis

A
  • frequently asymptomatic
  • HTN (hypertension)
  • aneurysm commonly in the abdominal aorta
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9
Q

Medical Intervention for Aortic Atherosclerosis

A

-surgical repair of aneurysm

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10
Q

Physical Therapy for Aortic Atherosclerosis

A

-strengthening program after repair

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11
Q

Atherosclerosis

A
  • hardening of the arteries

- leads to thickening of the vessels accompanied by loss of elasticity, flexibility, and contractility

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12
Q

What is Atrial fibrillation?

A
  • rapid, quivering of the heart mms
  • some mms fibers are contracted and some are not
  • strength is weak
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13
Q

Cyanosis

A

-lack of oxygen causing bluish tint

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14
Q

Peripheral cyanosis

A
  • seen in distal parts of the body (digits)
  • pertaining to a heart condition
  • cause bc heart is weak and it doesn’t create enough pressure to supply to distal areas of body
  • corrected by using heat in distal areas to open up blood vessels
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15
Q

Central cyanosis

A
  • due to respiratory conditions
  • seen in lips, tongue, mucous membrane
  • only way to correct is by supplying supplemental oxygen
  • pulse excementer will read 90% or lower
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16
Q

Dyspnea on exertion

A

-difficulty breathing during exercises

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17
Q

Edema

A
  • swelling in feet, hands & abdominal area

- bilateral, means it’s related to a heart condition

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18
Q

Fatigue

A
  • lack of energy

- has to be associated with the other signs and symptoms of cardiac disease to be heart related

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19
Q

Heart block

A
  • dealing with nerve conduction to the heart
  • If SA node malfunctions there is a back up system of the ventricles that contracts at a slower pace 40 bpm
  • it’s not sufficient to supply blood to the body
  • may lead to losing conscience or heart to completely stop
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20
Q

Intermittent claudication

A
  • on/off pain
  • pain in calf mms that is relieved by resting
  • caused by a blocking or narrowing in the popiplital artery so mms aren’t getting proper nourishment and/or oxygen
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21
Q

Pain

A
  • left chest pain (angina) & left arm pain, left shoulder, neck, right side of chest, jaw
  • sometimes pain between scapula
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22
Q

Palpitations

A

-irregular, pounding heartbeat

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23
Q

Premature ventricular contractions

A
  • when there not suppose to contract causing an irregularity
  • sometimes can lead to instant death
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24
Q

Reduced ejection fraction

A
  • normal volume of blood being squeezed by heart is 55-75% ejection fraction
  • anything less is reduced ejection fraction
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25
Q

Syncope

A
  • fainting, dizziness

- blood not going into brain area

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26
Q

Orthopnea

A
  • Difficulty breathing upon supine lying
  • when they lay down, there is a increase venous return to the heart
  • feels like their drowning
  • they instinctively sit up
    • the use of gravity reduces the return to the heart
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27
Q

What happens to blood in heart if it is going through atrial fibrillation?

A
  • Sit there and coagulate
  • thicken up and clot
  • usually the start of someone getting a heart attack or stroke
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28
Q

SA node

A
  • Pace maker of heart

- normal is 70 beats per minute

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29
Q

General signs and symptoms of cardiac disease.

A 
Atrial fibrillation 
Cyanosis
Dyspnea
Edema
Fatigue
Heart block
Intermittent claudication
Pain
Palpitations
Premature ventricular contractions
Reduced ejection fraction
Syncope
Ventricular fibrillation
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30
Q

If a person has a ejection fraction of 40% what can you say about this person’s heart? Physical therapy treatment?

A
  • weak
  • won’t be able to put them through physical therapy exertion
  • provide them therapy on patient education on energy conservation techniques
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31
Q

Normal heart rate?

A

60-100 bpm

  • higher than 100 tachycardia
  • lower than 60 bradycardia
  • average is 70
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32
Q

Normal SV?

A

70 ML

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33
Q

Cardiac output (CO)

A

HR x SV = CO

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34
Q

Normal cardiac output?

A

5 L per minute

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35
Q

Cardiac catheterization

A
  • catheter gets inserted in the inguinal femoral artery or the radial artery
  • it can show how severe the CAD is and whether there is valve disease, an aneurysm, myocardial infarction, or pericardial disease
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36
Q

Angiography

A
  • insert dye through catheter and take picture of it
  • goes to the coronary arteries
  • person undergoes this if experiencing chest pain
  • determines if there is a blockage in the coronary arteries and how much
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37
Q

Echocardiography

A
  • noninvasive procedure
  • a reading is taken of the heart and coronary blood vessels by bouncing sound waves off the heart
  • it can detect the size of the heart, valve function, thickness of the walls of the heart, CAD, and ischemia of the heart muscle
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38
Q

Electrocardiogram

A
  • looking for electro conductivity of heart
  • ECG strip
  • records the way the heart beats
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39
Q

ECG strips

A
  • readings from a electrocardiogram that measures heart rhythm and rate and can indicate hypertrophy and infarction of heart muscle
  • P wave- corresponds to atrial depolarization/contraction
  • QRS complex- corresponds to ventricles
  • T wave- corresponds to ventricular relaxation/repolarization
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40
Q

Flattened P wave in ECG strip?

A

-May mean person is in atrial fibrillation

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41
Q

QRS complex elevation in ECG strip?

A

-may mean person is having a MI(heart attack)

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42
Q

Holter monitoring test

A
  • portable EKG

- use it for 24 hours

43
Q

PET Scan

A
  • test making use of nuclear imaging

- scan of the heart

44
Q

Exercise Stress Test

A

-person goes through an exercise and specialist monitors heart rate

45
Q

Chemical stress test

A

-someone who can’t exercise ex.pt with osteoarthritis in the knees

46
Q

Levine sign?

A

-Person pounding chest

47
Q

Stable Angina

A
  • most common

- appears when person is exercising

48
Q

Unstable Angina

A

-no activity and angina shows up

49
Q

Circle of Willis

A
  • arteries in the head

- supplies blood to brain

50
Q

Atherosclerosis

A

-hardening of the arteries

51
Q

Arteriosclerosis

A
  • hardening of the walls of the arterioles in the extremities or organs
  • arteries become narrowed and blood flow decreases
  • the plaque build up first starts in the aorta
52
Q

Atherosclerosis and Arteriolsclerosis

A

-both conditions lead to thickening of the vessels accompanying by loss of elasticity, flexibility and contractility

53
Q

Etiology of Atherosclerosis and Arteriosclerosis

A
  • changes in the walls of the arteries due to hypertension, diabetes, cigarette smoking, family tendency, hypothyroidism, hypercholesterolemia
  • other causes may be from lack of exercise, obesity, and use of oral contraceptives
54
Q

Signs and symptoms of Atherosclerosis and Arteriosclerosis

A
  • no outward signs and symptoms
  • angina
  • CVA (stroke)
  • HTN
  • intermittent claudication, ulcers, end stage renal diseases, gangrene, DVT(deep vein thrombosis) or CVA from a thrombus(clot)
55
Q

Medical intervention for Atherosclerosis and Arteriosclerosis

A
  • anticoagulants such as ASA(acetal salicylic acid) aspirin
  • anti cholesterol and antihypertensive medications
  • carotid endarterectomy using saphenous vein(leg) or internal mammary artery
  • bypass graft
  • lifestyle change
56
Q

Transient Ischemic Attack (TIA)

A
  • precursor to a stroke
  • symptoms of a stroke
  • symptoms don’t last more than 24 hours
57
Q

Physical therapy for Atherosclerosis and Arteriosclerosis

A

-none but watch for complications from clot formation

58
Q

Cardiac arrest/heart attack/myocardial infraction

A
  • sudden stopping of the heart
  • the side the is usually effected is the left ventricle
  • the cause of this is complete inclusion of blood supply to ventricle
59
Q

Infarction

A

-death

60
Q

Etiology of Cardiac arrest/heart attack/myocardial infraction

A
  • myocardial infarction (MI)
  • loss of blood to the heart secondary to a systemic shock
  • injury causing massive loss of blood
  • electric shock or drowning
61
Q

What coronary artery is affected with MI?

A

Left anterior descending coronary artery

62
Q

Signs and symptoms of Cardiac arrest/heart attack/myocardial infraction

A
  • angina
  • dyspnea
  • pain in neck, crushing pain on left/right arm
  • sweating, pallor, nausea, rapid pulse
  • sudden onset of tachycardia or bradycardia
  • may have loss of consciousness
63
Q

Medical Intervention for Cardiac arrest/heart attack/myocardial infraction

A
  • CPR as needed
  • rest, oxygen supplement
  • pain medications
  • Thrombolytic agents, anticoagulants (blood thinner), antihypertensives, anti-cholesterol medications
  • angioplasty
  • CABG
  • lifestyle changes
64
Q

Physical therapy for Cardiac arrest/heart attack/myocardial infraction

A
  • cardiac rehabilitation
    • Phase I: inpatient (hospital)
    • Phase II: outpatient (SNF, Home)
    • Phase III: on their own
65
Q

Congestive Heart Failure

A
  • in the ventricles
  • a condition where the heart is no longer able to pump enough blood to meet the body’s needs
  • left ventricular failure
66
Q

Etiology of CHF

A
  • infarction of L ventricle - MI
  • aortic stenosis (narrowing of the aorta)
  • HTN
  • hyperthyroidism
67
Q

Etiology of R ventricular failure (cor pulmonale)

A
  • infarction of R ventricle
  • pulmonary valve stenosis
  • lung disease
68
Q

Signs and symptoms of CHF

A
  • pulmonary edema bc alevoli filled with fluid, feel like they are drowning
  • pleural effusion leading to dyspnea
  • central cyanosis
  • easily fatigued, lethargic
  • dyspneic (dry, nonproductive) with a cough bc of pulmonary edema
  • oliguric (reduced urine formation)
  • anasarca (general body edema)
  • weight gain overnight, usually more than 2lbs
69
Q

Right ventricular failure (cor pulmonale)

A
  • dependent edema on LE - swelling of the feet- bilateral - back up of blood in the right ventricle, right atrium, & vena cava causes the swelling
  • hepatomegaly, splenomegaly
  • distention of jugular vein bc of increased pressure of backed up blood from vena cave going into jugular vein
  • ascites - in alcoholics - retention of fluid in liver
70
Q

Medical intervention for Right ventricular failure (cor pulmonale)

A
  • beta blockers and digitalis medicines to increase the pumping ability of the heart
  • ACE inhibitors and vasodilators open blood vessels reducing resistance to blood flow - controls blood pressure
  • diuretics to remove excess water and sodium
  • heart transplant in severe cases
71
Q

Physical therapy for Right ventricular failure (cor pulmonale)

A
  • to increase endurance and strength
  • safety with gait
  • lifestyle change
  • cardiac rehab
72
Q

Hypertension and hypertension heart disease

A

-normal blood pressure exceeds a certain amount

73
Q

Normal systolic and diastolic blood pressure

A

-systolic:

74
Q

Prehypertension systolic and diastolic blood pressure

A
  • systolic: 120-139

- diastolic: 80-89

75
Q

Stage 1 hypertension systolic and diastolic blood pressure

A
  • systolic: 140-159

- diastolic: 90-99

76
Q

Stage 2 hypertension systolic and diastolic blood pressure

A
  • systolic: 160 and up

- diastolic: 100 and up

77
Q

Etiology of hypertension and hypertensive heart disease

A
  • primary or essential hypertension is idiopathic
  • secondary hypertension can be due to kidney disease, adrenal tumors, adrenal tumors, psychological factors, pain killers, oral contraceptives
  • labile HTN is a rare form of essential HTN not responsive to any intervention
78
Q

Signs and symptoms of hypertension and hypertensive heart disease

A
  • systolic BP is 140 or higher or diastolic BP is 90 or higher
  • prehypertension is systolic BP between 120 and 139 or diastolic BP between 80 and 89
  • no physical signs
79
Q

Medical intervention for hypertension and hypertensive heart disease

A
  • anti hypertensives
  • diuretics- bc of the retention of fluid which causes increase pressure
  • diet and lifestyle modification
80
Q

Complications of hypertension

A
  • cardiomegaly - bc of increased resistance to blood vessels so the heart has to pump against it
  • cor pulmonale (R ventricular hypertrophy)
  • CHF
  • atherosclerosis
  • hypertensive encephalopathy - increased blood pressure brain disease
  • blindness from retinal affectation - arteries to the eyes are sensitive so if blood pressure is high it can affects it
81
Q

Physical therapy for hypertension

A
  • BP monitoring
82
Q

Coronary artery bypass graft

A
  • a procedure that provide a bypass for the blood and restore arterial blood to the myocardium
  • uses saphenous vein or internal mammary artery
  • re establish circulation
83
Q

Heart transplant

A
  • maybe orthotopic(replace heart that’s bad) or heterotopic(transplant heart connected to your bad heart)
  • candidates must have end-stage CAD(coronary artery disease)
  • factors considered are survival rate, quality of life, relief of symptoms
84
Q

Open heart surgery

A
  • used for any procedure in which the heart muscle must be open to provide access for surgical intervention
  • most commonly done in mitral valve replacement
  • incision is known as median sternotomy
85
Q

Pacemaker insertion

A
  • cardiac pacemaker taking over function of the SA node when it is not functioning normally
  • pacemakers may be unipolar or bipolar
  • on-demand pacemakers vs fixed rate pacemakers
  • contraindicated in use of ES bc it will alter the frequency of the pacemaker
86
Q

Percutaneous transluminal coronary artery angioplasty

A
  • performed on vessels with atherosclerosis when the artery is not completely occluded
  • stent may be used
  • atheromas(plaques) may be surgically removed
87
Q

Peripheral vascular disease (PVD)

A
  • used to describe atherosclerosis of the peripheral arteries mainly of the LE bc they are more distal to the heart
  • commonly results from DM(diabetes), HTN, hypercholesterolemia
88
Q

Etiology of Peripheral vascular disease (PVD)

A
  • hx of trauma

- secondary to DM, HTN, hypercholesterolemia

89
Q

Signs and symptoms of Peripheral vascular disease (PVD)

A
  • reduced kidney function resulting in HTN, oliguria in affectation of arteries to the kidneys
  • constipation or malabsorptions in affectation of arteries to intestines
  • intermittent claudication in affectation of LEs
  • ulcers on lateral leg(bc of artery problem), gangrene and necrosis
90
Q

If a pt has a ulcer on the medial side of leg what problem do they have?

A

-venous problem

91
Q

Medical intervention for Peripheral vascular disease (PVD)

A
  • amputation in cases of gangrene
  • angioplasty or bypass grafts
  • statin medications - anti cholesterol medications for hypercholesterolemia
  • antiplatelet medications
92
Q

Physical therapy for Peripheral vascular disease (PVD)

A
  • no direct heating - bc the blockage won’t be able to supply the increase needs
  • no massage - bc you could dislodge the plaque and cause an embolus
  • patient education (raise head of bed, smoking cessation, diet, discipline with medications, nightly skin inspections, no compression stockings)
93
Q

Thrombophlebitis and DVT

A

-Inflammation and clotting within the veins

94
Q

Etiology of Thrombophlebitis and DVT

A

Infection, trauma, surgery to area, prolonged immobilization

-surgery to area and prolonged immobilization can lead to DVT(deep venous thrombosis)

95
Q

Signs and symptoms of Thrombophlebitis and DVT

A
  • fever, tenderness, erythema(red blood cells inflammation)
  • induration (hardening of the tissue)
  • pain and tightness in the area
  • (+) homan’s sign
96
Q

Medical intervention for Thrombophlebitis and DVT

A
  • bed rest
  • anticoagulants
  • compression garments -gives pressure to assist blood back
  • compression pumps
97
Q

Physical therapy for Thrombophlebitis and DVT

A

-early mobilization for prevention

98
Q

Lymphedema

A

-a chronic edema resulting from an increase in lymphatic fluid

99
Q

Etiology of Lymphedema

A
  • damage to the lymph nodes from neoplasms, cellulitis, trauma, post surgical complications, extensive burns, post radiation treatment
  • parasites filariasis in tropical countries
100
Q

Signs and symptoms of Lymphedema

A

-swelling of involved arm or leg

101
Q

Medical intervention for Lymphedema

A
  • lymphedema management
  • skin and wound care
  • will need constant treatment
102
Q

Pt who has a reduced ejection fraction, what kind of physical therapy treatment do they get?

A

-Pt education on energy conservation techniques

103
Q

Homan’s sign

A
  • it’s a sign of DVT

- characterized by pain in the calf when the foot is passively or actively dorsiflexed

104
Q

+ Homan’s sign

A
  • is when you grab pts calf and dorsiflex the foot and they say it’s painful
  • means there is a clot

Cardiovascular Pathologies (1 decks)

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