Coronary Artery Disease

Question 1

What is another name for Coronary Artery Disease?

Answer 1

Ischemic Heart Disease

Question 2

What is the leading cause death in the US?

Answer 2

CV disease of both genders of all races and ethnic groups

Question 3

Why do 60% of patients die in the first hour of experiencing an MI?

Answer 3

Most people are in Denial

Question 4

What is Arteriosclerosis?

Answer 4

Thickening and reduced elasticity of arterial walls

Question 5

What is Atherosclerosis?

Answer 5

is the abnormal accumulation of lipid deposits (LDL) and fibrous tissue within arterial walls and lumen
it is a type of arteriosclerosis – most common culprit of CAD
Most common place is in the vessels that supply the heart

Question 6

What is Coronary Atherosclerosis?

Answer 6

blockages and narrowing reduce blood flow to myocardium

Question 7

Where does plaque tend to accumulate?

Answer 7

The bifurcations in the coronary arteries

Question 8

What are Nonmodifiable risk factors for CAD?

Answer 8

Advancing Age, male gender, genetics

Question 9

What are modifiable risk factors for CAD?

Answer 9

Hypertension
Obesity
Smoking
Stress
Physical Inactivity
Diabetes Mellitus
Hyperlipidemia

Question 10

Is salt with iodide important in diet?

Answer 10

YES it is VERY important

Question 11

What are emerging risk factors of CAD?

Answer 11

Elevated homocysteine
Elevated C-reactive protein
Metabolic Syndrome

Question 12

What are risk factors specific to women?

Answer 12

Premature menopause
Oral Contraceptives
Hormone replacement

Question 13

What are general risk factors for CAD?

Answer 13

Fasting glucose> 100
Elevated Triglycerides
Elevated C-reactive Protein

Question 14

What is blood flow regulated by?

Answer 14

Aortic pressure
Heart Rate
Collateral Circulation
Atherosclerosis-most common cause

Question 15

In relation to Ischemia, what increases oxygen demand?

Answer 15

Exercise
Eating
Exposure to cold
Emotions 
Hypertension
Sexual Activity

Question 16

In relation to Ischemia, what signifies inadequate oxygen supply?

Answer 16

Coronary Artery Spasm
CAD
Anemia
Smoking
Hypotension or Dysrhythmia

Question 17

What is Angina Pectoris?

Answer 17

Temporary, reversible imbalance between supply and demand.
Transient, substernal chest, jaw, arm, shoulder, or neck pain or pressure caused by insufficient coronary blood blood flow.
Described as burning, squeezing, suffocating, heaviness or pressure.
Sometimes experience a feeling of sudden death

Question 18

Do Women have different symptoms than men?

Answer 18

Yes, women may experience nausea, vomiting, fatigue, upperback pain

Question 19

What is the most common cause of Angina?

Answer 19

Exercise

Question 20

What are the categories of Angina

Answer 20

Stable
Unstable
Prinzmetal’s

Question 21

What is Stable Angina?

Answer 21

Usually brought on by exercise

Question 22

What is unstable Angina?

Answer 22

Angina felt during rest

Question 23

What is Prinzmetal’s Angina?

Answer 23

Usually at rest and during the middle of the night

Question 24

What are some nursing interventions?

Answer 24

Ask if they have a history of smoking
Give them nitro under the tongue and should be sitting or laying down
Administer O2
Assess VS, Respiratory Distress, and Heart and Lung sounds

Question 25

What are diagnostic tests?

Answer 25

``` 12 lead ECG Cardiac specific Troponin and Myoglobin Full Lipid Profile CBC C-reactive protein Chest X-ray Echocardiogram Coronary Angiography ```

Question 26

What is involved in Angina Pectoris management?

Answer 26

Rest, Nitro sublingual, and oxygen Medication Reperfussion: PTCA and CABG

Question 27

Conservative management of Angina Pectoris

Answer 27

Smoking Cessation Diet=Reduce Fat, Lower LDL levels, Moderate alcohol intake, lose weight if overweight. Decrease Sodium Exercise

Question 28

What are the meds used in treatment of Coronary Artery Disease?

Answer 28

``` Nitroglycerin Calcium Channel Blockers Beta-Adrenergic Blockers Drugs used to lower cholesterol Antiplatelet ```

Question 29

Clinical manifestations of Angina

Answer 29

Chest pain substernal may radiate Pain typically occurs after precipitating event: exercise, stress, heavy meal Relieving Factors: Rest, NTG Activity, Pain, Rest, Relief

Question 30

Clinical manifestations of MI

Answer 30

Chest pain lasting more than 15-20 minutes, dyspnea, tachycardia, anxiety, diaphoresis, N/V, decreased LOC Unrelieved by NTG and Rest Women-Atypical pain

Question 31

Where do most occlusions occur?

Answer 31

The widowmaker the Left anterior descending artery

Question 32

What is MONAB

Answer 32

Morphine, Oxygen, Nitroglycerin, Aspirin, Beta blockers

Question 33

What are the treatment goals when collaborating with other professionals?

Answer 33

``` Relieve chest pain Reduce extent of myocardial damage Re-perfuse myocardium Maintain cardiovascular stability Decrease Cardiac Workload ```

Question 34

What are diagnostic tests of MI?

Answer 34

``` ECG Cardiac Markers such as Creatine Kinase which shows cardiac muscle damage Troponins T and I Myoglobin if negative no damage T wave inversion usually shows ischemia Bizarre Q wave ```

Question 35

Elevation of what segment indicates an MI?

Answer 35

ST segment and only needs to be a 1mm elevation to indicate MI

Question 36

What is used for management of MI?

Answer 36

Aspirin and ECG and Nitro Fibrinolytics can only be given in a short time frame 12 lead ECG ACEI, antidysrhytmics

Question 37

What are the revascularization procedures?

Answer 37

``` PTCA CABG -90% totally relieved -Heart Stopped during surgery -Heart is stopped and blood flow is maintained by machine ```