Coronary Vascular Disease Pt 1 Flashcards

1
Q

What is Coronary Vascular Disease?

A

umbrella term for all diseases that affect the heart or blood vessels

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2
Q

What diseases are included when thinking of coronary vascular disease?

A
  • coronary heart disease (clogged arteries) which can cause:
  • heart attacks
  • stroke
  • congenital heart defects
  • peripheral artery disease
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3
Q

What does coronary atherosclerosis affect?

A

The vessels that supply the heart with blood

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4
Q

Coronary Atherosclerosis is usually caused by what?

A

Atherosclerosis-a buildup of plaque-fatty substance inside the artery wall

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5
Q

Atherosclerosis leads to what?

A

a blockage/narrowing of arteries that supply blood to the myocardium (cardiac muscle)

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6
Q

Behavioral Risk Factors for CVD

A
  • tobacco
  • sedentary lifestyle
  • diet high in fat and calories
  • alcohol
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7
Q

Metabolic Risk Factors for CVD

A
  • HTN
  • diabetes
  • hyperlipidemia
  • obesity
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8
Q

General Risk Factors for CVD

A
  • age
  • gender
  • race
  • family history
  • stress
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9
Q

Metabolic Syndrome

A

cluster of conditions that occur together, increasing the risk of heart disease, stroke, and type 2 diabetes

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10
Q

How many risk factors must a person have to be considered to have metabolic syndrome?

A

3

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11
Q

Risk Factors for Metabolic Syndrome

A
  • large waist-35 in for women/40 in for men
  • high triglyceride level < 150
  • reduced “good”/HDL cholesterol
  • increased BP 130/85 or higher
  • elevated fasting BG < 110
  • elevated serum CRP/fibrinogen
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12
Q

S/S of CVD

A
  • may be progressive secondary to worsening of obstruct blood flow
  • angina
  • arrhythmias
  • MI
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13
Q

Symptoms of CVD are directly r/t what?

A

location and degree of narrowing

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14
Q

Normal Total Cholesterol

A

< 200

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15
Q

HDL or Good Cholesterol

A
  • < 50 women 35-80
  • < 50 in men 35-65
  • transports LDL to liver where it is broken down and excreted
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16
Q

LDL or Bad cholesterol

A
  • Normal < 130
  • transports cholesterol particles throughout the body
  • small particles easily build up in the walls of arteries, making them hard and narrow
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17
Q

Triglycerides

A
  • norm < 150
  • fat that comes primarily from food
  • body also produces it when it converts excess calories to fat for storage
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18
Q

Primary Treatment for CVD

A

Diet and Activity

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19
Q

Diet for CVD

A
  • heart healthy
  • control portion sizes
  • increase intake of fruits and vegetables
  • eat more whole grains
  • limited saturated fats/avoid trans fats
  • low fat protein sources
  • low sodium
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20
Q

Activity Requirements for CVD

A
  • increased physical activity
  • 2.5 hrs of moderate exercise each week
  • 75 mins of vigorous exercise each week
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21
Q

Secondary CVD Treatment

A

Lipid Lowering meds

-Statins

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22
Q

Types of Statins

A
  • atorvastatin/Lipitor
  • pravastatin/Pravachol
  • simvastatin/Zocor
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23
Q

Rules for Statins

A
  • contraindicated w/ liver disease
  • use cautiously w/ kidney disease
  • may cause rhabdomyolysis
  • interactions w/ multiple meds
24
Q

BP and CVD

A
  • hypertension puts added force against artery walls/makes them hard and stiff
  • extra pressure damages arteries making more vulnerable to narrowing/plaque build up
  • increases workload of left ventricle
25
Q

Hypertension w/ CVD can treated how?

A
  • through early detection and treatment
  • smoking cessation
  • weight control
  • alcohol avoidance
  • decreased sodium intake
  • increased exercise
  • meds
26
Q

What disease can increase the clients risk for a cardiac event?

A

Diabetes

27
Q

Diabetes Control

A
  • eat 3 meals a day at regular times
  • healthy carbs
  • avoid/limit simple and complex carbs
  • meds
28
Q

What type of angina occurs when the heart must work harder usually during physical exertion?

A

Stable Angina

29
Q

Can stable angina be stopped/relieved?

A

Yes by rest or meds

30
Q

Stable Angina

A
  • doesn’t come as surprise; all episodes are similar
  • lasts a short time
  • feels like gas/indigestion
  • may feel like chest pain that spreads to arms, back, or other areas
31
Q

What are possible triggers of stable angina?

A
  • emotional stress
  • exposure to very hot/cold temps
  • heavy metals
  • smoking
32
Q

Unstable angina often occurs when?

A

While resting, sleeping, or w/ little physical exertion

33
Q

Unstable Angina

A
  • comes as surprise
  • rest or meds do not help relieve it
  • may get worse over time
  • can lead to heart attack
  • more frequent, severe in nature, lasts longer
34
Q

Unstable angina is also known as what?

A

Acute coronary syndrome

35
Q

Assessment of Angina Position

A
  • left or right chest
  • sub sternal
  • epigastric
  • mid back
  • generalized
36
Q

Provocation of Angina

A

Cold
Heat
Stress

37
Q

Quality of Angina

A
  • discomfort
  • burning
  • sharp
  • aching
38
Q

Radiation of Angina

A
  • left/right arm
  • neck
  • jaw
  • anywhere
39
Q

S/S of Heart Attack

A
  • N/V
  • diaphoresis
  • anxiety
  • SOB
  • dizziness
40
Q

Nitrates (Nitroglycerin)

A
  • vasodilator
  • increase O2 supply
  • monitor HR and BP prior to administration
  • contraindicated w/ hypotension
  • may be administered SL q 1-5 mins up to 3 times
41
Q

How often should the patient replace their nitroglycerin?

A

q 6 months

42
Q

When should nitroglycerine be taken?

A

before “expected” pain w/ stable angina

43
Q

When should the patient go to the hospital after taking nitroglycerin?

A

If pain is unrelieved after 5 mins / 3 doses

44
Q

Nitroglycerin may cause what?

A
  • intense throbbing headache
  • tachycardia
  • hypotension
45
Q

What are some examples of beta blockers?

A
  • metoprolol/Toprol

- atenolol/Tenormin

46
Q

Beta Blockers

A
  • reduce demand for O2
  • reduce HR and BP
  • decreases imbalanced O2 needs during activity
47
Q

Abrupt withdrawal from a beta blocker could cause what?

A
  • palpations
  • hypertensive crisis
  • angina
  • MI
48
Q

Examples of calcium channel blockers

A

Norvasc

Cardizem

49
Q

Calcium Channel Blockers

A
  • decrease demand and increase supply of O2
  • decrease HR and BP
  • grapefruit juice alters absorption
50
Q

What should you avoid while taking calcium channel blockers?

A

Grapefruit juice

51
Q

Examples of Antiplatelet/Anticoagulants

A
  • aspirin
  • Plavix
  • heparin
52
Q

Anticoagulants/Antiplatelet

A
  • prevent thrombus formation
  • monitor for s/s of bleeding
  • assess H&H
53
Q

How long does it take for antiplatelet to take effect?

A

up to 7 days

54
Q

Symptoms of Heart attack

A
  • acute onset of pressure, tightness, pain, or squeezing
  • n/v, indigestion, heartburn, abdominal pain
  • SOB
  • cold sweat/diaphoresis
  • extreme fatigue
  • lightheaded/dizzy
55
Q

What can a heart attack be like for a woman?

A

May experience generalized CP w/ or w/o the other symptoms

56
Q

Elderly patients may experience what w/ a heart attack?

A

Silent ischemia-no symptoms/abnormal EKG