Exam 5 Module 10 Flashcards by Taylor Roney

Pathway of atherosclerosis

Initial endothelial injury
Fatty streak (lipids depositing)
Fibrous plaque and deposit growth
Complicated plaque rupture

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Coronary artery disease

Atherosclerosis impacting vessels of the heart

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Risk factors for coronary artery disease (modifiable and non-modifiable)

Modifiable:
High cholesterol, high low density lipoproteins (LDL)
Not exercising
Hypertension
Diabetes
Smoking
Obesity

Non-modifiable
Age
Genetics (family history)
Male> female

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Stable Angina

Chest pain/discomfort or tightness
Exercise induced
Resolves with rest
Ischemia = NO cell death= NO troponin

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Unstable angina

Chest pain that occurs at rest
Increases in frequency/severity over time
Unpredictable

Unstable fibrous plaque
Ischemia = NO cell death = NO troponin

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NSTEMI

Partial, severe occlusion
Ischemia » damage/death
Partial thickness (subendocardial tissue)
Damage occurs after 20 minutes of ischemia
Troponin detected

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STEMI

Total vessel occlusion
Full thickness damage of muscle
Troponin present
Elevated ST wave

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Sudden cardiac death

1 cause is ventricular arrhythmia

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Difference between cardiac arrest and heart attack

Cardiac arrest is an electrical problem

Heart attack is a circulation problem

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Causes of Right sided heart failure

Left heart failure (most common)
Elevated PA pressure
COPD
Pulmonary fibrosis
PE
Pulmonary hypertension
MI

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S/S of right sided heart failure

Peripheral edema
Hepatomegaly
Splenomegaly
Abdominal pain
GI/indegestion
JVD
Ascites
Weightgain

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Left sided heart failure causes

Systolic heart failure, floppy heart (most common)
MI, Systemic hypertension
Coronary artery disease
Cardiomyopathy
Valvular abnormalities

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S/S of lift sided heart failure

Pulmonary edema
Shortness of breath
Paroxysmal nocturnal dyspnea/tachypnea
Activity intolerance
Confusion
Tachycardia
Hypoxia

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Diastolic heart failure

Failure during ventricular relaxation
thickened myocardium (reduced chamber size)
Decreased filing ability (decreased preload)

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Diastolic heart failure causes

Chronic hypertension » hypertrophy and cardiomyopathy

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Results of diastolic heart failure

Back up of fluid into lungs
Decreased CO, EF
Adequate contractions, decreased chamber size

Systolic heart heart failure

Ventricular failure during contraction
Weak, floppy myocardium
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Causes of systolic heart failure

Chronic hypertension, ischemic heart disease (MI)

Results of systolic heart failure

Decreased CO and EF

Non-cyanotic congenital defects

Left » right shunt
• ventricular septal defect
• atrial septal defect
• patent ductus ateriosus

Cyanotic heart defects

right shunt » left
•tetralogy

Tetralogy of fallot

Right to left shunt causing cyanosis

Defects that can cause tetralogy of fallot

Ventricular septal defect
Pulmonary valve stenosis
Displaced aorta
Right ventricular hypertrophy

Rheumatic heart disease

Untreated strep infection causes inflammation of endocardium, myocardium and pericardium.

NOT an issue of bacteria on valves

Inflammation » stenosis, leaking (regurgitation), and vegetation (scarring)
• heart failure, endocarditis, thrombi/clot

Infective endocarditis

Inflammation of the heart due to bacteria Most commonly impacts tricuspid valve

Risk factors of infective endocarditis

IV drug use Prior heart damage/failure Dental procedures Cardiac surgery Indwelling IV lines

S/S of infective endocarditis

Fever Chills New heart murmur Night sweats Fatigue, Shortness of breath Chest pain Emboli

Complication of infective endocarditis

Congestive heart failure, MI, Glomerulonephritis

Myocarditis

Inflammation of heart muscle Caused by viral infection Complications: heart failure, arrhythmia, sudden death

Pericarditis and s/s

Inflammation of the outer lining of the heart Sharp stabbing chest pain that radiates along arm Self resolving

Pericardial effusion

Accumulation of fluid in pericardial sac sounds: pericardial friction rub, muffled heart, tachycardia

S/S of pericardial effusion

Chest pain Shortness of breath Light headed Dizzy

Pericardial tamponade

Fluid compresses heart (R side) Causes hemodynamic instability

S/S of pericardial tamponade

Becks triad Weakness Syncope Dizziness

Becks triad

Muffled heart sounds Hypotension JVD

Mitral stenosis

Narrowing of mitral valve, impeding blood flow from left atrium into left ventricle Causes decreased cardiac output, pulmonary edema

Mitral regurgitation

Insufficient valvular closing causes backflow of blood into left atrium during systole Causes decreased cardiac output, pulmonary edema

Emboli of infective endocarditis

Emboli can cause: splinter hemorrhages (under nails) Roth spots (retina Osler nodes (hands/feet)