Ischemic Heart Disease

Question 1

ischemia

Answer 1

condition in which blood flow is restricted or reduced in or to a part of the body

Question 2

hypoxemia

Answer 2

• low oxygen content in the blood

- low O2 saturation

Question 3

hypoxia

Answer 3

• body or a region of the body is deprived of adequate oxygen supply at the tissue level
• fully saturated blood but not getting to area needed

Question 4

acute coronary syndrome

Answer 4

• umbrella term for a range of symptoms associated with sudden, reduced blood flow to the heart

Question 5

what does acute coronary syndrome include

Answer 5

MI
unstable angina
ST segment elevation
non-ST segment elevation
myocardial infarction or heart attack

Question 6

is ACS a diagnosis?

Answer 6

yes

Question 7

patient history for someone with ACS

Answer 7

chest or left arm pain, hx of CAD

Question 8

examination of someone with ACS

Answer 8

• hypotension, diaphoresis
• pulmonary edema, rales
• ECG changes
• elevated cardiac biomarkers

Question 9

ischemic heart disease

Answer 9

• coronary heart disease
• coronary artery disease
• atherosclerotic heart disease

Question 10

what does ischemic heart disease include

Answer 10

heart attacks/MI

angina: stable or unstable

Question 11

what is the most common specific diagnosis under ACS

Answer 11

ischemic heart disease (IHD)

Question 12

causes of IHD

Answer 12

• atherosclerosis of the coronary arteries
• coronary thrombus or emboli
• coronary spasm
• complications of connective tissue disorders
• lupus
• RA

Question 13

risk factors IHD

Answer 13

age
HTN
diabetes
gender
smoking
physical inactivity
hypercholestermia/hyperlipidemia
high levels of stress
family history
poor diet
obesity

Question 14

symptoms of IHD

Answer 14

• chest pain
• pain in arms, jaw, neck, back or stomach
• SOB
• lightheaded
• nausea
• sweating
• females present diff than males

Question 15

how can IHD be diagnosed

Answer 15

blood testing

• cardiac enzymes, troponin, ANP & BNP are gold standard
• CRP

Question 16

plaque rupture

Answer 16

• exposes thrombogenic lipids to the blood

- stimulates localized thrombus formation with ischemic outcome

Question 17

occlusion event

Answer 17

damage is dependent on coronary involved

Question 18

cardiomyopathy

Answer 18

disease of the heart muscle

Question 19

ischemic cardiomyopathy

Answer 19

• heart is chronically ischemic
• chronic narrowing of the coronary arteries which in turn, diminishes blood supply to the heart
• most common type of dilated cardiomyopathy

Question 20

what causes ischemic cardiomyopathy

Answer 20

CAD which causes an insufficient blood flow to the heart resulting in myocyte ischemia

Question 21

the damage from the myocyte ischemia when you have ischemic cardiomyopathy causes what?

Answer 21

• cardiac remodeling
• myocardial fibrosis
• arrhythmias
• possible cardia conduction system impairments
• cell death
• left ventricular enlargement and dilation

Question 22

what is a precursor for ischemic cardiomyopathy

Answer 22

worsening CAD

Question 23

pt’s with ischemic cardiomyopathy develop what

Answer 23

• congestive heart failure

- most common presentation

Question 24

prognosis for ischemic cardiomyopathy

Answer 24

determined by myocardial viability (number of functioning myocytes)

Question 25

rheumatoid arthritis

Answer 25

- immune mediate chronic inflammatory disease | - morning stiffness, arthralgias, arthritis

Question 26

rheumatoid arthritis can appear as

Answer 26

``` pericarditis myocarditis valvular heart disease atherosclerotic CAD coronary arteritis aortitis cor pulmonale conduction disturbances ```

Question 27

rheumatoid arthritis is a primary pathogenic factor for what

Answer 27

premature development of atherosclerosis --> pulmonary HTN --> cor pulmonale

Question 28

angina pectoris

Answer 28

intermittent chest pain caused by transient, reversible myocardial ischemia

Question 29

angina leads to what

Answer 29

MI sudden cardiac death ischemic cardiomyopathy

Question 30

stable angina

Answer 30

- mismatch between O2 delivery and O2 need | - heart wants to pump blood but no O2 available so presents as angina

Question 31

how is stable angina brought on

Answer 31

- by exertion or other form of stress and reduces with reduced stress - occurs at a predictable HR

Question 32

unstable angina

Answer 32

- brought on by exertion or other form of stress | - onset is unpredictable

Question 33

what is the prognosis for unstable angina

Answer 33

- poor | - no exercise as treatment

Question 34

myocardial infarction

Answer 34

- due to sufficiently long ischemic insult - time is tissue - risk increases with age

Question 35

reperfusion injury

Answer 35

- tissue damage caused when the blood supply returns to tissue after a period of ischemia or lack of oxygen

Question 36

what is reperfusion injury associated with

Answer 36

- microvascular injury - due to increased permeability of capillaries and arterioles that lead to an increase in diffusion and fluid filtration to tissues

Question 37

sudden cardiac death

Answer 37

- natural unexpected death secondary to cardiac causes with rapid loss of consciousness - some cardiac issues that lead to this - can survive