Ischemic Heart Disease

Question 1

An obstruction in what artery impacts heart function?

Answer 1

Coronary

Question 2

List the main coronary arteries

Answer 2

Left
Right
Branches (circumflex, LAD)

Question 3

List the determinates of Myocardial Blood Flow

Answer 3

Diastolic BP
Resistance
Vasomotor Tone
LV End-Diastolic pressure

Question 4

Equation of Blood Pressure

Answer 4

BP = (Cardiac Output) X (Total Peripheral Resistance)

Question 5

What is the most powerful contributor to cardiovascular disease?

Answer 5

Hypertension

Question 6

At what BP vital should you STOP exercise?

Answer 6

-SBP > 250 mmHg OR DBP > 115mmHg
-BP drops 20 mmHg
- SBP drops 10 mmHg AND DBP drops 10 mmHg

Question 7

At what BP vital should you get medical clearance for exercise?

Answer 7

• Resting SBP > 200 mmHg
• DBP > 105 mmHg

Question 8

List side effects for taking BP medications

Answer 8

Orthostatic hypotension
Drop in BP during activity

Question 9

Uncontrolled hypertension can lead to what effect in the brain?

Answer 9

Cerebral aneurysm
Hemorrhagic CVA (stroke)

Question 10

Uncontrolled hypertension can lead to what effect in th eyes?

Answer 10

Retinopathy

Question 11

Uncontrolled hypertension can lead to what in the heart?

Answer 11

Congestive heart failure
Atherosclerosis
Angina
Myocardial infarction

Question 12

Uncontrolled hypertension can lead to what in the kidney?

Answer 12

Nephrosclerosis
Chronic renal failure

Question 13

Signs and symptoms for heart attack in men/general

Answer 13

Radiating pain (jaw or left side)
Crushing pain
“elephant is sitting on my chest”
“hard to breathe”

Question 14

Signs and symptoms for heart attack in women

Answer 14

Unusual fatigue
Sleep disturbances
SOB
Indigestion
Anxiety
Chest discomfrt

Question 15

Atypical signs and symptoms for heart attack

Answer 15

Indigestion
LV dysfunction
Arrhythmia
Syncope
Silent

Question 16

Precipitating factors of heart attack

Answer 16

Cold
Exertion
Anxiety
Heavy meals
Tachycardia
Hypoglycemia

Question 17

What factors can relieve heart attack temporarily?

Answer 17

Rest
NTG (nitroglycerin)

Question 18

How can we determine myocardial oxygen demand? (equation)

Answer 18

Rate pressure product = HR x SBP

Question 19

How many days without change is categorized as stable angina?

Answer 19

60 days

Question 20

How is stable angina characterized?

Answer 20

Chest pain

Question 21

How does stable angina typically present?

Answer 21

Tachycardia
Hypoxia

Question 22

How is stable angina relieved?

Answer 22

Rest
Sublingual nitroglycerin

Question 23

How is unstable angina characterized?

Answer 23

Sign/symptoms of inadequate blood supply to myocardium

Question 24

BIG sign/symptom of unstable angina?

Answer 24

Chest pain at rest

Question 25

When should a physician/nurse be notified when unstable angina suspected?

Answer 25

Angina at rest Angina at lower exertion Deterioration of previously stable pattern Drop in HR or BP w/ exercise

Question 26

How is prinzmetal angina characterized?

Answer 26

unusual syndrome of cardiac pain secondary to MI

Question 27

What type of angina is exclusively at rest?

Answer 27

Prinzmetal angina

Question 28

What type of angina is secondary to increased coronary vasomotor tone or vasospasm?

Answer 28

Prinzmetal angina

Question 29

What pharmacological drugs are used to treat prinzmetal angina?

Answer 29

Nitrates Calcium Channel Blockers

Question 30

Name two types of acute MI's

Answer 30

Transmural Non-transmural (subednocardial)

Question 31

What does a STEMI indicate?

Answer 31

Occlusion in a large vessel and a large area is at risk ST elevation

Question 32

Is a STEMI an emergency?

Answer 32

Yes! Requires thrombolytic therapy or immediate cardiac catheterization

Question 33

What does an NSTEMI indicate?

Answer 33

High grade lesion, without total occlusion to a smaller area (most of the time)

Question 34

List treatment/interventions of MI (acute coronary syndrome)

Answer 34

Morphine sulfate Beta blockers Aspirin EKG Blood draw for cardiac makers