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AP Summer > Ischemic Heart Disease & CHF > Flashcards

Ischemic Heart Disease & CHF Flashcards

(47 cards)

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0
Q

What are the risk factors for coronary artery disease?

A 
Age
HTN
Smoking
High Cholesterol
Diabetes
Family History
Obesity
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1
Q

What accounts for one third of all deaths in people over the age of 35 in the United States?

A

Coronary artery disease

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2
Q

What is acute coronary syndrome?

A

Acute coronary syndrome is applied to patients in whom there is a suspicion of myocardial ischemia

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3
Q

What are the three types of acute coronary syndrome?

A
  1. STEMI (ST Elevation MI)
  2. NSTEMI (Non ST Elevation MI)
  3. UA (Unstable Angina)
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4
Q

What is myocardial infarction?

A

A clinical advanced consequent to the death of cardiac myocytes that is caused by ischemia

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5
Q

What are the criteria for myocardial infarction?

A

EKG changes
Rise and fall of cardiac biomarkers (troponin)
New wall motion abnormalities
Symptoms of ischemia

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6
Q

What is a biomarker?

A

Cardiac enzymes in the heart

Basically let you know something is happening

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7
Q

What are the two medical therapies for coronary artery disease and how do they differ?

A 
Anti-anginal therapy (Controls symptoms)
Preventative therapy (Stop from recurring)
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8
Q

What are the three types of antianginal therapy?

A

Beta blockers
Calcium channel blockers
Nitrates

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9
Q

How do beta blockers work?

A

By slowing the heart rate and reducing contractility

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10
Q

What is an example of a calcium channel blocker that is a vasodilator with reflex tachycardia?

A

Nifedipine

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11
Q

Which calcium channel blocker is the strongest inotrope and is used in the treatment of Wolff-Parkinson-White?

A

Verapamil

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12
Q

How did nitrates work?

A

They are short acting venous dilators

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13
Q

In what way is ephedrine similar to nitrates?

A

Both have tachyphylaxis

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14
Q

What are the three types of preventative therapy for coronary artery disease?

A

Antiplatelet therapy
Risk reduction
Statins

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15
Q

What is the mainstay form of antiplatelet therapy?

A

Aspirin

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16
Q

How do statins work and what are the risks associated with their use?

A

Lower cholesterol

Risks: Can cause myopathy and liver dysfunction

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17
Q

How is cardiac failure defined?

A

Failure of the heart to maintain a cardiac output sufficient to meet the metabolic demands of the body

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18
Q

How is cardiac output calculated?

19
Q

How is the diagnosis of heart failure made?

Study These Flashcards
A

The diagnosis of heart failure requires that 2 major or 1 major and 2 minor criteria are met and not attributed to another medical condition.

20
Q

What are some of the possible MAJOR criteria for heart failure?

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A 
Paroxysmal nocturnal dyspnea
Orthopnea
Elevated jugular venous pressure
 pulmonary rales
Third heart sound
Cardiomegaly on chest x-ray
Pulmonary edema on chest x-ray
Weight loss of 4.5 kg in five days in response to treatment of presumed heart failure
21
Q

What are some possible causes of cardiac failure?

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A 
Ischemic versus nonischemic cardiomyopathy
Alcoholism
Infectious
Inflammatory
Congenital
Valvular
Oncological
Pharmacological
22
Q

What are the five main causes of cardiac failure that are treated?

Study These Flashcards
A
  1. Heart rate
  2. Rhythm
  3. Preload
  4. Afterload
  5. Contractility
23
Q

Ventricular arrhythmias are attributed to ______ until proven otherwise

24
What is cardiac resynchronization therapy?
A special pacemaker used to contract both right and left ventricle. -30% of patients with CHF have asynchronous contractions of the right and left ventricle
25
Practically speaking, preload is synonymous with what?
Volume (or CVP)
26
What are some possible causes of impairment to venous return?
Hemorrhage Dehydration Vascular occlusion Increased intrathoracic pressure
27
Practically speaking, afterload is synonymous with what?
Blood pressure (SVR)
28
What types of drugs are commonly used for afterload reduction?
Ace inhibitors - - nicardapine - - hydralazine - - nitroprusside
29
For a patient in cardiac failure, what is the relationship between blood pressure and forward flow?
Inversely related
30
Inotropic refers to ______ | Lusitropic refers to _______
Contractility | Relaxation
31
What is contractility?
Intrinsic ability of a cardiac muscle fiber to contract at a given fiber length
32
What are the two main causes of contractility impairment?
Ischemia | Cardiomyopathy (congenital or acquired)
33
If a patient presents with mottling of the knees and is cool to the touch this is indicative of what?
Poor perfusion and decreased blood flow to the extremities
34
What does a pathologic S III sound indicate?
Decreased compliance of the ventricles (as in CHF) and may be the earliest sign of heart failure
35
True or false: The human body produces enough acid to kill us in about seven minutes if not for the body buffers
True
36
What is a normal amount of lactic acid as measured in the blood?
Less than 2 mg/dL
37
Where is mixed venous blood best obtained?
From the distal port of a PA catheter Second best is from a central line
38
A decrease in venous oxygen saturation can cause what?
Decreased arterial saturation Decreased hemoglobin Decreased cardiac output Increased consumption
39
What is HOCM?
Hypertrophic obstructive cardiomyopathy
40
How is HOCM different from other forms of cardiomyopathy?
Only cardiomyopathy that's worse when pressure is higher
41
What are three important factors when treating HOCM patients?
1. Tight (decreased afterload) 2. Slow (decreased HR) 3. Full (increased volume)
42
What drug is given with patients with aspirin allergies?
Chlopitigril (plavix)
43
When do most episodes of angina occur?
In early morning
44
What drug class is known to cause hypoxic pulmonary vasodilation?
Nitrates
45
What is an ICD?
Implantable cardiac defibrillator
46
What is SAM?
Systolic arterial/anterior motion | Is caused when a myopathy causes mitral valve to be sucked into aortic valve thus blocking flow

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