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Reviewer #8 Flashcards

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1
Q

Generic term for disorders of the heart and blood vessels.

A

CardioVascular Disease (CVD)

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2
Q

Refers more specifically to an ischaemic pathology related to disease of the blood vessels, causing myocardial oxygenation issues.

A

Coronary Heart Disease (CHD)

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3
Q

Two main clinical forms of this CHD

A

Angina and Myocardial Infarction

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4
Q

Progressive disease characterised by atheroma
(plaque) formation, which affects the intimal and medial layers of large and midsize arteries.

A

Atherosclerosis

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5
Q

Myocardial cells become ischaemic when the oxygen supply is inadequate to meet metabolic demands.

A

Myocardial Ischemia

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6
Q

Coronary heart disease is manifested by

A

Angina pectoris, Acute coronary syndrome, or Myocardial infarction

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7
Q

Chest pain resulting from reduced coronary blood flow, which causes a temporary imbalance between myocardial blood supply and demand

A

Angina Pectoris

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8
Q

Byproduct of anaerobic metabolism

A

Lactic Acid

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9
Q

How does lactic acid cause chest pain?

A

Stimulates nerve endings in the muscle, causing pain

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10
Q

Occurs when complete obstruction of a coronary artery interrupts blood supply to an area of myocardium. Affected tissue becomes ischaemic and eventually dies (infarcts) if the blood supply is not restored.

A

Myocardial Infarction

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11
Q

Specific indicators of myocardial infarction.

A

Elevated levels of Creatine Kinase and Cardiac specific troponins

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12
Q

Coronary heart disease is generally divided into two categories

A

Chronic Ischemic Heart Disease and Acute Coronary Syndrome

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13
Q

Chronic Ischemic Heart Disease includes

A

Stable and unstable angina pectoris and silent myocardial ischaemia

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14
Q

Acute Coronary Syndrome includes

A

Unstable Angina to Myocardial Infarction

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15
Q

Pain lasts a few minutes and occurs in a pattern, such as during exercise or stress and can be relieved by rest

A

Stable Angina

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16
Q

Pain can be stronger or last longer than stable angina and does not follow a pattern and is not relieved by rest

A

Unstable Angina

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17
Q

Almost always occurs when a person is at rest, usually between midnight and early morning.

A

Prinzmetals angina (Variant Angina)

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18
Q

Most common presenting symptom of CHD in women

A

Angina

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19
Q

Most common presenting symptom of CHD in men

A

Acute coronary syndromes and myocardial infarction

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20
Q

Pain in angina pectoris is defined as

A

Tight, squeezing, heavy pressure or constricting sensation.

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21
Q

The gold standard for evaluating the coronary arteries

A

Coronary Angiography

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22
Q

DOC for Angina

A

Nitrates (Nitroglycerin)

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23
Q

3 classes of drugs used in angina

A
  1. Nitrates
  2. Beta-blockers
  3. Calcium channel blockers
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24
Q

A condition of unstable cardiac ischaemia.

A

Acute coronary syndrome

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25
Procedures may be used to restore blood flow and oxygen to ischaemic tissue
Revascularisation procedures
26
Procedures are used to restore blood flow to the ischaemic myocardium in the person with CHD.
Percutaneous Transluminal Coronary Revascularisation
27
Surgery for coronary heart disease involves using a section of a vein or an artery to create a connection (or bypass) between the aorta and the coronary artery beyond the obstruction
Coronary Artery Bypass Grafting
28
2 types of atherosclerotic lesion
1. Stable 2. Unstable
29
Lesions progress by gradually occluding the vessel lumen
Stable atherosclerotic lesion
30
Prone to rupture and thrombus formation
Unstable atherosclerotic lesion
31
If nitrates doesnt work in angina it is
Myocardial Infarction
32
Depolarization is defined as
Contraction
33
Repolarization is defined as
Resting
34
Areas of skin that send signals to the brain through the spinal nerves.
Dermatome map
35
Technique to evaluate myocardial perfusion
Radionuclide testing
36
Usually caused by ulceration or rupture of a complicated atherosclerotic lesion.
Coronary occlusion
37
Disturbances or irregularities of heart rhythm, and are the most frequent complication of MI.
Arrhythmias
38
Infarcted tissues are
Arrhythmogenic
39
These are common following an MI. May also be predictive of more dangerous arrhythmias such as ventricular tachycardia or ventricular fibrillation
Premature Ventricular Contraction (PVC)
40
Immediate treatment goals for patient with MI
1. Relieve chest pain 2. Reduce the extent of myocardial damage 3. Maintain cardiovascular stability 4. Decrease cardiac workload 5. Prevent complications
41
A platelet inhibitor, now considered an essential part of treating AMI
Aspirin
42
Pain relief is vital in managing the care of a person with AMI so these drugs are used
Analgesia
43
DOC for pain unrelieved by glyceryl trinitrate and for sedation
Morphine Sulfate
44
Drugs that dissolve or break up blood clots, are first of line drugs for AMI
Thrombolytic therapy
45
Mechanical circulatory support device that may be used after cardiac surgery or to treat cardiogenic shock following MI.
Inta-Aortic Balloon Pump (IABP) or Intra-Aortic Balloon Counter Pulsation
46
Long term program of medical evaluation, exercise, risk factor modification, education and counselling designed to limit the physical and psychological effects of cardiac illness and improve quality of life.
Cardiac Rehabilitation
47
A complex syndrome caused by conditions that impair the ejection of oxygen and nutrient rich blood from ventricles.
Heart Failure
48
Heart failure is a long term effect of?
Coronary Heart Disease and Myocardial Infarction
49
Amount of blood pumped from the ventricles in 1 minute
Cardiac Output
50
Ability of the heart to increase CO to meet metabolic demand
Cardiac Reserve
51
Cardiac Output is a product of?
Heart rate and Stroke volume
52
The volume of blood ejected with each heartbeat, determined by preload, afterload, and myocardial contractility
Stroke Volume
53
Volume of blood in the ventricles at end diastole.
Preload
54
Force needed to eject blood into the circulation.
Afterload
55
Natural ability of cardiac muscle fibers to shorten during systole.
Contractility
56
Percentage of blood in the ventricle that is ejected during systole. Normal fraction is 60%
Ejection Fraction (EF)
57
The greater the stretch of cardiac muscle fibers, the greater the force of contraction
Frank Starling Mechanism
58
RAAS
Renin-Angiotensin Aldosterone System
59
Occurs as existing cardiac muscle cells enlarge, increasing their contractile elements (actin and myosin) and force of contraction.
Ventricular Hypertrophy
60
Occurs when the ventricle fails to contract adequately to eject a sufficient blood volume into the arterial system.
Systolic Failure
61
Results when the heart cannot completely relax in diastolic filling decreases, increasing the importance of atrial contraction to preload.
Diastolic Failure
62
Which side of heart failure is more dangerous?
Left Sided Heart Failure
63
Can left sided heart failure cause right sided one?
Yes but not vice versa
64
The greatest risk in the first hour after MI
Ventricular Fibrillation
65
Abnormal slow rhythms
BradyArrhythmia
66
Weakening and bulging of the ventricular wall.
Ventricular Aneurysm
67
Backflow of blood into the atria during systole
Regurgitation
68
Inflammation of the pericardial tissue surrounding the heart
Pericarditis
69
Ability of pacemaker cells to spontaneously initiate an electrical impulse (action potential).
Automaticity
70
Ability of myocardial cells to respond to stimuli generated by pacemaker cells.
Excitability
71
Ability to transmit an impulse from cell to cell.
Conductivity
72
Inability of cardiac cells to respond to additional stimuli immediately following depolarisation.
Refractoriness
73
Ability of myocardial fibres to shorten in response to a stimulus.
Contractility
74
Primary pacemaker of the heart
SA Node
75
A phenomenon of normal and slow conduction, is a major cause of tachyarrhythmias.
Re-entry phenomenon
76
Normal heart rhythm
Normal Sinus Rhythm
77
Breakdown of cells
Lyse
78
Condition in which the person awakens at night acutely short of breath
Paroxysmal Nocturnal Dyspnea
79
Condition in which the person awakens at night acutely short of breath
Paroxysmal Nocturnal Dyspnea
80
Voiding more than one time at night
Nocturia
81
Main problem for left sided heart failure
Pulmonary congestion
82
Main problem for right sided heart failure
Anasarca
83
Main drug classes used to treat heart failure
Angiotensin-Converting Enzymes (ACE), Angiotensin II Receptor Blockers (ARB), Beta-Blockers, Diuretics, Inotropic
84
Coronary Heart Disease is usually caused by?
Atherosclerosis
85
Classic manifestation of MI
Pain
86
In giving diuretics it is important to check for?
Blood Pressure
87
Patients with CHF needs daily monitoring of?
Weight
88
Type of angina that develops due to coronary artery spasm
Prinzmetal angina
89
Primary test used to establish diagnosis of ACS
Electrocardiogram
90
In episodes of angina what changes happen in the ECG result?
ST segment sloping down
91
Drug that has electrophysiological effects. Slows conduction through AV node decreasing heart rate and reducing oxygen consumption
Digoxin
92
Antidote for digoxin
Digibind
93
Common side effect of Nitrates
Headache
94
What does MI show in ECG
Elevated ST segment
95
STEMI meaning
ST Elevated Myocardial Infarction
96
DOC for CHF
Digoxin
97
Digoxin is classified as
Positiove Inotropics

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