Term
| the death of myocardial tissue caused by prolonged lack of blood and o2 supply |
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Definition
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Term
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Definition
| occlusion of a coronary artery |
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Term
| over a period of 4 to 6 hors a process of _ develops |
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Definition
| ischemia, injury and infarction |
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Term
| reuslts from a lack of blood and O2 to a portion of the heart muscle |
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Definition
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Term
| if ischemia is not reversed _ occurs |
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Definition
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Term
| ischemia lasting _ or more is sufficient ot produce irreversible tissue damage |
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Definition
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Term
| the healing process after infarction begins within |
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Definition
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Term
| the myocardium is especially vulnerable to stress because of the weakness of the healing tissue for about _ after MI |
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Definition
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Term
| coplete haling of MI takes about |
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Definition
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Term
| for purposes of dianosis and treatment, health care providers divide MI into two types |
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Definition
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Term
| the ST segment of an ECG is usually flat or |
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Definition
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Term
| because the ST segment can be displaced when partial or coplete lack of o2 flow to the myocardial cell occurs, the appearance of a pt's ST segment is an important component of the assessment of an |
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Definition
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Term
| pt usually have transient or partial occlusion of a coronary artery |
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Definition
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Term
| pt has total occlusion of a coronary artery from coronary thrombosis |
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Definition
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Term
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Definition
| dysrhthmias, HF, cardiogenic shock, thromboembolism, sudden cardiac death, ventricular aneurtysm and rupture |
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Term
| the ventricl fails to empty effeciecntly which can increase preload leading to systemic and pulmonary edema |
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Definition
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Term
| initial signs and symptoms of HF |
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Definition
| dyspnea, restlessness, increased HF, cardiac output and BP fall |
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Term
| untreated HF progresses to |
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Definition
| cardiogenic shock and death |
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Term
| the most frequent cause of death after an MI |
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Definition
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Term
| usually r/t to extensive injury to the left ventricle and is morre common when the patient has had a previous infarction |
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Definition
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Term
| _ may be caused by pulmonary embolism |
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Definition
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Term
| massive pulmonary embolism is charactrized by |
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Definition
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Term
| occurs when heart activitiy and respirations cease abruptly |
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Definition
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Term
| the most common underlying reason for sudden cardiac death is _ and it can be a complication of MI |
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Definition
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Term
| other caused of sudden cardiac death include |
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Definition
| vetricular dysfunciton, cardiomyopathy, electrolyt imbalance, electrocution and pulmonary embolism |
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Term
| the classic symptom of MI |
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Definition
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Term
| pain r/t to MI is typically |
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Definition
| a heavy or contrictive pain located below or behind sternum |
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Term
| proteins relased form the cardiac muscle when the muscle is damaged |
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Definition
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Term
| troponin levels elevate in _ after myocardial injury, peak in _ and remain in the circulation for up to _ |
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Definition
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Term
| with ischemia the _ is often depressed and the _ inverted |
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Definition
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Term
| if prolonged total cocclusion of a coronary artery has cocured the ECG will shos |
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Definition
| ST segment elevation STEMI |
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Term
| if transient or partial occlusion of the arter has occurd the ECG may not show |
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Definition
| ST segment elevation (NSTEMI) |
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Term
| after infarction another change often seen on the ECG is a significant |
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Definition
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Term
| one that is greater than one third of the height of the R wave |
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Definition
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Term
| the most frequently observed syrhthmias are |
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Definition
| premature ventricular contractions, ventricular tachycardia, ventricular fibrillation |
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Term
| the goals of medical therapy after MI are to |
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Definition
| limit the amount of cardiac muscle injury, rlieve symptoms and to prevent or minimize complications |
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Term
| administ3ered to dilate coronary arteries and increase blood flow to the damaged area |
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Definition
| sublingual or IV nitroglycerin |
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Term
| if _ relieves the pain of MI the infarction may not extend |
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Definition
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Term
| causes peripheral pooling of the blood which decreases the blood returning to the heart and lungs |
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Definition
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Term
| morphine also _ thereby improving gas exchange |
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Definition
| diminishes anxiety, decreases tachypnea and rleaxes bronchial smooth muscles |
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Term
| _ recommended for patients with STEMI when PCI is not available within _ of first medical contact |
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Definition
| fibrinolytic therapy, 120 min |
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Term
| fbrinlytics such as _ are administered IV to dissolve the thrombus r/t MI |
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Definition
| streptokinase and tissue plasminogent activator |
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Term
| fibrinolytic therapy is most effective when initiated early but may be administered up to _ from onset of chest pain |
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Definition
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Term
| after administration of the fibrinolytic agents _ is administered to prevent further clot formation |
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Definition
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Term
| to monitor the affectiveness fo fibrinolytic agents the nurse should assess for _ |
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Definition
| relief of chest pain and return of ST segment to baseline |
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Term
| the greatest risk when using fibrinolytic agents |
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Definition
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Term
| _ should be administered as soon as the patients can tolerate them and if not contraindicated |
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Definition
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Term
| bete adrendergic blockers improve survival rate by |
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Definition
| decreasing the HR, rducing the work of the heart and lessing the o2 demand of the myocardium |
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Term
| _ may be prescribed for some patients to minimize the abnormal shaping or ventricular remodeling that can occur in teh damaged ventricular muscle |
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Definition
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Term
| the first choice of treatment of an MI if available |
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Definition
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Term
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Definition
| percutaneous coronary intervention |
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Term
| the goal of PCI is to reopen the occluded artery within _ of arrival to the emergency department |
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Definition
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Term
| several pci can prcedures can be performed in the cardiac catheterization laboratory |
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Definition
| percuatneous transluminal coronary (PTCA) angioplasty, intracoronary stent placement, aterectomy, laser angioplasty |
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Term
| involves placing passage of a catheter through a peripheral artery into the occluded coronary artery |
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Definition
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Term
| when appropriate PTCA and/or intracoronary stent placement is preferred over cornary artery bypass surgery because it can be done |
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Definition
| under local anestetic, less invasive and recovery time is faster |
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Term
| complications of PTCA and intracoronary stents include |
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Definition
| coronary artery dissection, dyrhthmias, coronary spasm, hematoma or bleeding at the catheter sit, restenosis and death |
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Term
| may be performed to improve the blood supply to the myocardium |
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Definition
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Term
| in coronary artery bypass graft surger the _ are remvoed from one or both legs, inspected for patency and reversed to that the valves do not _ blood flow |
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Definition
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Term
| CBAG is a major surgery that requires the heartbeat to be stopped and the patient to be placed on _ during the sugerty |
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Definition
| cardipulmonary bypass machine |
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Term
| complications of cardiopulmonary bypass (CPB) |
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Definition
| postop bleeding, hypothermia, dysrhthmias, unstable hemodynamics and pulmonary dysfunciton |
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Term
| another approach to surgical revascularization, is being used on patientws who requrie surgery on the arteries of the anterior heart called |
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Definition
| mininmally invasive direct coronary artery bypass grafting (MIDCAB) |
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Term
| midcab is performed through a small _ incision |
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Definition
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Term
| in MIDCAB the pt's left internal mammarey arter is used to bypase the _ and the bypass is accomplished on a _ |
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Definition
| stenosed vessel, beating heart |
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Term
| usually uses a full sternotomy incision to provid the surgeon access to all coranry vessels |
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Definition
| off pump coronary artery bypass (OPCAB) |
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Term
| othe OPCAB surgery is accomplished on a _ withiout used of a _ |
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Definition
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Term
| newere approach used by making three tiny incisions on the pt's chest between ribs and a small camera and two robotic arms are inserted |
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Definition
| totally endoscopic coronary artery bypass (TECAB) |
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Term
| TECAB surgery is done on a beating heart and _ due to the small incisions and is easier to recover from |
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Definition
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Term
| notifiy the health care provider of changes in the ECG rhthm such as |
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Definition
| inverted T wave, ST segment elevation and/or Q wave |
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Term
| four phases of cardiac rehabilitation |
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Definition
| inpatient managemnt, telemetry monitoring during exercise, later rehabilitation(unmonitored), maintenance |
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