Term
| According to AHA, what are 4 major cardiovascular diseases? |
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Definition
Ischemic (coronary) heart disease
HTN
Heart Failure
Cerebrovascular Dz (Stroke) |
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Term
| What is the first leading cause of death |
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Definition
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Term
| Cold weather causes what 4 things? |
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Definition
1. Vasoconstriction peripherally and in coronary arteries
2. Diastole decreases
3. Heart works harder
4. Can cause heart attack |
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Term
| What makes up the outer layer of the coronary arteries? |
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Definition
Adventitia
Basic support structure |
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Term
| What makes up the middle layer of the coronary arteries? |
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Definition
Media
Multiple layers of smooth ms cells
Makes adjustments to luminal diameter |
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Term
| What is the inner layer of the coronary arteries called? |
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Definition
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Term
| An endothelial layer, basement membrane, smooth muscle cells. |
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Definition
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Term
| Selectively permeable to macromolecules of the size of low-density lipoprotein. Located in the inner layer of coronary arteries |
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Definition
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Term
| What are 2 tihngs that are most likely to accumulate in the intima? |
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Definition
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Term
| This is where plaques build up over time and and increase in blood pressure over time will damage the inside of the vessel. |
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Definition
| Inner Layer (Intima) of coronary arteries |
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Term
| Name 2 basic rules of fluid dynamics |
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Definition
-Fluids flow from an area of high to low pressure
-Fluids follow the path of least resistance |
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Term
| The primary driving force moving blood into myocardial tissue |
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Definition
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Term
| __ __ plays a role in determining volume of blood passed along to tissue |
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Definition
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Term
| Resistance to flow is commonly caused by __ ( due to plaque build up) |
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Definition
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Term
| The pressure within the ventricle at the end of diastole |
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Definition
| Left ventricular end-diastolic pressure |
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Term
| How can a spasm be diagnosed? |
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Definition
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Term
| Increase in spasms result in a decrease in what? |
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Definition
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Term
| Name 4 major determinants of myocardial blood flow. |
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Definition
1. Diastolic BP
2. Vasomotor Tone
3. Resistance to Flow
4. Left Ventricular End-Diastolic Pressure |
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Term
| What are atherosclerotic plaques composed of?(2) |
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Definition
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Term
| Name 2 things that can result from atherosclerosis. |
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Definition
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Term
| Fatty streak that consists of lipid-laden macrophages and smooth muscle cells |
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Definition
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Term
| Responsible for reduction of blood vessel compliance. |
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Definition
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Term
| Organization of "fibrous cap" of thrombi over advanced plaques that have developed on endothelial lining |
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Definition
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Term
| The more a vessel is blocked, the more prone it is to ___ which causes chest pain. |
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Definition
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Term
| Hyperplasia of intimal smooth ms cells is hallmark of advanced atherosclerosis creating a coronary artery that is prone to ___ |
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Definition
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Term
| Variant angina associated with ST-segment elevation, at rest, and not associated with any preceding increase in myocardial oxygen demand |
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Definition
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Term
| ___ elevation can likely cause infarction |
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Definition
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Term
| Framingham Study tested relationship between __ and __ factors and contribution to development of coronary artherosclerosis. |
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Definition
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Term
| The greater the number of risk factors present, the greater the likelihood that ___ and ultimately __, will exists |
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Definition
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Term
| Name 4 modifiable risk factors for myocardial perfusion |
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Definition
-Cigarette Smoking
-HBP (over 140/90)
-High Blood Cholesterol levels
-Physical inactivity |
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Term
| The best predictor is ratio of total cholesterol to HDL |
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Definition
| High blood cholesterol levels |
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Term
| Name 3 non-modifiable risk factors for myocardial perfusion |
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Definition
-Heredity
-Male sex
-Increased age |
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Term
| Sense of time urgency and easily aroused hostility or type A behavior |
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Definition
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Term
| nme 1 contributing risk factor for myocardial perfusion |
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Definition
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Term
| A vasodilator that is known to cause major headaches. |
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Definition
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Term
| Name 4 clinical courses for myocardial perfusion |
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Definition
1. Sudden Cardiac Death
2. Chronic Stable Angina
3. Acute Coronary Syndrome (ACS)
4. Cardiac Muscle Dysfunction |
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Term
| This is where the pt dies within 1 hour of the onset of symptoms |
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Definition
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Term
| This pt may carry nitro-glycerine tablets with them so if they have signs, tell them to take their meds |
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Definition
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Term
| What are 3 characteristic sof Acute Coronary Syndrome (ACS) |
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Definition
1. Unstable Angina (nitro may not help) (can occur during exercise or rest)
2. ST-segment elevation myocardial infarction (STEMI)
3. Non-STEMI |
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Term
| Related to HTN or damage to the heart |
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Definition
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Term
| Ventricular tachycardia and ventricular fibrillation, leading to cessation of cardiac output |
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Definition
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Term
| Heart beating so fast that blood is not going anywhere |
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Definition
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Term
| Heart is quivering so blood just sits in the vessels |
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Definition
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Term
| What is necessary to try to save a pt when they experience sudden cardiac death? |
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Definition
| Prompt delievery of CPR with AED and entry into emergency medical system |
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Term
| The lower ejection fraction is, the more likely the pt is to be put on what? |
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Definition
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Term
| Described as substernal pressure. Can occur anywhere from epigastric area to jaw. Symptoms are squeezing, tightness, or crushing. |
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Definition
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Term
| The imbalance in supply and demand of myocardial oxygen |
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Definition
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Term
| Well-established level of onset. Result of not enough blood supply to meet the metabolic demand. Usually can control symptoms by reducing the intensity of exercise or taking sublingual nitroglycerin |
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Definition
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Term
| Chest discomfort that is accelerating in frequency or severity, may occur at rest |
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Definition
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Term
| Unstable Angina or Acute Myocardial Infarction |
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Definition
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Term
| Name 4 factors that contribute to unstable angina. |
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Definition
1. Circadian variations in catecholamine levels
2. Increase in plasma viscosity
3. Increase in platelet activation
4. Pathological changes in atherosclerotic plaques |
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Term
| Develops a Q wave on ECG in subsequent 24-28 hours (transmural infarction) |
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Definition
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Term
| Does not develop a Q wave on ECG (referred to nontransmural or subendocardial region infarction) |
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Definition
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Term
| Name 10 medical management techniques of Acute Coronary Syndrome |
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Definition
1. Primary concern for management is to re-perfuse the area of the heart that is not getting enough blood and oxygen
2. Control for cardiac pain
3. Limit any amount of necrosis
4. Prevent Complications
5. Fibrinolysis and PTCA if within 3 hours of onset
6. Aspirin (to think blood)
7. Improve oxygenation
8. Limiation of infarct size
9. Prophylaxis for arrhythmias
10. Control of other complications |
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Term
| Name 4 medications that help control cardiac pain. |
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Definition
1. Nitrates (vasodilator)
2. Morphine (big pain reliever and respiratory depressor)
3. Beta Blocker (Increases heart contractility by slowing HR down and increasing CO. Diastolic period is longer to increase perfusion) |
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Term
| What does PTCA stand for? |
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Definition
| Percutaneous Transluminal Coronary Arteriogram |
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Term
| Name 2 complications with STEMI and non-STEMI |
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Definition
-Abnl contraction patterns
-Persistent angina and arrhythmias (STEMI) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Abnl movement, heart not working together |
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Definition
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Term
| Name 4 abnormal contraction patters (decrease CO) |
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Definition
Dyssynchrony
Akinesis
Hypokinesis
Dyskinesis |
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Term
| Name 3 factors of ventricular remodeling |
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Definition
1. with STEMI, changes in shape, size, and thickness of myocardium
2. Areas of ventricular dilation and ventricular hypertorphy
3. Factors that affect remodeling (size of infarct, ventricular load, and patency of artery that was infarcted) |
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Term
| That 3 factors that affect remodeling |
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Definition
1. Size of infarct
2. Ventricular load
3. Patency of the artery that was infarcted |
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Term
| How is prognosis for angina decided? |
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Definition
| Related to complications, infarction size, presence of dz on other coronary arteries, and left ventricular function |
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Term
| Do we know alot about the natural history of coronary dz? |
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Definition
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Term
| Knowledge of risk factors can assist in determining what? |
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Definition
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Term
| Name 5 ways to decrease HTN |
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Definition
Decrease salt intake
Exercise
Manage stress
Diet
Smoking cessation |
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Term
| Produces a pressure overload on the left ventricle. Diastolic dysfunction with impairment of LV relaxation develops early. |
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Definition
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Term
| What is the goal when treating hypertension? |
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Definition
| Normalize BP both as rest and during exertion; reverse LVH and myocardial dysfunction |
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Term
| With HTN, exercise is reduced by what? |
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Definition
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Term
| With HTN, __ __ increases subnormally and peak HR is lower which reduces CO |
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Definition
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Term
| Exercise leads to reductions in both __ and ___ BP |
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Definition
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Term
| There is a high percentage of pts referred to PT that have recognized or unrecognized what? |
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Definition
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Term
| PT should refer pt to DR if resting BP is high which is what? |
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Definition
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Term
| Symptoms that develop with stroke are mostly caused by __ events |
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Definition
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Term
| Name 3 treatments for stroke prevention |
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Definition
1. Risk factor reduction and medical management
2. Reduction in BP (very important)
3. Combo of aspirin, lipid-lowering meds, and antihypertensive meds |
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Term
| Name 3 implications for PT intervention in pts who have cerebrovascular dz. |
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Definition
1. Pts with dx of carotid or vertebral dz should have BP monitored at rest and with all new activities
2. Educated about primary and secondary prevention
3. Taught symptoms of instability |
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Term
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Definition
Can't feel face
Nausea
Confusion
One side of body is numb |
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Term
| Referred to as atherosclerotic occlusive dz |
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Definition
| PAD (peripheral artery dz) |
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Term
| Atheromatous plaque obstruction of large or medium-sized arteries supplying blood to the extremeties |
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Definition
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Term
| Pts with PAD are unable to produce normal increases in ___ __ __ |
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Definition
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Term
| In pts with PAD, __ __ leads to moderate to severe impairment in walking ability |
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Definition
| Intermittent claudication |
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Term
| ___ has improved pain-free and maximal walking tolerance on level ground and during constant-load treadmill exercise |
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Definition
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Term
| All pts with PAD should receive ___ and __ monitoring during PT eval |
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Definition
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Term
| Where renal artery stenosis results from atherosclerosis of the renal artery |
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Definition
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Term
| A pathological permanent dilation of the aortic wall involving any number of segments of the aorta. |
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Definition
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Term
| Described in terms of location, size, morphological appearance, and origin. Rupture is a major risk with this. |
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Definition
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Term
| Name 8 implications for PT with a pt who has PAD. |
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Definition
1. Check for pulsating tumor/mass in abdominal area
2. Bruit heard over swollen area in abdomen
3. Pressure on surrounding parts such as low back
4. Leg pain/claudication pain
5. Numbness in LEs
6. Excessive Fatigue
7. Poor distal pulses
8. Low back pain |
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