Term
| What is the difference between stable and unstable angina? |
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Definition
| unstable angina has chest pain/discomfort at rest |
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Term
| What is the cause of unstable angina? |
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Definition
| multifactorial: coronary AS, fibrous cap erosion --> thrombosis |
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Term
| What is another term for crescendo angina? |
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Definition
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Term
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Definition
| a milder form of heart attack; non-ST elevation myocardial infarction |
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Term
|
Definition
| partially occluded coronary artery |
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Term
| How is NSTEMI different from unstable angina? |
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Definition
| cardiac enzymes are released by damaged cardiac muscle |
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Term
| What are the 3 cardiac enzymes we test for? |
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Definition
| troponin I and T, Creatine kinase - myocardial band |
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Term
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Definition
| more severe myocardial infarction than NSTEMI |
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Term
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Definition
| total occlusion of coronary artery |
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Term
| How long after a STEMI does myocardial necrosis occur? |
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Definition
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Term
| How many Americans have an MI per yr? How many die? |
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Definition
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Term
| What are s/sx of myocardial infarction? |
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Definition
| sudden pericardial pain, may radiate to left arm and jaw |
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Term
| How long does pain last during STEMI? Will NTG relieve this? |
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Definition
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Term
| What % of AMI are mild or silent? |
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Definition
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Term
| What are 3 secondary s/sx of MI? |
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Definition
| nausea, diaphoresis(sweat), dyspnea |
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Term
| What are clinical signs that an MI has occurred? |
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Definition
pt is in pain, apprehensive. Hypotension and tachycardia often present
ECG abnormalities, Deep Q waves due to loss of ventricular muscle mass, ST segment abnormalities
cardiac enzymes in blood |
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Term
| What does MI occur most often? |
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Definition
| morning as the body is waking up and trying to get going |
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Term
| What is released by the ANS during an MI? |
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Definition
| Mass amounts of epinephrine to try and get heart going |
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Term
| What causes dyspnea during MI? |
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Definition
| blood backs up in to the lungs due to ventricular constriction |
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Term
| What are the immediate therapies for MI? |
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Definition
morphine for pain
O2
NTG
ASA
lidocaine (antiarrhythmic) if necessary
induced hypothermia (91.4*F or 33*C)
heparin for NSTEMI |
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Term
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Definition
| platelet inhibitors to prevent thrombus formation in an ongoing MI |
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Term
| What is used to treat a STEMI? |
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Definition
| Try to break clot through t-PA (tissue type plasminogen activator); given within 3 hrs of STEMi onset |
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Term
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Definition
| it breaks down fibrin, and only fibrin |
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Term
| What are the serious side effects of TPA? |
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Definition
| It breaks down ALL fibrin clots, so bleeding out is possible |
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Term
| What does low molecular weight heparin do? |
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Definition
| Given with t-PA to enhance it's effect |
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Term
| What is adjunctive therapy? |
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Definition
beta blockers to decrease oxygen demand of myocardial tissue
ACE inhibitors to reduce post-infarction remodeling
low dose ASA
clopidogrel enhances ASA
prasugrel works like clopidogrel
statins stabilize plaques
anticoagulants |
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Term
| What does thymosin beta-4 do? |
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Definition
prevent cell death and limit scar formation
injection of bone marrow cells into damaged areas of heart |
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Term
| What are the complications of MI? |
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Definition
death
arrhythmia
HF = greater than 30% of myocardium infarcted
chamber wall defects: ventricular septum, ventricular aneurysm, cardiac rupture |
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Term
| What is sudden cardiac death? |
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Definition
cardiac death within 6 hrs of symptoms
Can be caused by cardiomyopathy, congenital, valvular dz, |
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Term
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Definition
| return of blood through heart valve |
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Term
| What is a valvular prolapse? |
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Definition
| sinking down or protrustion of a tissue |
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Term
| What is, by far, the most common valvular stenosis? |
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Definition
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Term
| What causes aortic stenosis? |
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Definition
| calcification of heart valves |
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Term
| Does valvular calcification indicate a blood Ca++ level problem? |
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Definition
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Term
| What is rheumatic heart dz? |
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Definition
| valvular dz due to autoimmune attack; rheumatic fever |
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Term
| What does a stenotic aortic valve cause? |
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Definition
| pressure overload --> left ventricular hypertrophy |
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Term
| What are the signs of aortic valve stenosis? |
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Definition
systolic ejection murmur (not considered a true heart sound)
S2 is soft/quiet
S4 heart sound develops due to hypertrophy |
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Term
| What are the s/sx of aortic stenosis? |
|
Definition
First, it has to be very severe. Only 30% of blood flow is still present.
1. Angina; 50% dead in 5 years (without tx)
2. syncope upon exercise
3. HF (worst case) 50% dead in 1-2 yrs without tx |
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Term
| What is mitral stenosis etiology? |
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Definition
Almost all cases are secondary to rheumatic heart dz
occurs in women primarily |
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Term
| What does mitral stenosis cause? |
|
Definition
impedes left ventricular filling
increased load on right ventricle to compensate
pulmonary congestion follows blood backup |
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Term
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Definition
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Term
|
Definition
| accumulation of fluid in peritoneal cavity |
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Term
| What does stagnat blood in an enlarged atrium lead to? |
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Definition
| embolism. Enlarged atrium seen in mitral stenosis |
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Term
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Definition
| leukocytes, bacteria attach to valves in heart? |
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Term
| What is a systolic murmur? Diastolic murmur? |
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Definition
Systolic murmur is when pulmonary/aortic valves are leaking
Diastolic murmur is when mitral/tricuspid valves are leaking |
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