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How is hypertension defined by the American Heart Association?
- Systolic >140 and diastolic >90
- Patient is taking medications for HTN
- Doctor prescribed HTN medications
used to estimate risk of developing heart disease. High blood cholesterol a cholesterol greater than or equal to 240 mg/dL
Test for hypertension/CAD: A form of fat in the blood stream; the storage form of food used for energy. A desirable triglyceride level is <100
Test for Hypertension/CAD: The carrier of cholesterol; the “good” cholesterol. HDL’s transport cholesterol back to the liver for processing and excretion. A desirable HDL level is >35 mg/dL.
Test for hypertension/CAD: The carrier of cholesterol; the “bad” cholesterol. This cholesterol may get deposited in the lining of vessels of the vascular system. A desirable LDL level is <100 mg/dL.
How does hypertension develop
- Overactive Renin-Aldosterone problems (vasoconstriction)
- Overactive SNS firing continously
- Peripheral vascular resistence
- Insulin resistence/Diabetes
- 90 - 95% of the population
- Family History
- Kidney disease
- Taking stimulants or drugs
- Pregnancy Induced
What is normal BP range and different stages of hypertension
- Normal range 120/80
- Pre-hypertension–need lifestyle
- changes: systolic 120-139 diastolic 80-89
Stage I & II: Requires meds and lifestyle changes
What are some early symptoms of hypertension
- Vague headache
- Occasional dizziness
What are some S/S of advanced hypertension
- Morning Headache
- Blurred vision
What are some common medications given for hypertension and CAD
- Diuretics - decrease blood volume + plaque = decrease BP
- Beta - Blockers - SNS inhibitory mechanisms
- Direct vasodilators - relax blood vessles
- ACE Inhibitors - blocks angio I from becoming angio II
- Angiotesnsin inhibitor - blocks vasocontriction from angio II
- Calcium Channel Blockers - depolorization slowing
- HMG-CoA Reductase Inhibior - lower cholesterol levels
S/S of coronary artery disease (CAD)
- Typically asymptomatic until reaching advanced state
- Edema in the lower extremeties
Pre procedure Cardiac catheterization
- Physical Assessment
- Vital sings
- Pedal pulses
Post procedure Cardiac catheterization
- Bed rest 4 – 8 hrs.
- Patient must lay flat
- Assess site for Vasoseal/Femstop
- Pedal pulses
- Transient substernal chest pain brought on by exercise, strees, extreme temperature changes, eating a heavy meal.
- Less than 15 minutes that is relieved with nitroglycerin and/or rest is considered angina.
- Nitroglycerin can be given 1 pill every 5 minutes for angina
- Nitroglycerin will decrease BP
- Nitroglycerin is a vasodilator with a side effect of light-headedness
What signs and symptoms will a woman display while having an MI
back and epigastric pain
- Plaque ruptures and clogs the coronary arteries of
- the heart can cause heart muscle death distal to the region of blockage
What is the initial treatment for a patient with an MI.
- 1. 12-lead EKG
- 2. Morphine
- 3. Nitroglycerin
- 4. Order a Troponin
Why would an opiod analgesic be used for an acute MI
Relieve anxiety, pain, distress, and reduce myocardial oxygen demand by causing vasodilation
When is an EKG performed
- Tracing of the electrical activity of the heart.
- First test to be performed before medications are given for angina, MI, or CHF
What is the treatment for a patient who is having an MI within the 1rst 6 hours
Fibrinolytic, aspirin, antidysrythmic
Blood test to differentiate between unstable angina and MI in patients with chest pain. A troponin level > 0.1 ng/mL is reflective of a possible MI. Normal level should be <0.03
- Used in the event of a heart attack.
- Special drugs that work to break up clots that are blocking an artery.
- Sometimes called clot busters.
- used in the case of an MI.
- Reduce ventricular conduction
What are the different diagnositic studies for CHF/CAD
- Lipid Panel
- Fasting Blood Sugar
- Typically used for CHF
- B-Type natiuretic peptied is released from the ventricles in response to stress.
- A level of < 100 pg/mL is good
- C-reactive protien is a blood test marker for inflammation in the body; which can cause artherosclerosis.
- You are at high risk for cardiovascular disease if your CRP level is higher than 3.0 mg/L
Machine that is worn for 24 - 48 hours that measres heart rhythms.
Test that uses sound waves to create a moving picture of the heart without using radiation. This test can detect back flow and cross flow
Exercise Stress Test
Electrodes are attached to an ECG monitor while the patient exercises on a treadmill. If the patient develops chest pain or angina then this is a concern
Cardiac Computed Tomography
Multiple X-rays taken of the heart without using IV or contrast dye. A negative test indicates low risk but does not absolutely rule out a future MI
Uses a CT scanner in which contrast dye is injectced in the catheter vein in the arm to detect for artherosclerosis in the coronary arteries of the heart
Passing a thin flexible cardiac catheter into the right or lef side of the heart either from the groin or the arm in which ballon angioplasty can be performed if there is blockage in the coronary artery.
- Drug used to prevent clot formation
- Coumadin with a side efffect of hemmorage
What is a good fasting blood sugar level
Anything less than or equal to 110
Reflection of #RBC with O2/CO2 carrying capacity
- % of blood volume made up of RBC's
- 42% - 52%