Cardiac

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Author:
CharlieSCC
ID:
183345
Filename:
Cardiac
Updated:
2012-11-12 23:14:07
Tags:
cardiac Angina MI CHF
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Description:
Cardiac unit
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  1. Definition- Coronary Artery Disease
    Variety of pathologic conditions that obstruct blood flow through the arteries that supply the heart (coronary arteries)
  2. CAD

     Atherosclerosis
    fatty deposits/plaques
  3. CAD

     Arteriosclerosis
    Arteriosclerosis- narrowing/hardening of arteries: aging
  4. CAD
    Atherosclerosis- fatty deposits/plaques

    Arteriosclerosis- narrowing/hardening of arteries: aging

    Arteritis

    Coronary Artery Spasm

    Coronary thrombosis- clot produces occlusion

    Embolus

    Coronary Arteries

    Hyperlipidemia
  5. CAD

    Hyperlipidemia
    Increased lipid levels in the blood results in:

    Atherosclerosis

    Accumulation of fatty materials, clotting factors, Ca++, and fibrous tissue within the arterial walls

    Plaque (atheromas) form

    Lumen becomes narrowed

    Blood supply obstructed to the myocardium
  6. CAD

     Atherosclerosis
    Progression of atherosclerosis

    Usually develop near the origin and bifurcation of the main coronary arteries

    Left coronary artery more often affected

    First effect is localized; then more diffuse

    Manifestations of myocardial ischemia do not occur until tissues blood supply is reduced by 60-75%

    Angina

    Myocardial Infarction•          Sudden Death
  7. CAD

    Angina Pectoris
    At rest, myocardial blood flood maintained despite considerable coronary artery narrowing

    If myocardium has increased metabolic needs: physical activity

    Needs not met d/t this narrowing

    Symptoms result from insufficient supply of O2 to myocardium

    Since insufficient O2- convert from aerobic to anaerobic metabolism

    Byproduct: lactic acid

    Initiate sensory receptors leads to PAIN
  8. CAD

    Myocardial Infarction
    One of the coronary arteries or its branches suddenly b/c occluded

    Caused by coronary thrombosis, vasoconstriction of the arteries, or sudden atherosclerotic changes (plaque rupture)

    Area deprived of O2

    Myocardial tissue dies

    Myocardial Infarction
  9. Non-modifiable Risk Factors for CAD
    Age (>65 yo)

    Sex (Male until after Menopause)

    Race (African American)

    Family History
  10. Modifiable Risk Factors for CAD
    Hyperlipidemia (↑ LDL)

    High fat diet

    HTN

    DM

    Obesity (central abd)

    Smoking

    Physical inactivity
  11. Diagnosis of Angina
    Pt history- manifestations exhibited

    EKG- changes seen during chest pain but return to baseline

    Holter monitoring

    Coronary angiogram (Cardiac Catheterization

    Stress Test
  12. Treatment for Angina Episode
    Rest

    O2

    Monitor for dysrhythmias

    Sublingual Nitroglycerin
  13. Angina Meds
    Sublingual Nitroglycerin

    • Other forms of Nitroglycerin- long term prevention of Angina
    •      Nitro-Bid/Isordil- po

    • Beta Adrenergic Blocking Agents (“Beta Blockers”)
    •       Inderal (propranolol); Tenormin (atenolol)-  “olol”

    • Calcium Channel Blockers
    •      Procardia (nifedipine); Calan, Isoptin (verapamil)
  14. Activity level for Client with CAD/Angina
    Minimize precipitating events

    Smoking cessation

    Engage in regular exercise

    Wt reduction

    Avoid caffeine

    Regular medical followup

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