Cardiac

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  1. Coronary Circulation
    • RCA- right coronary artery. perfuses RA, RV, inferior LV +/- SA +AV nodes (block heart rhythm block
    • LCA- left coronary artery. 2 major branches
    • - LAD (left anterior descending artery)- perfuses LV, anterior septum, and apex
    • - L circumflex- perfuses LA, lateral & posterior LV +/- SA & AV nodes
    • ** 75% of blood flow to heart is during diastole
    • feeds the body during systole
    • important- chest pain- control time in which heart can perfuse itself
  2. Coronary artery disease
    • #1 cause of death in US
    • > 25 million adults diag with hear dx
    • 45% MI- those > 65
    • > 50% deaths= females
    • women dying from this
  3. CAD- what is happening in the body
    • Atherosclerosis- plaque formation in vessels- dec blood supply
    • vasospasm- cant let blood thru
    • dec O2 supply- think pt w/bronchitis
    • inc O2 demand- anything that makes your heart work more
  4. CAD PATHO
    • Endothelial injury
    • Inflammatory process
    • -monocytes
    • - fatty streaks
    • 1. Inflammation
    • - smoking, HTN can cause injury to the endothelial
    • smooth muscle cell proliferation (grow more)
    • - atheromas/plaques
    • 2. Plaque formation
    • - form plaque - build up narrowing
    • Rupture
    • platelet aggregation
    • 3. thrombosis formation- risk for stroke
    • - unstable smoking, htn inc lipid- platelets try to fix rupture in vessels0 form clot thrombosis
  5. PATHO- Chronic & collateral circulation
    heart can build up new vessels to get blood where it needs to go- tissues going on for a long time. angioplasty can make this go away
  6. cardiac assessment
    • Hx- risk factors
    • nonmodifiable
    • - heredity-
    • - age men 45 women 55
    • - gender- males
    • - ethnicity- african american inc mortality
    • Modifiable
    • - ** smoking
    • - ** high chol
    • - ** HTN
    • - obesity, sedentary
    • - DM, stress, drugs (illicit drug cocaine) vasocontrition
    • metabolic syndrome
    • - CA, P, Cerbral vascular p. 729
  7. Diagnostic studies
    • Lipoproteins - helps to move non-soluble water
    • - chol- 12 hr fasting
    • - HDL "good"
    • - LDL/VLDL- goal = <130mg/dl
    •    - gets stuck in artery
    • you need this in your body
  8. Serum markers
    • Homocysteine
    • - elevation leads to inhibition of anticoagulation and endothelial damage (Amino acid deviaritive, eleb helps CAD progress)
  9. Heart Disease in Women
    • rates of diagnosis and death rising
    • inc after menopause
    • AA mortality 70% higher
    • strong genetic link
    • DM= 7x more CV events- they are at extreme risk
    • HTN= greater risk also
    • Smoking- inc risk
  10. Heart Disease in Women- pain
    • Pain- varies greatly **
    • - more generalized
    • - heaviness, squeezing mid back, arm, shoulder
    • - palpitations or fleeting pain
    • - antacids may relieve
    • - MI pain- neck, back, arm, shoulder, jaw
    • - elderly w/DM may not have any pain- neuropathy
    • EKG- may not have classic changes
  11. Heart Disease in Women- focus
    • risk assessment- non v modifiable risk factors Look at these things
    • ETT- more false (+) in women excerise tolerance test- stress test lots of false + chest pain but may not be
    • cardiac cath- most reliable **
  12. Primary Prevention
    • Diet
    • exercise- FITT
    • - Frequency 5 times a week
    • - Intensity- moderate
    • - type- cardio
    • - time- 30 mins/day
    • Control HTN
    • Control DM
    • Control HLD
    • Smoking cessation
    • Control modifiable risk factors. Meds too
    • Diet and exercise
  13. Cardiac Diet
    • lifestyle modification
    • total fat < 25-35% total calories
    • Cholesterol < 200mg/dl
    • high fiber- good for the heart- more fruits veggies less fat
    • low sodium- 2-3g
    • avoid caffeine

Card Set Information

Author:
Prittyrick
ID:
329016
Filename:
Cardiac
Updated:
2017-03-01 00:33:05
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