Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
40 Cards in this Set
- Front
- Back
What are some risk factors for ischemic heart disease?
|
1. age
2. family history 3. tobacco abuse 4. HTN 5. hyperlipidemia 6. DM 7. obesity |
|
What are some common signs and symptoms of ischemic heart disease?
|
1. chest pain/pressure (can also radiate)
2. diaphoresis 3. nausea 4. dyspnea 5. dizziness 6. heartburn/epigastric pain 7. any complaint that is same as in previous cardiac event |
|
What are some signs and symptoms that are probably not cardiac in nature?
|
1. feels like room is spinning
2. perioral numbness 3. pain radiating into legs 4. tingling in fingers and face 5. sharp, stabbing pain w/inspiration 6. reproduceable pain 7. rating of cardiac pain on 1-10 scale |
|
In HF, which side will cause pulmonary edema in general?
|
left-sided HF
|
|
What is the clenching chest sign known as?
|
levine sign
|
|
What is the most common cause of right-sided HF?
|
left-sided HF
|
|
What is the normal BP in the right heart? Left heart?
|
1. 25/10
2. 120/80 |
|
What signs might be found during physical exam of patient with ischemia?
|
1. diaphoretic
2. clenching chest (Levine sign) 3. rales on lung auscultation 4. new heart murmurs 5. S3 gallop 6. jugular venous distention 7. peripheral edema 8. pulsus alternans 9. hypotension and tachycardia 10. tender liver |
|
What are the age risk factors for ischemic heart disease in males and females?
|
1. males >45 y/o
2. females >55 y/o or premature menopause or HRT |
|
What are the family history risk factors for ischemic heart disease in males and females?
|
1. must occur before 55 y/o in father or 1st degree male relative
2. must occur before 65 y/o in mother or 1st degree female relative |
|
What are high homocysteine levels associated with?
|
increased incidence of ischemic heart disease
|
|
What 2 drug combo is used for HTN with known CAD?
|
BB's (cardioprotective) and ACE-I's
|
|
T or F: folic acid, vitamin E, and anti-oxidants have all been proven to treat ischemia.
|
false
|
|
What will oxidized LDL do to the risk factors for ischemic heart disease?
|
amplify them
|
|
What is the 10 year risk calculator based upon?
|
1. age
2. gender 3. total cholesterol 4. HDL 5. systolic BP 6. smoking history |
|
T or F: CRP has been linked to symptomatic atherosclerosis.
|
true
|
|
What are the LDL goals in high risk CHD? Moderately high risk CHD? Moderate risk CHD? Low risk CHD?
|
1. high risk goal=<100mg/dL (optional goal=<70mg/dL)
2. moderately high risk goal= <130mg/dL (optional goal=<100mg/dL) 3. moderate risk goal=<130mg/dL 4. low risk goal=<160mg/dL |
|
What defines high risk CHD? Moderately high risk? Moderate risk? Low risk?
|
1. 10 year risk>20%
2. >2 risk factors (10 year risk=10-20%) 3. >2 risk factors (10 year risk=<10%) 4. <1 risk factor |
|
What are the 3 determinants of oxygen supply to the coronary aa.?
|
1. coronary perfusion pressure
2. time available for coronary blood flow 3. coronary vessel quality |
|
What are the 3 determinants of oxygen demand to the coronary aa.?
|
1. HR
2. contractility 3. afterload |
|
What is the formula for coronary perfusion pressure?
|
CPP=diastolic pressure-LVEDP
|
|
Which MI cardiac marker usually appears in <6 hours? After 12-36 hours? 2-3 days?
|
1. myoglobin
2. troponin and CKMB 3. LDH and AST |
|
What is an exercise stress test looking for?
|
ST changes during max HR
|
|
When would you order an exercise stress test? Heart cath? Stress/chemical ECHO?
|
1. if patient can tolerate exercise and MI risk is low
2. if patient MI risk is high 3. in-between patients |
|
What are the sequential treatments for acute ischemia?
|
1. oxygen
2. ASA-inhibits platelet activation 3. plavix-inhibits platelet aggregation 4. heparin-inhibits factor X and thrombin 5. morphine-analgesic and vasodilator 6. NO 7. BB 8. ACE-I's 9. glycoprotein 2B3A inhibitors |
|
For ST elevations to be valid, how often should they be present in an ECG?
|
must be present in 2 contiguous leads for 3 or more beats
|
|
If you can't get ischemic patient to cath lab in ____ minutes, you must give thrombolytics.
|
90
|
|
What are the indications for thrombolytics in AMI?
|
1. can't get to cath lab <90 minutes
2. 1mm ST elevation in 2 contiguous leads 3. new LBB 4. patient has presented <12 hours from sx onset 5. no contraindications |
|
What are absolute contraindications for thrombolytics?
|
1. prior intracranial hemorrhage
2. cerebral AVM 3. malignant cranial neoplasm 4. ischemic stroke < 3 months 5. suspected aortic dissection 6. active bleeding 7. significant closed head or facial trauma < 3 months |
|
What are relative contraindications for thrombolytics?
|
1. severe or poorly controlled HTN
2. hx of ischemic stroke > 3 months 3. prolonged resucitation > 10 minutes 4. major surgery < 3 weeks 5. recent internal bleeding < 3 weeks 6. noncompressible vascular punctures 7. allergies to thrombolytics 8. pregnancy 9. active peptic ulcer 10. current use of anticoagulants 11. patient is stable and symptoms began > 12 hrs ago |
|
What is the rule of thumb for interventions if 2 or less coronary aa. are atherosclerotic? 3 or more?
|
1. percutaneous coronary intervention (drug-eluting stents)
2. coronary artery bypass graft |
|
If a drug-eluting stent is chosen for treatment of CAD, what drug should be given with it?
|
plavix
|
|
What is a possible adverse effect of CABG?
|
cognitive problems
|
|
How does a non-STEMI differ from a STEMI?
|
non-STEMI has no ST elevation on ECG
|
|
Non-STEMI's have s/s of what ischemic condition?
|
unstable angina
|
|
What drug can produce an intense coronary vasospasm?
|
cocaine
|
|
What is used to treat prinzmetal's angina?
|
CCB's
|
|
What are some possible post-MI complications?
|
1. ruptures
2. stents close 3. pericardial tamponade 4. arrhythmias 5. pericarditis |
|
What is a possible therapeutic intevention for someone post-MI with a weakened heart?
|
intra-aortic balloon pump: balloon inflates during diastole to allow heart to work better
|
|
What therapy is indicated to prevent the brain from swelling in cases of post-MI reperfusion?
|
therapeutic hypothermia
|