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N126-U3-I. MI/CHF #1
Dobrisky-Cardiac Module: pathophys, diagnostic tests, MI vs Angina
| Question | Answer |
|---|---|
| How does atherosclerosis affect coronary arteries? | The lumen is narrowed and can cause eventual complete blockage. |
| As a result of progressive coronary artery disease, what happens to cardiac output? | it decreases |
| Decreased cardiac output leads to what changes in tissue perfusion? | it decreases |
| What is the sequence of events during an acute myocardial infarction? | The coronary artery ruptures, a clot forms, vasoconstriction occurs which results in ischemia/injury/death of tissue. |
| What is the role of the sympathetic nervous system during myocardial infarction? | peripheral vasoconstriction, an increase in afterload, an increase in preload and increase in myocardialoxygen demand and further myocardial ischemia and possibly cell death. |
| The zone of infarction describes what? | The area of the ventrical wall that has been damaged. |
| Necrosis is in what area of the zone of infarction? | the center |
| Describe the cell in the center of this zone. | Nectrotic, cell death, no tissue is being perfused. |
| What is the middle layer of the zone of infarction? | the area of hypoxia or injury |
| What is the outermost perimeter of the zone of infarction? | the area of ischemia. |
| Describe typical pain associated with myocardial infarction. | intense, crushing, substernal or anterior chest pain which may radiate to neck, jaw and back. |
| Is typical pain with MI relieved by NTG and/or rest? | No. |
| Describe atypical pain associated with an MI. | pain may radiate to the neck, jaw, back or down the right chest and arm. |
| What type of pain is associated with a silent MI? | No pain |
| What symptom of an MI is most common in the elderly? | disorientation |
| Nausea/indegestion, dyspnea and SOB/crackles are symptoms more commonly found in which gender? | Women |
| Decreased urinary output is considered a symptom in what stage of an MI? | late stage |
| Describe the skin of a patient during an MI? | pale, cool, diaphoretic |
| What is the underlying cause of all symptoms of MI? | decreased oxygen |
| Decreased oxygen will cause irritation of what nerve? | the phrenic nerve |
| What serum enzymes are most important to determining if the pt has suffered a myocardial infarction? | CPK, LDH, SGOT (AST) |
| When will CPK show signs of an MI? | 3 to 6 hours |
| When will LDH show signs of an MI? | 8 to 12 hours |
| When will SGOT (AST) show signs of an MI? | 6 to 10 hours |
| What is serum troponin? | myocardial muscle protein that breaks down when MI occurs |
| When will Serum troponin I show signs of an MI? | 3 hours to 7 days |
| When will serum troponin T show signs of an MI? | 3 and 1/2 hours to 12-14 days. |
| What is the onset and decline of serum myoglobin? | onset-one hour, decline-4 to 6 hours |
| Hb and HCT may ________ in CV disease. | increase |
| WBC usually _________ in CV disease. | increases |
| Hb and HCT may decrease in _________. | anemias |
| What blood coagulation tests should be checked? | PT/INR and PTT |
| Why should blood coagulation tests be done? | to check for anticoagulation and bleeding. |
| An increase in platelets will lead to what? | clotting |
| How do elevated serum lipids affect heart health? | increased lipids lead to atherosclerosis |
| Atherosclerosis prevents what to the myocardium? | prevents adequate tissue perfusion |
| What information may a 12 lead ECG give about a patient suffering an MI? | arrhythmias, inverted T wave of ischemia, ST segment elevation of injury and Q wave changes in necrosis. |
| Inverted T waves indicates | ischemia |
| ST segment elevation indicates | injury |
| Q wave changes are associated with | necrosis |
| What arteries might be affected in an acute MI? | Left anterior descending, left circumflex and right coronary artery |
| Nausea and/or belching is a common symptom of which, an MI or angina? | angina |
| Extreme fatigue is a common symptom of which, an MI or angina? | MI |
| What are the goals of treatment of acute MI? | Limit infarct size, prevent and recognize complications. |
| How does thrombolytic therapy increase ventricular function? | it decreases infarct size |
| How does thrombolytic therapy increase survival? | by dissolving clots |
| What affect does morphine sulfate have on BP? | decreases |
| Is morphine a vasodilator or vasoconstrictor? | vasodilator |
| How does lowering BP and dilating vessels affect the workload of the heart? | decreases |
Created by:
Lori Dobrisky
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