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Cardiac Disorders
Patho L7
| Question | Answer |
|---|---|
| Ischemia | a medical condition where reduced blood flow deprives body tissues of essential oxygen and nutrients |
| Unstable Angina | • New episode or increased severity • Not relieved with rest • Medical emergency |
| Chronic Stable Angina | • Consistent, chronic pain • Self-medication with nitroglycerin |
| What causes unstable angina? | Myocardial ischemia |
| Unstable Angina Pathophysiology | Cardiac tissue oxygen demands exceeds delivery |
| Coronary thrombus— | blockage |
| Unstable Angina Signs and Symptoms | Chest pain brought on by exertion Pain radiating to shoulder, jaw, and down the arm Crushing sensation on left side of chest |
| What occurs in an MI (Myocardial Infarction) | ‒ Blood clot (coronary thrombosis) ‒ Atherosclerotic plaque - Oxygen starvation |
| Unstable Angina Diagnostics | • High sensitivity C-reactive protein (hs-CRP) • Cardiac enzymes • High sensitivity cardiac troponin (hs-cTn ECG- can look completely normal or show transient (temporary) signs of heart muscle ischemia (reduced blood flow) |
| Angina: Surgical and Endovascular Options | Coronary artery bypass graft (CABG) • Creates new routes around occlusions |
| Chronic Stable Angina | Recurring episodes of chest pain |
| Chronic Stable Angina Treatment | Nitroglycerin preparations: Tablet, sprays |
| Acute Myocardial Infarction | Prolonged cardiac tissue ischemia § Irreversible damage Due to: • Atherosclerotic plaque • Thrombus |
| Greater than 30 minutes of ischemia causes ________ damage | irreversible |
| Zone of injury | • Surrounds zone of ischemia • Some recoverable cells |
| Necrotic cells release? | Release cellular contents (cardiac markers such as troponin) |
| MI Signs and Symptoms and Diagnosis | Symptoms • Crushing chest pain • Levine’s sign (clenched fist over the chest) • Pain radiating to shoulder, jaw, down left arm • Sweating, nausea, anxiety • Anginal equivalents |
| “Silent MI” | • No signs or symptom |
| Can an ECG diagnose MI? | NO ECG can appear similar in angina pectoris and MI |
| What is used to diagnose MI then? | Highly sensitive cardiac troponin and CPK- MB are tests used to confirm diagnosis of MI |
| MI Complications Dysrhythmia | Heart is destabilized electrically |
| MI Complications Thromboembolism | • Poorly contracting heart chambers cause stagnant blood, increasing risk for clot formation |
| MI Complications Pericarditis | Pericardial friction rub, stabbing pain with inspiratio |
| Heart failure progresses to | cardiogenic shock Ventricles fail to pump sufficient bloo |
| ***BP, cardiac output drop → hypoperfusion of organs → leading to organ failure | |
| Infectious Endocarditis (IE) | Normally bacterial Damages valves- Develops on valve |
| Atrial Fibrillation | Most common arrhythmia • Absence of coordinated, rhythmic atrial contractions Increase the risk of clot formation and stroke Multiple irregular fibrillatory P waves |
| Premature Ventricular Contraction (PVC) | Ventricle beats independently § Widened QRS complex |
| Ventricular Tachycardia | Rapid, ineffective ventricular contractions Series of widened QRS waves Without P or T waves |
| Ventricular Fibrillation | Fibrillation = quivering May be precipitated by PVC falling on the T wave, interrupting refractory period Contraction is uncoordinated, with no effective pumping Rhythym degenerates |
| Disruption in electrical signal Supraventricular: | SA node, atria, AV node |
| Disruption in electrical signal Ventricular | Bundle of His, bundles branches, Purkinje fibers, and ventricle musc |
| Heart block | Conduction system impulse blocked ‒ Most commonly at the AV node ‒ Complete heart block: |
| left-sided failure is the leading cause of | right-sided failure |
| Left-Sided Heart Failure What happens | The left ventricle cannot pump oxygen-rich blood out to the body effectively, or it becomes too stiff to relax and fill properly. This causes blood to back up into the lungs (pulmonary circulation). |
| Main symptoms | • Shortness of breath (dyspnea), especially during exertion or when lying flat (orthopnea) • Persistent cough, wheezing, or crackles in the lungs • sputum (in severe pulmonary edema) • Extreme fatigue, weakness, and exercise intolerance • Tachycardia |
| Right-Sided Heart Failure What happens | The right ventricle is too weak to pump deoxygenated blood efficiently to the lungs. This causes blood and fluid to back up into the body's systemic veins and tissues. |
| Right-Sided Heart Failure Symptoms | • Swelling (peripheral edema) in the legs, ankles, feet, or lower back • Abdominal bloating, nausea, loss of appetite, or fluid buildup in the abdomen • Enlarged liver • Bulging or distended neck veins • Unexplained weight gain from fluid retention |
| Left-Sided Heart Failure Clinical Presentation |
Created by:
liladdoyle