Cardiac system
What are major cultural differences? BP, gender differences, ethnicity
- BP: Hypertension in black Americans is among the highest in the world.
- Gender: More men than women have hypertension up to age 64 yrs. After the age of 65, a
higher percentage of women than men. Leading cause of death in women is CVD
- Ethnicity:
What are some changes that happen as we age? List 3-4 major changes
- Increase in systolic BP. This is caused by thickening
and stiffening of the large arteries, which in turn are
caused by collagen and calcium deposits in vessel
walls and loss of elastic fibers.(arteriosclerosis)
- Cardiac output doesn’t change or resting heart does
not change. Heart does not enlarge.
- Dysrhythmias (irregular heartbeats). The presence of
supraventricular and ventricular dysrhythmias
increases with age.
- CVD increases with age. Lifestyle habits (smoking,
chronic alcohol use, obesity, lack of exercise and diet)
play a significant role in heart disease.
- Ectopic beats are common in aging people.
- Electrocardiograph:
o Proloned P-R interval (first-degree AV block)
o Prolonged Q-T interval
o QRS interval is unchanged
o Left axis deviation from age-related mild LV
hypertrophy and fibrosis in left bundle branch
o Increased incidence of bundle branch block
What are some common risk factors for cardiovascular disease? List 3-4 modifiable and non-
modifiable
- Modifiable Risk Factors: smoking, diet, alcohol use, exercise patterns and stress
- Non-Modifiable Risk Factors: gender, age, genetrics
, - Elevated serum cholesterol, elevated blood pressure, blood glucose levels above 100
mg/dL or known diabetes mellitus, Obesity, any length of hormone replacement therapy
for post-menopausal women, cigarette smoking, low activity level.
What are some common subjective complaints? Chest pain, etc. just list
- Chest pain (angina)
- Dyspnea (shortness of breath)
o Paroxysmal nocturnal dyspnea (shortness of
breath generally occurring at night) occurs with
heart failure. Lying down increases the volume of
intrathoracic blood, and the weakened heart
cannot accommodate the increased load.
Classically, the person awakens after 2 hours of
sleep, arises, and flings open a window with the
perception of needing fresh air.
- Orthopnea: the need to assume a more upright
position to breath. Note the exact number of pillows
used.
- Cough: Sputum production (coughing up material from the respiratory tract)
o Hempotysis (coughing up blood)
- Fatigue: Fatigue from decreased cardiac output is worse in the evening, whereas fatigue
from anxiety or depression occurs all day or is worse in the morning.
- Cyanosis or pallor: Cyanosis (blusish discoloration) or
pallor (pale) occurs with MI or low cardiac output,
decreased tissue perfusion
- Edema: Edema (swelling in feet and legs) is dependent
when caused by heart failure. Cardiac edema is
bilateral. Worse in evenings. Better in the morning
after elevating legs all night.
- Nocturia: Nocturia (urgent need to urinate at night) recumbency at night promotes fluid
resportion and excretion; this occurs with heart failure in the person who is ambulatory
during the day
- Past cardiac history: History of: hypertension, elevate
cholesterol or triglycerides, heart murmur, congenital
heart disease.
- Family cardiac history: Family history of hypertension,
obesity, diabetes, CAD, sudden death at younger age
- Patient-centered care (cardiac risk factors): nutrition,
What are major cultural differences? BP, gender differences, ethnicity
- BP: Hypertension in black Americans is among the highest in the world.
- Gender: More men than women have hypertension up to age 64 yrs. After the age of 65, a
higher percentage of women than men. Leading cause of death in women is CVD
- Ethnicity:
What are some changes that happen as we age? List 3-4 major changes
- Increase in systolic BP. This is caused by thickening
and stiffening of the large arteries, which in turn are
caused by collagen and calcium deposits in vessel
walls and loss of elastic fibers.(arteriosclerosis)
- Cardiac output doesn’t change or resting heart does
not change. Heart does not enlarge.
- Dysrhythmias (irregular heartbeats). The presence of
supraventricular and ventricular dysrhythmias
increases with age.
- CVD increases with age. Lifestyle habits (smoking,
chronic alcohol use, obesity, lack of exercise and diet)
play a significant role in heart disease.
- Ectopic beats are common in aging people.
- Electrocardiograph:
o Proloned P-R interval (first-degree AV block)
o Prolonged Q-T interval
o QRS interval is unchanged
o Left axis deviation from age-related mild LV
hypertrophy and fibrosis in left bundle branch
o Increased incidence of bundle branch block
What are some common risk factors for cardiovascular disease? List 3-4 modifiable and non-
modifiable
- Modifiable Risk Factors: smoking, diet, alcohol use, exercise patterns and stress
- Non-Modifiable Risk Factors: gender, age, genetrics
, - Elevated serum cholesterol, elevated blood pressure, blood glucose levels above 100
mg/dL or known diabetes mellitus, Obesity, any length of hormone replacement therapy
for post-menopausal women, cigarette smoking, low activity level.
What are some common subjective complaints? Chest pain, etc. just list
- Chest pain (angina)
- Dyspnea (shortness of breath)
o Paroxysmal nocturnal dyspnea (shortness of
breath generally occurring at night) occurs with
heart failure. Lying down increases the volume of
intrathoracic blood, and the weakened heart
cannot accommodate the increased load.
Classically, the person awakens after 2 hours of
sleep, arises, and flings open a window with the
perception of needing fresh air.
- Orthopnea: the need to assume a more upright
position to breath. Note the exact number of pillows
used.
- Cough: Sputum production (coughing up material from the respiratory tract)
o Hempotysis (coughing up blood)
- Fatigue: Fatigue from decreased cardiac output is worse in the evening, whereas fatigue
from anxiety or depression occurs all day or is worse in the morning.
- Cyanosis or pallor: Cyanosis (blusish discoloration) or
pallor (pale) occurs with MI or low cardiac output,
decreased tissue perfusion
- Edema: Edema (swelling in feet and legs) is dependent
when caused by heart failure. Cardiac edema is
bilateral. Worse in evenings. Better in the morning
after elevating legs all night.
- Nocturia: Nocturia (urgent need to urinate at night) recumbency at night promotes fluid
resportion and excretion; this occurs with heart failure in the person who is ambulatory
during the day
- Past cardiac history: History of: hypertension, elevate
cholesterol or triglycerides, heart murmur, congenital
heart disease.
- Family cardiac history: Family history of hypertension,
obesity, diabetes, CAD, sudden death at younger age
- Patient-centered care (cardiac risk factors): nutrition,
