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What are the non-modifiable risk factors for CAD? What is the
pathophysiology of Atherosclerosis/CAD? -ANSWER-- Circulating
fats/lipids accumulate in artery lining
- Atheromas or plaques protrude into the lumen of the vessel and
obstruct blood flow
- If the lesion ruptures, thrombi form leading to acute MI, sudden
cardiac death or stroke
- Can happen in any artery, but the anatomic structure of the coronary
arteries makes them particularly susceptible to atherosclerosis
- Older Adults: Increased risk of arteriosclerosis
What are the non-modifiable risk factors for CAD? -ANSWER-- Age:
Males > 45, postmenopausal women
- Gender: Males < 55 at greater risk, then evens out
- Other: Race, Family history, Type I Diabetes
What are the modifiable risk factors for CAD? -ANSWER-- Conditions:
Type II Diabetes, hypertension, obesity, high cholesterol
- Behaviors: Smoking, physical inactivity, unhealthy diet, ETOH, stress
,What criteria define Metabolic Syndrome? -ANSWER-Requires 3 or
more of:
- Insulin Resistance: Fasting glucose ≥ 100 mg/dL
- Abdominal Obesity: Waist >35" (female) or >40" (male)
- Dyslipidemia: Triglycerides >150 mg/dL; HDL <50 mg/dL (female) or
<40 mg/dL (male)
- Hypertension: 130/85 or higher (or on meds)
angina pectoris (chest pain) -ANSWER-Almost always associated with a
significant obstruction of a major coronary artery
Define Ischemia. -ANSWER-An inadequate blood supply that deprives
the cardiac muscle cells of oxygen needed for their survival
Define Angina. -ANSWER-Chest pain that is brought about by
myocardial ischemia (can be stable or unstable)
Stable angina -ANSWER-chest pain that occurs when a person is active
or under severe stress, but goes away with rest
unstable angina -ANSWER-- chest pain that occurs while a person is at
rest and not exerting himself
,- not relieved by nitro
What are the symptoms of myocardial ischemia (Classic vs. Older
Adults)? -ANSWER-- Classic: Acute onset of chest pain, SOB, extreme
fatigue, diaphoresis, N/V
- Older Adults: May lack classic symptoms; weakness or exercise
intolerance may indicate ischemia
What are the four key areas of CAD prevention and management? -
ANSWER-- manage hypertension
- manage diabetes
- control cholesterol levels (diet, exercise, medication)
- smoking cessation
What medications and treatments are used for CAD and Angina? -
ANSWER-- Nitroglycerin SL (3 doses, 5 mins apart)
- Oxygen administration
- Beta blockers
- ACE Inhibitors
- Calcium channel blockers
- Antiplatelet/anticoagulants (like chewable aspirin)
Nitroglycerin instructions -ANSWER--take tab
, -if pain is not relieved in 5 minutes call 911 then take another tab
-can take up to 3 tabs all 5 minutes apart
What is Heart Failure (HF) and its physiological results? -ANSWER--
chronic, progressive condition in which the heart muscle
becomes weak and ineffective.
- The weakened heart can't keep up with its workload and can't supply
the body cells with enough blood for other organs to function.
- The cause of heart failure can be due to a variety of pathological
conditions.
Heart Failure Overview -ANSWER-- blood flow out of heart slows
- blood returning to heart backs up
- decreased cardiac output initiates RAAS (kidneys hold on to Na+ &
H2O)
- congestion in body's tissues:
lungs (pulmonary edema) interferes with effective
respiration/oxygenation
venous system causes peripheral edema
portal system (liver and gut) causes abdominal pain/swelling
What is Ejection Fraction (EF) and how is it measured? -ANSWER-- EF is
the % of blood that leaves a ventricle (is ejected) with each contraction