1
Q
always ask about the ______
A
cough
2
Q
air hunger
A
paroxysmal nocturnal dyspnea (PND)
3
Q
term for a pt that is ashen and sweaty
A
diaphoresis
4
Q
not enough blood getting to lower leg muscles
A
claudication
5
Q
claudication is a sign of ____
A
PAD
6
Q
term for use of bathroom at night
A
nocturina
7
Q
chest pain due to lack of O2 to myocardial tissue
A
angina
8
Q
cell death of heart muscle
A
myocardial infarction
9
Q
4 CV disorders that mimic MS dysfunction
A
- angina
- MI
- pericarditis
- dissecting aortic aneurysm
10
Q
3 major disorders of the myocardium causing insufficient blood supply to the heart
A
- ischemic heart disease
- coronary heart disease
- coronary artery disease
11
Q
1 cause of morbidity and mortality in US
A
ischemic heart disease
12
Q
~2 mil middle aged and older people have _____________
A
silent MIs
13
Q
death rates of ischemic heart disease have ___ due to ______________
A
declined; lifestyle improvements
14
Q
incidence of ischemic heart disease has ________
A
not decreased
15
Q
thickening of the arterial wall due to accumulation of cells
A
atherosclerosis
16
Q
disease termed by narrowing of arteries of heart
A
cardiovascular disease
17
Q
when the arteries of the heart are narrowed
A
CAD
18
Q
when the arteries to the brain are narrowed
A
CVD
19
Q
blood vessels in body are narrowed
A
PAD
20
Q
15 CAD risk factors
yes 15… sigh
A
- smoking
- elevated cholesterol
- high LDL
- HTN
- gender
- family history
- stress
- elevated triglycerides
- obesity
- sedentary
- diabetes
- low HDL
- hormonal status
- age
- oxidative stress
21
Q
total body inflammation from diseases
A
oxidative stress
22
Q
LDL should be below _____
A
100
23
Q
optimal HDL levels for male and female
A
male: 40+
female: 50+
24
Q
after menopause, incidence for CAD _______
A
increases
25
starts in young adulthood and signs/sxs appear later
atherosclerosis
26
normal first sx of CHD
angina
27
most accurate diagnostic/prognostic assessment of CAD
echocardiogram
28
PTCA
percutaneous transluminal coronary angioplasty
29
balloon system passed through a catheter inserted into an artery
PTCA
30
3 PTCA destinations
femoral, brachial, radial arteries
31
removal of plaque with a rotating blade
atherectomy
32
chest artery or graft used to channel blood around narrowed coronary artery
bypass surgery
33
would you have an elderly person undergo bypass surgery?
no
34
6 sternal precautions
1. no pulling
2. no pushing
3. no lifting of 5-10#
4. no driving
5. avoid shoulder horizontal abd w ER
6. if sternum is not stable - no flexion or abd
35
6 types of angina
```
chronic stable
new onset
preinfarction (unstable)
postinfarction
prinzmetals
resting
```
36
if a pt has new onset angina while they are being treated by you...
call 911
37
classic, exertional angina; occurs at predictable workloads or stress and responds to rest/NTG
chronic stable
38
occurs after MI when residual ischemia triggers an episode
postinfarction angina
39
angina that is a symptom of worsening ischemia
unstable angina
40
caused by coronary artery spasm; early morning at the same time at rest
Prinzmetal's angina (variant, vasospastic)
41
angina that occurs at rest and is relieved when person sits or stands up
resting angina
42
etiology of angina
decrease in O2 supply from artherosclerotic narrowing or spasm
43
4 triggers of angina
1. exercise
2. exposure to cold
3. emotional stress
4. large meal
44
angina can be referred to any dermatome from ___ to ____
C3-T4
45
is exercise helpful or harmful for angina treatment/management?
helpful
46
80-90% of MIs result from a _______
thrombus (clot)
47
time of day that MIs frequently occur at
early morning
48
2 classes of patients that are at higher risk for silent ischemia
diabetics
| postmenopausal women not recieving hormones
49
7 postinfarction complications
1. dysrrhythmias
2. CHF
3. cardiogenic shock
4. pericarditis
5. rupture of heart
6. thrombembolism
7. recurrent infarction
50
condition in which your heart suddenly can't pump enough blood to meet your body's needs
cardiogenic shock
51
inflammation of sac outside heart
pericarditis
52
HR cap in homecare
20 beats above resting
53
backup of blood causing high pressure in pulmonary capillaries leading to pulmonary congestion and HTN
CHF
54
CHF is not a disease. What is it?
a group of clinical manifestations caused by inadequate pump performance from cardiac valves or myocardium
55
term for left-sided failure vs right-sided
L: CHF
R: Cor Pulmonale
56
when LV can no longer maintain a normal Q (cardiac output)
left-sided failure - CHF
57
CHF can turn into
pulmonary edema
58
biggest giveaway for CHF
3lb weight gain overnight
59
Where do you see weakness for CHF patients?
Legs
60
Edema scale
1+: indentation barely visible
2+: slight ind, normal in 15s
3+: deeper indentation and returns <30s
4+: indentation lasts for >30s
61
For LVAD:
| Blood flows from a tube connected to the __________ into a ____________ implanted in __________.
LV
Mechanical pump
Upper abdomen
62
Can all pts with CAD be stented?
No
63
LVADs are used before _____________
Transplantation
64
Definition of HTN
Persistent elevation of BP above 140 OR 90 at least two separate occasions at least 2 weeks apart
65
HTN is regulated by _____ and _____
Cardiac output
| Total peripheral resistance
66
Force exerted against the walls of the arteries and arterioles
Blood pressure
67
Pressure in vessels when heart is relaxed between beats
DBP
68
Pressure exerted in arteries when heart contracts
SBP
69
At age 55-60, what happens to SBP and DBP?
DBP declines or plateaus
| SBP increases
70
5 types of HTN
1. Primary
2. Secondary
3. Labile
4. Malignant
5. Isolated systolic HTN
71
Accounts for 90-95% of HTN
Primary
72
Intermittent elevation of BP interspersed with normal readings
Labile HTN
73
A syndrome w markedly elevated BP and organ damage
Malignant HTN
74
Elevated SBP independent of a change in DBP
Isolated systolic HTN
75
Risk of _____ doubles with each increment of 20/10 mmHg of increasing BP
CVD
76
Goal BP for patients with diabetes or renal disease
Less than 130/80
77
HTN is 2x as prevalent and more severe among _____
Blacks than whites
78
Is HTN more common in males or females at an earlier age?
Men
79
At a later age, is HTN more common in males or females?
Females
80
2 main causes for cases of HTN
Alcohol, salt sensitivity
81
Most important factor of prevention of HTN
Exercise/physical activity
82
an excessive fall in BP when an upright position is assumed
Orthostatic hypotension
83
Drop of BP to constitute orthostatic hypotension (quantify it)
SBP 20+
| DBP + SBP 10+
84
Increase of pulse (#) to constitute orthostatic hypotension
15 bpm
85
Group of conditions affecting the heart muscle
Cardiomyopathies
86
Cardiomyopathies mainly affect this age group
Young adults in 20s-30s
87
Can cardiomyopathy be genetic?
Yes - hypertrophic type
88
Cure for cardiomyopathy
Cardiac transplantation
89
Disturbance of HR
Dysrhythmia
90
Dysrhythmias are classified according to their....(3)
Origin, pattern, rate
91
Electronic pulse generator for increased vagal tone, SA and AV block
Pacemaker
92
battery-powered device placed under the skin that keeps track of your heart rate
Implantable cardioverter defibrillator (ICD)
93
What to do if a pts defibrillator goes off?
Call 911
94
For supraventricular and ventricular arrythmias - destruction of area generating abnormal rhythm
Radiofrequency catheter ablation
95
an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever
Rheumatic fever
96
Rheumatic fever causes...
Heart and valve inflammation
97
What happens to heart valves in rheumatic fever?
They become stenosed or regurgitative
98
Infection of endocardium and valves from strep or staph
Infective endocarditis
99
Where does infective endocarditis manifest?
Mouth, respiratory, GI systems
100
Pts with endocarditis may also show....
Arthralgia, arthritis
101
Narrowing of valve
Stenosis
102
Aortic stenosis is a disease of ________
Aging
103
5 diseases of heart valves
1. Aortic stenosis
2. Aortic regurgitation
3. Mitral regurgitation
4. Mitral stenosis
5. Mitral valve prolapse
104
blood flows backwards into the heart instead of pumping out
aortic regurgitation
105
a condition in which the heart's mitral valve doesn't close tightly, which allows blood to flow backward into the L atrium
mitral regurgitation
106
the leaflets of the mitral valve bulge (prolapse) upward or back into the left atrium as the heart contracts
mitral valve prolapse
107
triad of symptoms for MVP
fatigue, palpitations, dyspnea
108
this condition might cause the patient to have an anxiety attack
MVP
109
name 2 congenital defects
1. patent ductus arteriosus
| 2. tetraogy of fallot
110
congenital defect in which the aorta originates from the RV or overrides a hole in the septum
tetralogy of fallot
111
does PVD just apply to arteries?
no. arteries and veins
112
occlusive arterial disease most prominently affecting the abdominal aorta and the small- and medium-sized arteries of the lower extremities
arteriosclerosis obliterans
113
main sign of arteriosclerosis obliterans
diminished or absent pulses
114
intermittent episodes of small artery or arteriole constriction producing temporary pallor and cyanosis
Raynaud's Disorder
115
caused by small blood vessels that become inflamed and swollen
thromboangiitis obliterans
116
partial or complete occlusion of a vein by a thrombus
thrombophlebitis
117
6 signs of DVT
1. dull ache
2. tight feeling
3. swelling/warmth in calf or ankle
4. slight fever
5. tachycardia
6. homans sign
118
proximal thrombosis poses a _______ risk for PE
greater
119
DVT is a/an ______ emergency
acute
120
Gnarled, enlarged veins, most commonly appearing in the legs and feet.
varicose veins
121
occurs when damaged valves prevent venous return
chronic venous insufficiency
122
abnormal stretching in the wall of an artery, vein or heart
aneurysm
123
2 types of aneurysms (locations)
thoracic and abnominal
124
which type of aneurysm is more common?
abdominal
125
in pts with aneurysm, what must be watched during exercise?
SBP
126
in abdominal aneurysm, what is able to be felt by therapist?
pulsating mass in supine
127
two types of shock + define
cardiogenic: decreased ability to pump blood
hemorrhagic: diminished blood volume
128
3 types of cardiomyopathies
restrictive, hypertrophic, dilated
129
most common cardiomyopathy
dilated
130
6 risk factors for dilated cardiomyopathy
smoking, HTN, obesity, alcohol abuse, pregnancy, infection
131
in LVAD, where does pump propel blood?
into aorta
132
6 signs of MI
1. chest pain
2. pallor
3. SOB
4. profuse perspiration
5. nausea
6. dizziness/fainting
Patho
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