NUR 406 > CV Content > Flashcards

CV Content Flashcards

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1
Q

What is myocarditis?

A

Inflammatory disease of the myocardium (heart muscle)

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2
Q

What happens to cardiac myocytes in myocarditis?

A

Degeneration and necrosis

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3
Q

What are the possible severity levels of myocarditis?

A

Mild symptoms to lethal heart failure

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4
Q

What long-term structural changes can myocarditis cause?

A

Fibrosis and scarring

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5
Q

What functional issue can myocarditis cause in the heart?

A

Disrupted electrical conduction

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6
Q

What causes conduction abnormalities in myocarditis?

A

Inflammatory cytokines and T-cell activation

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7
Q

What is the most common cause of myocarditis in the US and Europe?

A

Viral infections

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8
Q

Which viruses are most commonly responsible for myocarditis?

A

Coxsackie virus A and B

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9
Q

What determines treatment for myocarditis?

A

Severity of symptoms

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10
Q

What medications are used to treat myocarditis?

A

Antivirals and anti-inflammatories

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11
Q

What is the pericardium?

A

Sac-like membrane surrounding the heart and roots of major vessels

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12
Q

What is the normal amount of pericardial fluid?

A

15–50 mL

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13
Q

What is the function of pericardial fluid?

A

Lubrication between pericardial layers

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14
Q

What is pericarditis?

A

Inflammation of the pericardium

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15
Q

What happens to fluid in pericarditis?

A

It accumulates in the pericardial space

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16
Q

What is pericardial effusion?

A

Excess fluid in the pericardial space

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17
Q

What effect does pericardial effusion have on the heart?

A

Compresses chambers and limits filling

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18
Q

At what volume does tamponade typically occur?

A

Around 200 mL

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19
Q

What is cardiac tamponade?

A

Compression of the heart due to fluid accumulation

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20
Q

Why is cardiac tamponade life-threatening?

A

Prevents proper cardiac filling → decreased cardiac output

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21
Q

What is the urgent treatment for cardiac tamponade?

A

Rapid removal of fluid

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22
Q

What type of chest pain occurs in acute pericarditis?

A

Sharp pain worse with deep breathing

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23
Q

What systemic symptom may occur in pericarditis?

A

Fever

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24
Q

What respiratory symptom occurs in pericarditis?

A

Dyspnea (painful breathing)

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25
What sound is heard with a pericardial friction rub?
Scratching or rubbing (like a balloon)
26
Why are heart sounds muffled in pericarditis?
Fluid layer dampens sound transmission
27
What ECG changes occur in pericarditis?
ST elevation and possible depressions
28
Why can pericarditis mimic MI on ECG?
Similar ST changes
29
How can pericarditis be differentiated from MI?
Clinical symptoms differ
30
What are signs of decreased cardiac output in tamponade?
Hypotension, confusion, dizziness
31
What causes jugular vein distension in tamponade?
Blood backing up due to poor cardiac output
32
What triad of findings includes muffled heart sounds in tamponade?
Part of Beck’s triad (with hypotension and JVD)
33
What is pulsus paradoxus?
Drop in systolic BP during inspiration
34
What is the normal BP response during inspiration?
Slight increase
35
Why is pulsus paradoxus called paradoxical?
BP decreases instead of increasing
36
What does pulsus paradoxus indicate?
Impaired cardiac filling
37
How common is pulsus paradoxus in tamponade?
70–80% of patients
38
How is pulsus paradoxus best observed?
Via arterial line with real-time BP monitoring
39
What is first-line treatment for pericarditis?
NSAIDs
40
What additional medications can treat pericarditis?
Aspirin, corticosteroids
41
What is the role of corticosteroids in pericarditis?
Variable effectiveness
42
What medication is used if NSAIDs fail in pericarditis?
Colchicine
43
What is colchicine traditionally used for?
Gout
44
What is pericardiocentesis?
Needle drainage of pericardial fluid
45
When is pericardiocentesis performed?
Emergency (cardiac tamponade)
46
What is acute myocardial infarction (MI)?
Death of myocardial tissue due to ischemia
47
What is a primary initial treatment for MI?
Oxygen
48
What is the purpose of oxygen in MI?
Increase oxygen delivery to ischemic tissue
49
When may oxygen not be beneficial?
If patient is not hypoxic
50
Why is morphine used in MI?
Pain relief and possible vasodilation
51
What are side effects of morphine?
Respiratory depression and hypotension
52
Why is morphine use controversial in MI?
May not improve outcomes and may inhibit antiplatelets
53
What alternative to morphine may be used?
Fentanyl or other opioids
54
Why is aspirin given in MI?
Reduces platelet aggregation
55
What effect does aspirin have on clots?
Prevents growth of thrombus
56
How should aspirin be given?
Chewed for rapid absorption
57
What outcome benefit does aspirin provide in STEMI?
Reduces mortality
58
What is the role of nitroglycerin in MI?
Decreases preload and dilates veins
59
What forms can nitroglycerin be given in?
Sublingual or IV
60
What must be assessed before giving nitroglycerin?
Blood pressure tolerance
61
What are side effects of nitroglycerin?
Hypotension, headache, flushing
62
What drug is contraindicated with nitroglycerin?
Sildenafil (Viagra)
63
Why is sildenafil contraindicated with nitroglycerin?
Severe hypotension due to combined vasodilation
64
What is the role of beta blockers in MI?
Reduce HR, BP, and oxygen demand
65
What benefits do beta blockers provide?
Reduce infarct size and mortality
66
When are beta blockers avoided?
If contraindications present
67
What is the preferred treatment for STEMI?
Percutaneous coronary intervention (PCI)
68
When are thrombolytics used in STEMI?
If PCI is unavailable
69
What is the prototype thrombolytic drug?
Alteplase (tPA)
70
How does alteplase work?
Converts plasminogen to plasmin to dissolve clot
71
When is thrombolytic therapy ideally given?
Within 4–6 hours of chest pain onset
72
When is alteplase most effective?
30–70 minutes after symptom onset
73
What is a major adverse effect of thrombolytics?
Bleeding
74
What drugs are given alongside thrombolytics?
Heparin and clopidogrel
75
Why are heparin and clopidogrel given?
Prevent formation of new clots
76
What is reperfusion injury?
Damage after blood flow returns to ischemic tissue
77
What causes reperfusion injury?
Oxidative free radicals from WBCs
78
What happens to myocardium during reperfusion injury?
Becomes stunned
79
What complication can reperfusion injury lead to?
Heart failure
80
What dysrhythmias can occur with reperfusion?
Ventricular tachycardia and ventricular fibrillation
81
What must be monitored before giving MI medications?
Vital signs (BP, HR, respiratory status)
82
Why is monitoring vital signs important in MI treatment?
Medications can destabilize patient
83
What is the survival rate for treated MI patients in the US?
90–95%
84
What is a major cause of MI mortality?
Delay in seeking treatment
85
What is a silent MI?
MI without noticeable symptoms
86
Which patients are more likely to have silent MIs?
Older adults and diabetics
87
What percentage of MI patients are under 65?
About 50%
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