angina
chest pain or discomfort caused by myocaridal ischemia that occurs from imbalance betweeen myocardial oxygen supply and demand
stable angina
occurs with exertion and is releived by rest
unstable angina
pain is more severe, may occur at rest and requires frequent nitrate therapy
ST seg depression or t wave inversion
ECG may show these or no changes in unstable angina
variant angina
caused by coronary artery aspasm occurs at rest without any other precipiating factors
variant angina
ECG shows marked ST elevation and the ST segment returns to normal after the spasm subsides
STEMI
usually occurs because of plaque rupture leading to complete occulsion of the artery
NSTEMI
usually results from a partially occluded vessel
PTCA
used to compress intracoronary plaque to increase blood flow to the myocardium, goal is to open coronary arteries; best treats non calcified lesions that are accessible for dilation
intracoronary stent
tubes that are implanted at the site of stenosis to widen the arterial lumen by squeezing atherosclerotic plaque agiainst the artery's walls. helps keep the lumen open by providing structural support.
CABG
ischemic areas of the myocardium are revascularized by implantation of the internal mammary artery or bypassing of the coronary occulsion with a saphenous vein graph or radial artery graph
Port access coronary artery bypass PACAB
heart is stopped and the patient undergoes cardiopulmonary bypass. surgical teams pass instruments thorugh the ports to perorm the bypassses using the internal mammary artery, saphenous vein, or radial artery
Minimally invasive coronary artery bypass MIDCAB
heart is still beating and is intended for use when only one or two arteries will be bypassed. internal mammary artery is commonly used
transmyocardial revascularization
high energy laser creates channels from the epidural surface into the left ventricle chamber to increase perfusion directly to the heart muscle
enhanced external counterpulsation
used for angina when the patient is not a canidate for bypass surgery or percutaneous coronary intervention
radiofrequency catheter ablation
method used to treat dysrhymias when medications, cardioversion, or both are not effective, objective is to pernamentaly interrupt electrical conduction or activity in a region of dysrhytmogenic cardiac issue
stage A
at high risk for developing HF, but w/o structural heart disease or symtoms of HF
stage B
structural heart disease or symptoms of HF
stage C
structural heart disease with prior or current symptoms of HF
stage D
refractory HF reqiuring specialized interventions
class 1
asymptomatic with activity
class 2
symptomatic with moderate exertion
class 3
symptomatic with minimal exertion
class 4
symptomatic with rest
class 5
symptomatic with rest, dysnpea with little or no exertion
systolic HF
results from impaired pumping of the ventricles
diastolic HF
results from impaired filling or relaxation of the ventricles
HF
progressive exertional dyspnea, paroxysmal nocturnal dyspnea, fatigability, loss of appetite, abdominal bloating, nausea and vomitting and eventual organ system dysunction, particuallry rental
left sided HF
dyspnea/orthopnea, cheyne-stokes, paroxysmal nocturnal dyspnea, cough, fatigue or activity intolerance, diaphoresis, pulmonary crackles, elevated pulmonary capillary occulsion pressure, S3 and S4 gallop, tachycardia, tachypnea, hepatojugular reflex
right sided HF
JVD, liver engorgement, edema, ascites, loss of appetitie, n & v, elevated CVP or RAP
cardiac transplantation
therapeutic option of LAST resort for patients with end stage HF, those who have severe cardiac disability and a poor prognosis for 6 month survival
pulmonary edema
this sometimes occurs with patients with HF have systolic bp 150 or higher, the sensitive heart is sensitive to increases in fluid
pulmonary edema
reduces the amount of lung tissue space avialble for gas exhcange and results in symptoms of dysnepa, cyanosis, severe anxiety, diaphoresis, pallor, blood tingued and frothy sputum
ABGs will show respiratory acidosis and hypoxemia
cardiogenic shock
acute and omnious form of pump failure, increased HR, dysrythmias, decreased BP, tachypnea, chest pain, oliguria, left and right ventricular failure, Increased preload increased afterload
pericarditis
fluid accumulates btw the two layers and sqeezes the heart restricting its action and may result in cardiac tamponade
pericarditis
precordial pain that radiates to shoulder, neck, and arm..is intensified during inspiration, movement, coughing or swalowing, pericardial friction rub, dyspnea, persistent temp elevateion, increased WBC and sed rate, increased anxiety may have pulsus para
pericarditis
diffuse ST segment elevation and PR segment deviaitons opposite to P wave polarity. T waves progressviely flatten and invert with generalied t wave inversions present in most leads
endocarditis
occurs when microorganisms circulating the bloodstream attach to an endocardial surface, staph aureus is most common cause, infectious lesions form on the heart valves creating a cauliflower appearance
endocarditis
high fever and shaking chills, night sweats, cough, weight loss, general mailse, HA, musculoskeltal complaints, new murmurs, skin abnormalties
aortic aneurysm
most are asymptomatic, no symptoms until disection, may have abdominal or back pain, usually found on routine exam
aortic dissection
life threatening emergency, common in those with marfan syndrome, severe chest pain radiateing to shoulder blades, can move to arms and legs, weak pulse in one arm, drop in bp, difference in bp btw extremities, loss of consciousness, difficulty speaking,
angina
pain is frequently retrosternal, left pectoral or epigastric may radiate to jaw, left should or left arm. may be associated with dysnpea, light headneess, or diaphoreisis, usally lasts 1 to 5 mins and occurs with exertion and subsides with rest
right sided heart failure
elevated CVP or RAP
pericarditis
ST elevation and PR segment deviations opposite to p wave polarity. t waves progressively flatten and invert with generalized t waves in most or all leads
cardiomyopathy
decreased CO, decreased tissue perfusion, activity intolerance