Terminology
What is ischemia
-lack of blood flow to organs/tissues=will cause cell death and tissue necrosis
-ex: blot clot (thrombus), hypertension
What is the problem in right-sided heart failure?
-the pressure is too high to overcome in the lungs
-the right side works hard to compensate and eventually can not maintain CO
-blood backs up to body
Dilated cardiomyopathy
-Risk factors: genetics (african american males), ETOH, cocaine, ischemic heart disease, chemotherapy
What is MONA protocol
-morphine
-oxygen
-nitroglycerin
-aspirin
Virchows triad
-venous blood stasis
-increased coagulation
-vessel wall injury
What is a pericardiocentesis
needle and catheter place in the pericardial space to drain excess fluid
Where is blood back up to in left-sided heart failure and why?
backs up to the lungs
-cannot overcome systemic pressures to pump to the body
This type of cardiomyopathy is the leading cause of sudden cardiac death (SCD) during exertion among athletes
Hypertrophic
What is the pathology behind CAD
-atherosclerosis in the coronary arteries
-decreased perfusion=decreased O2 for myocardium=ischemia if left untreated=sudden death
Symptoms of pericarditis
-flu like manifestations
-edema
-sharp chest pain with deep inspiration=relieved by sitting up and leaning forward
-hallmark sign=pericardial friction rub on auscultation of chest
What two factors are used to calculate cardiac output
HR x SV=CO
Symptoms of right-sided heart failure
-ascites
-distended jugular veins (JVD)
-enlarged liver and spleen
-dependent edema
-wt gain
-anorexia, complaints of GI distress
Pathology behind restrictive cardiomyopathy
-stiff heart (protein deposits)=prevents heart from being able to dilate and pump hard enough
Unstable vs stable angina
Unstable=>20 min of chest pain unrelieved by rest and NTG
Stable: angina that subsides with rest or NTG
-medical emergency
-fluid compresses the heart =prevents stretching and filling of all four heart chambers=decreased cardiac output=decreased arterial blood pressure
W
-the ability of the heart to change the force of contraction
-contraction is greatest when the cardiac muscle fibers are optimally stretched
-excessive volume filling=filaments are pulled too far apart=decreased Co
Symptoms of left-sided heart failure
-paroxysmal nocturnal dyspnea
-restlessness
-confusion
-fatigue
-cyanosis
-pulmonary congestion (cough, crackles, wheezes, tachypnea)
What is the pathology behind hypertrophic cardiomyopathy
-heart muscle increases= decreased ventricle size= decreased fill capacity
-only cardiomyopathy that does not have decreased CO
Risk factors for CAD
-age
-men >45 yo
-women after menopause
-family hx
-smoking
-obesity
-physical inactivity
-stress
-diabetes mellitus
Clinical manifestations of endocarditis
-flu like symptoms
-heart murmur
-petechiae
-osler nodes
-jane way lesion
-splinter hemorrhages under nails
What is hypertension
-consistent systolic bp >140
-consistent diastolic bp >90
-Diagnosis: two to three blood pressure reading X 3 appointments on both arms
-24 hour blood pressure monitoring test to confirm HTN
Treatment/nursing interventions for cor pulmonale
-treat underlying causes
-daily weight
-strict fluid restrictions
-document I&O
Treatment for each type of cardiomyopathy
Dilated: pharmacologic
Hypertrophic: removal of excess tissue
Restrictive: heart transplant
Clinical Manifestations of Angina
-substernal chest pain or pressure=radiates to neck, jaw, shoulders, back or arms
-epigastric discomfort
-anxiety
-diaphoresis
-pallor
-dizziness
-N/V
-promote a "healthy" lifestyle
-decrease hyperlipidemia (LDL)
-control hypertension
-stop smoking
-low-fat diet