CV 1
upon sitting or standing up, pt. gets dizzy/lightheaded, and there is a 20+ drop in SPB/10+ drop in DBP
what is orthostatic hypotension?
HR less than 60, HR more than 100
what is bradycardia and tachycardia?
age, gender, family history, genetics, ethnicity
what are non-modifiable risk factors?
diet, smoking, exercise, sedentary time
commonly called heart attack; cell death of heart due to blockage of coronary arteries (chest pain, L shoulder/arm pain - sometimes R for women, SOB, back and jaw pain, diaphoresis/sweating)
what is a myocardial infarction?
state normal HR, RR, spO2, and optimal RPE and RPD vitals and what we should expect with exercise for each
-HR = 60-100 (inc. w/ exercise)
-RR = 12-20 (inc. w/ exercise)
-spO2 = 95-100% (may be lower w/ COPD, can drop with exercise, below 90%/88% is unacceptable)
-RPE = 6 at rest (11-13 w/ exercise is ideal, stop exercise @ 16)
-RPD = 0 at rest (don't exceed 4-5 w/ exercise)
state the BP scale
-normal = less than 120/less than 80
-elevated = 120-129/less than 80
-stage 1 HTN = 130-139/80-89
-stage 2 HTN = 140+/90+
-hypertensive crisis = 180+/120+
med used with controllable angina to reduce chest pain during exercise (if improvement of angina does not occur with 1-2, call EMS)
what is nitroglycerin?
early heartbeat; dips down/p-wave bay not be present, low dip on t-wave - will feel like heart is skipping a beat if symptomatic, EKG monitor will tell us (3+ in a row is MEDICAL EMERGENCY)
what is a PVC (premature ventricular contraction?)
can be used for SA node malfunction to control HR (bradycardia, tachycardia, arrythmias, etc.)
what is a pacemaker?
(-pine) used to lower BP, side effects include fluid retention, palpitations, headache and dizziness - PTA should use RPE/RPD as BP will not respond normally to exercise
what are calcium channel blockers?
(-olol) used to reduce HR and BP; side effects include insomnia, nausea, fatigue, slow pulse, weakness and dizziness - PTA should use RPE/RPD to monitor because HR/BP won't respond to exercise normally
what are beta blockers?
can cause muscle atrophy, osteoporosis, weight gain, immunosuppression, and slow wound healing - used for pts. after a heart transplant
what are corticosteroids?
what is phase 3 of cardiac rehab?
weeks 1-3 following d/c from hospital (but can go longer), increasing MaxHR based on pt. response, working at 50-90% of MaxHR (usually outpatient setting)
what is phase 2 of cardiac rehab?
"Stretching and thinning of heart mm., cardiac enlargement, increased filling but reduced rejection of blood” - myocardium is bigger, thinner, floppier and not strong; can fill but not pump out
what is a dilated cardiomyopathy?
"thickening of walls of heart that reduces size of heart chambers and reduces heart ability to fill” - walls of heart/heart itself are big; cannot fill enough but is strong
what is a hypertrophic cardiomyopathy?
"walls of ventricle become stiff, preventing heart from filling/ejecting blood adequately” - fibrotic, stiff, not going to fill well and not going to eject well (no give)
what is a restrictive cardiomyopathy?
lasts 3-5 days following some cardiac event (CABG, MI, etc.), allows CV system to get back to normal slowly by working at 40-60% of MaxHR (usually inpatient setting)
what is phase 1 or cardiac rehab?
1-2 on w/ stable/predictable ______ is acceptable, at 3-4 we stop exercise
what is the angina scale and how we apply it?
an area of the body is not receiving blood - once it is 80% occluded pt. becomes symptomatic and area begins to become infarcted
What is ischemia?
DEPENDENT/PERIPHERAL EDEMA, "cor pulmonale", jugular vein distention, weight gain, cyanosis of nail beds, nausea and anorexia
what is right sided heart failure?
PULMONARY EDEMA, fatigue, diaphoresis, orthopnea/progressive dyspnea, muscle weakness, anxiety, irritability, confusion
what is left sided heart failure?
-ejection fraction (EF) is below 40% (55-70% is normal)
-can't fill enough = diastolic (EF may be retained)
-can't pump/contract enough = systolic
-S/S = fatigue, possible resp. issues, S3/S4 heart sound
what is heart failure?
recite the cardiac cycle
blood enters heart from body thru SUPERIOR AND INFERIOR VENA CAVA -> R ATRIUM -> R AV/BICUSPID VALVE -> R VENTRICLE -> PULMONARY VALVE -> PULMONARY ARTERIES -> LUNGS (to oxygenate) -> back to heart thru PULMONARY VEINS -> L ATRIUM -> L AV VALVE/BICUSPID/MITRAL -> L VENTRICLE -> AORTIC VALVE -> AORTA -> ARTERIES to supply body with oxygenated blood