cardio disease/problems/pharm/about

Anemia

less RBC

lower O2 delivery to tissue

sickle cell anemia

RBC is abnormally shaped due to abnormal hemoglobin

causes RBC to rupture prematurely

leukemia

malignant disease of blood-forming tissue

Uncontrolled production and accumulation of WBC

hemophillia

deficiency of coagulation

hypertension (HTN)

heart works harder

causes it to thicken

can produce a CVA

can reduce blood suplly to the kidney by thicking the arteriy that supply them

diuretcis

decrease blood volume

ACE inhibitors

block hormone that increases BP

Beta blocker

inhibts the relase of renin and decreases the rate and force of the heart

vasodilators

realx the muscles of the artieral wall

ca channel blockers

(along side of vasodilators)

slow Ca flow into smooth muscle and myofibers

aneurysm

think weakened section of a wall of a blood vessel

can grow and burst

CAD

myocardial recives an inadequate amount of oxyegn

usually due ot a blockge in artiers

(Arterosclersosis or Artery spasms)

deep vein thrombosis

clot in a vein of an lower extermity

can eventually cause a PE

rheumatic fever

bacteria that cause an infection of the heart

Valves of the heart become damaged

mitral valve prolapse

valve does not close properly

blood may flow back into the heart

heart is prone to infection

diagnosed with a stethoscope or echocardiogram

ischemia

reduction of blood flow

hypoxia

reduced O supply that can be caused by ischemia

may or may not kill the cells

angina pectoris

pain in the chest

also in neck, chin, and down left arm

silent myocardial ischemia

ischemic episode occurring without pain

myocardial infarction

death of an area of the heart due to reduced blood supply

tissue replaced by scar (loses strength)

hibernating myocardium

section of the heart that has severe stenosis but is not dead yet

tissue is not dead but apperas to be

these area are ischemic but still viable (chronic ischemia)

what does hibernating myocardium present as

decreased perf on stress and usually rest

decreased contractiliblity (wall motion)

stunned myocardium

artery has been reopened to revascularize the myocardium

will restore wall motion in a couple of weeks

what will stunned myocardium present as

normal or almost normal perfusion

Absent or decreased contractility

reverse redistribution (RR)

excessive wahshout

shows less perfusion on rest than stress

pt ususally has had artery open with thrombolic agent

defect on stress perfusion = ususally a surrounding ischemia

left bundle branch block (LBBB)

present as a false positive on regualr ECG

may show a reversible septal defect (false positive)

(due to the septal wall not relaxing during diastocilc filling)

myocardial dilation 2 types

transient left ventricle dilation

fixed cavity dilation

transient left ventricle dilation

LV cavity is dilated on post stress but not post rest

(indicated LV dysfunction)

fixed cavity dilation

dilation on both stress and rest

preexisting cavity condition

right vent activity

normal= less activity than the LV

abrnoaml= significant acitivty that is equal to LV and acitivty is on rest images

lung: heart ratio

Ti-201 localkizes in the lungs

if excessive = bad

L:H > 35 indicates

LV dysfucion

mulit-vessel disease

adenosine

direct vasodilator (natural in body)

biologic T1/2 for adenosine

15 sec

contraindications for adenosine

Caffeine (blocks adenosine)

Xanthine meds (Theophylline and Aminophylline)

how long is adenosine injected for

4 min

RP injected at 2min

lexiscan

detection of reversible perfusion defects

bio T1/2 for lexiscan

2 min

contradictions for Lexiscan

pt with a 2nd/3rd degree AV block

pt with sinus node dysfunction

dipyridamole

persantine

indirect vasodilator

inhibits the reabsorptption of natural adenosine in the body (coronary artery constantly under increased effects of adenosine)

normal arteries will dialt and diseased arteries will not (already dilated)

bio T1/2 for dipyridamole

20min

what is used to reverse the effects of dipyridamole

aminophyiiline

shouldn’t be given before 7 min

how long is dipyridamole injected for

over 4 min

inject RP at 6 min

dobutamine

increase HR and BP

bio T1/2 for dobutamine

2min

what is the most common reason for using dobutamine

pt has had caffeine

cant be off Xanthine meds

erythrocytes

iron portion of hemoglobin broken down and re-used in bone marrow to make more RBC’s

flexible biconcave shaped (so it can squeeze thru capillaries)

hematocrit

gives % of RBC

H of 50 = 50%l

leukocytes

ingest bacteria and dipose of dead tissye, uncontrolled production, and accumulation of WBC

thromboytes

help repair slightly damaged blood vessels

through blood clotting th

thrombolytic agents

drugs given to dissolve clots

restore circulation

ex of thrombotic agents

Streptokinase

Tissues Plasminogen gen activator (t-PA) (activate in coronary artery )

anticoagulats

prevent clotting in blood

(in the body Heparin)

ex of anticoagulations

heparin

coumadin (warfarin): slower than heparin but more powerful

citrate phosphate dextrose (CPD): added to blood (outside body)