Cardiovascular Diseases: CAD and Chronic Stable Angina

Comprehensive vocabulary flashcards covering pathophysiology, risk factors, clinical assessment, and pharmacology for Coronary Artery Disease (CAD) and Chronic Stable Angina.

Primary Physiological Concept of CV Problems

All cardiovascular problems are fundamentally a problem of perfusion.

Physiological Concepts for CAD/Angina

Perfusion and adequate oxygenation.

Physiological Concepts for PVD

Vascular resistance and adequate oxygenation.

Coronary Artery Disease (CAD)

A condition caused by atherosclerosis in which lipids deposit within the inner lining of the coronary arteries in response to cell wall injury and inflammation.

Atherosclerosis Formation

The progressive accumulation of cholesterol particles and lipid deposits in the lining of an artery, leading to plaque formation and arterial narrowing.

Nonmodifiable Risk Factors for CAD

Increasing age, sex (varies by age), ethnicity, and genetic predisposition.

Major Modifiable Risk Factors for CAD

Elevated serum lipids, hypertension, diabetes mellitus, tobacco use, physical inactivity, and obesity.

Contributing Modifiable Risk Factors for CAD

Psychosocial factors, high homocysteine levels, and substance abuse.

Statins (e.g., Atorvastatin)

Lipid-lowering medications used to prevent atherosclerosis; key nursing considerations include monitoring liver function and watching for rhabdomyolysis (muscle pain, tenderness, or weakness).

Niacin

A lipid-lowering therapy that causes flushing, should be taken with food, and elevates homocysteine levels.

Fibric Acid Derivatives

Lipid-lowering agents that increase the pharmacologic effects of warfarin.

Bile-Acid Sequestrants

Lipid-lowering drugs that cause GI upset and interfere with the absorption of multiple other medications.

Cholesterol Absorption Inhibitors

Lipid-lowering drugs that must not be used in patients with liver impairment.

Chronic Stable Angina

Episodic chest pain lasting 5 to 15 minutes that is predictable in onset, duration, and intensity, and is relieved by rest or nitroglycerin.

Myocardial Ischemia

A state that occurs when myocardial demand for oxygen exceeds the available blood and oxygen supply.

Primary Goal in Managing Chronic Stable Angina

To decrease $O_2$ demand while increasing $O_2$ supply.

Angina Pain Radiation Locations

Chest pain radiating to the mid sternum, left shoulder and down both arms, neck and jaw, epigastric area, or intrascapular region.

PQRST Assessment of Angina

P: Precipitating events; Q: Quality of pain; R: Radiation of pain; S: Severity of pain; T: Timing.

ABCDEF Treatment Strategy for Angina

A: Antiplatelet/anticoagulant/antianginal/ACEi/ARB; B: Beta blockers, Blood pressure control; C: Cigarette smoking cessation, Cholesterol management, Calcium channel blockers, Cardiac rehab; D: Diet, Diabetes management, Depression screening; E: Education, Exercise; F: Flu vaccine.

Nitroglycerin

A direct vasodilator used for angina relief available in quick (SL tabs, translingual spray, IV) or slow release (patch, ointments, sustained release tablets); side effects include severe hypotension, tachycardia, dizziness, headache, and syncope.

ACE Inhibitors (e.g., Captopril, Lisinopril, Enalapril, Quinapril)

Medications indicated for hypertension, heart failure, and post-MI to prevent ventricular remodeling; key side effects include postural hypotension, fatigue, renal insufficiency, and persistent cough.

Beta-Adrenergic Antagonists (Beta-Blockers)

Drugs such as propranolol, atenolol, and metoprolol that decrease myocardial $O_2$ consumption and increase ventricular filling time; side effects include hypotension, bradycardia (AV block), HF symptoms (coughing, SOB, edema, fatigue), drowsiness, and depression.

Calcium Channel Blockers (e.g., Verapamil, Nifedipine, Diltiazem)

Drugs that block calcium access to cardiac cells, reducing contractility, conductivity, and $O_2$ demand; side effects include hypotension, bradycardia, AV block, headache, abdominal discomfort (constipation, nausea), and peripheral edema.

Aspirin Therapy in CAD

An antiplatelet agent prescribed to prevent platelet aggregation; a common adverse effect is gastrointestinal bleeding, presenting as black, tarry stools.