Chapter 13 - Cardiovascular Alterations

CAD Risk Factors

• Men

• Family History

• Men in > mid 40s / Women after menopause

• Smoking

• High blood cholesterol

• HTN

• Inactivity/Obesity

• DM

What medication is contraindicated to give to patients if they’re already taking phosphodiesterase type 5 inhibitors for erectile dysfunction?

NTG

Uses for Echocardiography

• Ejection Fraction

• Valvular Disease

Ejection Fraction (Range)

55% to 60%

Ejection Fraction

amount of blood pumped by the left ventricle each beat/systole

T/F: Left sided catherization measures LVEF

T

Vascular Closure Device (VCD)

Placed at catheter insertion site

• pressure must be applied for 15 to 30 mins

Troponin I (Levels)

< 0.03

Troponin T (Levels)

< 0.1

What effect does daily ASA do?

Prevent platelet adherence

Unstable Angina

• more severe (MI risk)

• MAY occurs at rest

Variant/Prinzmetal’s Angina

• often occurs at rest

• marked ST elevation

Unstable Angina Tx

• NTG

• Beta-blockers

• CCB

Why should patients on beta-blockers know?

• May cause asthma attack

• Hypoglycemic symptoms are masked (check BG!!)

NTG Storage

• replace q6mos or sooner if no relief

• patch should NOT be worn > 12-14hrs

What are patients place on indefinitely after a stent procedure?

Antiplatelets

• Aspirin

Anticoagulants

• Apixaban (Eliquis)

Transvenous Pacemaker

• more comfortable

• more complication

• done for when pt is at the hospital

Primary Prevention of ICDs

• for pts @ risk for sudden cardiac death

  • pts with HF

  • congenital heart disease

  • genetic mutation

Secondary Prevention of ICDs

• patients that have survived

  • cardiac arrest

  • sustained VT

T/F: Newer ICDs are MRI compatible

T

ICD Patient Education

• restrict activity of the arm on side of the implant (post-op)

• carry ID card

• record diary of events if device fires

• keep cellphone 6in away from ICD

• inform TSA

• avoid driving for 6mos if history of sudden cardiac arrest

Left Sided HF

⬇CO → LV volume → backup into left atrium & pulmonary veins → congestion

T/F: Right Sided HF can be a consequence of LHF

T

LSHF S/S

• Weight gain

• Elevated PAOP

RSHF S/S

• JVD

• edema

• increased abdominal girth

• decreased appetite + N/V

Digoxin

(+) inotrope increasing the hearts contractility and CO