Coronary Artery Disease (CAD) Review Flashcards

Flashcards covering pathophysiology, risk factors, clinical presentation, lab diagnostic markers, and treatment protocols for Coronary Artery Disease (CAD) and Acute Coronary Syndrome (ACS).

What key characteristic distinguishes a non-ST elevation myocardial infarction (NSTEMI) from unstable angina?

Cardiac markers are elevated in NSTEMI, whereas cardiac markers are not elevated in unstable angina.

At what ages does nonmodifiable risk for Coronary Artery Disease (CAD) significantly increase for male and female clients?

Male clients have an increased risk starting at age $45$, while female clients' risk increases around age $55$.

What family history factors significantly increase a client's risk for Coronary Artery Disease?

Risk increases if a father or brother was diagnosed with heart disease prior to age $55$ or a mother prior to age $65$.

What percentage of adults in the United States is estimated to be affected by Coronary Artery Disease?

It is estimated that approximately $4\%$ to $5\%$ of adults in the U.S. are affected by CAD.

How do myocardial infarction manifestations in female clients commonly differ from typical presentations?

Female clients may not experience chest pain and instead present with extreme fatigue, dizziness, abdominal pain, nausea, and pressure in the lower chest or upper abdomen.

What atypical myocardial infarction manifestations may present in older adults over the age of $85$?

Older adults over age $85$ may present with no chest pain, but rather nausea and vomiting, shortness of breath, profuse sweating, and syncope.

What are the respective roles of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) in the body?

LDL is the bad cholesterol and the primary source of plaque buildup in arteries, whereas HDL is the good cholesterol that carries cholesterol away from the arteries.

Which vitamins break down homocysteine under normal physiological conditions?

Vitamin B12, vitamin B6, and folic acid break down homocysteine into other needed substances, leaving very little in the blood.

What is the timeline for detecting cardiac troponins I and T in blood serum after an acute myocardial infarction?

Troponins can be detected within $4\,\text{hr}$ from onset, peak in $24\text{ to }48\,\text{hr}$, and remain elevated for days.

Why is Creatine kinase-MB (CK-MB) valuable in detecting reinfarction after a myocardial infarction?

CK-MB can be detected within $4\,\text{hr}$, peaks by $24\,\text{hr}$, and returns to normal within $48\text{ to }72\,\text{hr}$, so new elevations indicate reinfarction.

What is the detection timeline for myoglobin following myocardial injury?

Myoglobin is detected within $1\,\text{hr}$ after injury, peaks within $4\text{ to }12\,\text{hr}$, and then returns to normal.

What procedure is considered the gold standard for evaluating Coronary Artery Disease and treating blockages?

Cardiac catheterization or coronary angiogram.

What target heart rate goal must a client reach during an exercise stress test?

The client must reach $85\%$ of the predicted heart rate for their age.

What medication is administered intravenously during a stress test for clients unable to walk on a treadmill?

Dobutamine.

Where is the apical pulse best heard during a cardiac physical assessment?

At the fifth intercostal space, at the left midclavicular line.

Which stethoscope attachments are used to listen to $S_1$/$S_2$ versus $S_3$/$S_4$ heart sounds?

The diaphragm is used to listen to the rate and regularity of $S_1$ and $S_2$, while the bell is used to auscultate $S_3$ or $S_4$.

What dosage of aspirin is initially recommended for clients presenting with elevated troponins or ECG changes indicative of ACS?

Clients should initially take $150\text{ to }300\,\text{mg}$ of aspirin.

What are the American Heart Association recommended door-to-treatment target times for a STEMI?

Door-to-procedure time for percutaneous coronary intervention (PCI) is $90\,\text{min}$ or less, and door-to-administration time for thrombolytics is $30\,\text{min}$ or less.

What arterial blockage criteria warrant Coronary Artery Bypass Graft (CABG) surgery?

Disease greater than $50\%$ in the left main artery, $\ge 70\%$ stenosis of three coronary arteries, two-vessel disease including the LAD, or significant narrowing greater than $70\%$ with persistent anginal symptoms despite maximal medical therapy.

What post-operative ICU stay duration is typical following Coronary Artery Bypass Graft (CABG) surgery?

Clients are typically admitted to the ICU for close monitoring for approximately $24\text{ to }48\,\text{hr}$.