Coronary Artery Disease and Heart Failure

What is coronary artery disease

Atherosclerosis blocks coronary arteries

What is ischemia

lack of O2/blood

causes heart attack

What is acute coronary syndrome

sudden decrease of blood to the heart

What are the ECG changes in Acute Coronary Syndrome

T-wave inversion

ST-segment depression or elevation

abnormal Q wave

What are serum cardiac markers released from necrotic heart cells

Creatine kinase (high=muscle breakdown occurring)

troponin (high=cardiac eskemia)

What is the average Creatine kinase (muscle breakdown)

20-200

what is regular troponin levels

0-0.04

every time our muscle contracts what is released

troponin

What are the characteristics of Acute Myocardial Infarction (Heart attack)

Chest pain (not enough 02)

Sympathetic nervous system response (nausea, vomiting, tachycardia, vasoconstriction)

Hypotension and shock

What are the characteristics of Chronic Ischemia Heart disease

Stable (chest pain/agina)

Less blood (atheroscclerosis, vasospasm)

Higher oxygen demand

Chronic Ischemia can always result in what

Acute coronary syndrome

What is primary prevention for treatment of Coronary Related Disease

Limiting fats (diet)

Limit smoking

Exercise (Increase HDL)

overall modifiable things

What is secondary prevention for treatment of Coronary Related Disease

Taking BP (vitals)

Bloodwork (Cholesterol + Lipid levels)

Understand past family history

What is tertiary prevention for treatment of Coronary Related Disease

Medication (Vasodilators)

Anticoagulants

antiplatelets

Diet (less salt)

Stenting (Opening BVs)

Cardiac Bypass (Highway)

What name do we use for primary treatment when somone has chest pain that is coronary related

MONA

What does the M stand for in MONA

Morphine (Pain,venodilation(increase preload) )

HR decreases

What does the O stand for in MONA

Oxygen (Increase O2 to the heart)

What does the N stand for in MONA

Nitroglycerin (Vasodilation and increase perfusion/bloodflow)

BP decreases

What does the A stand for in MONA

Aspirin (Inhibit activity of platelets/no clots)

What is STEMI

ST-Elevation Myocardial Infarction

What is heart failure

Heart cannot pump blood effectively to meet body’s needs

What are the 4 factors that affect how well the heart pumps

Preload (filling)

Afterload (resistance)

Contractility/Inotropy (squeezing strength)

Heart Rate/Chronotropy (bpm)

What is Systolic Heart failure

HFrEF (Heart Failure with reduced ejection fraction)

Heart cannot squeeze strongly enough

What is Diastolic heart failure

HRpEF (Heart failure with preserved ejection fraction)

Heart cannot relax and fill properly

Right side of heart delivers blood to where

Lungs (pulmonary circulation)

Left side of heart delivers blood to where

Body (Systemic circulation)

what is orthopnea

difficult breathing while lying down

What are the characteristics of Left sided HF

Diastolic (LV does not accept enough blood from lungs)

Systolic (LV does not pump enough enough blood to body)

Symptoms: Dyspnea, Orthopnea, Coughing up blood, S3 (kentucky)

What are the characteristics of Right sided HF

Diastolic (RV does not accept enough blood from body)

Systolic (RV does not pump enough blood to lungs)

Symptoms: Abdominal pain, Anorexia, Nausea, Constipation, Jugular venous distention

What is Dilated cardiomyopathy

heart chamber becomes enlarged

happens in systolic HF

What is Hypertrophic cardiomyopathy

thickening of arterial walls/cells

happens in Diastolic HF

What is pulmonary edema

fluid buildup in the lungs

lungs become stiffer and gas exchange decreases

What is the New York Heart Associated Classification (I-IV)

looking at clinical manifestations

Class I: Ordinary physical activity does not cause unusual symptoms

Class II: Comfortable at rest, but ordinary activity causes symptoms such as shortness of breath or fatigue.

Class III: Comfortable at rest, but less-than-ordinary activity causes symptoms

Class IV: Symptoms occur even at rest, and physical activity worsens them

What is an echocardiogram

Ultrasounds for structure of the heart

What is regular ejection fracture in the heart

55-65%

What is BNP

Brain natriuretic peptide (leaking of Protein hormone)

normal would be 0-100 (increase means stretching of the heart)

can result in vasodilation