Coronary Artery Disease Quiz
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Questions and Answers

Which type of angina is characterized by chest pain that occurs with exertion and is relieved by rest?

  • Silent ischemia
  • Variant angina
  • Stable angina (correct)
  • Unstable angina

    • What is the primary disease process underlying coronary artery disease as mentioned?

  • Coronary thrombosis
  • Heart failure
  • Atherosclerosis (correct)
  • Hypertension

    • Which form of angina manifests with severe pain at rest, often caused by vasospasm?

  • Silent ischemia
  • Stable angina
  • Variant angina (correct)
  • Intractable angina

    • In myocardial infarction, what is the term used for a heart attack that affects the entire thickness of the myocardial wall?

    <p>Transmural infarction</p> Signup and view all the answers

    Which of the following is NOT a modifiable risk factor for coronary artery disease?

    <p>Age</p> Signup and view all the answers

    What is the main consequence of a prolonged total occlusion of coronary arterial blood flow?

    <p>Myocardial infarction</p> Signup and view all the answers

    Which type of angina is typically associated with severe incapacitating chest pain?

    <p>Unstable angina</p> Signup and view all the answers

    What causes the pain associated with silent ischemia?

    <p>There is no pain reported</p> Signup and view all the answers

    Which of the following is a non-modifiable risk factor for coronary artery disease (CAD)?

    <p>Family history of CAD</p> Signup and view all the answers

    What is a common symptom of myocardial ischemia?

    <p>Angina pectoris</p> Signup and view all the answers

    Which medication is classified as a beta-blocker used in medical management of CAD?

    <p>Atenolol</p> Signup and view all the answers

    Which of the following is NOT a typical sign of decreased cardiac output?

    <p>Increased urine output</p> Signup and view all the answers

    What critical aspect differentiates angina pectoris from a myocardial infarction?

    <p>Duration of chest pain</p> Signup and view all the answers

    Which condition can contribute to myocardial ischemia when the myocardium does not receive sufficient oxygen?

    <p>Exercise</p> Signup and view all the answers

    What is the primary goal of using anticoagulants in CAD management?

    <p>To prevent blood coagulation</p> Signup and view all the answers

    Which population is typically more predisposed to developing CAD earlier due to gender differences?

    <p>Men over 45</p> Signup and view all the answers

    Which factor could lead to unrecognized coronary artery disease in individuals?

    <p>Sedentary lifestyle</p> Signup and view all the answers

    Which of the following diagnostic methods is used to assess the electrical activity of the heart?

    <p>Electrocardiogram (ECG)</p> Signup and view all the answers

    What is the primary consequence of an atrial septal defect (ASD) over time?

    <p>Blood begins to flow from the right atrium into the left atrium.</p> Signup and view all the answers

    What is a common symptom indicative of decreased cardiac output in patients with cardiac conditions?

    <p>Decreased exercise tolerance</p> Signup and view all the answers

    Which type of cardiomyopathy is characterized by an enlarged heart due to coronary artery disease?

    <p>Dilated cardiomyopathy (DCM)</p> Signup and view all the answers

    What is one of the implications of increased systemic vascular resistance?

    <p>Decreased stroke volume</p> Signup and view all the answers

    In patients with ventricular septal defects (VSD), which of the following occurs as a complication?

    <p>Pulmonary vascular congestion and hypertension</p> Signup and view all the answers

    Which of the following conditions is NOT classified under cardiomyopathy?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    What leads to heart failure in the pathophysiology of cardiomyopathies?

    <p>Impaired cardiac output</p> Signup and view all the answers

    What is one possible neurological complication of atrial septal defects?

    <p>Cerebrovascular accidents (strokes)</p> Signup and view all the answers

    Which symptom is commonly linked to right ventricular failure due to septal defects?

    <p>Syncope</p> Signup and view all the answers

    What role does the renin-angiotensin-aldosterone system play in heart conditions?

    <p>It increases systemic vascular resistance.</p> Signup and view all the answers

    Which of the following is a common cause of serious dysrhythmias due to insufficient oxygenated blood to the heart?

    <p>Coronary Artery Disease (CAD)</p> Signup and view all the answers

    What is a likely sign of decreased cardiac output in a client with dysrhythmia?

    <p>Pale and cool skin</p> Signup and view all the answers

    Which of the following conditions can predispose a client to the development of dysrhythmias?

    <p>Myocardial ischemia</p> Signup and view all the answers

    Which pharmacological treatment is classified specifically as an antidysrhythmic agent?

    <p>Amiodarone</p> Signup and view all the answers

    Which of the following best describes the effect of dysrhythmias on the heart's function?

    <p>They may lead to irregular heartbeat and decreased pumping action.</p> Signup and view all the answers

    What type of heart condition does inadequate ventilation contribute to as a potential cause of dysrhythmias?

    <p>Myocardial ischemia</p> Signup and view all the answers

    Which of the following symptoms is commonly reported by clients experiencing tachydysrhythmias?

    <p>Palpitations or fluttering in the chest</p> Signup and view all the answers

    What role do inotropic agents, like Dobutamine, play in the management of cardiac dysrhythmias?

    <p>They increase the force of heart contraction.</p> Signup and view all the answers

    In the context of dysrhythmias, shock is recognized as a potential contributor to what underlying issue?

    <p>Myocardial ischemia</p> Signup and view all the answers

    Which of the following treatments might be employed for irreversible or severe dysrhythmias?

    <p>Temporary pacing</p> Signup and view all the answers

    What is the primary cause of cardiogenic pulmonary edema?

    <p>Inadequate output from the left ventricle</p> Signup and view all the answers

    Which of the following signs indicates acute respiratory distress associated with pulmonary edema?

    <p>Cyanosis</p> Signup and view all the answers

    What role do diuretics play in the medical management of pulmonary edema?

    <p>Reduce fluid overload in the lungs</p> Signup and view all the answers

    What is a common pathophysiological effect of arteriosclerosis on blood circulation?

    <p>Decreased oxygen delivery to organs</p> Signup and view all the answers

    Atherosclerosis is primarily characterized by the accumulation of what in the arterial lumen?

    <p>Plaque formed from cholesterol</p> Signup and view all the answers

    Study Notes

    Cardiovascular System Overview

    • The cardiovascular system's function is to provide oxygen and nutrients to body cells and remove waste products.
    • Heart disease is the leading cause of death for adults in the United States.
    • The primary focus of treatment is disease prevention.

    Pericardial Membranes

    • The pericardium encloses the heart.
    • The outermost layer, the fibrous pericardium, is a tough sac made of connective tissue.
    • The parietal pericardium is a thin serous membrane lining the fibrous pericardium.
    • The visceral pericardium (epicardium) is a serous membrane on the heart's surface.
    • Serous fluid reduces friction during heartbeats.

    Chambers of the Heart

    • The four chambers of the heart (atria and ventricles) are composed of cardiac muscle (myocardium).
    • The endocardium is a smooth layer of simple squamous epithelium lining the heart chambers and valves.
    • The interatrial septum separates the right and left atria.
    • The interventricular septum separates the right and left ventricles.
    • The right atrium receives deoxygenated blood from the body.
    • The left atrium receives oxygenated blood from the lungs.
    • The right ventricle pumps blood to the lungs.
    • The left ventricle pumps blood to the body.

    Coronary Vessels

    • Coronary vessels supply oxygenated blood to the myocardium.
    • Obstruction of a coronary artery can lead to myocardial infarction (MI).

    Cardiac Cycle

    • The atria receive blood from veins, and as pressure increases, the AV valves open.
    • Two-thirds of atrial blood flows passively into the ventricles, then atrial contraction pushes the remaining blood into the ventricles.
    • Ventricular contraction closes AV valves and opens the aortic and pulmonary semilunar valves.
    • Ventricular contraction pumps blood into the arteries.
    • The cycle begins again as blood fills the atria.

    Heart Sounds

    • Lub-dup (two heart sounds) are generated by the closing of the AV and semilunar valves, respectively.
    • Irregular closure of a valve can cause a heart murmur.

    Cardiac Conduction Pathway

    • The SA node, located in the right atrium, initiates each heartbeat.
    • The SA node's cells depolarize rapidly, setting the rhythm for the heart.
    • The AV node is in the lower interatrial septum, receiving and transmitting the depolarization signal from the SA node to the AV bundle.
    • The AV bundle (bundle of His) is the first part of the ventricles to depolarize

    Heart Rate

    • A healthy adult's heart rate is typically 60-80 beats per minute.
    • Children and infants have higher heart rates due to smaller size and higher metabolic rate.
    • Physical fitness can influence resting heart rate.

    Cardiac Output

    • Cardiac output is the amount of blood pumped by a ventricle in one minute.
    • Cardiac output is calculated by stroke volume multiplied by heart rate.
    • Stroke volume is the amount of blood pumped in a single heartbeat.
    • Starling's law states that the more the cardiac muscle fibers are stretched, the more forcefully they contract.

    Regulation of Heart Rate

    • The nervous system regulates the heart rate.
    • The medulla contains cardiac centers (accelerator and inhibitory).
    • The sympathetic nervous system increases heart rate and force of contraction.
    • The parasympathetic nervous system (vagus nerves) decreases heart rate.
    • Pressoreceptors monitor blood pressure in the carotid and aortic sinuses.
    • Chemoreceptors in the carotid and aortic bodies monitor oxygen levels in the blood.

    Aging and the Heart

    • Heart muscle efficiency diminishes with age.
    • Maximum cardiac output and heart rate decrease.
    • Resting levels may still be adequate.
    • Atherosclerosis (cholesterol deposits) is more frequent, narrowing coronary arteries and impacting blood flow.

    High Blood Pressure

    • Hypertension causes the left ventricle to work harder, possibly enlarging and weakening it.
    • The condition can lead to congestive heart failure, thickened heart valves, heart murmurs, and arrhythmias.

    Assessment of the Cardiovascular System

    • Assessment frequency depends on patient symptoms, risk factors, and the clinical setting.

    History Taking

    • Client and/or family members provide a description of symptoms before and during admission.
    • Past and family medical histories are important for identifying potential predisposing factors.
    • Common signs and symptoms include chest pain (angina), shortness of breath (dyspnea), palpitations, and edema.

    Physical Examination

    • General appearance can reveal anxiety, depression, or pain.
    • Pain can be caused by reduced blood supply and ischemia.
    • Evaluation of vital signs (pulse, blood pressure) is essential.
    • Auscultation of heart sounds is a critical part of the assessment.
    • Palpating peripheral pulses helps determine perfusion.

    Cardiac Rhythm and Heart Sounds

    • Cardiac rhythm can be observed continuously with monitoring.
    • Normal heart sounds (S1 and S2) are evaluated.
    • Abnormal sounds (S3, S4) occur in specific pathophysiological situations.

    Peripheral Pulses

    • The nurse assesses peripheral pulses' presence and strength.
    • Skin color changes may indicate perfusion problems (e.g. pallor, bluish discoloration, and edema).
    • Assessment of peripheral edema, weight gain, and abdominal distention can be indicative of heart failure.

    Diagnostic Tests

    • General laboratory tests assess chemical levels, such as blood glucose and electrolytes, cholesterol, and triglycerides.
    • Tests for enzymes and isoenzymes are used to assess tissue or cellular damage (especially cardiac tissue).
    • Radiography, radionuclide studies, MRI, echocardiography, and electrocardiography are valuable in diagnosing cardiovascular issues and monitoring progress.

    Cardiac Cycle

    • Cardiac catheterization is a procedure with a catheter inserted into a vessel (artery or vein) and guided to the heart.

    Arteriography

    • A series of radiographic images of the heart chambers and vessels, after injection of dye.
    • Techniques vary, including coronary arteriography, angiocardiography, and aortography.

    Disorders of the Cardiovascular System

    • Disorders may arise from various causes and may impact heart function in different ways.
    • Conditions like hypertension, heart failure (left and right-sided), and other specific cardiac disorders will be addressed in later sections.

    Cardiac Hemodynamics

    • Cardiac output (CO) assesses the heart's pumping ability.
    • CO is calculated as the product of heart rate (HR) and stroke volume (SV).
    • The autonomic nervous system, the kidneys, and other endocrine glands regulate arterial pressure.

    Hypertension

    • Blood pressure (BP) is the force of blood against the blood vessel walls and is affected by cardiac output and peripheral resistance.
    • Classifications, including primary (essential) and secondary hypertension, are considered.
    • Modifiable and non-modifiable risk factors contribute to hypertension.
    • Signs and symptoms, including hypertension crisis (urgency and emergency), clinical presentation, and diagnostic assessment will be discussed in detail.

    Heart Failure

    • Heart failure occurs when the heart cannot pump blood effectively to meet the body's metabolic needs.
    • Complications include pulmonary edema and other systemic effects.
    • Etiology describes the mechanisms and causes behind this condition.
    • Signs and symptoms provide a basis for recognizing heart failure.
    • Classifications of heart failure (acute and chronic, left and right-sided) will be considered.

    Compensation Mechanisms

    • Compensatory mechanisms initiate to try to restore homeostasis when heart function is impaired.

    Cardiogenic Pulmonary Edema

    • This condition results from fluid accumulation in the lungs due to impaired cardiac function.
    • Mechanisms, signs, symptoms, diagnosis, management and complications associated with cardiogenic pulmonary edema.

    Coronary and Peripheral Vascular Disorders

    • These diseases can affect blood vessels outside the heart.
    • Conditions like atherosclerosis, angina, myocardial infarction, and thrombosis.

    Atherosclerosis

    • Atherosclerosis involves fatty deposits (plaque) that accumulate in the arteries affecting blood flow.

    Angina Pectoris

    • Angina pectoris is a condition characterized by chest pain due to insufficient blood flow to the heart.
    • It can be stable or unstable, among other types.

    Myocardial Infarction

    • Myocardial (heart) infarction (MI) happens when a portion of cardiac muscle dies due to oxygen deprivation.

    Causes of Coronary Artery Disease

    • Risk factors for coronary artery disease (CAD) include modifiable factors like hyperlipidemia, smoking, and hypertension and non-modifiable factors like aging, family history, and gender.

    Peripheral Vascular Diseases

    • Peripheral vascular diseases affect blood flow in smaller blood vessels outside the heart.
    • Conditions such as Raynaud's phenomenon (primary and secondary), thrombosis, and embolism.
    • Pathogenesis, clinical presentation, diagnostic procedures, and management strategies for these conditions.

    Varicose Veins, Venous Insufficiency and Aneurysms

    • Disorders affecting the veins and other significant blood vessels.

    Cardiac Dysrhythmias

    • Disorders of the heartbeat's electrical conduction system.
    • Conditions like sinus bradycardia, sinus tachycardia, premature atrial contractions, atrial fibrillation, atrial flutter, heart block, and premature ventricular contractions.
    • Classifications, causes, signs, symptoms, and management methods for each issue.

    Valvular Disorders of the Heart

    • Conditions impacting the heart valves.
    • Examples including aortic stenosis, aortic regurgitation, and mitral regurgitation.

    Septal Defects

    • Conditions involving abnormal openings in the heart's septum (wall that separates the left and right sides).

    Cardiomyopathy

    • Diseases associated with structural and functional cardiac abnormalities.
    • Classifications, pathophysiology, clinical signs, and management strategies.

    Infectious and Inflammatory Heart Diseases

    • Conditions causing inflammation of the heart structures, including endocarditis, myocarditis, rheumatic carditis, and pericarditis.

    Other Relevant Topics

    • Specific details on various diagnostics, treatments, and management strategies for each condition.

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    Overview of the Cardiovascular System PDF

    Description

    Test your knowledge on coronary artery disease, including types of angina, risk factors, and myocardial infarction. This quiz covers important concepts related to heart health and medical management. Explore the specific characteristics and consequences of coronary artery conditions.

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