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Questions and Answers
What is a key characteristic of the Mediterranean diet?
What is a key characteristic of the Mediterranean diet?
Which of the following cholesterol levels is considered acceptable for low-density lipoproteins (LDL)?
Which of the following cholesterol levels is considered acceptable for low-density lipoproteins (LDL)?
Which dietary change is recommended to reduce the risk of coronary artery disease?
Which dietary change is recommended to reduce the risk of coronary artery disease?
Which of the following statements about heart failure is true?
Which of the following statements about heart failure is true?
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What is the desirable range for triglyceride levels in a healthy individual?
What is the desirable range for triglyceride levels in a healthy individual?
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What is the primary function of the myocardium layer of the heart?
What is the primary function of the myocardium layer of the heart?
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During which phase of the cardiac cycle do the ventricles fill with blood?
During which phase of the cardiac cycle do the ventricles fill with blood?
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What is the total cardiac output at rest and what can it increase to during exercise?
What is the total cardiac output at rest and what can it increase to during exercise?
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Which layer of the heart is primarily responsible for lining the heart and valves?
Which layer of the heart is primarily responsible for lining the heart and valves?
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What does the apical impulse indicate regarding heart function?
What does the apical impulse indicate regarding heart function?
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What are the characteristics of Roth spots?
What are the characteristics of Roth spots?
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Which conditions typically warrant antibiotic prophylaxis?
Which conditions typically warrant antibiotic prophylaxis?
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What is the primary medication of choice for treating infective endocarditis?
What is the primary medication of choice for treating infective endocarditis?
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What are common non-specific symptoms of myocarditis?
What are common non-specific symptoms of myocarditis?
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In what manner is antibiotic therapy usually administered for infective endocarditis?
In what manner is antibiotic therapy usually administered for infective endocarditis?
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Which of the following is a typical nursing instruction for a client with infective endocarditis?
Which of the following is a typical nursing instruction for a client with infective endocarditis?
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What is the most common type of myocarditis?
What is the most common type of myocarditis?
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What could indicate progression of myocarditis disease severity?
What could indicate progression of myocarditis disease severity?
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What is the primary role of thrombolytics in treating acute myocardial infarction?
What is the primary role of thrombolytics in treating acute myocardial infarction?
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Which of the following is NOT a component of the THROMBINS2 protocol?
Which of the following is NOT a component of the THROMBINS2 protocol?
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Which symptom is commonly associated with a patient experiencing acute myocardial infarction?
Which symptom is commonly associated with a patient experiencing acute myocardial infarction?
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What effect do ACE inhibitors have on the heart during an acute myocardial infarction?
What effect do ACE inhibitors have on the heart during an acute myocardial infarction?
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What is the characteristic physical finding in a patient with heart failure due to myocardial infarction?
What is the characteristic physical finding in a patient with heart failure due to myocardial infarction?
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What is the primary cause of angina pectoris?
What is the primary cause of angina pectoris?
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Which type of angina is characterized by pain that occurs predictably on exertion and is relieved by rest?
Which type of angina is characterized by pain that occurs predictably on exertion and is relieved by rest?
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What is a common manifestation of angina pectoris?
What is a common manifestation of angina pectoris?
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Which of the following triggers is least likely to induce angina?
Which of the following triggers is least likely to induce angina?
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What distinguishes unstable angina from stable angina?
What distinguishes unstable angina from stable angina?
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What is a potential characteristic of variant angina?
What is a potential characteristic of variant angina?
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Which statement about silent ischemia is true?
Which statement about silent ischemia is true?
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What is a significant emotional factor that may trigger angina?
What is a significant emotional factor that may trigger angina?
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Study Notes
Heart Anatomy and Function
- The heart is a hollow, muscular organ weighing approximately 300g.
- It is located in the mediastinum, the space between the lungs, and rests on the diaphragm.
- The heart pumps blood to the tissues, delivering oxygen and nutrients.
- The heart has three layers:
- Endocardium: Lines the inside of the heart and valves.
- Myocardium: Composed of muscle fibers responsible for contraction.
- Epicardium: The outermost layer containing the coronary arteries.
- The pericardium is a thin layer of fibrous tissue that surrounds the heart, containing pericardial fluid for lubrication.
- Visceral pericardium: Adheres to the epicardium.
- Parietal pericardium: Envelopes the visceral pericardium, supporting the heart.
- The heart's pumping action is achieved through rhythmic relaxation and contraction.
- Systole: Contraction of the atria and ventricles.
- Diastole: Relaxation of the ventricles, allowing them to fill with blood.
- The heart has two chambers:
- Atria (upper chambers): Collect and receive blood.
- Ventricles (lower chambers): Pump and contract blood.
- The apical impulse (PMI) is located at the 5th intercostal space (ICS), left mid-clavicular line.
Heart Mechanical Properties
- Cardiac output: The volume of blood ejected by the heart per minute (5 L/min).
- During exercise, cardiac output can increase fourfold (to 20 L/min).
Cholesterol and Cardiovascular Disease
- Cholesterol is found in all body tissues and is a major component of cell membranes, brain and nerve cells, and some gallstones.
- Elevated cholesterol levels, LDL (Low density lipoprotein) levels, and triglycerides place individuals at risk for coronary artery disease.
Diet Recommendations for Cardiovascular Health
- Maintain a low-calorie, low-sodium, low-cholesterol, and low-fat diet.
- Increase dietary fiber intake.
- Target cholesterol levels:
- Total cholesterol: 140 to 199 mg/dL
- LDL: Lower than 130 mg/dL
- HDL: 30 to 70 mg/dL
- Triglycerides: Lower than 200 mg/dL
Heart Failure (HF)
- HF is the heart's inability to pump enough blood to meet tissue needs for oxygen and nutrients.
- Symptoms: fatigue, dyspnea, palpitations, and, in advanced stages, tachycardia, pulmonary edema, diaphoresis, neck vein distention, and cardiomegaly.
Infective Endocarditis
- Caused by bacterial, fungal, or other microbial infections of the heart's inner lining (endocardium).
- Prevention: Antibiotic prophylaxis is recommended for high-risk patients before and sometimes after procedures like dental work, tonsillectomy, bronchoscopy, cystoscopy, etc.
- Medical Management:
- Intravenous antibiotic therapy for 2 to 6 weeks.
- Penicillin is often the drug of choice.
- Antifungal agents like amphotericin B are used for fungal infections.
- Nurse home care instructions:
- Maintain aseptic technique for IV antibiotic administration.
- Monitor IV catheter sites for infection.
- Record daily temperatures and report fevers.
- Practice oral hygiene twice daily with a soft toothbrush and rinse well after brushing.
- Avoid oral irrigation devices and flossing.
Myocarditis
- Inflammation of the myocardium.
- Most common type is viral myocarditis.
- Characterized by necrosis, cell injury, and inflammation of the heart muscle.
- Symptoms: Fatigue, dyspnea, palpitations, and in advanced cases, heart failure symptoms.
Angina Pectoris
- Chest pain or pressure caused by insufficient coronary blood flow, resulting in decreased oxygen supply to the heart muscle.
- Usually caused by atherosclerotic disease.
- Types of angina:
- Stable angina: Predictable pain with exertion, relieved by rest and/or nitroglycerin.
- Unstable angina: Increasing frequency and severity, may not be relieved by rest or nitroglycerin.
- Intractable or refractory angina: Severe, incapacitating chest pain.
- Variant angina (Prinzmetal's angina): Pain at rest with reversible ST-segment elevation, possibly due to coronary vasospasm.
- Silent ischemia: Electrocardiographic evidence of ischemia without patient experiencing pain.
- Triggering factors: Exertion, exposure to cold, heavy meals, stress, or emotional situations.
- Manifestations: Heavy sensation in the chest ranging from discomfort to agonizing pain, severe apprehension, retrosternal pain, pain radiating to neck, jaw, shoulders, and arm.
- Management:
- Nitroglycerin: Potent vasodilator that increases oxygen supply and decreases demand.
- ACE inhibitors: Decrease blood pressure, reducing heart workload.
- Thrombolytics: Dissolve blood clots in coronary arteries.
- THROMBINS2: A newer approach to angina management incorporating thienopyridines, heparin, RAAS inhibitors, oxygen, morphine, beta-blockers, invasive interventions, nitroglycerin, statins, and aspirin.
Acute Myocardial Infarction (AMI) Presentation
- General: Alert, anxious, restless, and often fatigued.
- Skin: Cool, clammy, and diaphoretic.
- Heart: S3 or S4 gallop may be present, dysrhythmias or murmurs, and jugular venous distention (indicating pump failure).
- Lungs: Dyspnea, tachypnea, and rales (crackles) suggest pulmonary congestion and heart failure.
- Circulatory: Peripheral pulses may be pounding or thready, regular or irregular.
- Gastrointestinal: Nausea and vomiting.
Cardiomyopathy
- Disease of the heart muscle associated with cardiac dysfunction.
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Description
Test your knowledge on the anatomy and functions of the heart with this quiz. Explore the structure and layers of this vital organ, including the myocardium, pericardium, and the processes of systole and diastole. Ideal for students studying cardiovascular physiology.
