Cardiovascular
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Questions and Answers

What is the primary function of the heart described in the content?

  • To produce hormones regulating blood pressure
  • To filter toxins from the blood
  • To circulate blood throughout the body (correct)
  • To store oxygen for energy

What indicates myocardial injury on a 12-lead electrocardiogram?

  • Deep and wide Q waves (correct)
  • Consistent P wave morphology
  • Flat T waves
  • Narrow QRS complexes

Which cardiac biomarker has a normal level of less than 0.04 ng/mL?

  • CPK-MB
  • Troponin T
  • Troponin I (correct)
  • BNP

What medication is known for reducing platelet aggregation?

<p>Aspirin (ASA) (B)</p> Signup and view all the answers

What is an expected use of troponin levels in clinical evaluation?

<p>To diagnose myocardial infarction (A)</p> Signup and view all the answers

What is the primary cause of hypertension in approximately 90% of cases?

<p>Unknown etiology (B)</p> Signup and view all the answers

At what systolic blood pressure (SBP) is an individual classified as having Stage 1 hypertension?

<p>140-159 mmHg (B)</p> Signup and view all the answers

Which of the following is a common condition that chronic high blood pressure can lead to?

<p>Stroke (C)</p> Signup and view all the answers

Which class of antihypertensive therapy does Metoprolol belong to?

<p>Beta Blockers (B)</p> Signup and view all the answers

What is one of the effects of calcium channel blockers on the cardiovascular system?

<p>Cause vasodilation (A)</p> Signup and view all the answers

What is the primary role of the renin-angiotensin-aldosterone system (RAAS) in blood pressure regulation?

<p>Manage fluid balance and vascular resistance (D)</p> Signup and view all the answers

What is the adult dosage for Clonidine as a centrally acting adrenergic inhibitor?

<p>1 mg BID (A)</p> Signup and view all the answers

What is the classification for a blood pressure reading of 135/85 mmHg?

<p>Pre Hypertension (B)</p> Signup and view all the answers

What condition is associated with abnormal blood pressure regulation due to a benign or malignant adrenal tumor?

<p>Pheochromocytoma (D)</p> Signup and view all the answers

Which of the following has been shown to decrease heart rate as an effect?

<p>Propranolol (B)</p> Signup and view all the answers

What is the primary action of calcium channel blockers in the treatment of cardiac conditions?

<p>Dilate coronary arteries (B)</p> Signup and view all the answers

Which of the following medications is contraindicated for clients with respiratory conditions such as asthma?

<p>Propranolol (A)</p> Signup and view all the answers

What is the main purpose of anticoagulants like heparin during cardiac events?

<p>Prevent coronary artery thrombosis (A)</p> Signup and view all the answers

What is a key characteristic of percutaneous coronary intervention (PCI)?

<p>It restores blood flow non-surgically. (C)</p> Signup and view all the answers

Which class of drugs is particularly effective in managing heart failure by inhibiting the renin-angiotensin-aldosterone system?

<p>Ace inhibitors (C)</p> Signup and view all the answers

Which factor is NOT listed as a major cause of heart failure?

<p>Cirrhosis of the liver (D)</p> Signup and view all the answers

What is the primary effect of angiotensin receptor blockers (ARBs) in heart failure treatment?

<p>Reduce peripheral resistance (B)</p> Signup and view all the answers

Which of the following describes a benefit of coronary artery bypass graft (CABG) surgery?

<p>It restores blood flow to heart muscle. (C)</p> Signup and view all the answers

What condition is treated with minoxidil?

<p>Refractory hypertension (C)</p> Signup and view all the answers

Which of the following is a common type of arteriosclerosis?

<p>Atherosclerosis (A)</p> Signup and view all the answers

Which of these is NOT considered a modifiable risk factor for cardiovascular disease?

<p>Age (B)</p> Signup and view all the answers

What is the primary effect of nitroglycerin in treating angina pectoris?

<p>Vasodilates veins and arteries (C)</p> Signup and view all the answers

Which factor contributes to the thickening of the intima media in arteries?

<p>Plaque buildup (D)</p> Signup and view all the answers

What is one side effect of using nitroglycerin?

<p>Headache (A)</p> Signup and view all the answers

Which of the following statements about unstable angina is true?

<p>It presents with new signs and symptoms (B)</p> Signup and view all the answers

What condition can lead to myocardial ischemia?

<p>Atherosclerosis (B)</p> Signup and view all the answers

Flashcards

Hypertension (High Blood Pressure)

A condition where blood pressure is consistently elevated.

Essential Hypertension

High blood pressure with an unknown cause in 90% of cases.

Secondary Hypertension

High blood pressure caused by an underlying condition.

Blood Pressure

The force of blood pushing against the walls of blood vessels.

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Normal Blood Pressure

Blood pressure values typically less than 120/80 mmHg.

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Systolic Blood Pressure

The pressure in the arteries when the heart beats.

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Diastolic Blood Pressure

The pressure in the arteries between heartbeats.

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Antihypertensive Therapy

Treatment for high blood pressure, using various medications to lower it.

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Beta Blockers

A class of drugs used to lower BP, by slowing down the heart rate

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ACE Inhibitors

Medications that reduce blood pressure by affecting a hormone pathway.

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Minoxidil (Loniten)

A vasodilator used to treat refractory hypertension (high blood pressure not controlled by multiple medications).

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Nitroprusside

A potent, direct intravenous vasodilator, primarily for severe high blood pressure.

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Atherosclerosis

Most common type of arteriosclerosis, characterized by plaque buildup in arteries.

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Myocardial Ischemia

Lack of oxygen to the heart muscle, often due to narrowed arteries.

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Stable Angina

Chest pain relieved by rest, a common symptom of coronary artery disease.

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Unstable Angina

Chest pain that doesn't go away with rest, a more serious symptom.

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Nitroglycerin

A vasodilator used to treat angina by relaxing blood vessels.

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Myocardial Infarction (Heart Attack)

The blockage of blood flow to part of the heart, causing damage or death of heart tissue.

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Cardiac Biomarkers

Blood tests that measure proteins released from damaged cardiac tissue. High levels signify potential heart issues.

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12-Lead ECG

A diagnostic tool for evaluating heart function by measuring electrical activity through electrodes placed on the chest.

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Elevated Troponin levels

Higher than normal levels of cardiac proteins indicating damage to the heart muscle. Usually means cardiac tissue has been irreversibly injured.

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Lipid Reducing Agent

A medication that lowers the levels of cholesterol and 'bad' LDL cholesterol in the blood.

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Ca Channel Blockers

Medications that dilate coronary arteries by relaxing smooth muscle, thus reducing the workload of the heart.

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Heparin

An anticoagulant that prevents coronary artery thrombosis (blood clots).

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Percutaneous Coronary Intervention (PCI)

Non-surgical procedure in the catheterization lab that opens narrowed coronary arteries.

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What does a coronary artery bypass graft (CABG) achieve?

CABG restores blood flow to the heart muscle, relieves angina (chest pain), and prolongs life.

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Excessive workload on the heart

A major cause of heart failure that can be triggered by conditions like tachycardia (rapid heart rate).

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Diuretics for Heart Failure

Medications that help remove excess fluid from the body, reducing the workload on the heart.

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ACE Inhibitors for Heart Failure

Drugs that block the RAAS system, reducing blood pressure and improving heart function.

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Study Notes

Cardiovascular System Overview

  • This presentation covers the cardiovascular system, focusing on hypertension.

Hypertension

  • 90% of hypertension cases have an unknown cause (etiology).
  • 10% of cases are related to renal disease.
  • Pre-eclampsia during pregnancy can cause hypertension.
  • Pheochromocytoma (tumor of the adrenal gland) can lead to secondary hypertension.
  • Benign or malignant tumors of the adrenal gland can cause secondary hypertension.
  • Adrenalectomy is a surgical procedure to remove the adrenal gland (used to treat certain types of hypertension).

Blood Pressure Classification (Adults)

  • Normal: Systolic Blood Pressure (SBP) less than 120 mmHg and Diastolic Blood Pressure (DBP) less than 80 mmHg.
  • Prehypertension: SBP 120-139 mmHg and DBP 80-89 mmHg.
  • Stage 1 Hypertension: SBP 140-159 mmHg and DBP 90-99 mmHg.
  • Stage 2 Hypertension: SBP ≥ 160 mmHg and DBP ≥ 100 mmHg.

Hypertension: Silent Killer

  • Untreated hypertension can lead to serious complications.
  • Blood vessel damage (arteriosclerosis) is a potential outcome.
  • Possible complications include heart attack, heart failure, and kidney failure.
  • Stroke can also occur.

Hypertension: Physiological Control

  • The sympathetic nervous system plays a role in regulating blood pressure
  • Baroreceptors in the right atrium, aortic arch, and carotid bodies sense blood pressure changes.
  • The renin-angiotensin-aldosterone system (RAAS) is important in blood pressure regulation.

Antihypertensive Therapy (Drugs)

  • Beta Blockers:
    • Propranolol (Inderal) - Nonselective (blocks Beta 1 & Beta 2).
    • Nadolol (Corgard) - Nonselective (blocks Beta 1 & Beta 2).
    • Metoprolol (Lopressor) - Cardio-selective (blocks Beta 1 only).
    • Atenolol (Tenormin) - Cardio-selective (blocks Beta 1 only).
  • Angiotensin Converting Enzyme (ACE) Inhibitors:
    • Benazepril (Lotensin).
    • Captopril (Capoten).
  • Calcium Channel Blockers:
    • Cardizem (Diltiazem).
    • Procardia (Nifedipine).

Centrally Acting Adrenergic Inhibitors

  • Clonidine (Catapres): Adult dosage is 1 mg BID.
  • Methyldopa (Aldomet): Adult dosage is 250 mg 2-3 times daily for 2 days.

Vasodilators

  • Minoxidil (Loniten) – Vasodilator used to treat refractory hypertension.
  • Nitroprusside (Nipride) – potent and direct vasodilator (needs to be administered intravenously).

Arteriosclerosis/Atherosclerosis

  • Arteriosclerosis is a general term for "hardening of the arteries."
  • Atherosclerosis is a type of arteriosclerosis causing plaque buildup in the arteries.
  • This buildup leads to myocardial ischemia (lack of oxygen to the heart muscle).

Unmodifiable Risk Factors:

  • Age and Gender are unmodifiable risk factors that affect the development or progression of cardiovascular disease

Modifiable Risk Factors

  • High blood pressure
  • Smoking
  • Stress
  • Hyperlipidemia
  • Sedentary lifestyle
  • Obesity
  • Diabetes Mellitus (linked with other cardiovascular risks).

Angina Pectoris

  • Stable angina is relieved by rest.
  • Unstable angina is not relieved by rest, indicating a more serious condition.

Treatment of Angina Pectoris

  • Morphine (opioid analgesic).
  • Oxygen to improve oxygen supply.
  • Nitroglycerin (vasodilator) - can cause headaches.
  • Aspirin (to decrease platelet aggregation).

Myocardial Infarction (MI)

  • MI primarily occurs on the left side.
  • Left anterior descending (LAD) artery is commonly affected.
  • LAD is a major artery in the heart.
  • MI results in dead heart tissue.

Diagnosis/Screening

  • 12-Lead ECG is used for diagnosis and screening.
  • ST elevation indicates injury.
  • ST depression indicates ischemia.
  • Deep and wide Q waves suggest a pathologic infarction.

Laboratory Tests (Cardiac Biomarkers)

  • Elevated CPK-MB signifies muscle injury.
  • Elevated Troponin I or T frequently indicate myocardial injury, even heart attack (MI).
  • Other conditions can cause elevated troponins.

Stress Test

  • This assessment evaluates the heart's response to physical activity (often treadmill).

Drugs

  • ASA – Lowers platelet aggregation.
  • Lipid-reducing agents (e.g., lovastatin) lower total cholesterol and LDL cholesterol.
  • Vasodilators (e.g., nitroglycerin) dilate blood vessels (sublingually administered).

Drugs (cont.)

  • Calcium channel blockers (e.g., Cardizem, Procardia) dilate coronary arteries and lower blood pressure.
  • Beta blockers (e.g., propranolol) decrease heart rate and contractility. These medications are contraindicated for clients with certain respiratory conditions.
  • Anticoagulants (e.g., heparin) can help prevent blood clots.

Physical Assessment of the Heart

  • Specific areas of the chest are examined for heart sounds (e.g., aortic area, pulmonic area, tricuspid area, mitral area).

Focused Cardiac Assessment

  • Location, radiation, quality, aggravating factors, and alleviating factors of pain are key elements of the assessment.

Percutaneous Coronary Intervention (PCI)

  • This non-surgical procedure is performed in a catheterization laboratory.
  • It may involve stent placement to restore blood flow.

Coronary Artery Bypass Graft (CABG)

  • CABG surgically restores blood flow to the heart muscle.
  • It can help alleviate angina and prolong life.

Heart Failure: Causes

  • Excessive workload.
  • Hypertension
  • Myocardial infarction
  • Alcohol abuse
  • Cocaine abuse

Treatment of Heart Failure

  • Diuretics (treat fluid buildup).
  • Agents that inhibit the Renin-Angiotensin-Aldosterone system (RAAS).
  • ACE Inhibitors.
  • Cardiac Glycosides (e.g., Digoxin).
  • Positive inotropic effects strengthen the heartbeat.
  • Negative chronotropic effects help regulate the heart rate.

ACE Inhibitors Examples

  • Enalapril (Vasotec).
  • Lisinopril (Prinivil).
  • Fosinopril (Monopril).
  • Quinapril (Accupril).
  • Ramipril (Altace).

Angiotensin Receptor Blockers (ARBs)

  • Candesartan (Atacand).
  • Valsartan (Diovan).
  • ARBs block Angiotensin II action, resulting in vasodilation and reduced blood volume.
  • ARBs can improve heart failure outcomes.

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