MS4 Quiz 1 (minus dysrhythmia's and
12 lead)...
What are the three stages of atherosclerosis?
fatty streak, fibrous plaque, complicated lesion
Fatty streak
accumulation of lipoproteins within the walls of an artery
Fibrous plaque
Smooth muscles cells proliferate, produce collagen and migrate over a fatty streak
Complicated lesion
-plaque rupture
-thrombus formation
-further narrowing or total occlusion of vessel
Collateral circulation
- smaller blood vessels (anastomoses) combine to reroute the blood around the blockage. Trying to
get blood to the distal tissue.
- This cannot happen in acute coronary occlusion bc there isn't enough time
Non modifiable risk factors for CAD
- Age (men >45, women>55)
- gender (earlier in men dt estrogen...women have atypical symptoms)
- ethnicity (white and black males)
- family history/genetics
Major modifiable risk factors for CAD
- high serum lipid, HTN, sedentary, obesity, diabetes, metabolic syndrome
- DIET- fat should be 25-35% of diet
Contributing modifiable risk factors for CAD
Psych, substance abuse
CAD nutrition
lower LDL, lower saturated fats, increase complex carbs
Meds CAD
Lipid lowering drugs, antiplt therapy,
Stable angina
chest pain that occurs when a person is active or under severe stress
- relieved with nitro or resting
, Nitroglycerine administration
sublingual nitro- can take up to three tablets 5 minutes apart.
Goal for angina treatment
reduce o2 demand and increase o2 supply
Unstable Angina
- chest pain that occurs while a person is at rest and exertion
- will increase in duration, frequency, or severity...lasts more than 10 minute
Silent angina
Myocardial ischemia with no symptoms
Who is at risk for silent angina?
Diabetics due to neuropathy affecting the nerves that innervate the cardiovascular system
SS of angina for a woman
fatigue, SOB, epigastric pain, anxiety, nausea
How to differentiate between angina and MI?
- chest pain unrelieved by rest or nitro, and if it lasts more than 30 minutes= MI
- MI also have SOB, nausea and vomiting, sweating
What is the difference between CAD and ACS (acute coronary syndrome)?
CAD is the underlying condition, and ACS is a serious complication that can arise when the existing
plaque becomes unstable.
How can CAD progress to ACS?
Plaque rupture causing a thrombus to form at the rupture site which causes a complete or partial
blockage.
NSTEMI
- Infarction limited to the inner layer of the myocardium of the ventricular wall from complete
occlusion
- Cardiac markers are elevated
ECG changes for NSTEMI
- NO ST segment elevation
- ST segment depression, T wave inversion
STEMI
- Infarction that is in the entire thickness of the myocardium from complete and persistent occlusion
- Cardiac markers elevated
ECG changes for STEMI
12 lead)...
What are the three stages of atherosclerosis?
fatty streak, fibrous plaque, complicated lesion
Fatty streak
accumulation of lipoproteins within the walls of an artery
Fibrous plaque
Smooth muscles cells proliferate, produce collagen and migrate over a fatty streak
Complicated lesion
-plaque rupture
-thrombus formation
-further narrowing or total occlusion of vessel
Collateral circulation
- smaller blood vessels (anastomoses) combine to reroute the blood around the blockage. Trying to
get blood to the distal tissue.
- This cannot happen in acute coronary occlusion bc there isn't enough time
Non modifiable risk factors for CAD
- Age (men >45, women>55)
- gender (earlier in men dt estrogen...women have atypical symptoms)
- ethnicity (white and black males)
- family history/genetics
Major modifiable risk factors for CAD
- high serum lipid, HTN, sedentary, obesity, diabetes, metabolic syndrome
- DIET- fat should be 25-35% of diet
Contributing modifiable risk factors for CAD
Psych, substance abuse
CAD nutrition
lower LDL, lower saturated fats, increase complex carbs
Meds CAD
Lipid lowering drugs, antiplt therapy,
Stable angina
chest pain that occurs when a person is active or under severe stress
- relieved with nitro or resting
, Nitroglycerine administration
sublingual nitro- can take up to three tablets 5 minutes apart.
Goal for angina treatment
reduce o2 demand and increase o2 supply
Unstable Angina
- chest pain that occurs while a person is at rest and exertion
- will increase in duration, frequency, or severity...lasts more than 10 minute
Silent angina
Myocardial ischemia with no symptoms
Who is at risk for silent angina?
Diabetics due to neuropathy affecting the nerves that innervate the cardiovascular system
SS of angina for a woman
fatigue, SOB, epigastric pain, anxiety, nausea
How to differentiate between angina and MI?
- chest pain unrelieved by rest or nitro, and if it lasts more than 30 minutes= MI
- MI also have SOB, nausea and vomiting, sweating
What is the difference between CAD and ACS (acute coronary syndrome)?
CAD is the underlying condition, and ACS is a serious complication that can arise when the existing
plaque becomes unstable.
How can CAD progress to ACS?
Plaque rupture causing a thrombus to form at the rupture site which causes a complete or partial
blockage.
NSTEMI
- Infarction limited to the inner layer of the myocardium of the ventricular wall from complete
occlusion
- Cardiac markers are elevated
ECG changes for NSTEMI
- NO ST segment elevation
- ST segment depression, T wave inversion
STEMI
- Infarction that is in the entire thickness of the myocardium from complete and persistent occlusion
- Cardiac markers elevated
ECG changes for STEMI
