INREP – Cardiovascular Disorders - Anxiety and apprehension

Anatomy: - Shock like manifestation

- Heart failure symptoms
4 Chambers: ECG Result:
 RA Pathologic Q wave
 LA Inverted T wave
 RV Elevated ST segment
 LV Cardiac Enzymes:
Cardiac Output (amount per minute) - CK-MB, Troponin, AST, LDH
- Stroke volume x Heart Rate (formula) Complications:
- Stroke volume: amount of heart pump in the heart 1. Cardiogenic Shock
per beat 2. Heart Failure
- Per beat: 70ml 3. Dysrhythmias
- 70ml x 70bpm = 4900 ml or 5L (C.O.) Management:
Oxygen
1. Coronary Artery Disease (CAD) Beta blockers (-lol)
Causes: Anticoagulant (prevent)
- Increase fats - 2 Types:
- Sedentary lifestyle o Oral – warfarin (PT: 11-15 seconds)
- Smoking (nicotine – vasoconstriction – narrowing) o Parenteral – Heparin (APTT: 25-45 seconds)
- Stress (SNS – increase BP – vasoconstriction – Thrombolytics (dissolve) (-kinase)
narrowing) Morphine
S/S: NONE Ace Inhibitors (-pril)
2 Types: NTG
1. Atherosclerosis Surgical Procedure:
- Plaque, fats, intima - PTCA - balloon
2. Arteriosclerosis - Coronary Artery Stent - tube
- Hardening, calcium, media - Atherectomy – rotating catheter
- Brachytherapy – internal radiation
3 Layers of Blood Vessel: - Coronary Artery Bypass Graft
1. Tunica Intima – innermost
2. Tunica Media – middle, muscle 4. Congestive Heart Failure
3. Tunica Adventitia - outermost - Inability of ♥ to pump effectively
Causes: Any weakness
Management: 2 Types:
1. Diet: decrease fats 1. Right Sided – systemic
2. Stop smoking 2. Left Sided – pulmonary
3. Exercise Management:
4. Relaxation Morphine
5. Meds: Antihyperlipidemia, Antihypertensive Aminophylline (bronchodilator)
Diuretics
2. Angina Pectoris (♥, temporary) Digoxin (increase contraction, decrease heart rate)
S/S: Oxygen
- Chest pain bc of lactic acid ---- anaerobic Gasses (monitor)
2 Types of Angina: - Other Interventions:
1. Stable o Restrict fluid intake
- Predictable, during activation, can be relieve by rest
and meds 5. Dysrhythmias
- 40% blockage 2 Normal ♥ Sounds:
2. Unstable 1. S1 – closure of atrioventricular valves
- Unpredictable even at rest, cannot be relieved by rest 2. S2 - closure of semilunar valves
and meds Abnormal:
- 70% blockage 1. S3 – normal tp youth, athlete, pregnant, elderly
ECG Result: ST segment depression 2. S4 – MI
Management: Causes: Any diseases of the heart
1. NTG: 3 times, no 4th: if not relieve can be M.I or may cause 3 Types:
rebound effect. 1. Tachycardia – increase HR, organized
- Sublingual 2. Fibrillation – Increase HR, chaotic
- Dark tightly sealed container because photosensitive 3. Heart block – Decrease HR, disorganized
- Every 6 months change NTG Management:
- Anti Dysrhythmic Drugs
3. Myocardial Infarction (♥, permanent) o Anesthetic
Cause: CAD o Beta Blockers
S/S: o Calcium Channel Blockers
- Chest pain - Artifical Cardiac Pacemaker
 - Cardioversion
- Defibrillator

6. Peripheral Artery Disease