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NUR%20214%20Cardiovascular%20Fall%202010%20Heart%20Disease

NUR%20214%20Cardiovascular%20Fall%202010%20Heart%20Disease...

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Heart Disease NUR 214
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HEART DISEASE IN THE US Heart disease is the leading cause of death in the United States. Almost 2,000 Americans die of heart disease each day - one death every 44 seconds Coronary heart disease is the principal type of heart disease. It is estimated that about 47% of cardiac deaths occur before emergency services or transport to a hospital. In 2009, heart disease is projected to cost more than $304.6 billion, including health care services, medications, and lost productivity. Coronary Artery Disease
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Myocardial Ischemia Imbalance between coronary blood supply and metabolic demand of the cardiac cells Most common cause: atherosclerotic plaques in the coronary circulation Unstable Plaque Ulceration or rupture exposes vessel wall Platelets adhere to site (platelet adhesion) Thrombus (clot) formation
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Obstructive Plaque Exertional angina Vasodilator response to stress Normal Fatty streak Plaque Increased plaque Obstructive atherosclerotic plaque Noninvasive tests: normal Noninvasive tests: abnormal
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Disease Progression 1.Fatty Streak 2. Fibrous Plaque 3. Complicated Lesion
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Reversible Myocardial Ischemia (Angina) Discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back (Angina) Uncomfortable pressure, squeezing, fullness, or pain. Discomfort in other areas of the upper body. Pain or discomfort in one or both arms, the back, neck, jaw, or stomach. Shortness of breath. Often comes along with chest discomfort. Can occur before chest discomfort. Other symptoms: breaking out in a cold sweat, nausea, or light-headedness.
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Myocardial Ischemia
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Acute Coronary Syndrome Sudden and extended obstruction of the myocardial blood supply caused by a thrombus If vessel obstruction is not quickly reversed, ischemia progresses to obstruction Result is Myocardial Infarction
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Disorders of the Heart Wall Acute Pericarditis Inflammation of the pericardial membrane Viral, Bacterial or Idiopathic Symptoms Sudden onset of retro-sternal chest pain that worsens with respiration and lying down Low grade fever Friction Rub Treatment based on etiology Anti-bacterial or anti-viral medications Steroids Pericardial fluid aspiration May progress to Chronic Constrictive Pericarditis
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Infective Endocarditis Inflammation of the cardiac valves Bacterial etiology Streptococcus Staphylococcus Risk Factors: Valvular Heart Disease (Mitral Valve Prolapse) Prosthetic Heart Valves Congenital Anomalies (ventricular septal defect) Male Gender IV drug use Long term use of indwelling catheters Recent Cardiac Surgery
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Clinical Manifestations Fever
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