Ischemia – lack of adequate blood supply Infarct – Tissue death from lack of blood supply Deterioration of pacemaker cells Cause conduction disorders Heart failure – heart or vessels weaken and become damaged leading to insufficient pumping or failure Usually a complication of many cardiovascular diseases
Acquired Cardiovascular disorders cont Damage to arterial walls Infection Endocarditis Pericarditis Each increase of 20/10 mmHg above 115/75 CVD risk doubles Decreased HDLs with increased total cholesterol increased fatty deposits Substance abuse and renal failure also damage
2: Signs of Heart Attack Chest discomfort Pain or discomfort in other areas of the upper body Shortness of breath Breaking out in a cold sweat Feeling of impending doom Chest pain Women Indigestion, fatigue, nausea (Refer to Health Promotion Point p. 374 for details.)
Risk Factors for Cardiovascular Disease Unmodifiable risk factors: Heredity, race, sex, and age Modifiable risk factors: Obesity, high cholesterol, hypertension, diabetes Cause physical changes in vessel walls Leads to more rapid arteriosclerosis Cigarette smoking, excessive alcohol intake, cocaine use Sedentary lifestyle, excessive stress (Refer to Table 17-1 for more details.) Diabetics who keep fasting glucose less than 100 are at the same risk for cardiovascular disease as same as someone without diabetes
Metabolic Syndrome Components Elevated waist circumference Men >40 Women >35 Elevated triglycerides: 150 mg/dL or greater Reduced HDL cholesterol Men <40 Women <50 Elevated blood pressure @ or above 130/85 Elevated fasting glucose > 100 If diabetic can keep A1C below 6% (Box 17-1) Any 3 of the five= positive for metabolic syndrome
Although b/p rises with age, should be treated New guidelines in 2014 say individuals 60 or older with systolic >150 or diastolic >90 should be take antihypertensives HTN has been associated with more rapid memory loss Teaching is very important in prevention and control of high blood pressure Management of HTN also important
Diagnostic Tests and Procedures (table 17-2) Telemetry/electrocardiography (EKG/ECG)/Holter monitor (shows us a continues rate and rhythm) Electrodes and wires attached to pts Can detect dysrhythmias and alert nurse Used for patients experiencing acute cardiac problems, after cardiac surgery, and post pacemaker Complete blood count (CBC), urinalysis, blood lipid and cholesterol assessment Done to rule out cardiac issues d/t secondary cause Hyperthyroidism, Cushing syndrome, arterial stenosis, among others can lead to HTN
Diagnostic Tests and Procedures (table 18-2) pg 376-381 Doppler flow studies (echocardiogram & venous ultrasound) Used to detect thrombus Used for all the other parts of the cardiovascular system An ultrasound we can use Getting legs, feet, carotid checked Angiography Determine narrowing arteries Nuclear medicine scans/CT angiography Detects emboli in lungs Exercise-Stress Test No caffeine or smoking 6-8 hours before No B/P meds and light breakfast
Diagnostic Tests and Procedures Retrograde filling test Position pt supine, raise leg 90 degrees If vein does not fill within 35 sec valves not functioning properly.
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