NUR 339 Final Exam 1
- left anterior descending artery and right coronary artery
left coronary artery splits and becomes
- SA node
pacemaker of the heart
- during diastole
coronary arteries are perfused
- inner (subendocardium) to outside
damage to the heart usually begins in the
- tachycardia
decreased coronary artery perfusion
- heart damage, less perfusion
severe hypotension causes
- preload
stretch of LV myocardial fibers at end of diastole filling volume of the heart determined by venous return
- diuretics 1 / 3
decrease preload
- afterload
resistance to ventricular ejection; pressure ventricle must overcome to pump out blood
- heart valve stenosis
cusps are too stiff; unable to shut tightly; allowing regur- gitation; increased after load
- use cardiac markers
diagnose non STEMI
- 12 lead ECG
diagnose STEMI
- medications that decrease afterload
ACE inhibitors, beta blockers, alpha blockers (lower BP)
- Stable angina
short-lived, after exertion, exposure to cold/stress tx
received by rest or NTG
caused by fixed obstruction due to atherosclerosis
- unstable angina (worse)
unpredictable, may occur at rest & usually prolonged new-onset/exertional with increase in 2 / 3
severity cause
atherosclerotic plaque disruption, abnormal constriction of coronary arteries
- varient (Prinzmetal's, vasospastic)
cause
vasospasm rather than plaque may be associated w/ coronary stenosis but can occur w/o presence of disease pain usually occurs at rest, during sleep, w/ minimal exercise or stress
cyclic pattern tx
calcium channel antagonists, short & long-term nitrates
17. STEMI
ST elevation MI
transmural/Q-wave - full thickness of of ventricular wall thorough tissue death
- non STEMI
non-ST elevation MI
subendocardial/non Q wave - involves inner 1/3 to 1/2 of ventricular wall not necessarily as bad as other version
- cardiac markers
creatine kinase (CK), myoglobin, troponin
- / 3