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A condition of myocardial oxygen deficit; Supply inadequate to meet demand |
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Occurs with ongoing ischemia; may be reversible or go on to infarction |
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Progression to irreversible cell death; causes permanent impairment of electrical activity and contraction |
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Episodic chest pain, lasting 5-15 minutes; provoked by stress/exertion |
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Chest pain occurs at rest, usually at the same time of day |
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A change in prior angina pattern; increased severity, frequency, duration; more NTG; pain now comes with rest when it was previously only exertional |
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Usually caused by coronary disease; problem in the bundle of His; causes impulse to first travel through the right ventricle and then to the left ventricle instead of at the same time |
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Right Bundle Branch Block |
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Definition
Problem in the bundle of His; causes the impulse to first travel through the left ventricle before heading to the right ventricle |
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Definition
Preceded by a viral infection; common cause of chest pain; usually self-limited but can cause complications; sharp stabbing chest pain; positional and pleuritic; usually nonexertional and no SOB |
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Caused by an inflammatory infiltrate/infection; elevated troponin due to death of heart muscle; Hypokinesis of heart muscle; supportive care only; usually self-limited |
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Rheumatic heart disease is the most common predisposing factor and mitral valve is most commong valve; initiated by subclinical bacteremia; Strep (65%) and Staph (10-30%; accompanied by fever |
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Right Ventricular Hypertrophy |
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Definition
Caused by increased pressure and/or volume; occurs in pulmonary valave stenosis, COPD, status asthmaticus, pulmonary embolus, mitral valve stenosis or insufficiency |
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Left Ventricular Hypertrophy |
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Definition
Caused by increased pressure and/or volume; occurs in mitral insufficiency, systemic hypertension, acute MI, aortic stenosis or insufficiency |
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A clinical syndrome in which heart disease reduces cardiac output, increases venous pressures, and is accompanied by molecular abnormalities that cause progressive deterioration of the failing heart and premature myocardial cell death |
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Most important initial test for ischemic heart disease |
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Uses exercise to induce myocardial ischemia that is not present at rest; used to evalute for angina/ischemia in patients with suggestive symptoms, high-risk patients, older patients beginning a strenuous exercise program |
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Often normal in patients with ischemic heart disease; useful in assessing heart size, interstitial edema, pneumonia, pneumothorax, aortic artery dissection, congestive heart failure, tumors |
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Indicator of irreversible myocardial cell damage; peak level correlates with amount of myocardial damage |
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Indicator of increased ventricular volume/pressure/stretch; rises in congestive heart failure |
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Uptake is proportional to myocardial blood flow; areas of diminished uptake relect relatve hypoperfusion |
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Stress Radionuclide Studies |
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Definition
Used to check for zones of hypoperfusion that may only be present during exercise/exertion; Used to check for coronary artery disease |
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Multiple-gated blood pool imaging (MUGA) scan |
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Definition
The heart is imaged through several hundred cardiac cycles to provide clear image of heart throughout the cycle; used to calculate left ventricular ejection fraction (often used in patients about to undergo chemotherapy with chemotoxic agents); look for focal wall abnormalities |
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Uses positron emitting agents to show perfusion/metabolism of myocardium; can distinguish stunned myocardium from cars |
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Give sizes of all four chambers; morphology and function of valves; pericardial effusion; ventricular size, function and thickness; left ventricular ejection fraction; wall motion abnormalities |
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Two-dimensional echocardiogram |
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Definition
Gives a cross-section of cardiac structures (form of echo) |
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Definition
Measures speed and direction of cardiac blood flow; detects valvular regurgitation |
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Transesophageal echo (TEE) |
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Definition
Transducer is passed into esophagus; enables clearer visualization of cardiac structures |
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Performed at rest and with exercise; shows wall motion abnormalities which can indicate either reversible ischemia or prior infarction |
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Can detect and quantify coronary artery calcification |
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Provides excellent anatomic definition of heart; shows myocardial thickness, chamber size, congenital defects |
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Coronary catheterization/angiography |
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Definition
Definitive diagnostic test for coronary artery disease; visualizes the location and severity of coronary artery stenosis; angioplasty and stenting can be performed as part of the same procedure |
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Definition
Portable cardiac monitor worn by patient to record cardiac activity for a 24 hr period |
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Records only when patient activates it when they are experiencing symptoms |
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Most common form; 4 chamber cardiac enlargement; cardiac output normal at rest but doesn't adequately increase with exertion; Ejection fraction <30% |
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Hypertrophic Cardiomyopathy |
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Definition
Ejection fraction >60% (high percentage, low volume); left ventricle and septum thickened; presents between ages 20 and 40 |
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Restrictive Cardiomyopathy |
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Definition
Ejection fraction decreased 25 to 50%; left ventricular internal dimension decreased; rigid walls |
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Definition
Cessation of breathing or shallow breathing while sleeping associated with excessive daytime sleepiness; associated with obesity |
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