reason for seeking care: | Chest pain
Palpitations (anxious, stress)
cough
shortness of breath (exertion, lying down, at night)
cyanosis or pallor
weakness/fatigue
unexpected weight changes
swelling of the extremities
dizziness
headache
high or low blood pressure
pain in extremities |
A feeling or sensation of own's heartbeat
could be due to:
strenous activities
excessive intake of caffeine
alcohol use
nicotine (tobacco, cigarette)
electrolyte (imbalances)
stress
lack of sleep
dehydration
hormonal changes | palpation |
Assessing the heart: pain: consider the: | location
radiation
nature/characteristics |
Assessing the heart: shortness of breath on excertion abv. soboc
difficulty in breathing due on just by doing simple activities
relieve by resting | Dyspnea on excertion
Sudden dyspnea without reason, patient may need to seek medical treatment |
Assessing the heart: Shortness of breath/difficulty breathing when the patient is lying down
relieve by sitting, standing or putting 2-3 pillows in the back | orthopnea |
Assessing the heart: difficulty breathing that occurs at night during sleeping causing disturbance of sleep
could be respiratory or circulatory condition
obstructive sleep apnea is already a condition that can cause the PND | Paroxysmal Norcturnal Dyspnea (PND) |
Palpitations: trigger by a temporary or sudden blood drop in the brain
loss of oxygenated blood in the brain leads loss of consciousness and lose of muscle contraction | light-headedness (near syncope) fainting (syncope) |
Inspection and palpation: general appearance: body build:
true or false: you judge the patient by her physical appearance. | false, do not judge the patient, must obtain BMI |
Inspection and palpation: face: yellowish patch in the inner erelids
makita usually sa elderly patient due tot he increase of cholesterol level | xanthelesma (a type of xanthoma) |
Inspection and palpation: face: makita sa cornea
it is a half circle of gray, white, (I dunno, visible?) color deposit in the outer edge of the cornea
wovet, increased cholesterol and fats it will occur the whole outer edges of cornea
seen/common in elderly patient | arcus senilis |
Inspection and palpation: edema: | check the extremities of the patient |
Inspection and palpation: clubbing: | due to decrease of O2 level in the tissue |
Inspection and palpation: quick test on the nail bed
used to check the circulatory as well as check if the patient is dehydrated
depending on the amount of blood flow going to the tissue
apply pressure to the nailbeds then check if it pales/blanches then release pressure then observe the blood return
from being pale/blance it will turn pink to red
observe the time maximum of 2 seconds | Decreased CRT (capillary refill time) |
Inspection and palpation: palpation of heart borders or boundaries: | aortic area
pulmonic area
both left ventricular area (you can keme keme & vibration)
sternoclavicular area |
Inspection and palpation: palpation of heart borders or boundaries: palpable buzzing sensation
vibration | thrills |
Inspection and palpation: palpation of heart borders or boundaries: strong outward thrust of the chest wall
pounding | heave |
Two fatty elements inside the body | cholesterol
triglycerides |
waxy, fat-like substance that's found in all the cells in your body
our body needs some cholesterol to make hormones, vit. D, and substances that help you digest foods | cholesterol |
are a type of fat (lipid)found in your blood that:
stores unused/extra calories and provide your body w/ energy | triglyceride |
Three types of cholesterol:
High-density lipoprotein
good cholesterol
carries/flushing out LDL
protects against heart attacks & stroke | HDL |
Three types of cholesterol:
Low-density lipoprotein
bad cholesterol- builds up in the blood vessels | LDL |
Three types of cholesterol: | HDL
LDL
VLDL |
Athero- plaque, sclerosis- hardening
accumulation of fatty deposits in the lining of the artery
hardening of the artery due to build up of plaques
blood vessels receive injury- our body will compensate by reducing hormones, fibrines, blood-clotting
factors- will cause harm to the arterial walls | atherosclerosis |
Atherosclerosis risk factors: | Dyslipidemia
smoking
high blood pressure
poor diet/inactivity
stress
family history |
Atherosclerosis: risk factors: abnormally high levels of lipoproteins or fats in our blood especially the LDL | Dyslipidemia |
risk factors of atherosclerosis mostly affects | coronary artery |
responsible for carrying oxygenated blood around the heart muscles | Coronary artery |
Involve/block w/ plaques the brain will be affected because it is responsible for carrying oxygenated blood to the brain | carotid artery |
Atherosclerosis may develop: | thrombosis
embolism
ischemia |
formation of blood clot within the blood vessels
the clot or thrombos will interrupt the blood flow to the tissues
If there is an interruption to the blood flow it will lead to necrosis or tissue death | thrombosis |
blockage due to the thrombos may develop a mass called?
will develop if there is an increase blood pressure, turbulence kaayo ang pressure sa blood vessels sa patient, due to the increase turbulent flow of the blood it will loosen the thrombos to the arterial wall it will travel to the blood stream (travelling clot)
delikado if mo lodge to other parts especially the coronary artery
air (even parenteral administration), other bacterias, and solid materials can cause this
plaques will gradually thicken and hardens with material cells and deposits
it it will lodge in a certain artery, this will result to restricting or obstructing the opening of the blood vessels | embolism/embolus |
Normally, if the blood clot or embolus will restrict the opening of the blood vessel or the lumen of the blood vessels then normally it will reduce the blood flow to the tissue resulting or leading in?
localized blocking of blood flow
as we get old there is also a degenerative changes in the artery. if there is a sudden obstruction in the artery, it will lead to this. | ischemia |
If an embolus lodge to the lung it lead to: | pulmonary embolus |
If an embolus lodge the carotid artery it will block the cerebral vessels then it will lead to:
or also known as what? | CVA (cerebro vascular accident) or also known as stroke |
Ischemia will lead to ??? that leads to death | myocardial infarction or heart attack |
Common symptoms of ischemia: | pain- over the heart, upper part of the abdomen
-radiate to the jaw, shoulder, arm
pallor
diaphoresis- excessive sweating
nausea
dyspnea
the pain is burning sensation as described |
Diagnostic procedure for MI (myocardial infarction) | BCG- electrocardiography
measurement of enzymes |
If the wall of our artery becomes weak it can stretch and balloon out called?
commonly caused by artherosclerosis
may be caused by or may cause malformations of arteries due to injury
very dangerous once it ruptures and causes hemorrhage | Aneurysm |
Layers of artery: | intima
media
adventitia |
Other names of aneurysm: | aortic aneurysm
brain aneurysm
cerebral aneurysm- rupture of cerebral artery, causes stroke
peripheral aneurysm
thoracic artery aneurysm |
common sites for aneurysm | abdominal carotid artery |
Dissecting aneurysm: common emergency/ surgical care is: | grafting |
Types of aneurysm | saccular aneurysm- (ball/circle-shaped/round)
fussiform aneurysm
ruptured aneurysm- the most dangerous |
abnormally high blood pressure | hypertension |
normal blood pressure | 120/80 |
is a force asserted by the blood against the wall of our blood vessels | blood pressure |
device used to measure blood pressure | sphygmomanometer |
Types of hypertension: | essential hypertension
secondary hypertension |
Types of hypertension:
primary hypertension
does not develop over time
it is sometimes the genetic
inherited | Essential hypertension |
Types of hypertension:
caused by other conditions such as kidney diseases or etc.
lifestyle
side effects of medications | secondary hypertension |
Heart disease: a result of atherosclerosis of the blood vessels, hardening of the plaque in the coronary artery
diagnosed using ECG; studies the apical impulse in the heart | Coronary Artery Disease (CAD) |
Heart disease: Coronary heart disease: doing an exercise, there is an electrode place in the chest of the patient to monitor the heartbeat or the heart function | stress test |
Heart disease: Coronary heart disease: recording/imaging of the coronary artery/arteries | Coronary angiography |
Heart disease: Coronary heart disease: using the ultrasound narrowing of the lumen at one or more of the coronary arteries, usually due to atherosclerosis | echocardiography |
Heart disease: Coronary heart disease: Common symptoms: | chest pain/angina pectoris- crushing
disphoresis
dypnea |
Heart disease: Coronary heart disease: treated by: | controlled exercise
medications- nitroglycerin |
Heart disease: Coronary heart disease: treatment: | Angioplasty/PTCA
CABG |
Heart disease: Coronary heart disease: treatment: minimally invasive procedure that opens blocked coronary arteries to improve blood flow tot he heart
using catheter to dilate the blockage introducing a balloon that serves to widen the area (inflate; deflate) | [Percutaneous transluminal coronary angioplasty] Angioplasty/PTCA |
Heart disease: irregularity of heart rate or heart rhythm
a higher or lower average heart rate (bradycardia, tachycardia) ECG
extra beats
alteration in the patterns of the heart | arrhythmia |
normal heart rate | 60/100 bpm |
Electrical coronation system: chords of fibrous tissue called? | chordae tendineae |
Electrical coronation system: Where the impulse stimulates ventricular contraction | Purkinje fibers |
Heart disease: Arrhythmia: treatment: restoration of a normal heart rhythm
may use a drug or electro current
patch place in the chest and it will slowly give electric current to the head | cardioversion |
Heart disease: Arrhythmia: treatment: introduces/sends an electric shock to the heart
stop fibrillation | defibrillation |
Heart disease: Arrhythmia: treatment: implanted to the chest to regulate heart beat upper chamber
can be removed if the heartbeat becomes regulated/normal | artificial pacemaker |
Heart disease: Arrhythmia: treatment: implanted under the skin
a device that tracks the heart rate and the rhythm
sends shock to the heart | implantable converter defibrillator (ICD) |
Heart disease: Arrhythmia: treatment: portable device that records 24 hours the ECG of the heart
place in the chest
could be brought at home | Holter monitor |
refers to any condition in which the heart fails to empty effectively/pump effectively
causes: CAD, HP, diabetes, heart valve problems
Signs and symptoms:
Edema (pulmonary edema)
cyanosis
dyspnea
syncope
treated with:
rest
drugs to strengthen heart contractions
diuretics
restrict salty foods | heart failure |
Infection w/ group A streptococcus that permanently damages the heart valves | Rheumatic heart Failure (RFA) |
Prolapsing in the mitral valve- dli na gaclose properly that leads to backflow
repeated infection
surgical valve replacement | Rheumatic Heart Disease (RHO) |