1. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Coronary Artery Disease Coronary artery disease: A condition involving the arteries that supply the myocardium, in which the arteries become narrowed due to atherosclerotic deposits over time, causing temporary cardiac ischemia and eventually heart attack

2. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Coronary Artery Disease (cont’d.) Angina pectoris: A condition of chest pain after exertion that is the result of reduced oxygen supply to the myocardium

3. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Coronary Artery Disease (cont’d.) Myocardial infarction: (MI) - Death of myocardial tissue caused by the development of ischemia  Most common cause is coronary thrombosis.

4. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.  Administer oxygen, give morphine for pain.  Administer aspirin.  Induce vasodilation by nitroglycerin drip.  Administer lidocaine by intravenous drip.  Administer thrombolytic drugs.  Restore blood flow by angioplasty. Treatment Options for Myocardial Infarction

5. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Hypertensive Heart Disease Hypertensive heart disease: A condition caused by chronically elevated pressure throughout the vascular system.  Most prevalent cardiovascular disorder in the U.S.

6. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Treatment of Hypertension  Diuretics to reduce circulating blood volume  Beta-adrenergic blockers to slow heartbeat  Vasodilators to dilate vessels  Angiotensin-converting enzyme (ACE) inhibitors to produce vasodilation and increase renal blood flow

7. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Hypertensive Heart Disease  Essential hypertension  Malignant hypertension

8. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Congestive Heart Failure Congestive heart failure (CHF): An acute or chronic inability of the heart to pump enough blood throughout the body

9. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.  gradually increasing dyspnea  cardiac and respiratory rates increase  neck veins distend  edema in ankles  liver and spleen enlarge Signs of Congestive Heart Failure

10. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Congestive Heart Failure (cont’d.)  left-sided congestive heart failure  left ventricle does not empty  blood backs up in pulmonary circulation  pulmonary congestion  right-sided congestive heart failure  right ventricle cannot empty  blood backs up in systemic circulation  edema in legs and digestive system

11. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Rheumatic Fever Rheumatic fever: a systemic inflammatory and autoimmune disease involving the joints and cardiac tissue  generally preceded by sore throat caused by group A beta-hemolytic streptococcus

12. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Rheumatic Fever (cont’d.) Rheumatic heart disease: the cardiac manifestations that follow rheumatic fever  usually affects mitral and aortic valves

13. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Valvular Heart Disease Valvular heart disease: an acquired or congenital disorder that can involve any of the four valves of the heart (pulmonary, tricuspid, aortic, or mitral) Mitral valve prolapse (MVP): occurs when the valve cusps do not close completely

14. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Valve Insufficiency and Stenosis  Valve insufficiency: failure of valves to close completely, allows blood to be forced back into heart  Stenosis: hardening of cusps of valves that prevents complete opening of valves, impedes blood flow into next chamber

15. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Cardiac Arrhythmias Cardiac arrhythmias (irregular heartbeats): any deviation from the normal heartbeat, i.e., the normal sinus rhythm

16. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Vascular Conditions Emboli: clots of aggregated material (usually blood) that can lodge in a blood vessel and inhibit the blood flow Venous thrombosis: blood clot that has formed in the deep veins of the legs  most common type of embolus

17. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Vascular Conditions (cont’d.) Arteriosclerosis: a condition that occurs when the walls of the arterioles thicken, with loss of elasticity and contractility Atherosclerosis: a thickening and hardening of the arteries that occurs when plaques of cholesterol and lipids form in the arterial tunica intima

18. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Risk Factors of Atherosclerosis  heredity  sedentary lifestyle  diet rich in lipids and cholesterol-producing foods  smoking  diabetes mellitus  hypertension  obesity

19. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Vascular Conditions (cont’d.) Aneurysm: a weakening and resulting local dilation of the wall of an artery

20. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Vascular Conditions (cont’d.) Phlebitis: an inflammation of a vein that occurs most often in the lower legs, but any vein may be affected Thrombophlebitis: The result of an inflammation of a vein with the formation of a thrombus on the vessel wall Varicose veins: Swollen, tortuous, and knotted veins that usually occur in the lower legs