Most common cardiac valve disease in women?

• Mitral valve prolapse is the most common valve disorder in the U.S. with a prevalence estimated at 3%, MVP tends to be most prevalent in young women pg. 1094
• Common in young women, leaflets of valve prolapse into atrium- may cause mitral regurgitation, back flow of blood-murmur
• https://youtu.be/Q84DwBABbY0
• At risk for stroke and endocarditis
• Left ventricle become hypertrophied- pulmonary hypertension- right sided heart failure
• Valve repair and surgery may be warranted

Dermatomes: are spinal cord levels that are associated with a specific area

• https://youtu.be/CYZBH6NX8wg

Agnosia: is when an individual is unable to visualize or recognize objects due to injury

When myocardial ischemia may be reversible?

• If blood flow is restored within 20 min **** Key to perfusion
• Many individuals with reversible myocardial ischemia exhibit a normal physical examination between episodes.
• Physical examination of an individual experiencing myocardial ischemia may disclose tachycardia, extra heart sounds (gallops or murmurs) and pulmonary congestion indicating impaired left ventricular function.
• Unstable angina is the result of reversible myocardial ischemia and is a harbinger of impending infarction
• Pt with coronary artery disease may experience ischemia during mental emotional or body stress like exercise.
• Ischemia is low blood supply- cells are alive but starving- do not functions normally

Symptoms of Stable Angina:

• Atypical chest pain, palpitations, sense of unease, severe fatigue, angina pectoris, radiation to neck, lower jaw, left arm, left shoulder, or occasionally back or down right arm.
• https://youtu.be/7XkOuo5DwAU
• Gradual luminal narrowing, heart can not meet the demands- chest pain develops- with rest it subsides.
• Relieved with Nitroglycerin
• Pain eases with rest- gold standard

Orthostatic Hypotension:

• BP changes from lying to sitting or standing position
• Decrease of systolic BP by at least 20mmHg and diastolic by at least 10mmHg within 3 minutes of standing.
• When it occurs patients feel syncopal, fainting, dizziness, and loss of vision.
• Treatment: correct underlying disorder, raise HOB, watch salt intake, adjust BP meds, TED hose,
  • Why increase HOB- so the body can adjust to sitting before standing- so the sympathetic system has time to catch up in elderly or hypovolemic patients.

Isolated systolic hypertension:

• High systolic with normal diastolic: Systolic >140 mmHg/ Diastolic <90mmHg
• Becoming more prevalent in all age groups and is strongly associated with cardiovascular/CVA events.

Results of sustained controlled hypertension:

• Pg. 555
• Increased peripheral resistance and increased blood volume causes HTN- sustained over time- remodeling of vessels resulting in changes known as hyaline sclerosis and atherosclerosis.
• Effects eyes- retinal changes- kidneys- heart- brain

Insulin resistance on the development of primary resistance:......... Continue