CVD

1. Class 1
   1. Pain with hard ex
2. Class 2
   1. pain during mod ex
3. Class 3
   1. limitation normal activ
4. Class 4
   1. occurs at rest
5. treament
   1. surgery
      1. CABG

         Nota:

         • coronary bypass graft surgery 
      2. PTCA

         Nota:

         • baloon and stent 
   2. lifestyle
      1. diet
      2. exericse
         1. aerobic
            1. 3-5days week
               1. mod level
                  1. 30-60min day
         2. resistance
            1. 2-3days week
               1. mod leve.
                  1. 8-10reps/ 2-4sets
                     1. full body
         3. stretching
            1. 2-3days week
               1. 2-4 sets
         4. considerations
         5. contraindications
6. Medications
   1. nitrates
      1. convert niitrates to nitric oxide
         1. promotes dilation
            1. increase in blood flow to heart
      2. glycerly trinitrate

1. less elastic

1. Exercise
   1. 30min most days
      1. Aerobic 7/6 drop in BP
         1. Resistance training 3/3 BP drop
2. Diet
3. Stop smoking

1. ACE inhibitor
   1. block conversion of angiotensin 1 to 2
      1. 2 is vasocontrictor
         1. lowers BP
   2. catopril
      1. enalapril
         1. ramipril
   3. causes cough
2. Angiotensin II receptor antagonists
   1. binds to specific receptors for 2
   2. losatan
      1. irbesartan
         1. temisartan
   3. no cough
3. Beta blocker
   1. block activity of adrenaline at b receptor
      1. prevents sympathetic acceleration of heart
         1. reduce cardiac ouput
            1. reduce BP
   2. selective b1 receptors
      1. atenolol
         1. bisprolol
            1. reoprolol
   3. non selective
      1. cause brochoconstriction
         1. timolol
            1. pindolol
4. Calcium channel antagonists (Blocker)
   1. decrease entry of calcium into heart
      1. effect cardiac contractility and conduction
   2. verapamil
      1. diltiazem
5. Diuretic
   1. reduction in fluid load, increase urine
      1. lowers BP

1. cells become hypoxic

1. reduced ejection, stroke volume, bp response

1. break off
2. blood clots forms on

1. LV failure causes < CO LV filling pressure and LV hypertrophy

1. CABG
2. heart transplant
3. reudction in fluid and sodium
4. Exericse

1. SOB
2. feet swelling
3. weakness
4. weight gain

1. Cause intermittent claudication

   Nota:

   • painful cramping of leg or hip muscles 

1. 1: Asymptomatic
2. 2 intermiddent claudication
3. 3. pain at rest
4. 4. gangrene/ tissue loss

Nota:

• % of blood leaving heart everytime it contracts 

1. BP> 180/110

1. BP >250/115