Exercise Intensity
Light: walking 10 to 15 steps, preparing a simple meal for one, retrieving a newspaper from just outside the door, pulling down a bedspread, brushing teeth
Moderate: making the bed, dusting and sweeping, walking a level short block, office filing
Moderately heavy: climbing one or two flights of stairs, lifting full cartons, long walks, sexual intercourse
Heavy: jogging, vigorous athletics of any kind, cleaning the entire house in less than a day, raking a large number of leaves, mowing a large lawn with a hand mower, shoveling deep snow
Abnormalities
Angina – Pain caused by myocardial ischemia
PathophysiologyÂ
- Occurs when myocardial oxygen demand exceeds supply
- Can be recurrent or present as initial incidence
Patient Data
Subjective –
- Substernal pain or intense pressure radiating to the neck, jaws, and arms, particularly the left
- Often accompanied by shortness of breath, fatigue, diaphoresis, faintness, and syncope
Objective –
- No definitive examination findings suggest angina
- Tachycardia, tachypnea, hypertension, and/or diaphoresis
- Ischemia may lead to presence of crackles due to pulmonary edema or a reduction in the S1 intensity or an S4
- Physical examination may suggest other comorbidities that place the patient at higher risk for angina symptoms, such as chronic obstructive pulmonary disorder, xanthelasma, hypertension, evidence of peripheral arterial disease, abnormal pulsations on palpation over precordium, murmurs, or arrhythmias.
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Bacterial Endocarditis – Bacterial infection of the endothelial layer of the heart and valves
Congestive Heart Failure (CHF)–Left-Sided – Heart fails to propel blood forward with its usual force, resulting in congestion in the pulmonary circulation
Congestive Heart Failure (CHF)–Right-Sided – Heart fails to propel blood forward with its usual force, resulting in congestion in the systemic circulation
Pericarditis – Inflammation of the pericardium
Cardiac Tamponade – Excessive accumulation of effused fluids or blood between the pericardium and the heart
Cor Pulmonale – Enlargement of the right ventricle secondary to chronic lung disease
Myocardial Infarction – Ischemic myocardial necrosis caused by abrupt decrease in coronary blood flow to a segment of the myocardium
Myocarditis – Focal or diffuse inflammation of the myocardium
Conduction Disturbances – Conduction disturbances either proximal to the bundle of His or diffusely throughout the conduction system
Sick Sinus Syndrome – Arrhythmias caused by a malfunction of the sinus node
Atrial (Auricular) Flutter
Sinus Bradycardia
Atrial Fibrillation
Heart Block
Supraventricular Tachycardia
Paroxysmal atrial tachycardia
Ventricular Tachycardia
Ventricular Fibrillation
Ventricular Septal Defect (VSD)Â – Opening between the left and right ventricles
Tetralogy of Fallot – Congenital heart defect composed of four cardiac defects: ventricular septal defect, pulmonic stenosis, dextroposition of the aorta, and right ventricular hypertrophy
Patent Ductus Arteriosus – Failure of the ductus arteriosis to close after birth
Atrial Septal Defect (ASD)Â – Congenital defect in the septum dividing the left and right atria
Acute Rheumatic Fever – Systemic connective tissue disease occurring after streptococcal pharyngitis or skin infection
Atherosclerotic Heart Disease (Atherosclerosis, Coronary Heart Disease)Â – Narrowing of the small blood vessels that supply blood and oxygen to the heart
Senile Cardiac Amyloidosis – Amyloid, a fibrillary protein produced by chronic inflammation or neoplastic disease, deposition in the heart