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Clinical Methods > Cardiac Disorders and 12 Lead EKG Part 4 > Flashcards

Cardiac Disorders and 12 Lead EKG Part 4 Flashcards

1
Q

In diastolic heart failure, EF is often normal. True or false?

A

true

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2
Q

NY Heart Association classification system:

No limitation and no symptoms with ordinary physical activity is Class ___.

A

I

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3
Q

NY Heart Association classification system:

Slight limitation and symptoms with ordinary physical activity. Comfortable at rest.

Class __.

A

2

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4
Q

NY Heart Association classification system:

More pronounced limitation because of symptoms, even with less than ordinary physical activity. Comfortable only at rest.

Class __

A

3

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5
Q

NY Heart Association classification system:

Severe to complete limitation of physical activity. Symptoms are present with any degree of physical activity and also appear at rest.

Class ___

A

4

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6
Q

Symptoms of ____ include fatigue at rest or with minimal exertion.

A

CHF

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7
Q

Hallmark symptoms include dyspnea, tachypnea, orthopnea, PND, and S3.

Signs include moist rales in the lungs –> pulmonary edema.

A

Left CHF

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8
Q

Hallmark symptoms include systemic venous congestion as evidence by JVD, oranomegaly (liver and spleen), RUQ tenderness and elevation of liver tests, and pulmonary edema.

A

Right CHF

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9
Q

In CXR, distension of the pulmonary veins in upper lobes of the lungs (pulmonary venous HTN), hilar and perihilar haze (perivascular edema, pleural effusions and pericardial effusion indicate ____.

A

CHF

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10
Q

Short-term treatment of CHF goals include: (3)

A
  • relieve symptoms of circulatory congestion
  • increase tissue perfusion
  • improve quality of life
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11
Q

Long-term treatment goals for CHF: (1)

A

slow or reverse progressive LV dysfunction (ventricular remodeling) that results in a dilated ventricular chamber and low EF

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12
Q

Non-pharmacologic management of CHF: (6)

A
  • Na restriction
  • exercise
  • angioplasty and bypass surgery
  • valve repairs
  • heart transplant
  • ventricular assist device
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13
Q

List 4 drugs that are good options for CHF patients.

A
  • ketamine
  • opioids
  • benzodiazepines
  • etomidate

Caution: nitrous oxide & opioids/benzos = cardiac depression!

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14
Q

Volatile anesthetics are encouraged for CHF patients. True or false?

A

false

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15
Q

Use caution when using propofol for CHF patients. True or false?

A

true

It is not a direct myocardial depressant, but causes peripheral vasodilation which decreases BP.

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16
Q

For severe CHF patients, consider opioids only, positive pressure ventilation, invasive monitoring, and support of CO with dopamine and dobutamine also. True or false?

A

true

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17
Q

What condition is characterized by myocardial dysfunction unrelated to the usual causes of heart disease (CAD, valve disease, or HTN)

A

cardiomyopathy

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18
Q

Common to all cardiomyopathy is progressive, life threatening CHF. True or false?

A

true

19
Q

Right ventricular enlargement that develops secondary to pulmonary HTN indicates ____ ____.

A

Cor Pulmonale

20
Q

COPD with associated loss of pulmonary capillaries and arterial hypoxemia –> pulmonary vascular vasoconstriction –> hypertrophy of vascular smooth muscle and increases pulmonary vascular resistance–> ______ _____.

A

cor pulmonale

21
Q

____ ____ is obscured by COPD and results in:

  • dyspnea
  • effort -related syncope
  • elevated pulmonary artery pressures
A

Cor pulmonale

22
Q

CXR reveals:

  • right ventricular hypertrophy reflected by decreases in retrosternal space on lateral view, or,
  • prominence of PA and decreased vascular markings are suggestive of pulmonary HTN

in this type of heart condition.

A

cor pulmonale

23
Q

Peaked p waves in II, III, AVF and right ventricular hypertrophy (right axis deviation and RBBB) show signs of ___ ____.

A

cor pulmonale

24
Q

To treat cor pulmonale, decrease the workload of the right ventricle by decreasing PVR. True or false?

A

true

25
Q

Treatments for cor pulmonale include: (7)

A
  • supplemental O2
  • anticoalgulation
  • diuretics
  • digitalis for CHF
  • vasodilators
  • antibiotics
  • heart-lung transplant
26
Q

Characterized by a sustained increase of pulmonary artery pressure without a demonstrable cause.

A

Primary pulmonary HTN

27
Q

In primary pulmonary HTN,

mean PA pressure > ___ mmHg (rest)

                                      \> \_\_\_ mmHg (exertion)
A

25

30

28
Q

Primary pulmonary HTN pathological changes include: (3)

A
  • in situ thrombosis
  • smooth muscle hypertrophy
  • intimal proliferation
29
Q

Early symptoms or primary pulmonary HTN include: (2)

A

dyspnea

fatigability

30
Q

____ ____ ____ to confirm diagnosis of primary pulmonary HTN.

A

Right heart catheterization

31
Q

There is no cure for primary pulmonary HTN. True or false?

A

true

32
Q

Treat primary pulmonary HTN with: (2)

A
  • Ca channel blockers (nifedipine & diltiazem)
  • or, IV prostacyclin as a bridge to transplantation for non-responders
33
Q

Inflammation of the pericardium usually caused by a viral infection is known as:

A

acute pericarditis

34
Q

What do these symptoms indicate?

  • chest pain worsening with inspiration
  • friction rub
  • diffuse ST segment elevation
A

acute pericarditis

35
Q

Treatment for acute pericarditis: (2)

A
  • oral analgesics for pain
  • NSAIDs
36
Q

What is the abnormal accumulation of fluid in the pericardial cavity?

A

pericardial effusion

37
Q

A pericardial effusion with enough pressure to adversely affect heart function is known as what?

A

cardiac tamponade

38
Q

Signs of impending tamponade include: (3)

A

dyspnea

low BP

distant heart sounds

39
Q

CXR reveals a “water bottle heart” indicates what?

A

cardiac tamponade

40
Q

What is the treatment for cardiac tamponade?

A

pericardiocentesis

needle is inserted through the chest wall into the pericardial space to withdraw excess fluid

41
Q

_____ ____ is a long-term inflammation of the pericardium with thickening, scarring, and muscle tightening.

Causes include heart surgery, radiation therapy to the chest and TB.

A

Constrictive pericarditis

42
Q

Symptoms of constrictive pericarditis include: (5)

A
  • dyspnea
  • fatigue
  • peripheral edema
  • ascites
  • weakness
43
Q

What tests indicate constrictive pericarditis? (4)

A
  • chest CT (demonstrate thickening)
  • TEE
  • doppler flow studies
  • cardiac cath
44
Q

Treatment for constrictive pericarditis include: (2)

A

either resolves

surgical stripping of pericardium

Clinical Methods (23 decks)

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