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CCRN > Cardiac > Flashcards

Cardiac Flashcards

(85 cards)

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1
Q

Coronary arteries are perfused during?

A

Diastole

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2
Q

S1 signals

A

Closure of mitral and tricuspid valves

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3
Q

S2 signals

A

closure of pulmonic and aortic valve

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4
Q

S3 (ventricular gallop) is caused by?

A

Fluid overload, cardiomyopathy, mitral or tricuspid regurgitation

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5
Q

S4 (Atrial gallop) is caused by?

A

Ischemia, HTN, pulmonary stenosis, CAD, aortic stenosis, left ventricular hypertrophy

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6
Q

What is split S1 heart sounds?

A

Mitral valve closes before tricuspid valve occurs during RBBB, PVCs, or ventricular pacing

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7
Q

What is split S2 heart sounds?

A

Aortic valve closes before pulmonic valve occurs due to overfilled right ventricle or atrial septal defect

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8
Q

Troponin elevates in

A

3-6 hours

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9
Q

Troponin peaks in

A

14-20 hours

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10
Q

Troponin returns to normal in

A

1-2 weeks

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11
Q

Which medications should you avoid in suspected right ventricular infarction?

A

Medications that reduce pre-load (Morphine & Nitro!)

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12
Q

What are the big 5 medications prescirbed post MI?

A

Aspirin, Beta blockers, P2Y12 Inhibitor (plavix), ACEI or ARB, and statin

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13
Q

Inferior MI Artery

A

RCA

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14
Q

Inferior MI ST Elevation

A

II, III, aVF

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15
Q

Inferior MI Reciprocal changes

A

I, aVL

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16
Q

Inferior MI Symptoms

A

Bradycardia, First degree AVB, 2nd degree AVB Type I, Hypotension, N/V, diaphoresis

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17
Q

Right Ventricle MI Artery

A

Proximal RCA

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18
Q

Right Ventricle MI ST Elevation

A

V1 V2R-V4R

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19
Q

Right Ventricle MI Symptoms

A

Tachycardia, Hypotension, JVD

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20
Q

Right Ventricle MI Treatment

A

IV fluids (maximize pre-load), + inotrope (dobutamine)

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21
Q

Anterior Septal MI Artery

A

LAD or L main

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22
Q

Anterior septal MI ST elevation

A

V1-V4

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23
Q

Anterior Septal Reciprocal changes

A

II, III, aVF

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24
Q

Anterior septal MI symptoms

A

S3 heart sound, shock, heart blocks (2nd degree II, 3rd degree), BBB, new loud murmur (papillary muscle rupture)

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25
Lateral wall MI artery
L circumflex, LAD
26
Lateral wall MI ST elevation
I, aVL, V5-V6
27
Posterior Wall MI Artery
RCA (90%), LAD (10%)
28
Posterior wall MI ST elevation
posterior leads V7-V9, tall broad R wave in V1-V2
29
Pericarditis symptoms
Chest pain, pain improved when sitting up/leaning forward, pain worse with cough and position changes
30
Papillary muscle rupture associated with which MI?
Anterior or inferior wall MI
31
Papillary muscle rupture symptoms
hemodynamic instability, new loud systolic murmur, large V wave on PAOP waveform
32
Ventricular septal rupture associated with which MI?
anterior/septal wall MI
33
Ventricular septal rupture symptoms
acute SOB, S3 heart sound, crackle, holosystolic murmur
34
Cardiogenic shock clinical signs
S3, JVD, pulmonary edema, tachycardia, dysrhythmias, signs of decreased perfusion, decreased UO
35
Cardiogenic shock hemodynamics
MAP <65, decreased CO/CI, Increased SVR >1600, elevated RAP/CVP. increased PAOP >16, decreased SVO2
36
Cardiogenic shock treatment
vasopressors, +inotrope, loop diuretics, afterload reduction, mechanical support IABP
37
Alpha receptors
blood vessels
38
Beta1 receptors
located on the heart
39
Beta2 receptors
located in the bronchial and vascular smooth muscle
40
Phenylephrine receptors
All alpha
41
Norepinephrine receptors
Mostly alpha but some Beta1
42
Epinephrine receptors
Alpha, Beta1, and some Beta2
43
Dopamine receptors
Mostly Beta1, some Alpha, little Beta2
44
Dopamine effects
Increase HR, BP, and SVR
45
Dopamine nursing consideration
watch out for tachy arrhythmias and ventricular ectopy
46
Norepinephrine effects
increase BP and HR (sometimes)
47
Norepinephrine adverse effects
bradycardia, dysrhythmias, HTN, renal artery vasoconstriction
48
Epinephrine effects
increase BP HR
49
Epinephrine adverse effects
tachycardia, dysrhythmias, chest pain, hyperglycemia
50
phenylephrine effects
increase BP
51
phenylephrine adverse effects
reflexive bradycardia, dysrhythmias, HTN, chest pain
52
Dobutamine receptors
beta1
53
Dobutamine effects
increase CO, HR
54
Dobutamine adverse effects
tachycardia, hypo or hypertension, ectopy, hypokalemia
55
Milrinone effects
increase CO, decrease PAOP and SVR
56
Milrinone adverse effects
vasodilator with long half life!
57
Cardiac tamponade symptoms
Elevated CVP with JVD, hypotension, muffled heart sounds, wide mediastinum on CXR, sudden drop in chest tube output, narrow pulse pressure, tachycardia, electrical alternans, pulsus paradoxus, PEA
58
What is pulsus paradoxus?
>10 mm Hg drop in BP during inspiration.
59
Left sided HF=
blood backs up to the lungs
60
Left sided HF s/s
decreased CO/CI, tachypnea, tachycardia, S3 heart sound, mitral regurgitation, crackles, cough frothy sputum, increased PA pressures, increased PAOP, increased SVR
61
Right sided HF=
blood backs up to the venous periphery
62
Right sided HR s/s
JVD, hepatojugular reflux, peripheral edema, hepatomegaly, anorexia, N/V, ascites, tricuspid regurgitation, increased CVP RAP, increased liver enzymes
63
HF meds
ACEI, ARB, Beta blocker, aldosterone antagonist, vasodilator, diuretics
64
Acute HF meds
dobutamine or milrinone, diuretics, nitroglycerin
65
What is hypertrophic cardiomyopathy
Thickened interventricular septum resulting in diastolic dysfunction andd ventricular hypertrophy
66
Hypertrophic cardiomyopathy symptoms
S4 murmur
67
Hypertrophic cardiomyopathy treatment
Beta blockers and CCBs (avoid inotropes)
68
What is Takotsubo cardiomyopathy?
Weakening & ballooning of the left ventricle
69
Takotsubo symptoms
chest pain, SOB
70
What is stenOsis?
forward flow of blood through narrow, stenotic open valves
71
What is insuffiency/regurgitation?
Backward flow through incompetent closed valves
72
Mitral stenosis?
diastolic
73
Mitral regurg
systolic
74
aortic stenosis
systolic
75
Aortic regug
diastolic
76
Mitral insufficiency/regurgitation causes
MI, ruptured chordae tendineae, severe left HF, L ventricular hypertrophy, mitral valve prolapse, endocarditis, rheumatic heart disease
77
Mitral insufficiency/regurgitation symptoms
systolic murmur, orthopnea/dyspnea, fatigue, angina, increased left atrial pressure, right heart failure, left heart failure
78
Mitral stenosis symptoms
pinkish cheeks, pulmonary edema, increased right heart pressures, pulmonary hypertension
79
Aortic insufficiency/regurgitation causes
chronic hypertension, rhematic heart disease, endocarditis, marfans syndrome
80
Aortic insufficiency/regurgitation symptoms
DeMusset sign-head bobbing, brisk carotid upstroke, wide pulse pressure
81
Aortic stenosis symptoms
heart failure, activity intolerance, SOB
82
What is pericarditis?
Inflammation of the pericardial sac
83
What is myocarditis?
focal or diffuse inflammation of the myocardium
84
What is endocarditis?
infection of the endocardium or valve
85
Endocarditis symptoms
stabbing sharp pain, SOB, cough, JVD, pulsus paradoxus, pericardial friction rub, ST elevations, narrow pulse pressure

CCRN (4 decks)

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