Flashcards in cardio 3 Deck (70):
ST elevation MI:
It is when there is full mural MI,.
Is elevated st when there is transient or prolonged ischemia?
Pci what does it do? Percutaneous Coronary Intervention
It gives the tissue O2
plasminogen activator) or streptokinase are?
CAD and MI are leading causes of:?
There is a ______ week period post MI during whichpts are more vulnerable to a repeat
♥ ENZYMES Confirm Dx
Troponin CPK LDH
Enzyme specific to ♥ muscle?
Troponin, like traped in. When there is a MI the guy feels traped in.
Enzyme that is detectable 3-6 hours post MI?
Enzyme remains elevated 7-10 days
Nzyme that is seen at 3-4 hours from MI
CPK the peak is at c and c equals three. But Troponin also starts at three hours, but that goes from 3-6 here it is from 3-4.
So CPK just know that it is 3-4 hours.
This enzyme remains int he system for three days.
Troponin is 7-10 days, so even through this starts at best by teo hours, nevertheless Troponin is able to help diagnose for another 4-7 days for a total of 7-10 days.
Will cause very high CPK values
– Heat Stroke
– Side Effect From Statins (rare)
Theses are all part of Rhabdomyolysis. That there is trauma to to the tissue.
Like da hell, this is what you will say when someone hears that they have elevated lactic dehydrogenase levels.
This enzyme starts at 21-24 hours
This enzyme remains for 5-14 days
Ldh starts at _____ hours
Ldh lasts for ______ days?
Start and last for
Troponin 3-6, 7-10
CPK 3-4, 3
LDH 21-24, 5-14
So e best really is troponin, because it starts the earliest and even though it does not lasts the longest still Troponin will be great for diagnosis.
Difference betweeen CAD and CHF?
CAD is a condition that happens to the heart, and CHF is what the heart is after it has suffered some damage.
So CAD can cause an MI which will leave the heart at CHF.
Eft sided heart failure causes...
Right sided heart failure
With left sided heart failure e blood backs up to the...
Lungs... Right side heart... Body... This causes the right sided heart failure.
Right sided heart failure backs the blood to...
The body, causing edema.
liver enlargement – JVD
• positive hepatojugular reflux, ascites
• hear S3, S4
Are also causes of right sided heart failure, because the blood gets back into the system.
With systolic dysfunction the heart pumps out less blood, so it compensates with...
Increased heart rate thus the heart atrophies.
Diastolic dysfunction the heart cannot fill enough, so it cannot pump out enough, so although it can beat faster, it can also _______
Beat stronger, so the LV gets thicker.
Wit diastolic dysfunction, when the lv gets thicker does the heart get bigger?
the heart is losing the ability tocompensate for ongoing physiological
Ongoing... Chronic heart failure
initial manifestation of heart diseaseor exacerbation of chronic heart disease
Acute heart failure
R/I For CHF
BNP brain neutric acid
• CXR chest x ray
• Echo echocardiogram
Average range for BNP
Like a test.
You want 100 but even better if it is 500.
<100 of BNP
2% of CHF
>500 of BNP
98% chance of CHF
CXR will show...
• Pulmonary vascular congestion
• Pleural effusion
Remodleing of the heart is...
What causes heart remodeling?
from cardiac load or injury
• Cardiomegaly is an example of remodeling • Referred to as
CARDIAC REMODELING or VENTRICULAR REMODELING
Pleural effusion causes SOB because?
The lung area is filled with fluids and it causes the lungs to not inflate all the way properly so it would lead to less O2 coming in and the person will feel more tired.
CHF Echocardiogram will be able to show....
• dilated cardiac chambers
• valvular insufficiency or stenosis
• wall motion abnormalities
• akinesis, hypokenesis, dyskenesis
• ↓ EF (what did I just say was normal?) 60%
↓ edema (Lasix most common)
ACE inhibitors (Capoten, Vasotec)
↓ preload,↓ vasoconstriction and O2 retention
Vasodilators (Hydralazine, Natrecor)
↓ preload and afterload, relax vascular smoothmuscle
Two meds that lower preload...
ACE inhibitors (Capoten, Vasotec) ,
Vasodilators (Hydralazine, Natrecor)
Because they do not allow the ventricles to fill up with as much blood as it could have, because it lowers the amount if blood in the body, so less gets into the right and left ventricles and it causes less preload, and also if the blood vessels are dialated, then less pressure is had, with less pressure there will be less blood to fill the ventricles.
Besides decreasing preload, vasodilators will alos decrease _______?
The afterload, because the vessels are dilated then the pressure to overcome is lessened, and that is the afterload that has been lessened.
Beta blockers (-olols)
prevent overload fromsympathetic nervous system, the heart will pump less hard,a nd so the pressure to overcome will be less.
+ inotropes (Digoxin)
↑ contractility, it helps to compensate for the lack of the heart's ability to do its job oroperly.
• I – no limitation to physical activity
• II – slight limitation to activity, comfortable at rest
• III – marked limitation to activity, comfortableat rest
• IV – unable to perform physical activity
I class of CHF
no limitation to physical activity
II of CHF
slight limitation to activity, comfortable at rest
III Class of CHF
marked limitation to activity, comfortableat rest
IV class of CHF
unable to perform physical activitywithout discomfort
First people are all okay, then they get slightly distressed but they are okay with rest, then it progresses to the point that they are very dustressed but if they rest they will be okay, and then they cannot do physical activities without any distress.
Valvular insufficiency vs Valvular Stenosis
Stenosis is tightening, so it does not open enough to allow filling, insuffiecinecy, it is lack, so it does not close well enough to prevent retrograde backflow.
– Rheumatic ♥ Disease (typically preceded bywhat?)
– Marfan’s Syndrome
– Tumors or Vegetations
Are causes of?
Valvular insufficiency and stenosis.
Rub my tummy. Sometimes I get calm(insufficiency) and sometimes it is ticklish and I cramp(Stenosis).
Best diagnostic test for valves...
Echocardiogram, because we want to see how well something opens and closes so we want realtime imaging, hence, echocardiogram.
All the points that can cause valvular insufficiency or stenosis.
Lose perfect seal, leads to regurgitation, hear murmurr
The blood of an in-vitro child is very oxygenated so even before it goes to the child lungs it has O2, in fact the child's lungs will not transfer gases, so the heart is built to by oass that part, but going from the right atrium to the left atrium to the left ventricle to the aorta to the system. ASD is when that hole does not close and deoxygenated blood is still shunted from the right atrium to the left atrium and not getting reoxygenated,
Similar to ASD, that the blood goes from the right ventricle ti the left ventricle to the system.
PDA fetal ductus persists
There is a shunt connecting the pulmonary artery to the aorta, and blood gets sent back from the high pressure aorta to the lower pressure pulmonary artery.
Coarctation of A°
A kink in the aorta
Tetralogy of Fallot
Hypertrophied right ventricle,
VSD, so blood from the LV to the RV,
PUlomonic stenosis, so it does not open well enough, so the right ventricle needs to overwork to bet the blood out,
and Overriding Aorta
• Fainting or a fall with LOC frequently leads to acardiac w/u
Four Testing for the heart
• Holter monitor, long term EKG.
• Stress test uses EKG and exercise
• Tilt table
Test for a DVT by performing a ...
How do you treat a DVT?
Greenfield filter is used for?
Treating a DVT.
Homan's test is used for ...
Detecting a DVT.
Since any vessel can form an aneurysm it isextremely important
• Where it is
• What type and how big it is• What caused it