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CCRN > Cardiovascular > Flashcards

Cardiovascular Flashcards

(57 cards)

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1
Q

Which heart sound is associated with heart failure?

A

S3

  • may occur before crackles
  • caused by rush of blood into dilated ventricle
  • occurs early in diastole
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2
Q

S3 is caused by:

A
  • pulmonary hypertension and cor pulmonale

- mitral, aortic, or tricuspid insufficiency

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3
Q

Systolic blood blood pressure is and indirect measurement of what?

A

cardiac output and stroke volume

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4
Q

Diastolic blood pressure is an indirect measurement of what?

A

systemic vascular resistance (SVR)

-A decrease in diastolic pressure (wider pulse pressure) may indicate vasodilation, drop in SVR (sepsis, septic shock)

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5
Q

When are coronary arteries perfused?

A

during diastole

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6
Q

Murmurs of insufficiency occur when the valve is open or closed?

A

closed

acute or chronic

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7
Q

Murmurs of stenosis occur when the valve is open or closed?

A

open

chronic

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8
Q

Difference between Unstable Angina and NSTEMI?

A

NSTEMI: positive troponin, unrelenting chest pain

  • Both will have ST depression or T-wave inversion
  • (Unstable angina can be relieved by nitro)
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9
Q

What is Prinzmetal’s angina, aka variant

S/S of Variant or Prinzmetal’s Angina:

A
  • Unstable angina with transient ST elevation (pain and ST relieved by nitro)
  • Due to coronary artery spasm
  • Occurs randomly, or at rest, or same time each day
  • Can be due to nicotine, ETOH, or cocaine
  • Troponins are negative
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10
Q

Treatment/Management of Chest Pain

A
  • Stat EKG
  • (MONA)
  • Anticoagulant
  • Antiplatelet
  • Beta blocker
  • Treat the pain (nitro/morphine)
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11
Q

Types of antiplatelet agents:

A
  • Clopidogrel (Plavix)
  • Abciximab (Reopro)
  • Eptifibatide (Integrilin)
  • Tirofiban (Aggrastat)
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12
Q

Contraindications of beta blocker for ACS

A

-cocaine, hypotension, bradycardia, use of phosphodiesterase inhibitor drugs like sildenafil (Viagra)
(Metoprolol is cardioselective but propranolol isn’t)

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13
Q

What labs would you check for ACS/Chest Pain?

A

cardiac biomarkers, lipid profile, CBC, electrolytes, BUN, creatinine, mag, PT, and PTT

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14
Q

ECG lead changes in RCA and inferior LV

A

II, III, and aVF

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15
Q

ECG lead changes in LAD and anterior LV

A

V1, V2, V3, V4

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16
Q

ECG lead changes in circumflex and lateral LV

A

V5, V6, I, and aVL

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17
Q

ECG lead changes in low lateral LV

A

V5 and V6

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18
Q

ECG lead changes in high lateral LV

A

I and aVL

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19
Q

LOOK up videos and stuff for page 27, lead changes based on location of CAD

A

ugh (the last two bullets I didn’t make cards for)

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20
Q

Circumflex supplies what part of the heart? Which ECG leads?

A

lateral

I, aVL, V5, V6

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21
Q

RCA supplies what part of the heart? Which ECG leads?

A

Inferior

II, III, aVF

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22
Q

LAD supplies what part of the heart? ECG leads?

A

anterior wall and septum (bundle of His)

-Vleads 1-4 (V1, VII, VIII, V4)

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23
Q

Where in the heart is conduction located? Which wall?

Study These Flashcards
A

Inferior (AV node and SA node)

24
Q

Circumflex supplies the ____ part of the heart

25
RCA supplies the ______ part of the heart
Inferior wall
26
LAD supplies the ____ part of the heart
Anterior wall and septum
27
S1 sounds caused by closure of ____ valves loudest at the ____ marks the end of ______
closure of AV valves loudest at the apex end of diastole, beginning of systole
28
S2 caused by closure of _____ valves loudest at the ____ marks the end of ____
closure of semilunar valves (aortic/pulmonic) loudest at the base end of systole, beginning of diastole
29
S3 is caused by....?
heart failure, pulmonary hypertension, cor pulmonale, or mitral/aortic/or tricuspid insufficiency
30
what's a normal pulse pressure?
40-60 | systolic - diastolic
31
What is the evidence of reperfusion (post fibrinolytic therapy for MI)?
relief of chest pain no more ST deviations Increased troponin and CK-MB Reperfusion arrhythmias (VT, VF, accelerated ICR)
32
review page 29 (infarcts)
vbn,
33
look up
Sic Sinus Syndrome
34
what are two complications of PCI?
Stent thrombosis (chest pain, ST elevation) and retroperitoneal bleed
35
prolonged QT interval can lead to
torsades de point
36
Causes of prolonged QT : | and treatment?
Drugs: amio, quinidine, haldol, procainamide Electrolyte problems: hypokalemia, hypocalcemia, hypomagnesmia tx: magnesium
37
failure to pace: failure to capture: failure to sense:
pace: no spike (at all) when expected capture: spike without a QRS (for vent pacing) sense: pacing in native beats
38
systolic dysfunction (heart failure): associated with EF of ...
40% of less
39
which heart failure shows an enlarged heart on x-ray
systolic HF
40
s/s of right sided heart failure (7)
``` hepatomegaly splenomegaly dependent edema venous distention elevated CVP/JVD tricuspid insufficiency abdominal pain ```
41
s/s of left sided heart failure
``` orthopnea, dyspnea, tachypnea hypoxemia tachycardia crackles cough with pink, frothy sputum elevated PA diastolic/PAOP Diaphoresis Anxiety, confusion ```
42
what are the differences between dilated and hypertrophic cardiomyopathy?
Dilated: Systolic dysfunction, thinning, enlargement of LV; mitral valve regurge common d/t vent dilation Hypertrophic: Diastolic dysfunction, thickening of heart muscle and septum (at the expense of the LV chamber)
43
How is left ventricular preload and afterload affected by cardiogenic shock?
preload is elevated with associated pulmonary symptoms (high PAOP) left ventricular afterload (SVR) is elevated d/t vasoconstrictive compensatory mechanisms
44
what are 3 positive inotropes used to treat cardiogenic shock
norepi dopamine dobutamine, milrinone
45
In treatment of cardiogenic shock, what will enhance the effectiveness of the "pump"?
positive inotropes (levo, dopa, milrinone/dobutamine)
46
In treatment of cardiogenic shock, what will decrease the demand on the "pump"?
``` preload reduction afterload reduction optimize oxygenation mechanical ventilation treat pain IABP for short term support VAD (ventricular assist device), may be used for longer periods of time than IABP ```
47
VAD are used in which conditions?
ventricular heart failure, cardiogenic shock, and cardiac myopathies, pts awaiting heart transplant
48
What are the benefits of IABP therapy?
increases coronary perfusion and decreases afterload
49
What are 2 life threatening complications of a CABG?
tamponade and pericarditis
50
look up mediastinum
asdf
51
Which leads show the circumflex ?
lateral leads (I, AVL, V5, and V6)
52
which leads show the RCA?
inferior leads (II, III, and AVF)
53
Which leads show the LAD?
septum and anterior leads (V1-V4)
54
Which coronary artery supplies the SA and AV nodes?
RCA
55
An occlusion in the bundle of His would result in what heart block?
second-degree type II
56
What part of the heart does the RCA supply?
left ventricle
57
Where is the mitral valve attached on the heart?
left ventricle

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