Cardiovascular Diseases

Question 1

what are the heart wall layers?

Answer 1

Epicardium: Protects and encases heart
Myocardium: Performs pumping action
Endocardium: Lines atria, ventricles, and valves to allow smooth blood flow

Question 2

order for pulmonary circulation

Answer 2

Superior and Inferior Vena Cava
Right Atrium
Tricuspid Valve
Right Ventricle
Pulmonary Arteries
Lungs
Pulmonary Veins

Question 3

order for systemic circulation

Answer 3

Pulmonary Veins
Left Atrium
Bicuspid (aka Mitral) Valve
Left Ventricle
Aorta
Body
Superior and Inferior Vena Cava

Question 4

when do AV valves open and close?

Answer 4

Open = pressure in atria is > that in ventricles
Close = pressure in ventricles > that in atria

Question 5

when do semilunar valves open and close?

Answer 5

Open = when ventricles contract
Close = when ventricles relax

Question 6

how do the hearts muscular contractions occur?

Answer 6

by electrical impulse stimulation and depolorization by sodium, calcium and potassium channels then repolarization

Question 7

what is the order of cardiac conduction>

Answer 7

1. SA node: initiates bilateral atrial contraction
2. AV (node) bundle
3. purkinje fibers: initiates ventricular contraction

Question 8

what diagnoses can be evaluated with an EKG?

Answer 8

ischemia
cardiac arrest
conduction disorders
chest trauma
pericarditis
valvular disease
electrolyte disturbances

Question 9

what do the telemetry waves stand for?

Answer 9

P- Wave
atrial depolarization = Atrial contraction
After SA node fires the atria contract
QRS Complex
ventricular depolarization = Ventricular contraction
After AV node fires
T-Wave
ventricular repolarization = Ventricular relaxation

Question 10

what is the difference between systole + diastlole?

Answer 10

Systole- contraction of ventricles
optimal ~110-120 mm Hg
Diastole- relaxation of ventricles
optimal ~ 80 mm Hg

Question 11

what is coronary artery disease?

Answer 11

Narrowing of coronary arteries

-Typically due to artherosclerosis (hardening)

Question 12

what does coronary artery disease cause?

Answer 12

Causes increased blood pressure and prevents adequate blood supply to heart

Question 13

how do you diagnose coronary artery disease?

Answer 13

Cardiac Catheterization

-Insertion of radiopaque dye into the coronary artery to view blood flow

Question 14

what is the goal of tx in coronary artery disease?

Answer 14

to lower blood pressure and cholesterol

Question 15

how is Coronary artery disease surgically txed?

Answer 15

Coronary Artery Bypass Graft

-Blood vessel graft obtained from patient, connected to bypass the stenosis

Question 16

what must be considered after a coronary artery bypass graft?

Answer 16

Post-op tenderness
Impacts on lower body dressing
Scarring
Blood supply to hand

Question 17

what are the 4 valves of the heart?

Answer 17

Tricuspid valve (TV)
Mitral valve (MV)
Aortic valve (AV)
Pulmonic valve (PV)

Question 18

what are the causes of cardiac valve disease?

Answer 18

Mitral Regurgitation
mitral prolapse
Aortic Stenosis

Question 19

what can cardiac valve disease result in?

Answer 19

Valvular dysfunction causes heart murmurs and pooled blood in atria and ventricles.
Pooled blood can lead to blood clots.
Clots can travel to brain or lungs and cause death

Question 20

what is the goal in tx of cardiac valve disease?

Answer 20

Anticoagulants thin blood, minimize risk of clot formation

Question 21

what are the surgical txs of cardiac valve disease?

Answer 21

Valvuloplasty: repair flaps
Commissurotomy: separation of flaps
Annuloplasty: repair ring

Question 22

how are valves replaced?

Answer 22

Mechanical Valves (require anticoagulant)
Bioprosthetic Valves
(depend on life expectancy + contraindications to anticoagulation)

Question 23

what is an abdominal aortic aneurysm?

Answer 23

Increasing pressure in all layers of aortic lumen causing a bubble shaped deformity which can result in aortic dissection (tear)

Question 24

when is medication used for abdominal aortic aneurysm?

Answer 24

Used for smaller aneurysms (<5 cm) to lower blood pressure and cholesterol

Question 25

what are the surgical options for abdominal aortic aneurysm?

Answer 25

1. Endovascular Stent (femoral artery) | 2. Traditional Open

Question 26

what must be considered after an Endovascular Stent?

Answer 26

Avoid groin strain Maintain cleanliness around surgical incision Avoid strenuous and stressful activity

Question 27

what is the post operative goal of abdominal aortic aneurism ?

Answer 27

Protect the skin and muscle as skin and abdominal muscle incision heal

Question 28

what are precautions to take after traditional open surgery for abdominal aneurysm?

Answer 28

``` Lifting Anything Heaver than 5-10 Pounds Trunk Rotation Excessive Anterior Trunk Flexion Pushing or Pulling Driving Splinted Cough ```

Question 29

what is an arrythmia?

Answer 29

abnormal heart rhythm | can be consistant (regular) or inconsistent (irregular)

Question 30

what are the types of arrythimias?

Answer 30

Afib- atrial fibrillation Aflutter- atrial flutter Vfib- ventricular fibrillation Vtach- ventricular tachycardia

Question 31

what is the goal of tx for arrythmias?

Answer 31

to adjust the cardiac rhythm by blocking sodium, calcium or beta receptors

Question 32

what are surgical options for tx of arrythmias?

Answer 32

device to supply electricity to the natural pacemakers within the heart like pacemaker or ICD

Question 33

what are pacemakers?

Answer 33

Monitors and re-adjusts rhythm by electrical stimulation to myocardium to promote myocardial contraction

Question 34

what is a Implanted Cardioverter Defibrillator?

Answer 34

Left subclavicular implantation with leads to subclavian vein. Defibrillates heart to shock out of a dangerous rhythm

Question 35

what are precautions after arrythimia device implantation?

Answer 35

Sling for the First 24 Hours Lifting Anything Heavier than 5-10 Pounds Pushing or Pulling with Left Arm Driving Left Shoulder Flexion and Abduction Beyond 90 degrees

Question 36

what is congestive heart failure?

Answer 36

Combination of cardiac pathologies preventing heart from effectively pumping blood throughout the body and to the lungs i.e. HTN

Question 37

what is the goal of medication tx for coronary heart failure?

Answer 37

Reduce fluid overload and manage respiratory issues caused by pleural effusion and pulmonary edema

Question 38

what is pleural effusion?

Answer 38

fluid in the pleural space ie between the lining of the lungs and the internal lining of the thorax

Question 39

what is pleural edema?

Answer 39

fluid accumulation within in the lungs

Question 40

what are surgical management options for coronary heart failure?

Answer 40

Heart Transplantation | Ventricular Assistive Device (VAD) Implantation

Question 41

what are heart transplant consierations?

Answer 41

Age Prognosis Patient compliance with medical regime

Question 42

what are ventricular assistive devices?

Answer 42

Performs function of ventricle(s) when ventricles are unable | BiVAD (no sternotomy) or LVAD (sternotomy)