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536 Body Systems > Cardiovascular Examination > Flashcards

Cardiovascular Examination Flashcards

(57 cards)

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1
Q

S/S indicating cardiovascular examination necessary

A

chest pain, SOB, palpitations
fatigue
syncope/dizziness
Hx smoking/drugs/alcohol
symptoms brought on by exertion
onset/progression, nature, aggravating/alleviating factors

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2
Q

chart review for cardiac examination

A

imaging/procedures/lab values/ABGs
PMH/PSH
medications
nutrition
social history

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3
Q

General components of cardiac exam for PT

A

observe posture, breathing, cough
skin color/diaphoresis
pulse rhythm/quality
vitals
heart/lung sounds
chest wall motion/palpation
rhythm -EKG
circulation/lypmhatic system

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4
Q

pericarditis: condition/causes

A

inflammation of pericardium or serous fluid, self limited 1-3 weeks
most often viral, can be bacterial/inflammation induced from other cause
systemic disease can also onset or trauma

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5
Q

pericarditis: S/S

A

sharp/dull retrosternal pain
worse with cough/breathing/supine
relieved by sitting up/forward
dyspnea/cough
malaise/fever
EKG usually normal or ST elevation
friction rub on auscultation as layers rub together

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6
Q

pericarditis management

A

rest, pain relief, high dose antibiotics, pericardial drainage

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7
Q

constrictive pericarditis

A

chronic form, results in thickening pericardium restricting heart expansion

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8
Q

constrictive pericarditis s/s

A

dyspnea, fatigue from decreased CO
syncope/dizzyness
retrosternal chest pain
JVD

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9
Q

pericardial effusion

A

accumulation of fluid in pericardial space beyond normal 15-50 mL
stiff pericardium doesn’t tolerate fluid fluctuations

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10
Q

pericardial effusion s/s

A

fullness in chest, cough, dysphagia
muffled heart/lung sounds, dull percussion L lung
enlarged cardiac silhouette on xray
ECHO

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11
Q

pericardial effusion treatment

A

pericardiocentesis to drain fluid

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12
Q

cardiac tamponade

A

overaccumulation of pericardial fluid exerts pressure on heart
caused by pericarditis especially from cancer, viral, trauma, aortic aneurysm
results in poor filling of the heart, decreased BP, death

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13
Q

cardiac tamponade s/s

A

hypotension, shock, decreased CO like dyspnea/syncope, cough, tachycardia/pnea
JVD, decreased heart sounds
Beck’s triad: hypotension, JVD, muffled heart sounds

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14
Q

cardiac tamponade treatment

A

pericardial window to relieve pressure and drain fluid
pericardiocentesis

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15
Q

endocarditis

causes, tests

A

endocardium infection
often travels from other part of the body
eg dental work, GI/urinary procedure, catheter, tattoo
at risk those w artificial valve/damaged valve
can travel in body
test for w labs for inflammation, EKG, ECHO/TEE

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16
Q

endocarditis s/s

A

flu like rapid onset
mitral valve regurgitation

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17
Q

endocarditis treatment

A

long term antibiotics
cardiac supportive measures
may need valve replacement

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18
Q

myocarditis

causes and possible effects

A

inflammation of heart muscle
drug induced bac/viral infection
weakens pump/conduction
can lead to MI/CVA/arrhythmia/heart failure

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19
Q

myocarditis s/s

A

fever, diffuse chest pain, fatigue, SOB, edema

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20
Q

modifiable risk factors for cardiovascular disease

A

cholesterol
stress
diabetes
diet
HTN
weight BMI>30
activity level
tobacco

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20
Q

coronary artery disease

A

coronary arteries damaged or diseased
atherosclerotic plaque formed in vessel lumen
caused by fat or cholesterol build up in the blood

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21
Q

Non modifiable risk factors for CV disease

A

age >65 men >55 women
family history in 1st degree relative
genetics
male>female
african-american
chronic kidney disease
low SES

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22
Q

How does kidney function generally impact the heart?

Study These Flashcards
A

manages fluid volume and releases humoral regulatory mechanisms

23
Q

primary vs secondary hypertension

Study These Flashcards
A

primary - idiopathic, 90-95%
secondary - from kidney or endocrine disease

24
hypertension BP guidelines
normal <120/80 elevated 120-129/<80 stage 1 130-139/80-89 stage 2 >140/90 hypertensive emergency >180/>20 or >160/>100 w CV risk factors
25
additional risk factors for HTN beyond CV risks
stress sleep apnea birth control pill mod alc use
26
White coat HTN
BP elevated in office but normal at home 13-35%
27
Masked HTN
office BP readings normal while at home are elevated
28
effect of HTN on the heart
overload L ventricle increaeses stiffness, can lead to heart failure w/ EF, predisposed to MI
29
Manage HTN
weight loss aerobic exercise limit sodium reduce alc stop smoking treat sleep apnea pharm agents treatment depends on degree of HTN and risk factors
30
PT considerations for ther ex/treatment of pt w HTN
monitor BP beta blockers blunt HR response, decrease exercise tolerance, + increased risk of hypoglycemia avoid valsalva extend warm up/cool down hypotension post exercise
31
orthostatic hypotension
drop in BP with position change supine - sit - stand sustained BP reduction >20 caused by autonomic dysfx, volume depletion, CV disease, meds, neurogenic dx, paraneoplastic syndrome
32
orthostatic hypotension s/s
lightheadness, dizziness, falls, LOC, visual/cog disturbance, weakness, fatigue
33
POTS
postural orthostatic tachycardic syndrome increase in HR >30bpm, HR >120 bpm standing relieved by laying down
34
POTS treatment
target low blood volume Na+, hydration, meds
35
PT implications of orthostatic conditions
caution when standing, move LE before standing, Valsalva, pressure garments CV training for those who have avoided exercise
36
CAD risk factors
men >45, women >55 family history primary relatives smoker BMI>30 HTN 140>90 dyslipidemia diabetes chronic inflammation
37
HDL
good cholesterol high density lipoproteins increase with stopping smoking, weight loss, increasing aerobic exercise elevated triglycerides reduce HDL
38
LDL
bad cholesterol predict MI better than total level ideal <100 or <75 w risk factors
39
PT role in CAD
prevention w exercise prescription improve event free survival prescribe >150 min mod exercise over the week, resistance training
40
ischemic heart disease
mismatch myocardial O2 demand and supply hypoxia ventricular wall stress, preload, HR and contractility determine O2 demand
41
angina pectoris
discomfort in chest due to myocardial ischemia burning/pressure
42
stable angina
predictable pattern of discomfort that goes away and is triggered by activity and improves with rest or short time tachycardia, diaphoresis, nausea, dyspnea
43
levine's sign
clenched fist over sternum stable angina sign
44
triggers of stable angina
high BP anemia - lacking Hb stress extreme cold heavy meals physical exertion
45
Anginal scale
1+ light 2+ mod/bothersome 3+severe/v uncomfy 4+most severe pain
46
PT implications of stable angina
anginal picture - what causes and relieves pain How much exertion can pt take/exercise tolerance know meds and impact goal to increase tolerance of ADLs mod intensity 40-60%
47
variant or Prinzmetal angina
coronary artery spasm, not ischemia at rest/nighttime active patients, may/may not have CAD
48
silent ischemia
asymptomatic episodes, detected on EKG
49
unstable angina
progression of ischemic heart disease precursor to MI increase in frequency or duration lower threshold to trigger symptoms chest pain not relieved by rest changing pattern
50
PT implications of unstable angina
extended warm up and cool down know anginal picture so you know if it changes pt education on symptom monitoring pt meds 30-40% intensity take vitals!
51
Myocardial infarction
ischemia, often caused by thrombus/occlusion chest pain > 20 min not relieved by rest necrosis can occur
52
clinical features of MI
unstable angina severe substernal crushing pain dyspnea diaphoresis nausea/weakness/vomiting EKG abnx serum biomarkers troponins/CK
53
MI medical management
revascularization ASAP - cath lab <90 min CABG supplemental O2, bedrest, monitor EKG/ECHO, control arrhythmias
54
TIMI score
thrombolysis in MI risk score 1. age >65 2. 3+ CAD risk factors 3. CA stenosis>50% 4. ST elevation 5. 2 angina episodes in 24 hours 6. aspirin use in last week 7. elevated serum troponin or CK indicates ischemia/mortality risk
55
Time table for reperfusion of heart tissue
within 20 min - full salvage of tissue within 2-4 hours - partial salvage of tissue beyond this point, necrosis and tissue is not salvagable
56
MI complications
recurrent ischemia arrhythmias heart failure cardiogenic shock R ventricular infarction acute pericarditis thromboembolism

536 Body Systems (13 decks)

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