Cardiovascular Function & Perfusion Flashcards
1
Q
Where is the heart located?
A
In the Mediastinum
2
Q
Serous layer of the heart, it’s function is to protect the heart =
A
Epicardium
3
Q
The muscle layer of the heart that’s function is for pumping =
A
Myocardium
4
Q
This layer of the heart makes up the lining of the heart and heart valves =
A
Endocardium
5
Q
The sac that surrounds the heart =
A
Pericardium
6
Q
The sac that surrounds the heart =
A
Pericardium
7
Q
What are the names of the different layers of Pericardium?
A
Visceral Pericardium
Parietal Pericardium
8
Q
This layer of Pericardium covers the heart’s surface =
A
Visceral Pericardium
9
Q
This layer of the Pericardium makes up the lining of the Pericardial Sac =
A
Parietal Pericardium
10
Q
What does the Interventricular Septum do?
A
Separate the Ventricles
11
Q
What does the Interatrial Septum do?
A
Separate the Atria
12
Q
What joins Arteries and Capillaries?
A
Arterioles
13
Q
What joins Capillaries and Veins?
A
Venules
14
Q
Between the Arteries and Veins, which carries high-pressure blood and low-pressure blood?
A
Arteries = High-Pressure Blood
Veins = Low-Pressure Blood
15
Q
These permit gas exchange, the transfer of nutrients and the removal of waste between blood and the fluid of tissues =
A
Capillaries
16
Q
What is the outer-most layer of the blood vessels called?
A
Tunica Adventitia
17
Q
What is the middle layer of the blood vessels called?
A
Tunica Media
18
Q
What is the inner-most layer of the blood vessels called?
A
Tunica Intimae
19
Q
The normal cardiac output in a healthy adult at rest is-
A
5 to 6 L/min
20
Q
The force that the Myocardium generates during contraction =
A
Contractility
21
Q
What does a Heart Murmur indicate?
A
Turbulent blood flow through normal or abnormal valves
22
Q
An abnormal heart sound that’s typically heard over the left sternal border (Grating Sound) =
A
Pericardial Friction Rub
23
Q
What are the different types of Myocardial Infarction called?
A
ST Elevational Myocardial Infarction (STEMI)
Non-ST Elevation Myocardial Infarction (NSTEMI)
24
Q
What is the difference between Stable Angina and Unstable Angina?
A
Stable Angina is Chest Pain that has a trigger (Stress or Exercise)
Unstable Angina is Chest Pain that occurs without a trigger (Occurs at rest)
25
How can Angina be treated?
Rest
Nitroglycerin
26
STEMI, NSTEMI, Stable Angina, and Unstable Angina can all be caused by-
Coronary Artery Disease
27
An Acute Coronary Syndrome can cause-
A STEMI, NSTEMI, or Unstable Angina
28
A STEMI occurs due to-
An abrupt disruption of blood flow to an area of the heart
29
An NSTEMI has characteristics that are comparable to-
Unstable Angina
30
What is the difference between a NSTEMI and Unstable Angina?
Cardiac Markers are Elevated with an NSTEMI
31
What are the Risk Factors of Coronary Artery Disease?
Sedentary Lifestyle, Sex, Family History, Lack of Sleep, Hypertension, Diabetes, Race/Ethnicity, Homocysteine Levels, Lipid Levels, Smoking, Obesity, Stress, Age
32
What is Coronary Artery Disease?
When plaque narrows the arteries and blocks blood flow to the heart
33
After enough time passes while untreated, what can Coronary Artery Disease cause?
A Weakened Heart, Heart Failure, Arrhythmia
34
Mental health disorders can contribute to Cardiac Disorders. True or false?
True
35
What are the initial symptoms of Coronary Artery Disease?
It’s Asymptomatic at first
36
What’s the most common complaint of CAD?
Angina
37
What are some of the symptoms of CAD?
Tightness, Fullness, Pressure in Midsternal Area, Stable & Unstable Angina
Pain radiates to the left arm, neck, jaw, or back
Diaphoresis, Dizziness, N/V, SOB, Lightheadedness, Weakness
38
What types of pt’s experiencing an MI may not experience Angina (the Angina could also be atypical) =
Females, Elderly, People with Diabetes
39
What does the Parietal Pericardium attach to?
The Great Vessels, Diaphragm, Sternum, and Vertebral Column
40
What deoxygenated blood uses the Superior Vena Cava to get to the heart?
Deoxygenated blood that comes from the head and neck
41
What deoxygenated blood uses the Inferior Vena Cava to get to the heart?
Any deoxygenated blood that doesn’t come from the head and neck
42
What are the bodies Major Arteries?
Common Carotid Arteries
Brachial Arteries
Radial Arteries
Ulnar Arteries
Common Iliac Arteries
Femoral Arteries
Arch of the Aorta
Abdominal Aorta Artery
43
What are the bodies Major Veins?
Internal Jugular Veins
Superior Vena Cava
Inferior Vena Cava
Cephalic Veins
Basilic Veins
Common Iliac Veins
Femoral Veins
44
Where do the Coronary Arteries originate from?
From the base of the aorta just above the Aortic Valve
45
The Right and Left Coronary Arteries deliver oxygenated blood to the rest of the body during-
Diastole
46
What are the Left Coronary Artery’s branches?
Left Main Coronary Artery
Left Anterior Descending Artery
Circumflex Artery
47
What are the Right Coronary Artery’s branches?
Marginal Artery
Posterior Descending Artery
48
What are the factors that affect Cardiac Output?
Vasoconstriction, Compliance of the Arteries, Arterial Pressure, the amount of blood entering the heart from the veins, exercise
49
How should you auscultate for S3 and S4 sounds?
With the bell of the stethoscope
50
S3 sounds can be normal in patients who are-
Children or adults up to 40 years old
51
An S3 sound can indicate-
Heart Failure + Decreased Ventricular Compliance
52
What is an S4 sound caused by?
Decreased Ventricular Compliance
53
What can decreased ventricular compliance be caused by?
Hypertension, Aortic Stenosis, CAD, or Cardiomyopathy
54
What is Cardiomyopathy?
Heart Enlargement
55
What are the different types of Heart Murmurs?
Diastolic Murmurs
Systolic Murmurs
56
When can Diastolic Murmurs be heard?
Between S2 and S1
57
When can Systolic Murmurs be heard?
Between S1 and S2
58
What is a Pericardial Friction caused by?
Inflammation, Infection, or Infiltration in the Pericardial Sac
59
How are Pericardial Friction Rubs treated?
By treating what’s causing the problem
60
What is Atherosclerosis?
The closing or narrowing of Arteries
61
When does Plaque Formation occur in a person’s arteries?
Begins in childhood, continues into adulthood
62
What can cause Stable Angina to occur during exercise or stress?
When the body is undergoing exercise or stress, the body needs more blood to function properly. When the arteries are clogged with plaque, the amount of blood that’s needed isn’t available
63
Ischemia =
Not enough blood is getting to where it needs to be
64
When does CAD begin to develop?
During childhood
65
Are Homocysteine levels a modifiable factor?
Yes
66
What chronic diseases cause CAD?
Hyperlipidemia, Thyroid Disease, Depression, Joint Pain, BMI of 30 or higher, Gout, Osteoarthritis, Cancer
67
Female pt’s suffering from an MI may present with-
Extreme Fatigue, Dizziness, Abdominal Pain, Nausea, Pressure in Chest
68
If a pt with Diabetes has an MI, how might their pain differ from those who don’t have diabetes that have an MI?
Their pain is less severe and can their pain can occur in atypical locations
69
Where are some atypical locations that a pt with diabetes who is suffering from a MI may feel pain?
Right side of chest + Epigastric region + Back of neck + May experience none
70
What types of pt’s may suffer from an MI, have no chest pain, but still have N/V, SOB, Diaphoresis, and Syncope?
Older Adults over the age of 85 + Diabetic Pt’s (Due to nerve damage, may not feel pain)
71
What is it called if you are passing out?
Syncope
72
What are the lab studies that are important to keep in mind when thinking about CAD?
Cholesterol
Homocysteine
C-reactive Protein
Cardiac Enzymes
73
What are the different types of Cholesterol lab studies?
Total Cholesterol
High-Density Lipoprotein (LDL)
Low-Density Lipoprotein (HDL)
74
What are the different types of lab studies for Cardiac Enzymes?
Troponin 1
Troponin T
Creatine Kinase-MB (CK-MB)
75
The total cholesterol can be described as-
The total amount of HDL and LDL combined
76
What is LDL?
Bad cholesterol, primary source of plaque buildup in the arteries
77
What is HDL?
Good cholesterol, carries cholesterol away from the arteries
78
What breaks Homocysteine down into other substances that the body needs?
Vitamin B12
Vitamin B6
Folic Acid
79
By the time that Homocysteine is broken down, how much should still be left in the blood?
Very little
80
What problems can excess Homocysteine cause?
Damage to the lining of the arteries
Blood Clots
Blockages in the Blood Vessels
81
What does C-reactive protein do?
It detects inflammation in the body
82
Troponin 1 and T are both highly sensitive to-
Cardiac Injury
83
When can Troponin 1 and T be found in a pt’s blood serum?
Within 4 hours from the onset of acute MI manifestations
84
How long does it take for Troponin to peak?
Within 24-48 hrs
85
How long can Troponin levels remain elevated?
Days
86
CK-MB is an enzyme specific to the-
Heart
87
After an MI, CK-MB can be detected within-
4 hrs
88
After an MI, CK-MB levels will peak within-
24 hrs
89
After an MI, CK-MB will return to normal within-
48-72 hrs
90
This lab study can be useful for detecting re-infarction in pt’s =
CK-MB
91
ST Segment Elevation, ST Depression, and T Wave Inversion all suggest-
CAD
92
Outside of an EKG, what are the different ways to diagnose CAD?
Cardiac Catheterization
Stress Tests
X-Ray
93
What are the different types of stress tests that can be used to diagnose CAD?
Exercise Stress Test
Stress Echocardiogram
Nuclear Stress Test
94
What is the gold standard for evaluation CAD and Blockages?
Cardiac Catheterization
95
When doing a Cardiac Catheterization, a thin flexible sheath is guided into a large blood vessel in the-
Groin, Arm, or Neck
96
During a Cardiac Catheterization, after a catheter is guided into a large blood vessel, where does it get threaded towards?
It gets threaded up to the left or right side of the heart
97
After a Cardiac Catheter makes its way into heart during a Cardiac Catheterization, what happens next?
Contrast material is injected into the catheter.
Photos are taken as the contrast moves through the chambers of the heart, the valves, and major vessels of the heart.
98
What are stress tests used to evaluate, determine, and diagnose in regards to the heart?
Evaluates how well the heart functions during activity + Evaluates Treatment
Diagnoses CAD and Arrhythmias
Determines the risk of suffering a MI
99
How does an X-Ray help give a look into a pt’s cardiac status?
It CAN’T detect an MI, but it can detect Cardiomyopathy + Fluid filling the lungs + Any structural abnormalities
100
When assessing a pt with CAD, you should check their BP in-
Both arms (Differences between the 2 should be documented)
101
You have a pt with CAD. You take their BP and notice that one arm has a lower BP than the other.
Which arm is used for diagnostic and treatment purposes?
The arm with the highest BP
102
When assessing a pt with CAD, you should take note of any indications that Perfusion and Oxygenation are inadequate.
Some examples are-
Unrelieved Chest Pain + Restlessness + Changes in LOC
103
What is Perfusion?
Perfusion is whether or not blood is being sent to where it needs to be and if the oxygen it carries can get to the tissues that need them
104
When assessing a pt with CAD, you should take note of any indications that Perfusion and Oxygenation are inadequate.
What lab values indicate this?
Elevated Troponins, any Elevated ST Segment
105
Pt’s with an elevated Troponin level or ECG changes should initially take what med? How much of it?
150-300 mg of Aspirin
106
Pt’s with an elevated Troponin level or ECG changes should have what done after taking Aspirin?
Have 2 Large Gauge IV’s initiated
107
Pt’s with an elevated Troponin level or ECG changes should have what done after having 2 Large Gauge IV’s initiated?
Administer a single dose of IV Heparin followed by Continuous Infusion
108
Pt’s with an elevated Troponin level or ECG changes are recommended to have what done after having Heparin administered?
Antiplatelet Therapy with Ticagrelor or Clopidogrel PO
109
What should be used to treat pain for pt’s with an elevated Troponin level or ECG changes?
Morphine, Fentanyl, Nitroglycerin
110
What should be done for a pt who’s undergoing a STEMI?
An emergent heart cath and percutaneous intervention
111
You have a pt who’s undergoing a STEMI.
How long do you have to get them a heart catheter and percutaneous intervention?
90 Minutes
112
What do you do for a pt who’s undergoing a STEMI, but a Percutaneous Intervention isn’t available or the pt can’t be transferred to a cath lab within 120 mins?
Thrombolytics are recommended
113
For pt’s undergoing a NSTEMI or Unstable Angina, what is the first priority?
Control of Symptoms + Aspirin and Heparin
114
In all cases of NSTEMI or Unstable Angina, what should be started ASAP?
Beta Blockers, Statins, an ACE Innibitor
115
When dealing with a pt who is undergoing a NSTEMI or Unstable Angina, what should be done if they aren’t responsive to Percutaneous Intervention?
They should either be transferred to surgery for Coronary Artery Bypass Grafting (CABG) or be treated medically
116
Angioplasty and a CABG can both be used to-
Treat CAD
117
What meds can be used to treat CAD?
ACE Inhibitors + Beta Blockers + Calcium Channel Blockers + Nitrates + Statins + Non-Statins + Thrombolytics + Anti-Platelet Agents + Anticoagulants
118
When the heart’s valves are damaged or diseased, they are unable to-
Fully open and close
119
When the heart’s valves are unable to fully open or close, the heart will-
Have to work harder and become an insufficient pump
120
What are the causes of Valvular Disease?
Birth Defect + Rheumatic Disease + Endocarditis + Hypertension + MI + Atherosclerosis + Heart Failure + Lupus
121
A back up of blood in the heart =
Regurgitation
122
Regurgitation, when treated, can lead to-
Heart Failure, Sudden Cardiac Arrest, or Death
123
When the valves do not completely open, there is a narrowed path for blood to flow through the heart. This is called-
Stenosis
124
What are the risk factors for Valvular Dysfunction?
Over Age 75 + Inactivity + Unhealthy Eating Habits + Smoking + Obesity + Family History + Medical Procedures + Medical Devices
125
What are the symptoms of Valvular Dysfunction?
Dizzy Spells + Syncope + Lethargy + Weight Loss + SOB + Chest Discomfort + Edema of the Legs + Palpitations + Dyspnea + Arrhythmia + Abdominal Pain (Due to Enlarged Liver) + Heart Murmur
126
As a pt ages, their heart valves will-
Become stiff and thick, causing Ventricular Disease to develop
127
Can Valvular Dysfunction be Asymptomatic?
Yes
128
Can Valvular Dysfunction be debilitating and prevent someone from performing ADL’s?
Yes
129
What things can be used to diagnose Valvular Dysfunction?
Echocardiogram + Chest X-Ray + ECG Interpretation + Cardiac MRI + Cardiac Catheterization + Stress Test
130
This is used to diagnose Valvular Heart Disease and determine it’s severity using Sonography =
Echocardiogram
131
What does an Echocardiogram measure?
The amount of pressure that’s on each side of the valve, if the valve is Stenosed, and the size of the valve opening
Also measures how well the heart is able to pump blood
132
When using an Echocardiogram to measure how well the heart pumps blood, what you’re measuring is what’s referred to as the-
Ejection Fraction (EF)
133
What is the normal EF?
50-70%
134
A EF of less than 40% indicates-
A severe problem with the heart
135
What are the different types of Echocardiogram?
Transthoracic Echocardiogram (TTE)
Transesophageal Echocardiogram (TEE)
136
What does the TTE do?
Assesses the function of the valves + The size and function of the atria and ventricles
137
What does the TEE do?
Detects problems with the chordae and arrangement of the valves if mitral valve disease is suspected
138
This will evaluate any enlargement of the heart and aorta and any pulmonary congestion =
Chest X-Ray
139
This shows whether the heart rhythm is regular / irregular, the HR, and whether any previous heart damage has occurred =
ECG Interpretation
140
This uses magnets, radiofrequency, and a computer to visualize the heart, aorta root, and the ascending aorta =
Cardiac MRI
141
What does a Cardiac MRI assess?
Left Ventricular Volumes, Mass and Ejection Fraction, and how well the heart valves are functioning
142
What is injected into the heart during a Cardiac Catheterization?
A kind of dye (That way the X-Ray can be observed as the dye makes it’s way through the heart)
143
If a pt has Syncope, they are-
A fall risk
144
What environmental factors can increase a pt’s risk for Valvular Disease?
History of illicit drug use or IV drug use
145
Manifestations alone can be used to indicate the degree of severity of a Valvular Disease.
True or false?
False
146
The treatment of a Valvular Disease will vary based on-
What valves are effected and what the severity of it is
147
The initial treatment options for a Valvular Disease will focus on-
Symptom Management
148
What options will be needed for a pt with a Valvular Disease when pharmacological options alone won’t control it anymore?
Surgical options
149
What meds can be used to manage the symptoms of a Valvular Disease?
Diuretics + Vasodilators + Beta-Blockers + ACE Inhibitors + Calcium Channel Blockers + Digoxin
150
Is there any kind of drug therapy that can cure a valvular disease?
No, drug therapy can only manage the symptoms
151
How can surgeries be used to treat valvular disease?
They can be used to repair or replace the valve or valves depending on the surgery
152
What are the different types of surgeries used to treat Valvular Disease?
Valve Repair Surgery
Balloon Valvuloplasty
Valve Replacement Surgery
153
What are the different types of Valve Replacement Surgeries?
Bovine
Porcine
Human Valve
Mechanical Valve
154
Valve Repair Surgeries can only be used to-
Decrease Manifestations, not outright cure the problem
155
This is a minimally invasive procedure that expands the openings of Stenosed Valves =
Balloon Valvuloplasty
156
On which of the heart valves can Balloon Valvuloplasty be performed on?
Any of the 4 heart valves
157
When is Valve Replacement required?
For severe Valvular Disease
158
When replacing a heart valve, what are the 2 determining factors when considering which type of valve should be used?
Age + Presence of other diseases
159
What is Heart Failure defined as?
When the heart isn’t able to meet the needs of the Systemic Circulatory System
160
During Heart Failure, what is happening to the ventricles and blood?
The ventricles aren’t filling properly + the blood isn’t being ejected into the systemic circulatory system properly
161
What are the potential causes/risks of Heart Failure?
Hypertension + CAD + Uncontrolled Arrhythmias + MI + Diabetes + Valvular Disease + Chronic Infection + Cardiotoxic Agents + Metabolic Disease + Chronic Pulmonary Disease + Family History + Alcohol Abuse + Obesity + Diabetes
162
How many people with Heart Failure also have another Comorbid Condition?
Over Half
163
Heart failure has a high-
Mortality + Morbidity Rate
164
The prevalence of heart disease increases with-
Age
165
Manifestations of Heart Disease =
Inability to carry out ADL’s + SOB + Fatigue + Weakness + Insomnia + Edema + Depression + Hopelessness
166
What is Biventricular Heart Failure?
Heart Failure with manifestations of both Right and Left Sided Heart Failure
167
Left Sided Heart Failure Symptoms =
JVD + SOB + Hypotension + Tachycardia + Orthopnea + Exertional Dyspnea + Paroxysmal Nocturnal Dyspnea + Edema (Lower Extremities) + Weight Gain + Increased Abdominal Girth + Pulmonary Congestion
168
Right Sided Heart Failure Symptoms =
JVD + SOB + Chest Discomfort + S3 Murmurs + Palpitations + Ascites + Peripheral Edema + Enlarged Liver & Spleen
169
What is Paroxysmal Nocturnal Dyspnea?
An attack of severe SOB and coughing that usually occurs at night, which can cause a lack of sleep
170
What are the tools that can be used to diagnose and grade Heart Failure?
The Framingham Diagnostic Criteria of Heart Failure
The New York Heart Association Classification of Severity of Heart Failure
171
What blood test can be used to determine if the dyspnea a pt is presenting with is cardiac related or not?
The BNP
172
What blood test can be used to monitor the effectiveness of treatment for Heart Failure?
The BNP
173
These classification systems are strong predictors of readmission and risk of death due to Heart Failure =
The BNP Classification System
The NYHA’s Classification System
174
This can reduce the manifestations of Heart Failure by decreasing the damage by an MI =
Cardiac Catheterization
175
This is beneficial in the diagnosis of Heart Failure as it assesses both systolic and diastolic dysfunction. It also identifies abnormalities in wall motion or the function of the heart valves =
Echocardiogram
176
This assesses the size of the heart + the degree of pulmonary digestion =
Chest X-Ray
177
What’s the role of the nurse for a pt with Heart Failure?
Assess ability to perform ADL’s.
Education on the safe use of oxygen.
Be aware of any worsening symptoms.
Med safety & compliance.
Dietary Teaching.
Obtain Daily Weights.
178
What are some indications of worsening Heart Failure?
Weight Gain + Decreased ability to perform ADL’s + Edema + Rales in the Lungs
179
If a pt is having trouble breathing, what should their bed and position be switched to if it isn’t already?
Elevated HOB + High Fowler’s
180
What are the pharmacological interventions for Heart Failure?
ACE Inhibitors + Angiotensin II Receptor Blockers + Angiotensin Receptor Neprilysin Inhibitors + Beta Blockers + Aldosterone Antagonists + Hydralazine & Isosorbide Dinitrate + Diuretics
181
What are the Surgical Interventions for Heart Failure?
Cardiac Catheterization
Implantable Cardioverter Defibrillator
Biventricular Pacemaker
182
What are the categories of Cardiomyopathy?
Dilated
Hypertrophic
Restrictive
Arrhythmogenic
183
Is Cardiomyopathy an acute or chronic condition?
Chronic
184
Cardiomyopathy affects the heart’s ability to-
Pump blood efficiently
185
It is often that the direct cause of Cardiomyopathy is-
Unknown
186
This is the most common type of Cardiomyopathy =
Dilated Cardiomyopathy
187
This type of Cardiomyopathy occurs when dilation of the ventricles impairs the heart’s ability to contract =
Dilated Cardiomyopathy
188
When you have Dilated Cardiomyopathy, what happens to the heart?
The heart walls become weakened + Ineffective heart contractions cause a decreased CO (Leading to Heart Failure)
189
What does Hypertrophic Cardiomyopathy result from?
Hypertrophy or thickening of the Left Ventricular Walls and Septum
190
What does the thickening of the ventricles do to the heart?
It doesn’t allow for adequate blood refilling of the left ventricle, leading to a decreased CO
191
This is the least common type of Cardiomyopathy and has a poor prognosis =
Restrictive Cardiomyopathy
192
This type of Cardiomyopathy is characterized by stiffness of the ventricles which causes a decrease in diastolic ventricular filling =
Restrictive Cardiomyopathy
193
When does Arrhythmogenic Cardiomyopathy occur?
When Ventricular Muscle Fibers are replaced with Fibrous Fatty Tissues
194
During Arrhymogenic Cardiomyopathy, when the the ventricular muscle fibers are replaced, what do the Fibrous Fatty Tissues do to the heart?
They cause Electrical Instability + Lethal Dysrhythmias
195
What are the risk factors for Cardiomyopathy?
Inflammatory Process caused by Viral Infections + Autoimmune Disorders + Malnutrition + Alcohol Use + Genetic Disposition
196
Cardiomyopathy increases the risks of-
Depression, Financial Burden, Lack of Independent Functioning
197
What are some common adverse effects from meds used to manage Cardiomyopathy?
Decreased Sexual Libido + Mood Changes + Urinary Incontinence
198
What do the clinical presentations of Cardiomyopathy depend on?
The type of Cardiomyopathy the pt has
199
What are the clinical presentations of Cardiomyopathy?
Chest Discomfort + Peripheral Edema + Fatigue + Exertional Dyspnea + Lightheadedness + Near-Syncopal Episodes + Chest Discomfort + Palpitations + Ascites + Increased JVD + Risk of Sudden Cardiac Death
200
What is Ascites?
A condition where too much fluid builds up in the abdomen / belly, causing edema
201
What things can be used to diagnose Cardiomyopathy?
Chest X-Ray
Blood Tests
ECG Interpretation
202
What blood tests can be used to diagnose Cardiomyopathy?
CBC
Comprehensive Metabolism Panel
Troponin I
Troponin T
BNP
203
What does a Wide QRS Complex indicate?
A Bundle Branch Block
204
What does the absence of P Waves indicated?
Ventricular Fibrillation
205
Should Strenuous Activity be discontinued if a pt has Cardiomyopathy?
Yes
206
What Pharmacological Interventions can be used for Cardiomyopathy?
Diuretics + Vasodilators + ACE Inhibitors + Beta Blockers + Angiotensin II Receptor Blockers + Mineralocorticoid Antagonists + Calcium Channel Blockers
207
What surgical interventions can be used Cardiomyopathy?
Heart Transplant + Left Ventricular Assist Device (LVAD) + Septal Myectomy + Alcohol Septal Ablation + ICD
208
Meds given to a pt with Cardiomyopathy will be targeted towards-
Slowing the progression of Cardiomyopathies + Improving CO
209
What do Vasodilators do?
Decrease Fluid Overload
210
What are you doing during a Septal Myectomy?
Removing or Reducing portions of the Hypertrophied Ventricular Septum, allowing additional capacity for Diastolic Filling
211
Alcohol Septal Ablation is always completed in conjunction with a-
Cardiac Catheterization
212
What does an Alcohol Septal Ablation involve?
Injecting medical use alcohol into the thickened Septum tissue
213
Why would you want to inject medical use alcohol into thickened Septum tissue during an Alcohol Septal Ablation?
The alcohol eliminates the blood flow to the area, this causes tissue death that reduces the Septum’s thickness
214
What is Pericardial Effusion?
This is when excess fluid accumulates in the Pericardial Sac
215
What does Pericardial Effusion do to all of the chambers of heart?
It compresses them, making them unable to expand for refilling of blood (Decreases CO)
216
What triggers Pericardial Effusion to occur?
Pericarditis
217
What are the risk factors of Pericardial Effusion?
Cancer + Infection + Metabolic Illness + Cardiac Trauma
218
What are the manifestations of Pericardial Effusion?
Hyperthermia, Angina, Dry Cough + SOB upon exertion or when lying Supine
219
What things can be used to diagnose Pericardial Effusion?
Blood Tests
ECG Interpretation
Echocardiogram
Chest X-Ray
220
What blood tests can be used to diagnose Pericardial Effusion?
CBC + Chemistry Panel (Including Renal & Thyroid Functioning) + Cardiac Markers (CK-MB & Troponin)
221
What are the EKG changes associated with Pericardial Effusion?
Sinus Tachycardia + Low voltages of QRS Complexes + Electrical Alternans
222
This can be used to identify accumulation of Pericardial Fluid + Provide a measurement of the amount of Pericardial Effusion =
Echocardiogram
223
What can provide evidence of the collapse of the heart chambers and limited volume of blood filling?
Echocardiogram
224
A pleural effusion of greater than how many mL’s will show up on a Chest X-Ray?
Greater than 200 mL
225
People with Pericardial Effusion are a bleeding risk.
True or false?
True
226
What are things to assess for in a pt with Pericardial Effusion?
Fatigue + Edema + Dyspnea + Angina that’s worse when lying Supine and improves when in High Fowler’s Position
227
What things should be closely monitored for a pt with Pericardial Effusion?
Sinus Tachycardia, Hypotension, Muffled Heart Sounds
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What are some treatments / therapies for Pericardial Effusion?
Pericardiocentesis + Pericardial Window
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After a Pericardiocentesis, how long does the pt need to be closely monitored?
~48 hrs
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What’s essential to ensure the improvement of CO, Perfusion, and Maintenance of Hemodynamic Stability in a pt with Pericardial Effusion?
Continuous ECG + Close Monitoring
