Exam 1 (cardio) Flashcards
(137 cards)
1
Q
RHF: Signs
A
syncope, ascites
2
Q
LHF: Signs
A
syncope, dyspnea, cough
3
Q
What is normal BP?
A
120/80
4
Q
T/F: Inc. body temp. is indicative of heart failure
A
False.
“Dec.” body temp is indicative of heart failure.
5
Q
Tachycardia: Indications
A
fear, pain, heart failure
6
Q
Bradycardia: Indications
A
sleep, parasympathetic tone
7
Q
What do you pay attention to when taking the pulse?
A
Rate, Rhythm, Quality
8
Q
Hypokinetic Pulse: Indications
A
heart failure, stenosis, shock, effusion
9
Q
Hyperkinetic Pulse: Indication
A
exercise, anemia, shunts
10
Q
Respiration: Crackles - indication
A
fluid in lungs
11
Q
Respiration: Wheezes - indication
A
inflammation of the lungs
12
Q
What causes the S1 heart sound?
A
AV valves closing
13
Q
What causes the S2 heart sound?
A
the pulmonic and aortic valves closing
14
Q
What causes the S3 heart sound?
A
the passive filling of the ventricles (can be heard with dilated cardiomyopathy)
15
Q
What causes the S4 heart sound?
A
the forced refilling of the ventricles (can be heard with hypertrophic cardiomyopathy)
16
Q
What are causes for murmurs?
A
narrowing of a vessel, valvular insufficiency, inc. rate of flow, dec. viscosity
17
Q
What are Radiographs used to look at in the CV system?
A
lungs, pleural space, and pulmonary vessels
18
Q
What is Ultrasound used to look at in the CV system?
A
heart size, thickness, shape, function, and valves
19
Q
What is ECG used to look at in the CV system?
A
arrhythmias
20
Q
What are Angiograms used to look at in the CV system?
A
blood vessels for stenosis/clots
21
Q
What is Phonocardiograms (PCG) used to listen for?
A
murmurs and heart sounds
22
Q
What is the normal conduction pathway in the heart?
A
SA node -> AV node -> Bundle of His -> L/R AV Bundle Branches -> Purkinje Fibers
23
Q
Where are the ECG leads placed?
A
black - FL
white - FR
red - BL
green - BR
24
Q
ECG: Artifacts
A
interference, shivering, breathing, purring
25
ECG: Interference - Appearance
small, rapid, regular flux
26
ECG: Shivering - Appearance
large, rapid, irregular flux
27
ECG: Breathing - Appearance
wide tan() like lines
28
ECG Paper: Measurements
1 sq. = 1mm; 1cm H = 1mV
29
ECG: Determining HR
60 x (# of R-waves on strip/ # of sec. on strip)
30
What is the Mean Electrical Axis?
avg direction of activation of ventricular myocardium
31
Mean Electrical Axis: Normal Values
70-90
| 90
32
ECG: Normal P-wave Dimensions
0.04sec x 0.3mV
33
ECG: P-wave Abnormalities
inc. time (mound) = L. atrial enlargement (mitral (side))
| inc. mV (peak) = R. atrial enlargement (pulmonic (side))
34
ECG: Normal QRS Complex Dimensions
0.04-0.08sec x 2.5-3mV
35
ECG: QRS Complex Abnormalities
inc. mV +/ time = L. ventricular enlargement
| large S-wave = R. ventricular enlargement
36
ECG: R. Bundle Branch Block - Appearance
deep S, prolonged QRS, dec. R mV
37
ECG: L. Bundle Branch Block - Appearance
prolonged QRS, normal R
38
ECG: Low Voltage Complexes - Appearance
QRS complexes are
39
ECG: Low Voltage Complexes - Causes
obesity, pleural/pericardial effusion, pneumothorax
40
ECG: Normal S-T segment
within 1.5-2mm of baseline before QRS complex
41
ECG: Normal Q-T segment Length
inversely proportional to HR, changes with Ca/K
42
ECG: Normal T-wave Height
43
Bradyarrhythmia: Wandering Atrial Pacemaker - Cause
P-waves from outside the SA node
44
Bradyarrhythmia: Wander Atrial Pacemaker - Appearance
variable P-wave morphology, variable P-R interval
45
Bradyarrhythmia: Sinus Arrest - Cause
failure of SA node to beat
46
Bradyarrhythmia: Sinus Arrest - Appearance
QRS complexes w/o a P-wave (escape beats)
47
Bradyarrhythmia: Hyperkalemia - Appearance
tall T-waves, missing P-waves, prolonged QRS complexes
48
Bradyarrhythmia: AV Block - Cause
delay/failure of transmission at the AV node
49
Bradyarrhythmia: AV Block - 1st Degree
delayed transmission; prolonged P-R interval
50
Bradyarrhythmia: AV Block - 2nd Degree Mobitz Type I
intermittent failure of conduction; increasing P-R interval until missing QRS commplex
51
Bradyarrhythmia: AV Block - 2nd Degree Mobitz Type II
intermittent failure of conduction; no P-R interval changes before QRS complex is missing
52
Bradyarrhythmia: AV Block - 3rd Degree
no conduction through AV node; P-waves w/ escape beats
53
Bradyarrhythmia: Sick Sinus Syndrome - Cause
abnormal SA node + AV system
54
Bradyarrhythmia: Sick Sinus Syndrome - Appearance
intermittent Sinus arrest +/ AV block
55
Tachyarrhythmia: Superventricular Premature Depolarization - Cause
ectopic pathway in atria
56
Tachyarrhythmia: Superventricular Premature Depolarization - Appearance
premature P-waves (poss. hidden in T-wave), normal QRS
57
Tachyarrhythmia: Ventricular Premature Depolarization - Cause
ectopic focus in ventricle
58
Tachyarrhythmia: Ventricular Premature Depolarization - Appearance
premature, prolonged, bizarre QRS complexes, no P-wave;
if (+) R-wave, ectopic focus is in R. ventricle
if (-) R-wave, ectopic focus is in L. ventricle
59
Tachyarrhythmia: Ventricular Premature Depolarization - Fusion Beat
combo of normal and ectopic beats
60
Tachyarrhythmia: Ventricular Tachycardia - Appearance
4+ VPD's in a row
61
Tachyarrhythmia: Atrial Fibrillation - Cause
multiple ectopic foci
62
Tachyarrhythmia: Atrial Fibrillation - Appearance
no P-waves, normal QRS complexes, random R-R interval
63
Heart Failure: LCHF - Signs
Hypotension - pale mm, inc. CRT, HR; dec. pulse pressure, weakness, syncope, azotemia
Pulmonary Edema - dyspnea, coughing, tachypnea, exorcise intolerance, cyanosis
64
Hear Failure: RCHF - Signs
ascites, distended jugular veins, hepatosplenomegally, pleural effusion, hypotension
65
Heart Failure: Phase I
dz but no signs
66
Heart Failure: Phase II
cough, dyspnea/ exorcise intolerance
67
Heart Failure: Phase III
cough, dyspnea/orthopnea at night, exorcise intolerance
68
Hear Failure: Phase IV
cough, dyspnea, cyanosis at rest
69
Heart Failure: Stage A
high risk, but no dz
70
Heart Failure: Stage B1
structural dz, but no signs and normal rads and echo
71
Heart Failure: Stage B2
structural dz, but no signs, L. heart enlargement
72
Heart Failure: Stage C
past/current clinical signs of failure
73
Heart Failure: Stage D
End-stage dz
74
Heart Failure: Precautions
handle w/ care, oxygenate, reduce edema (diuretics), dec. preload (venodilators), dec. afterload (ACE inhibitors), inc. contractility (digoxin, pimobendan), restricted NA diet (kidney/geriatric)
75
Patent Ductus Arteriosus: Definition
duct connecting the pulmonary artery and the aorta
76
PDA: Dx - Radiographs
enlarged LA + LV, angiography
77
PDA: Dx - U/S
Enlarged LA + LV, doppler
78
PDA: Tx
surgery, embolization coil
79
Aortic Stenosis: Definition
band of fibrocartilage neart the aortic valve => LV hypertrophy
80
Aortic Stenosis: Effects
inc. afterload; dec. diastolic filling, output; hypoxia, arrhythmia, mismatched pulse (hypotonic), stenotic murmur
81
Aortic Stenosis: Dx - Radiographs
poss. LV hypertrophy, post stenotic aortic dilatation
82
Aortic Stenosis: Dx - U/S
thickened wall, narrowing near aortic valve, doppler, M-mode
83
Aortic Stenosis: Tx
symptomatic, dec. BP (B-blocker), control CHF, surgery
84
Pulmonic Stenosis: Definition
valvular dysplasia (thickening +/ fusion)
85
Pulmonic Stenosis: Effects
R. hypertrophy, arrhythmia, murmur, poss. uneven hypertrophy, turbulence => dilatation
86
Pulmonic Stenosis: Dx - Radiographs
enlarged R. heart, pulmonary trunk dilation, angiogram
87
Pulmonic Stenosis: Dx - U/S
doppler, appreciate valves
88
Pulmonic Stenosis: Tx
balloon valvuloplasty, patchgraft valvulplasty
89
Ventricular Septal Defect: Definition
a hole in the intraventricular wall
90
Ventricular Septal Defect: Effects
Volume overload => eccentric hypertrophy + dilatation (R. side too if defect is low); murmur
91
T/F: The louder the murmur, caused by VSD, the worse the prognosis.
False.
| The louder the murmur, the better the prognosis. B/c it's a smaller hole.
92
Ventricular Septal Defect: Dx - Radiographs
enlarged LV + LA, enlarged pulmonary vessels
93
Tetrology of Fallot: Definition
pulmonic stenosis, overiding aorta (aorta goes around pulmonary artery), VSD, enlarged RV
94
Tetrology of Fallot: Effects
cyanotic (in front and back), erythrocytosis, murmur (softens with inc. viscosity)
95
Tetrology of Fallot: Dx - Radiographs
dec. pulmonary vessel size, dilated pulmonary artery, angiogram
96
Tetrology of Fallot: Dx - U/S
doppler, identify defects and stenosis
97
Tetrology of Fallot: Tx
surgery
98
Dilated Cardiomyopathy: Definition
enlargement of LV
99
Dilated Cardiomyopathy: Signs
wt. loss, atrial fib, VPD, V-tach, LCHR +/ RCHF
100
Dilated Cardiomyopathy: Dx - Radiographs
globous heart
101
Dilated Cardiomyopathy: Dx - U/S
M-mode, doppler
102
Dilated Cardiomyopathy: Dx - ECG
atrial fib, VPD, V-tach
103
Dilated Cardiomyopathy: Tx - Early Phase
monitor
104
Dilated Cardiomyopathy: Tx - Occult Phase
ACE inhibitor, pimobendan, B-blockers, treat arrhythmias
105
Dilated Cardiomyopathy: Tx - Classic Phase
furosimide, ACE inhibiters, pimobendan, restricted Na diet
106
Dilated Cardiomyopathy: Tx - Severe (Hospitalized) Phase
O2, drain any fluid, furosimide, dobutamine/pimobendan, restricted Na diet, ACE inhibiter
107
Hypertrophic Cardiomyopathy: Definition
Thickening of the LV wall
108
Hypertrophic Cardiomyopathy: Signs
syncope, dyspnea, paresis (saddle thromus), steroids/stress, L-CHF, poss. murmur, focal retinal degeneration
109
Hypertrophic Cardiomyopathy: Dx - Radiographs
valentine shaped, enlarged LA, angiogram (shrunken LV space)
110
Hypertrophic Cardiomyopathy: Dx U/S
wall thickness
111
Hypertrophic Cardiomyopathy: Tx
nothing, treat failure accordingly; B-blockers help heart to fill more
112
Arrythmogenic RV Cardiomyopathy: Definition
fibrosis, inflammation, +/ fat infiltration of the RV
113
ARVC: Forms
Concealed - no signs
Overt - signs present
myocardial dysfunction - severe case
114
ARVC: Signs
weakness, syncope, R/L-CHF, VPD
115
ARVC: Dx
postmortem
116
ARVC: Tx
symptomatic, sotalol, carnitine?, Omega-3
117
Myxomatous AV Valvular Degeneration: Definition
callogen abnormality of the LAV valve => dysfunction, ruptured cordea tendonea
118
Myxomatous AV Valvular Degeneration: Syndromes
little regurge - asymptomatic, inc. LA, coughing
| large regurge - L-CHF, coughing
119
Myxomatous AV Valvular Degeneration: Signs
asymptomatic, cough, acute/chronic LHF (exercise intolerance, syncope, dyspnea, tamponade, systolic murmur (clicking sound), crackles
120
Myxomatous AV Valvular Degeneration: Dx - Lab
inc. BUN, Crea, liver enzymes
121
Myxomatous AV Valvular Degeneration: Dx - Radiographs
enlarged LA
122
Myxomatous AV Valvular Degeneration: Dx - U/S
thickened/prolapsed valves, enlarged LA, doppler
123
Myxomatous AV Valvular Degeneration: Tx
Symptomatic, CHF; arteriodilators - dec. resistance in the aorta making it the path of least resistance
124
Endocarditis: Definition
bacterial infection of the endocardium (often the aortic valve)
125
Endocarditis: Causative agents
Bartonell, Staph, Strep, E. coli, Corynebacterium, pseudomonas
126
Endocarditis: Effects
CHF, dysrrhythmia, septic emboli, polyarthritis, glomerulonephritis
127
Endocarditis: Signs
infection (source of bact), intermittent malaise, wt. loss, shifting lameness, fever, murmur (sudden, loud), bounding pulse, poss. renal/neuro signs
128
Endocarditis: Dx - Lab
infection leukogram, anemia, thrombocytopenia, PCR
129
Endocarditis: Dx - U/S
irregular valve
130
Endocarditis: Dx - Radiographs
CHF signs w/o enlarged heart
131
Endocarditis: Tx
symptomatic, antibiotics
132
Pericardial Effusion: Definition
inc. fluid in the pericardial sac,
133
Pericardial Effusion: Signs
lethargy, dyspnea, syncope, wt. loss, ascites, vomiting, pale mm, inc. CRT, muffled heart sounds
134
Pericardial Effusion: Dx - Radiology
round heart (smooth edges)
135
Pericardial Effusion: Dx - U/S
appreciate pericardial effusion
136
Pericardial Effusion: Dx - Lab
nRBCs, pericardioscentesis
137
Pericardial Effusion: Tx
balloon, pericardiotomy
