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Flashcards in Introduction to Cardiology - Brown Deck (22):
1

Functional Classification of Heart Disease

New York Heart Association Classification of Heart Disease: CLASS 1

  • no limitations of physical activity
  • ordinary physical activity does not cause undue fatigue, dyspnea or anginal pain

2

Describe the specific testing modalities used to further evaluate cardiac patients

ECHOCARDIOGRAM

provides more accurate information on:

  • chamber size
  • global systolic function
  • chamber wall thickness
  • valve motion & function
  • pericardial fluid
  • blood flow and pressure gradients

types:

  • transesophageal echo (TEE)
  • stress echo

3

Describe the specific testing modalities used to further evaluate cardiac patients:

ELECTROCARDIOGRAM

used to evaluate for:

  • cardiac rhythms
  • conduction abnormalities
  • evidence of LVH, MI, ischemia

** compare changes to old EKGs

** not used for routine screening for cardiac disease

4

Describe the specific testing modalities used to further evaluate cardiac patients

CHEST X-RAY

provides information about:

  • heart size
  • pulmonary circulation
  • primary pulmonary disease
  • aortic abnormalities

** compare with old films **

5

Functional Classification of Heart Disease

New York Heart Association Classification of Heart Disease: CLASS 3

  • marked limitation of physical activity
  • comfortable at rest, but less than ordinary activity causes symptoms

6

Functional Classification of Heart Disease

New York Heart Association Classification of Heart Disease: CLASS 4

  • unable to engage in any physical activity without discomfort
  • symptoms may be present at rest

7

Describe the specific testing modalities used to further evaluate cardiac patients:

CORONARY ARTERY CALCIUM SCORE

measures amount of calcium in coronary arteries

8

Describe the specific testing modalities used to further evaluate cardiac patients:

STRESS TESTING

 

useful to elicit ischemia due to fixed coronary lesions

limited usefulness in asymptomatic patients

follow protocols

useful in diagnosis and follow-up with CAD

9

Describe the specific testing modalities used to further evaluate cardiac patients:

ANKLE BRACHIAL INDEX

  • measure pt's brachial BP
  • measure ankle BP
  • divide ankle by brachial
  • 0.9-1.0 = normal
  • 0.7-0.9 = mild
  • 0.5-0.7 = moderate
  • < 0.5 = severe

10

Describe the specific testing modalities used to further evaluate cardiac patients:

ELECTROPHYSIOLOGIC TESTING (EP)

catheter-delivered electrodes induce rhythm disorders, identify structural basis for problem

more accurate than an EKG

11

Describe the specific testing modalities used to further evaluate cardiac patients:

PERCUTANEOUS INTERVENTION (PCI)

  • treatment modality for coronary artery stenosis
  • typically a stent is placed in the affected vessels
  • performed in cath lab, results are good

12

Describe the specific testing modalities used to further evaluate cardiac patients:

CT

  • original use to quantify amount of calcium in coronary vessels
  • allows for non-invasive coronary angiography

13

Common Symptoms of Possible Cardiac Origin

  • chest pain
  • chest pressure
  • dyspnea (+/- exertion)
  • orthopnea
  • paroxysmal nocturnal dyspnea
  • syncope or near syncope
  • transient neurologic deficits
  • edema
  • palpitations
  • cough

14

Describe the specific testing modalities used to further evaluate cardiac patients:

CARDIAC CATH & ANGIOGRAPHY

  • invasive procedure - performed in Cath Lab by interventional cardiologist
  • visualizes coronary vasculature
  • measures wedge pressures of valves and pulmonary capillaries
  • significant complications can develop

15

general approach to the evaluation and diagnosis of cardiac disorders

  • from the hx - develop a ddx which will direct your exam and need for further testing
  • EXAM
    • vital signs:
      • BP in 2 positions
      • pulse rate
      • weight
    • lungs
    • heart
    • peripheral vascular findings
    • jugular venous pulse
  • DIAGNOSTIC TESTS
    • Chest X-ray
    • Echocardiogram
    • ECG or EKG
    • Stress Testing
    • MRI & Fast CT
    • Cardiac Catheterization
    • Percutaneous Coronary Intervention
    • Blood Chemistry Tests
  • rule out life-threatening disorders first

16

define: Prevalence

estimate of how many people have a disease at a given point of time

17

Functional Classification of Heart Disease

New York Heart Association Classification of Heart Disease: CLASS 2

  • slight limitation of physical activity
  • ordinary physical activity results in symptoms

18

define: Incidence

estimate of the number of new cases of disease that develop in a population in a 1 year period

19

cardiovascular disease differences between men and women

Risk

  • risk is similar between men and women
  • MEN devlop disease earlier
  • risk equals out approximately 10 years after menopause, then WOMEN increase risk

Presenting Symptoms

  • MEN chest pain is most common
  • WOMEN shortness of breath, nausea/vomiting, back or jaw pain, lower chest or abdominal pain, dizziness, lightheadedness, fainting, fatigue

20

cardiovascular disease presentation in women

  • shortness of breath
  • nausea/vomiting
  • back or jaw pain
  • lower chest or abdominal pain
  • dizziness, lightheadedness, fainting, fatigue

21

Describe the specific testing modalities used to further evaluate cardiac patients:

BLOOD TESTS

  • Serum Lipid Profile
  • C-Reactive Protein
  • Blood Glucose
  • Troponin I or T
  • CK-MB

22

Describe the specific testing modalities used to further evaluate cardiac patients:

CARDIAC MRI

useful in imaging cardiac structures and function