Flashcards in Lecture 3 Deck (36):
What is important to ask in the patient history?
-presence of chest pain
-medical treatment sought and its outcome
-presence of palpitations
-presence of cardiac risks
-history of dizziness or syncope
-previous MI, cardiac studies or procedures
what are some risk factors for cardiovascular system?
What are some causes of dizziness/syncope?
-low blood sugar
what causes elongation of the heart?
What can a chest x-ray reveal?
-masses in lungs
-can see elongation of heart
What heart sound do you hear during S1?
mitral and tricuspid closure (ventricular systole)
What heart sound do you hear during S2?
aortic and pulmonic areas
What heart sound do you hear during S3?
(Ventricular gallop) early rapid diastolic filling of ventricles
What heart sound do you hear during S4?
(atrial gallop) ventricular filling due to atrial contraction, low pitched sound heard late in diastole just before S1
what is a summation gallop
volume overload (dilated cardiomyopathy)
what are ejection sounds?
dilated aortic or pulmonary artery
What are mid systolic clicks
what causes opening snaps?
mitral or tricuspid stenosis
What are 2 major goals for the exercise tolerance test?
1) detect presence of ischemia (angina)
2) determine functional aerobic capacity
what is the exercise tolerance test (ETT)?
examines the ability of the CV system to accommodate to increasing O2 demands (VO2)
What do METs measure?
basic O2 requirement at rest
What does MET stand for?
metabolic equivalents of energy expenditure
What does 1 MET equal in O2?
1 MET=3.4 ml O2/kg/min
What does 1 MET equal in functional terms?
What does the BRUCE protocol start at?
begins at 1.7 mph and 10% grade on treadmill at roughly 5 METs
what increases as workload increases for all modalities?
describe positive ETT?
there is a point when myocardial oxygen supply is not meeting the demand=ischemia (will get angina)
Describe negative ETT?
balance between oxygen supply and demand
Describe False-negative ETT?
ETT is interpreted as negative but there is ischemia
Describe False-positive ETT?
ETT is interpreted as positive but there is NO ischemia
What functional task is at 2 METs?
bed exercises (arm exercises in supine or sitting)
What functional task is at 4 METs?
walking on level surface
What functional task is at 6 METs?
What functional task is at 10 METs?
what is the O2 requirement at 10 METs?
What is the rule of thumb for progressing for Bruce protocol?
10 min, if they are able to sustain a pace for around 10 min they can progress maybe at the next visit.
when might they do an echocardiogram?
with a stress test
what is an echocardiogram?
use of ultrasound over the heart to see the chambers of the heart
What does the Thallium stress test help diagnose?
-extent of a coronary artery blockage
-prognosis of patients who've suffered a heart attack
-effectiveness of cardiac procedures done to improve circulation in coronary arteries
-causes of chest pain
-level of exercise that a patent can safely perform
What is a Persantine test?
use when a patient is unstable, decondition, unable to ambulate or cycle for stress test