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My notes from slides Flashcards

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1
Q

What four chambers make up the heart?

A
  • Upper chambers: atria
  • Lower chambers:
    ventricles
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2
Q

What are the atrioventricular valves (AV)?

A
  • Tricuspid valve
  • Mitral valve
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3
Q

What are Cordae tendineae?

A
  • Anatomic guidewires attached to papillary muscles within the heart
  • Keep them from inverting during ventricular contraction
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4
Q

What is the pulmonic valve?

Semilunar valve

A
  • Between right ventricle and pulmonary artery
  • Prevents blood from flowing back into the right ventricle after is goes into the lungs
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5
Q

What is the aortic valve?

Semilunar valve

A
  • Located between the left ventricle and the aorta
  • Prevents blood from flowing back into the left ventricle after it enters the aorta
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6
Q

What happens during diastole?

A

Chamber relaxation

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7
Q

What happens during systole?

A

Chamber contraction

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8
Q

At what phase do the atria fill with blood?

A

During diastole, passively

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9
Q

What is an atrial kick?

A
  • The contribution to ventricular filling made by contraction of the atrium
  • It is the amount of blood kicked in the atrium during atrial systole.
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10
Q

What are the risk factors for coronary heart disease?

A
  • Advanced age
  • High blood cholestoral and triglyceride levels
  • Unhealthy diet
  • Smoking
  • Diabetes
  • Excessive alcohol use
  • Obesity
  • Physical inactivity
  • Stress
  • Hormone replacement therapy
  • Oral contraceptives
  • Family hx of CHD
  • Advanced age
  • Sex
  • Rare or ethnicity
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11
Q

What is the pericardium?

A
  • Tough, fiberous sac surrounding the heart
  • Normally contains about 30 mL of serous fluid
  • Does not stretch readily
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12
Q

What is a pericardial tamponade?

A

Large collection of abnormal fluid accumulaiton around the pericardial sac

Infection processes
Cancer
Trauma

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13
Q

What is a pericardial effusion?

A

A small amount of abnormal fluid accumulation around the pericardial sac

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14
Q

Which pump is the low- pressure pump?

A
  • The right side
  • Circulates blood through the lungs

Seperated by the intraventricular septum

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15
Q

What is the high-pressure pump?

A
  • Left side
  • Circulates blood throughout the rest of the body

Seperated by the intraventricular septum

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16
Q

What is your systemic circulation?

A
  • The blood going through your body
  • Consists of all the blood vessels beyond the left ventricle up to the right atrium
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17
Q

What is your pulmonary cirulation?

A
  • The bloods vessels between the right ventricle and left atrium
  • Which recieve the output of the right side of the heart
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18
Q

What are the common principal structure that arteries and veins share?

A

Outside to inside
* Tunica adventitia
* Tunica media
* Tunica intima
* Epithelium
* Lumen

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19
Q

What is the sequence of the cardiac conduction pathway?

A
  • SA Node
  • Atria contract
  • Av Node
  • Bundle of his
  • Bundle branches
  • Purkinji fibers
  • Ventricle contracts

  • Internodal pathways
  • AV Node
  • Av juntion-bundle of his
  • Purkinji fibers
  • Dromotropic effect
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20
Q

What are dromotropic effects?

A
  • Impacts the velocity of conduction
  • Dromptophy can be effected by some medications
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21
Q

What are the factors that reduce the risk of CHD?

A
  • Quit smoking
  • Awareness
  • Behaviour modification
  • Blood pressure control
  • Cholestoral management
  • Lipid management
  • Weight management
  • Aerobic exercise
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22
Q

What does the cardiovascular system do?

A
  • Primary function to deliver oxygenated blood and nutrients to cells
  • Delivering chemical messages (hormones) in the body
  • Transporting waste products of metabolism from the cell to sites of recycling or excretion.
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23
Q

How much does the heart weight?

A
  • It weights only 250 to 300g
  • It moves 7,000-9,000 L of blood daily
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24
Q

The flow of blood through the heart

A
  • Low oxygen blood flows from the Vena cava’s (S,I)
  • Blood enters the Right atrium
  • Flows throught the tricuspid valve
  • Into the right ventricle
  • It sends blood through the pulmonary valve into the pulmonary arteries
  • The pulmonary artery carry deoxygenated blood to the lungs to pick up oxygen
  • Oxygenated blood returns from the lungs to the pulmonary veins
  • Into the left atrium
  • Through the bicuspid (mitral) valve
  • Into the left ventricle
  • The left ventricle cotnracts forcefully and pushes blood through the aortic valve
  • Into theaorta, then through the rest of the body.

RA—>RV—>Lungs—>LA—>LV—>Body

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25
What is the tricuspid valve?
Serperates the right atrium from the right ventricle
26
What is the mitral valve?
* Bicuspid valve * Seperates the left atrium from the left ventricle
27
What are the semilunar valves?
Two other valves found at the junction of the ventricels and the pulmonary and systemic circulation
28
What is the cardiac cycle?
* Comprises one complete phase of chamber relaxation **(diastole)**, followed by contraction **(systole)**
29
What is an atrial contraction?
The contents of each atrium are squeezed into the respective ventricle to complete ventricular filling
30
Atrial systole begins:
* 0-100 msec * Atrial contraction forces a small amount of additional blood into relaxed ventricles
31
Ventricular systole:
* 100 msec-370 msec * Atrial systole ends- atrial diastole begins * Venticular systole-first phase: ventricular contraction pushes AV valves closed but does not create enough pressure to open semilunar valves * Second phase- as ventricular pressure rises and exceeds pressure in the ateries, the semilunar valves open and blood is ejected.
32
Atrial Diastole:
* Ventricular diastole-early: As ventricles relax, pressure in ventricles drops, blood flows back against cusps of semilunar valves and forces them closed. * Blood flows into the relaxed atria
33
Ventricular diastole:
* Ventricular diastole-late: All chambers are relaxed * Ventricles fill passively
34
What do pulmonary artieris do?
Carry **deoxygenated** blood from the right ventricle to the lungs
35
What do pulmonary veins do?
Carry **oxygenated** blood from the lungs to the left atria
36
What is the significance to the external jugular veins?
* Most readily visible of the systemic veins * Reflect the condition of all other systemic veins * Distension signals back pressure from the right side of the heart * As pressure increases, swelling and edema occur
37
Flow of blood through vessels?
Aortic valve--> Ateries--> Arterioles--> Capilliaries-->Venules--> Viens--> IVC/SVC into the right atrium
38
What are the characteristics of the tunica adventicia?
* Protective outer layer of fibrous tissue * Provides blood vessels with the strength necessary to withstand high pressure
39
What are the characteristics of Tunica media?
* Middle layer of elastic fibres and muscle * Gives strength and contractility to blood vessels * Much thicker and more powerful in arteries than in veins
40
What are the characteristics of Tunica intima?
* Innermost layer of the blood vessels * Smooth lining * Only one cell thick
41
What is the lumen of blood vessels?
Opening within the blood vessels
42
What is the largest and smallest arteries in the body?
* Aorta is the largest * Arterioles are the tiniest arterial branch
43
What are venules?
* Smallest viens * Gradually empty into larger and larger veins
44
What are the two largest veins in the body?
Superior and inferior vena cavae
45
What are the characteristics of capilliaries?
* Network of microscopic vessels between the tiny arterioles and venules * Extremely thin wall (one cell thick) * Enables the exchange of gases and nutrients * Diameter is so small that red blood cells must pass through single file
46
What is the point of maximal impulse? (PMI)
* Visible apical thrust * Normally located on the left anterior part of the chest, in the midclavicular line, at the fifth intercostal space * Occurs when the heart's apex rotates forward with systole, gentle beating against the chest wall and producing a pulsation
47
What creates cardiac output?
Stroke volume x Heart rate
48
What defines cardiac output?
* Amount of blood that is pumped out by either ventricle * Normal cardiac output for an average adult is 5-6 L/min
49
What defines stroke volume? (SV)
* Amount of blood pumoed out by either ventricle in a single contraction (hearbeat); normally 60-100 mL * A healthy heart has considerable spare capacity ## Footnote * The heart must be able to increase its output several times over in response to the bodys increased demands for oxygen * This is done by increasing its SV, increasing its rate or both
50
What defines heart rate?
* A number of cardiac contractions per minute (pulse rate) * Normal HR is 60-100 beats per minute
51
Explain the frank starling mechanism.
* As thea heart fills up with more blood during Diastole it contracts harder to pump out more blood during systole * This increase in amount of blood returning to the heart causes the cardiac muscle to stretch to accomidate the larger volume.
52
What is preload?
* **The pressure in the ventricle at the end of diastole** * Pressure under which a ventricle fills * Influenced by the volume of blood returned by the veins to the heart
53
What is afterload?
* Load or pressure against which the ventricles contracts to eject blood * Rise in systemic vascular resistance (contriction of the arteries) leads to a higher afterload, and the cardiac output can drop. The load on the heart before it contracts.
54
Contractility or Inotrophy
* The heart varies the degree of contraction of its muscle without changing the stretch on the muscle * Changes may be induced by medications that have a postive or negative inotrophic effec * Heart can increase cardiac output, given a constant SV, by increasing the number of contractions per minute, increasing the heart rate (chronotropic effect). ## Footnote Refers to the strength of contraction of the heart muscle
55
Define contractility
* The instrinsic ability of the heart muscle (myocardium) to contract, independent of preload (initial stretch) and afterload (resistance). * Determines how forcefully the heart squeezes with each beat | The hearts natural strength to contract ## Footnote Influenced by : * Sympathetic nerve system (norepinephrine) * Calcium levels
56
Define Inotrophy
* Refers specifically to the force or energy of muscular contraction, especilly in the heart * Positive inotrophy: stronger contraction * Negative inotrophy: weaker contraction | The effect on the contraction strength ## Footnote When something increases contractility, it's said to have a positive inotropic effect.
57
Alpha receptor: organ and effect
* Arteries: constriction * Lungs: mild bronchoconstriction
58
Beta-1: organ and effect
* Heart: increased dromotropy, inotropy, chrontrophy * Beta agent has only one effect: increase it's rate force and automaticity ## Footnote Beta-1- you have one heart
59
Beta-2: organ and effect
* Lungs: smooth bronchial muscle dilation * Arteries: dilation ## Footnote Beta 2- two lungs
60
What does the sympathetic nervous response do?
* Speeds up the heart * Constricts blood vessels * Dilates bronchi and puplis
61
What does the parasympathetic response do?
* It regulates the bodys vegitative functions * Slows heart rate * Encourages digestion
62
What does vegas stimulation do?
* Pressure on the carotid sinus * Straining against a closed glottis (valsalva maneuvours) * Distention of a hollow organ * Slows down chronotrophy, inotrphy, domotrophy
63
What is acetylcholine (ACh)?
* Naturally occurring chemical * Stimulted by electrical impulses from the vegaas nerve (the chmical gives alternative names to parasympathetic nervous system: cholinergic system) ## Footnote * ACh signals the SA node indicating the brain in calling for a slowing of the heart
64
What is norepinephrine?
Chemical used by the sympathetic nervous system to convey its commands ## Footnote Travels to the SA node, Av node, and ventricles, speading the command from the sympathetic nerves
65
What is epinephrine?
* Mobalized by intense stimulation of the sympathetic nervous system * Produced in the adrenal gland (aka: adrenaline) * Gives an alternative name to the sympathetic nervous system: adrenergic system
66
What is blood pressure?
Bp= cardiac output x systmic vascular resistance (SVR) Cardiac output= bp divided by SVR
67
What is a symathomimetic drug?
* Drugs that have alpha or beta sympathetic properties * They imitate the actions of naturally occuring sympathetic chemicals
68
What are beta sympathetic agents?
* Classified into two groups baased on differences in the receptors in the hearts and lungs * Salbutamol ## Footnote Beta 1- acts on the cardiac beta receptors- 1 heart Beta 2- act chiefly on pulmonary beta receptors- 2 lungs
69
What are alpha agents?
* Slight bronchoconstriction on the lungs * Vasoconstriction on the arteries
70
What are sympatholytic or sympathetic blockers?
They block the action of sympathetic agents by preventing them from binding to receptors sites
71
What are beta blockers?
Occupy beta receptors in the heart, lungs, and arteries
72
What does atrophine do?
* Parasympathetic blocker, opposing the vegas nerve * used to speed the heart when excessive vagal firing has caused bradycardia
73
What does norepinephrine do?
* Sympathetic agent (primarily alpha) causing vasoconstriction * Used to increase blood pressure when hypotension is caused by vasoconstrictor effects * Indications cardiac arrest, anaphylactic shock and severe hypotension
74
What does Epinephrine do?
* Sympathetic agent (both beta and alpha) * Chronotropic, dromotropic, and inotropic effects with direct cardiac stimulation and vasoconstriction effects * Indicates cardiac arrest, anaphylactic shock and severe hypotension.
75
Describe automaticity
* The heart generates its own electrical impulses without stimulation from nerves. * The heart has specialized conduction tissues that can rapidly propagate electrical impulses to the muscular tissues of the heart.
76
What is the pacemaker in context of the heart tissue?
* Area of conduction tissue in which the elcetrical activity arises at any given time * Sets the pace for cardiac contraction
77
What is the dromotropic effect?
* Impactts the velocity of contraction * Dromotrophy can be affected by some medications
78
What is the dominant pacemaker of the heart?
* The SA node (sinoatrial node) * Located in the right atrium * Fastest pacemaker of the heart ## Footnote 60-100 beats/min
79
What do internodal pathways do?
* They spread electrical impulses across the two atria in about 0.08 sec, causing the atrial tissue to depolarize as they pass * Impulses received from the SA node at the AV junction Internodal pathways are specialized conduction fibers in the right atrium that carry electrical impulses from the SA node (sinoatrial node) to the AV node (atrioventricular node).
80
Atrioventricular node
* Serve as a gatekeeper to the ventricles * blood supply comes from the branh of the RCA
81
AV junction
Includes the AV node and its surrouding tissue along with the bundle of His ## Footnote 40-60 beats/min
82
Purkinje fibers
Thousands of fibrils distributed through the ventricular muscle ## Footnote 20-40 beats/min
83
What is the electrical conduction system pathway?
* SA node * Internodal pathways * AV nodes * Bundle of His * Bundle branches * Purkinje fibers
84
What is depolarization?
* At rest, the inside of the heart is negatively charged * Stimulus from the conduction system changes the permeability of the cell wall through opening of specialized channels, causing the inside of the cell to become more positive * A rapid influx of sodium is the primary driver of the initial phase of depolarization
85
Repolarization
* Closing of the sodium channels * Restores negative charge
86
What creates the P wave?
* Depolarization of the atria produces the P wave * Followed by a brief pause (delay at the AV junction)
87
What is the QRS complex?
* Occurs after the P wave * Represents deplolarization of the ventricles
88
What does the T wave represent?
Repolarization of the atria and ventricles
89
What is the PR interval (PRI)?
* Distance from the beginning of the p wave to the beginning of the QRS complex * Time required for an impulse to traverse the atria and AV junction ( normally 0.12-0.20 sec)
90
What is the ST segment?
* Line from the end of the QRS complex to the beginning of the T wave and should at the same level as the baseline (isoelectric line) * Elevated or depressed ST segment may indicate myocardial ischemia or injury
91
What is the RR interval?
* Time between two successive QRS complexes * Interval between two ventricular depolarizations * Gives an indication of HR
92
What is Atherosclerosis?
* A prgressive degenerative disease that remains asymptomatic for decades. * It effects all arteries, but mostly coronary, renal, aortic, femoral, carotid, and cerebral arteries ## Footnote Main underlying cause of: * Angina * MI * Heart failure * Aortic aneurysm and dissection * Peripheral vascular disorders * Stroke Plaque builds up in the arteries and causes hardening and narrowing.
93
What happens with Atherosclerosis?
* Chronic gradual narrowing of the arteries that can evetually causes ischemia from blood flow (stable angina, leg claudication), bruits may be heard on ascultation.
94
What is Ischemia?
Muscle deprived of oxygen
95
What is an Infarction?
Death of the ischemic area of the heart
96
What is a stable angina?
* Sudden pain that occurs when the supply of oxygen to the myocardium is insufficent to meet the demand. * Follows a reccurent pattern: person experiences pain after a certain predictable amount of exertion * Pain has a predictable location, intensity and duration * Pt with chronic, stable angina often take nitroglycerine or some other nitrate agent to relieve pain
97
What might happen when taken nitro with an unstable angina?
May not be relieved by pt's typical nitro spray
98
What is Prinzmetal angina?
* Caused by coronary artery vasospasm * More common in woman * Commonly occurs at rest (especially at night) * Most patients do not have exertional symptoms
99
What is stroke volume?
The amount of blood ejected by the left ventricle of the heart during each contraction.
100
An acute myocardial infarction? AMI
* Portion of the cardiac muscle is deprived of coronary blood flow long enough that portions of the muscle dies * 90% of all deaths from AMI's are due to arrhythmias (can be prevented or treated).
101
Order of treatment from Ischemic chest pain
1. Vital signs 2. ASA 3. 12 Lead 4. Nitroglycerine 5. Transport
102
What is Fibrinolysis?
* Fibrinolysis seeks to administer, during the early hours of MI, an agent that will activate the bodys own internal system for dissolving clots, the fibrinolytic system
103
Summerize Atherosclerosis
* A chronic condition where arties become narrowed and hardened due to build up of plaque, can affect any artery in the body * Reduces blood flow and can lese to coronary artery disease, stroke, or peripheral artery disease
104
Summerize CHD or CAD
* A type of atherosclerosis that specially affects the cornary arteries; localized to the heart * Reduces blood flow to the heart muscle, which can cause angina, AMI, or heart failure
105
Summerize Angina
* A symptom of CHD-chest pain or discomfort due to tempoary lack of oxygen to the heart muscle * Not a heart attack but a warning sign of reduced blood flow ## Footnote Stable, unstable
106
Summerize Acute coronary syndrome
* An umbrella term for any condtition brought on by sudden, reduced blood flow to the heart * Includes unstable angina, NSTEMI, STEMI * Usually due to the rupture of an atherosclerosis plaque with clot formation
107
Summerize Acute myocardial infarction (AMI)
* Occurs when blood flow to part of the heart is completely blocked, causing permanent damage (necrosis) to the heart muscle * NSTEMI * STEMI
108
How does the frank-starling mechanism effect chronic heart failure?
In the first stage of failure the heart will compensate using the Frank-starling mechanism to maintain cariac output by increasing the strove volume
109
What is ejection fraction
The percentage of blood the ventricle pumps out in each contraction
110
How does an AMI effect the left ventricle?
The left ventricle is most commonly damaged during an AMI, mitral valve regurgitation, and in chronic hypotension
111
What is cariogenic pulmonary edema?
Serum is forced out of the pulmonary capilliaries and into the alveoli
112
How does dyspnea and orthopnea effect the alveoli?
* When fluid occupies the alveoli, oxygenation is impaired * SOB, particularly in the recumbent position (orthopnea)
113
What is the orthopnea?
Dyspnea that occurs when lying down and is relieved by sitting or standing
114
What causes wheezing sounds? Crackles (rales)?
* Increasing interstitial pressure causes narrowing of the brochioles * Air passing through narrowed bronchioles creates wheezing noises * Air bubbling through the fluid-filled alveoli produces crackles (rales)
115
What is the most ocommon cause of right-sided heart failure?
Most commonly occurs as a result of **left-sided heart failure**
116
A pulmonary embolism?
Forward blood flow through the pulmonary circuitry to the left atrium is blocked by a blood clot, resulting in an increased workload on the right ventricle
117
Pulmoary hypertension?
Longstanding lung disease such as COPD and pulmonary fibrosis cause increased resistance to blood flow through the lungs, backing up blood into the right ventricle and increasing its workload.
118
What are the signs and symptoms of right-sided heart failure?
* The presence or absence of pulmonary edema on physcial examination can often provide a helpful clue as to weather right-side heart failure is secondary to left-side heart failure or due to primary lung or right-side heart problems * Blood backs up behind the right ventricle and increases the pressure in the systemic veins * Distention can be seen in the veins visible on the surface of the body (external jugular viens) * Edema develops, likely to be visible in dependent parts of the body (feet in a seated or standing patient, lower back in a bedridden patient).
119
The signs and symptoms of cardiac tamponade (vary depending on it cause)?
* If the onset is gradual (as with pericarditis) the inital reports might be dyspnea and weakness * If the cause is traumatic, the cheif complaint might be chest pain * Classic symptom of narrowing pulse pressure * Initial drop in BP is usually followed by an increase in HR, leading to tachycardia * Heart sounds might be muffled or quitier than usual owing to the buildup of fluid * Jugular venous distention * **Beck triad:** a combination of hypotension (weak or narrowing pulse pressure), jugular venous distension and muffled heart sounds
120
What is an aneurysm?
A sac or bulging resulting from the weakening of the wall of al blood vessel or ventricle
121
What is a characteristic symptom is an acute dissection of the aorta?
* Pain comes on suddenly * May be located in the anterior part of the chest or in the back between the shoulder blades
122
What happens to pulses in an AAA?
Triple A's will affect **lower limb** pulses while maintaning upper limb pulses
123
What is an s/s of an expanding or ruptured AAA?
* Sudden onset of abdominal or back pain when the aneurysm starts to expand or rupture, can also be present in the flanks. * Hypotenstion * The most characteristic physcial finding is a pulsatile mass palpable in the abdomen
124
Hypotension and hypertensive emergencies
* Most often is the result of advanced atherosclerosis or arteriosclerosis (decreases the lumen of the arteries and reduces their elasticity). * Increased afterload stimulates the Frank-Starling reflex, which raises the pressure behind the blood leaving the heart.
125
Define hypertensive emergency
* Defined as an acute elevation of BP with evidence of end-organ damage
126
What is hypertensive encephalopathy?
Severe hypertension, associated with loss of the blood-brain barrier and cerebral edema
127
What is mean arterial pressure (MAP)
* Calculated by adding one-third of the difference between the SBP and DBP to the DBP * When it exceeds 150mmHg, the pressure may breach the blood-brain barrier with resultant fluid leaking out, increasing intracranial pressure
128
Important symptom of hypertensive emergencies
First symptoms noticed are: * Severe headache * Nausea * Vomitting Followed by seizures and alterations in mental status Sometimes may show focal neurologic signs (sudden blindness, aphasia, or hemiparesis)
129
What is bradycardia?
* A HR less than 60 beats/min * Hypoxia is a common cause, should be corrected rather than treating the rhythm
130
What is tachycardia?
A HR greater than 100 beats/min
131
Defibrilliation on VF or pulseless VT
* Defib needs to be carried out as soon as possible in VF or pulseless VT * Likelihood of success declines rapidly with time
132
What do you do once an advance airway is placed? ## Footnote BLS std
Once an advance airway is placed, used continuous compressions and uniterrupted ventilation as above
133
Consider a supreglottic airway and capnography: ## Footnote ALS Std
If any advanced airway is used, ventilate every 6-8 seconds or 8-10 breaths/min with continuous compressions at least 100/min without pause for ventilations
134
What does higher ETC02 indicate?
Higher cardiac output (good CPR)
135
What does lower ETC02 indicate?
Change compressors or improve CPR quality
136
Considerations of ABC or CAB in the primary assesment
* Is the airway patent ( talking and patent, clear obstruction, positioning or adjunct) * Note the rate, quality and effort of breathing (initiate oxygen therapy if needed) * Check circulation ( radial for conscious, carotid for unconscious) note the rate, regularity and overall quality (weak/thready, regular or bounding) * Assess skin color and condition (pink, war, and dry) ## Footnote Check pulses first for unconscious patients, if no pulse begin CPR and apply defib pads
137
What vital signs do you need to take?
* Pulse * Blood pressure * Resp rate * GCS * Blood sugar (if indicated) * Skin color * Temperature * Pupils * ETCO2 (if applicable)
138
What is a pulse deficit?
Palpated radial pulse is less than the apical pulse rate or the left radial pulse is absent when the right is present
139
What is pulse paradoxus?
Excessive drop of more than 10mmHg in the systolic blood pressure (SBP) with each inspired breath
140
What is pulse alternans?
Alternates in strength from one breat to the next
141
Conditions for ASA ## Footnote Cardiac ischemic directive
* Age: greater than 18 years * LOA: Unaltered * HR,RR,SBP: N/A * Other: able to chew and swallow
142
Conditions for Nitro ## Footnote Cardiac ischemic directive
* Age: 18 years and older * LOA: unaltered * HR: 60-159 bpm * RR: N/A * SBP: Normotension * Other: prior history of nitro use OR IV access obtained
143
Contraindications for ASA ## Footnote Cardiac ischemic directive
* Allergy or sensitivity to NSAIDs * If asthmatics, no prior use of ASA * Current active bleeding * CVA or TBI in the previous 24 hours
144
Contraindications for Nitro ## Footnote Cardiac ischemia directive
* Allergy or sensitivity to nitrates * Phosphodiesterase inhibator use within the previous 48 hours * SBP drops of by one-third or more of its initial value after nitro is administered * 12-lead ECG compatible with right-ventricular MI
145
What do external jugular veins reflect?
* Pressure in the systemic circulation * Suggests right-side heart failure
146
How do you estimate venous pressure?
Place the patient in a semi-fowler position at 45 degree with the head slightly rotated away from the jugular vien you are examining
147
Inotrophy
Force or strength of cardiac muscle contraction
148
Chronotrophy
Rate of the heartbeat, specifically how quickly the SA node fires
149
Dromtrophy
The speed of the electrical conduction through the AV node Conduction speed

Cardiovascular Emergencies (40 decks)

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