11. Cardiovascular Flashcards
right diaphragm
- higher due to liver
- there is problem is the diaphragms are on the same level
tuberculosis
- traveling
- cough
- night sweats
- pockets of fluid in the lungs (upper airways)
pneumonia
- infection
- on one side can travel to other side
atelectasis
- trachea is not midline
- lung collapse
pulmonary artery/vein
- opposite
- exception
- artery- deoxygenated blood
- vein- oxygenated
tricuspid
-right side
patient has lower extremity edema
- problem with the
- back flow problem
- pooling in right side of heart
- problem with delivering blood to body (aorta, left side of heart)
bicuspid
-mitral valve
hearts own blood supply
- coronary arteries
- get blood supply where the aortic valve is
- if aortic valve is defective -> heart problems, myocardium
veins
-where ever there is veins there is lymphatic system
pericardium
- superficial fibrous
- protects
- anchors
- prevents overfill
epicardium
-visceral layer of the serous pericardium
parietal pericardium
surrounds the whole heart
-outer
visceral pericardium
hugs the heart
-inner
pericarditis
- inflammation of the pericardium
- infection
- painful
endocardium
-lines the ventricles and atria
interatrial septum
separates the atria
-muscle division
interventricular septum
separates the ventricles
-muscle division
strep infection -> rheumatic heart disease
- overtime can cause a condition with one of the valves
- affects a layer of the heart -> endocardium
- carditis in the endocardium
- endocarditis
vital signs
- breathing rate
- temperature
- blood pressure
- heart rate
- height
- weight
- BMI
bundle of his
-at the top of the septum
SA nodes
- controlled by CNS, brainstem
- action potentials
SA nodes
- controlled by CNS, brainstem
- action potentials
tricuspid valve
-sounds typically heard in right sternal margin of 5th intercostal space
S1, S2
lub dub
aortic valve
-sounds heard in 2nd intercostals space at right sternal margin
pulmonary valve
-sounds heard in 2nd intercostal space at left sternal margin
mitral valve
-sounds heard over heart apex (in 5th intercostal space) in line with middle of clavicle
arrhythmias
- abnormal heart rhythms
- dysrhythmias
- problems with the conduction or electrical system of the heart
- not a full PQARST rhythm (not 60-100)
aorta
largest artery in the body
apex of the heart
lower tip of the heart
artery
largest type of blood vessel
-carries blood away from the heart to all parts of the body
arteriole
-small artery
atrioventricular node (AV node)
specialized tissue in the wall between the atria
-electrical impulses pass from the pacemaker (SA node) through the AV node and the atrioventricular bundle or bundle of His toward ventricles
atrioventricular bundle (bundle of His)
specialized muscle fibers connecting the atria with the ventricles and transmitting electrical impulses between them
atrium
-one of two upper chambers of the heart
capillary
- smallest blood vessel
- materials pass to and from the bloodstream through the thin capillary walls
coronary arteries
-blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle
carbon dioxide
-gas (waste) released by body cells, transported via veins to the heart, and then to the lungs for exhalation
deoxygenated blood
blood that in oxygen poor
diastole
relaxation phase of the heartbeat
electrocardiogram
record of the electricity flowing through the heart
-electricity is represented by waves or deflections called P, QRS, or T
endocardium
-inner lining of the heart
endothelium
innermost lining of blood vessels
mitral valve
valve between the left atrium and the left ventricle
-bicuspid valve
murmur
abnormal swishing sound caused by improper closure of the heart valves
myocardium
muscular, middle layer of the heart
normal sinus rhythm
heart rhythm originating in the sinoatrial node with a rate in patients at rest of 60-100 beats per minute
oxygen
gas that enters the blood through the lungs and travels to the heart to be pumped via arteries to all body cells
pacemaker (sinoatrial node)
specialized nervous tissue in the right atrium that beings the heart beat
-an artificial cardiac pacemaker is an electronic apparatus implanted in the chest to stimulate heart muscle that is weak and not functioning
pericardium
double layered membrane surrounding the heart
pulmonary artery
artery carrying oxygen poor blood from the heart to the lungs
pulmonary circulation
flow of blood from the heart to the lungs and back to the heart
pulmonary valve
valve positioned between the right ventricle and the pulmonary artery
pulmonary vein
one of two pairs of vessels carrying oxygenated blood from the lungs to the left atrium of the heart
pulse
beat of the heart as felt through the walls of the arteries
septum
partition or wall dividing a cavity
-such as between the right and left atria (interatrial septum) and right and left ventricles (interventricular septum)
sinoatrial node (SA node)
pacemaker of the heart
sphygmomanometer
instrument to measure blood pressure
systemic circulation
flow of blood from body tissue to the heart and then from the heart back to body tissues
systole
contraction phase of the heart beat
tricuspid valve
located between the right atrium and the right ventricle
-it has three leaflets, or cusps
valve
structure in veins or in the heart that temporarily closes an opening so that blood flows in only one direction
vein
thin walled vessel that carries blood from body tissues and lungs back to the heart
-veins contain valves to prevent back flow
vena cava
largest vein in the body
-superior and inferior venae cavae return blood to the right atrium of the heart
ventricle
one of two lower chambers of the heart
venule
small vein
angi/o
vessel
aort/o
aorta
arter/o; arteri/o
artery
ather/o
yellowish plaque, fatty substance
atri/o
atrium, upper heart chamber
brachi/o
arm
cardi/o
heart
cholesterol/o
cholesterol (lipid substance)
coron/o
heart
cyan/o
blue
myx/o
mucus
ox/o
oxygen
phleb/o
vein
rrhythm/o
rhythm
sphygm/o
pulse
steth/o
chest
thromb/o
clot
valvul/o
valve
vas/o
vessel
vascul/o
vessel
ven/o, ven/i
vein
ventricul/o
ventricle, lower heart chamber
arrhythmias
-abnormal heart rhythms (dysrhythmias)
bradycardia and heart block (atrioventricular block)
- arrhythmia
- failure of proper conduction of impulses from the SA node through the AV node to the atrioventricular bundle (bundle of his)
- bradycardia
- if this happens sometimes irregular rhythm
- if this is consistent ventricles contract slower than atria and are not coordinate -> complete heart block
flutter
- rapid but regular contraction, usually of the atria
- may reach up to 300 beats per minute
- symptoms of heart disease
fibrillation
- very rapid, random inefficient, and irregular contractions of the heart (350 beats or more per minute)
- impulses move randomly -> quiver
- prescribe anticoagulants
- atrial fibrillation (AF)- most common arrhythmia
- ventricular fibrillation (VF)- electrical impulses move randomly throughout the ventricles
paroxysmal AF
-irregular heart beats occur periodically and episodically
permanent or persistent AF
irregular heartbeats continue indefinitely
- can lead to blood clots
- greater risk for stroke
permanent or persistent AF
irregular heart
ventricular fibrillation (VF)
- electrical impulses move randomly throughout the ventricles
- can cause cardiac death or heart attack
- can be interrupted with defibrillation
- medication: digoxin, beta blockers, calcium channel blockers
- treats people with high risk for having ventricular tachycardia, ventricular fibrillation, and cardiac arrest
implantable cardioverter-defibrillator (ICD)
- small electrical device that is implanted inside the chest
- sense arrhythmias and terminate with electric shock
automatic external defibrillators
- AED
- reverse ventricular fibrillation
catheter ablation
-minimally invasive treatment for cardiac arrhythmias
-uses radiofrequency energy delivered from the tip of catheter inserted through blood vessel into heart
-destroys tissues that causes arrhythmias
-treats Supraventricular tachycardia (SVT), atrial flutter, atrial fibrillation, and ventricular
tachycardia (VT)
congenital heart disease
-abnormalities in the heart at birth
coarctation of the aorta (CoA)
narrowing (coarctation) of the aorta
-treated with surgical removal of constricted region and end-to-end anastomosis of the aortic segments
patent ductus arteriosus (PDA)
- passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth
- oxygenated blood from the aorta flows into the pulmonary artery
- congenital
septal defects
- small holes in the wall between the atria (atrial septal defects) or the ventricles (ventricular septal defects)
- close spontaneously if not requires open heart surgery
- congenital
tetralogy of fallot
- causes cyanosis (blue baby)
- congenital malformation involving four distinct heart defects:
- pulmonary artery stenosis- pulmonary artery is narrow or obstructed
- ventricular septal defect- large hole between two ventricles lets venous blood pass from the right to the left ventricle and out to the aorta without oxygenation
- shift of the aorta to the right- aorta overrides the interventricular septum, oxygen poor blood passes from the right ventricle to the aorta
- hypertrophy of the right ventricle- myocardium works harder to pump blood through a narrowed pulmonary artery
transposition of the heart arteries (TGA)
- pulmonary artery from the left ventricle and the aorta from the right ventricle
- causes cyanosis and hypoxia
congestive heart failure (CHF)
- heart is unable to pump its required amount of blood
- two types: systolic and diastolic
- causes shortness of breath, exercise intolerance, fluid retention, pulmonary edema(-fluid accumulation in the lungs)
systolic congestive heart failure (CHF)
- left ventricular dysfunction results in a low ejection fraction (the amount of blood that leaves the left ventricle)
- less blood is pumped from the heart
diastolic congestive heart failure (CHF)
- heart can contract normally but is stiff when relaxed or filling with blood
- fluid backs up in the lungs and other parts of body
- cause is hypertension
angiotensin-converting enzyme (ACE) inhibitors (type 1), beta blockers, spironolactone, digoxin
increases excretion of water and sodium by the kidney
- treats congestive heart failure
- lowers blood pressure
left ventricular assist device (LVAD)
- booster pump implanted in the abdomen, with a cannula (tube) inserted into the left ventricle
- pumps blood out of the heart to the body
- used while waiting for heart transplant or if it isnt an option
coronary artery disease (CAD)
-disease of the arteries surrounding the heart
-coronary arteries arise from the aorta
-usually a results of atherosclerosis (fatty compound deposition on inner lining of coronary arteries)
-
thrombotic occulsion
-blocking of the coronary artery by a clot
-
ischemia
decreased blood flow
infarct
- area of dead myocardial tissue
- replaced by scar tissue
- caused by thrombotic occlusion -> ischemia -> necrosis
myocardial infarction
-atherosclerosis (fatty compound on inner lining of artery) -> thrombotic occlusion (clot) -> ischemia (decreased blood flow) -> necrosis -> infarction
acute coronary syndromes (ACSs)
conditions caused by myocardial ischemia
- unstable angina (chest pain or chest pain of increasing frequency)
- myocardial infarction
- consequence of plaque rupture in coronary arteries
- treat with stents, balloon catheter, anticoagulants, antiplatelet agents
nitroglycerin
- treats angina
- taken sublingually (under tongue)
- nitrate- vasodilator that increases coronary blood flow and lower BP
calcium channel blockers
-relax muscles in blood vessels
-used to treat angina and hypertension
-dilates blood vessels by blocking the influx of
calcium into muscle cells lining vessels.
statin
lower cholesterol
beta blockers
reduce the force and speed of heart beat and lower BP
- used to treat angina, hypertension, and arrhythmias
- blocks the epinephrine at receptor sites on cells -> slows heartbeat and reducing the workload on the heart
asprin
prevent clumping of platelets
coronary artery bypass grafting (CABG)
open heart operation for CAD
-replaced clogged vessels
percutaneous coronary intervention (PCI)
- catheterization with balloons and stents open clogged coronary arteries
- treats CAD
endocarditis
- inflammation of the inner lining of the heart
- produces lesions called vegetations that break off into blood stream as emboli (material that travels through blood)
- emboli can lodge -> transient ischemic attack (TIA or stroke) or petechiae
- treated by antibiotics
hypertensive heart disease
- high blood pressure affecting the heart
- this condition results from the narrowing of arterioles -> increased BP
- causes left ventricular hypertrophy- pumps more vigorously to overcome increased resistance in arteries
mitral valve prolapse (MVP)
- improper closure of the mitral valve
- mitral valve enlarges and prolapses into the left atrium during systole
- doctor hears auscultation and mitral regurgitation
- most live normally but can cause endocarditis
murmur
- extra heart sounds heart between normal beats
- usually caused by valvular defect or disease that disrupt smooth flow of blood in heart
- bruit- heart on auscultation
- thrill- vibration felt on palpation of chest
pericarditis
- inflammation of the membrane (pericardium) surrounding the heart
- usually results from pulmonary infection
- pericardial friction rub found with auscultation
- treated with antibiotics
cardiac tamponade
-compression of the heart caused by collection of fluid in the pericardial cavity
rheumatic heart disease
- heart disease caused by rheumatic fever
- rheumatic fever is a childhood disease that follows streptococcal infection with sore throat
- heart valves can be damaged by inflammation and scarred with vegetations
- treated with penicillin
- mitral stenosis, atrial fibrillation, and congestive heart failure can results in rheumatic heart disease
aneurysm
- local widening (dilation) of an arterial wall
- caused by atherosclerosis and hypertension or congenital weakness in vessel wall
- danger of an aneurysm is rupture and hemorrhage
- treatment for large arteries -> stent
deep vein thrombosis (DVT)
- blood clot (thrombus) form in a large vein, usually in a lower limb
- results in pulmonary embolism (clot travels to lung) if not treated
- treated with anitcoagulant
hypertension (HTN)
-high blood pressure
-most is essential hypertension
-treated by diuretics, ACE inhibitors, calcium
channel blockers, beta-blockers, Losing weight, limiting sodium (salt) intake, stopping smoking, and reducing fat in the diet
-secondary hypertension- increased in pressure caused by another associated lesion
peripheral arterial disease (PAD)
-blocking of arteries carrying blood to the legs, arms, kidneys and other organs
-sign is intermittent claudication- no pain in leg at rest but pain when walking
-
raynauds disease
- recurrent episodes of pallor and cyanosis primarily in fingers and toes
- affects blood flow in arteries
- marked by brief episodes of intense constriction and vasospasms of arterioles in young health women
- triggered by cold temp, emotional stress, or cigarette smoking and caffeine
varicose veins
- abnormally swollen and twisted veins, usually occurring in the legs
- caused by damaged valves that fail to prevent backflow
- blood collects in veins -> enlarged
- varicose veins in anus- hemorrhoids
- treats with sclerotherapy
angina (pectoris)
-chest pain resulting from myocardial ischemia
-Stable angina occurs predictably with
exertion
-unstable angina is chest pain that occurs more often and with less exertion
angiotensin converting enzyme (ACE) inhibitor
-antihypertensive drug
-blocks the conversion of angiotensin I to angiotensin II, causing
blood vessels to dilate
-prevents heart attacks, CHF, stroke, and death.
biventricular pacemaker
-Device enabling ventricles to beat together (in synchrony) so that more blood is pumped out
of the heart.
bruit
abnormal blowing or swishing sound heard during auscultation of an artery or organ
cardiac tamponade
-pressure on the heart caused by fluid in the pericardial space
claudication
-Pain, tension, and weakness in a leg after walking has begun, but absence of pain at rest
digoxin
-drug that treats arrhythmias and strengthens the heartbeat
embolus
-Clot or other substance that travels to a distant location and suddenly blocks a blood vessel.
infarction
-area of dead tissue
nitrates
Drugs used in the treatment of angina. They dilate blood vessels, increasing blood flow and
oxygen to myocardial tissue.
nitroglycerin
nitrate drug used in the treatment of angina
occulsion
closure of a blood vessel due to blockage
palpitations
Uncomfortable sensations in the chest related to cardiac arrhythmias, such as premature ventricular contractions (PVCs)
patent
open
pericardial friction rub
- scraping or grating noise heard on auscultation of the heart
- suggestive of pericarditis
statins
-drugs used to lower cholesterol in the bloodstream
thrill
vibration felt over an area of turmoil in blood flow (as a blocked artery)
vegetations
-clumps of platelets, clotting proteins, microorganisms, and RBC on diseased heart valves
BNP test
- Measurement of BNP (brain natriuretic peptide) in blood
- elevated in patients with heart failure
- assess the degree of heart failure
- useful in the diagnosis of CHF in patients with dyspnea
- secreted when the heart becomes overloaded, and acts as a diuretic to help heart function return to normal
cardiac biomarkers
- chemicals measured in the blood as evidence of a heart attack.
- damaged heart muscle releases chemicals into
- substances tested for: troponin-I & troponin-T
- predicting risk for heart attack, stroke, or other major heart disease.
lipid tests (lipid profile)
- measurement of cholesterol and triglycerides (fats) in a blood sample
- high levels associated with atherosclerosis
- greater than 200 is high risk
- saturated fats increase cholesterol
- polyunsaturated fats decrease blood cholesterol
- treatment: statins
lipoprotein electrophoresis
- lipoproteins (Combinations of fat and proteins) are physically separated and measured in a blood sample
- ex. low density lipoprotein and high density lipoprotein
angiography
- x-ray imaging of blood vessels after injection of contrast material
- arteriography is x-ray imaging of arteries after injection of contrast via a catheter into aorta or artery
computed tomography angiography (CTA)
-3-D x-ray images of the heart and coronary arteries using computed
tomography
digital subtraction angiography (DSA)
- video equipment and a computer produce x-ray images of blood vessels
- takes two pictures before and after contrast material
beam computed tomography (EBCT or EBT)
early CAD
- coronary artery calcium score
- indicates future risk of heart attack and stroke
- score >400 high risk
doppler ultrasound studies
-sound waves measure blood flow within blood vessels
echocardiography (ECHO)
echoes generated by high frequency sound waves produce images of the heart
-show structure and movement of heart
cardiac MRI
- images of the heart are produced using radiowave energy in a magnetic field
- multiple planes
- info about left and right ventricular function, wall thickness, and fibrosis, aneurysms, cardiac output, and patency of peripheral and coronary arteries
cardiac catheterization
- thin, flexible tube is guided into the heart via a vein or an artery
- detects pressure and patterns of blood flow in the heart
- contrast injected and x-ray images taken of the heart and blood vessels
electrocardiography
- recording of electricity flowing through the heart
- monitoring patients heart rhythm
holter monitoring
- an ECG device is worn during a 24 hour period to detect cardiac arrhythmias
- rhythm changes are correlated with symptoms recorded in a diary
stress test
- exercise tolerance test (ETT) determines the heart response to physical exertion (stress)
- 3-minute stages at set speed and elevation of a treadmill
- monitors vital signs and ECG rhythms
- diagnoses CAD and left ventricular function
catheter ablation
- brief delivery of radiofrequency energy to destroy areas of heart tissue that may be causing arrhythmias
- catheter guided through vein in leg to vena cava and into the heart
coronary artery bypass grafting (CABG)
- arteries and veins are anastomosed to coronary arteries to detour around blockages
- vein grafts are used to keep myocardium supplied with oxygenated blood
defibrillation
-brief discharges of electricity are applied across the chest to stop dysrhythmias (ventricular fibrillation)
endarterectomy
surgical removal of plaque from the inner layer of an artery
-carotid endarterectomy- remove plaque buildup in the carotid artery to reduce risk of stroke
extracorporeal circulation
- heart lung machine diverts blood from the heart and lungs while the heart is repaired
- oxygenated the blood and returns it to blood vessel
- uses extracorporeal membrane oxygenation (ECMO)
heart transplantation
- donor heart is transferred to a recipient
- while waiting you may need left ventricular assist device (LVAD)
percutaneous coronary intervention (PCI)
- balloon tipped catheter is inserted into a coronary artery to open the artery
- stent are put in place
thrombolytic therapy
-drugs to dissolve colts are injected into the bloodstream of patient with coronary thrombosis
transcatheter aortic valve replacement (TAVR)
-placement of a balloon expandable aortic heart valve into the body via catheter
carotid artery
blood to brain
