Abnormal CV Response (exam 3)

Question 1

What is cardiac output?

Answer 1

Q=SV*HR, amt of blood pumped through the body per minute

Question 2

What is a normal cardiac output?

Answer 2

4-8 L/min

Question 3

Normal HR values

Answer 3

60-100 bpm

Question 4

Normal respiratory rates

Answer 4

12-20

Question 5

Normal blood pressure

Answer 5

120/80

Question 6

Normal SpO2

Answer 6

98-100 (age effect is minimal)

Question 7

Effect of exercise on HR

Answer 7

HR goes up

Question 8

What is a blunted response? Who gets it

Answer 8

HR goes up, not as much. DM or beta blockers

Question 9

What happens to BP with exercise?

Answer 9

Goes up

Question 10

What does it mean if your BP does not go up during exercise?

Answer 10

Cardiac Output is going down

If your highly trained, workload is not high enough

Question 11

What happens toRR with exercise?

Answer 11

Goes up

Question 12

What happens to SpO2 with exercise?

Answer 12

stays same

Question 13

What is stroke volume?

Answer 13

Amt of blood ejected out of the heart each beat

Question 14

What is the stroke volume dependent on?

Answer 14

Preload (venous return), Contractility, Afterload

Question 15

What are some factors that influence heart rate?

Answer 15

Intrinsic rhythm and autonomic regulation

Question 16

What is venous return? What effect will it have?

Answer 16

Amt of blood returned to heart from periphery. If you have less venous return, then you will have a lower End Diastolic Volume and lower cardiac output

Question 17

What is the Frank-Sterling Relationship?

Answer 17

Length tension relationship btwn myocardium and strength of contraction?

Question 18

What is afterload?

Answer 18

Amount of force required by heart to overcome pressure of aortic valve to send blood out into the system. Higher force needed, less blood can be pumped out

Question 19

What are the 4 factors that cause an abnormal effect on the CV system?

Answer 19

Heart Rate, Rhythm, volume, pressure

Question 20

What is resting HR in reference to?

Answer 20

In reference to baseline

Question 21

What is chronotropic Incompetence?

Answer 21

Inability for heart rate to increase in response to increased activity and/or inability to achieve 85% of HR max

Question 22

What is chronotropic Incompetence associated with?

Answer 22

Left Ventricle dysfunction, myocardial ischemia and increased mortality

Question 23

What are some potential causes or associations of Chronotropic incompetence?

Answer 23

Older age
Presence of CAD
Smoking 
Exercise inteolerance
LV dialation
Ischemia
SA or AV node dysfunction 
Issue with modulating autonomic tone

Question 24

What does a delayed decrease in HR during 1st minute of recovery lead to?

Answer 24

increased mortality

Question 25

What are some pathologies that will give you an abnormal HR response?

Answer 25

``` Medications Heart transplant Autonomic dysfunction Ischemia Mechanical support ```

Question 26

What are the two types of arrhythmias?

Answer 26

Atrial and ventricular

Question 27

Atrial/Ventricular arrythmias are not predictive of mortality or a diagnostic for CAD?

Answer 27

Atrial

Question 28

What is a drop in systolic blood pressure associated with?

Answer 28

severe CAD and ischemic LV dysfunction. Can also identify those at risk for Ventricular fibrillation

Question 29

What is the normal response to standing?

Answer 29

500-1000 mL pooling of blood in legs decrease venous return to heart decrease CO and BP decrease arterial barorecptor response and increased sympathetic activity increased venous return, PVR, CO, limits fall in BP

Question 30

What is orthostasis?

Answer 30

When going from sitting to standing, the SBP drops >20 mmHG and the DBP drops >10 mmHg. THis must happen within 3 minutes of standing or at least 60 degrees on a tilt table.

Question 31

What are some confounding variables for orthostasis?

Answer 31

Food ingestion, time of day, state of hydration, ambient temperature, recent recumbency, postural reconditioning, hypertension, medications, gender, age

Question 32

What are some medications that cause orthostasis?

Answer 32

``` Antidepressants Beta and alpha blockers ACE inhibitors Vasodilators/nitrates Calcium channel blockers Opiates ```

Question 33

What are some causes of Orthostasis?

Answer 33

Decreased intravascular volume Autonomic insufficency alcohol consumption (impairs vasoconstriction) aging

Question 34

What does POTS stand for?

Answer 34

Postural Tachycardia Syndrome? Sustained HR increase of > 30 bpm w/in 10 minutes f standing or head-up tilt without orthostatic hypotension

Question 35

Who is POTS more common in?

Answer 35

women

Question 36

What are some symptoms of POTS?

Answer 36

lightheadedness, visual blurring

Question 37

How do you treat orthostasis?

Answer 37

Medications (midodrine, florinef) Diet (increased salt) Compression (LE compression therapy: 40-60 mmHg, abdominal binder