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1
Q

How many chambers are in the heart?

A

4

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2
Q

The circulatory system includes: 5

A
  1. Lungs
  2. Veins
  3. Arteries
  4. Capillaries
  5. The heart
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3
Q

What is the function of the circulatory system?

A

transport oxygen and nutrients to the body’s cells and carry away the waste material of cellular metabolism.

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4
Q

What are the 3 layers of the of heart

A
  1. inner endocardium
  2. middle muscular myocardium
  3. double-layered outer sac, the pericardium
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5
Q

Diastole is

A

Relaxation

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6
Q

Systole is

A

Contraction

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7
Q

Pulmonary circulation

A

Supplies blood to the lungs

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8
Q

What kind of blood is carried via pulmonary circulation and what happens?

A

oxygen depleted blood. C02 is exchanged for O2 and pulmonary vein carries oxygenated blood to the left atria.

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9
Q

Systematic circulation

A

includes coronary circulation and supplies oxygenated blood and nutrients to the body.

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10
Q

Ischemia is

A

a lack of oxygen

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11
Q

Unmodifiable risk factors include (3)

A
  1. age
  2. gender
  3. family history
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12
Q

Modifiable risk factors include (4)

A
  1. hyperlipidemia
  2. Smoking
  3. Hypertension
  4. Diabetes
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13
Q

What is elevated in hyperlipidemia and what is low in hyperlipidemia

A

elevated total cholesterol
elevated LDL
low HDL
and elevated trigs

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14
Q

Increased HDL has a protective value against what

A

CAD

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15
Q

Metabolic syndrome is characterized as having the following (5)

A
  1. Abdominal obesity
  2. elevated trigs
  3. low HDL
  4. Hypertension
  5. Insulin resistance
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16
Q

Aortic sclerosis is

A

the thickening of the aortic valve w/o obstruction

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17
Q

Decreased ankle-brachial index

A

leg BP/arm BP < 1

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18
Q

carotid intimal-media thickness is

A

US assessment of the wall thickness of the inner two layers of the wall of the carotid artery

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19
Q

What are additional risk factors of CAD

A
  1. Metabolic syndrome
  2. Aortic sclerosis
  3. decreased ankle-brachial index
  4. presence of microalbuminuria and/or renal insufficiency
  5. the presence of LVH on EKG or Echo
  6. increased carotid intimal-media thickness
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20
Q

Angina pectoris (cardiac chest pain) is when

A

oxygen demand exceeds oxygen supply

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21
Q

Typical Angina is

A

described as a squeezing or pressure in the middle of the chest (relatively short 1-15 min)

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22
Q

Stable Angina is

A

chest discomfort that occurs predictably and reproducibly at a certain level of exertion and is relieved with rest or nitroglycerin.

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23
Q

Unstable Angina

A

symptoms usually occur more easily or at rest

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24
Q

Dyspnea is

A

shortness of breath (SOB)

25
Ejection fraction is
the pumping ability of the heart
26
Congestive heart failure (CHF) is when
fluid builds up in the lungs or other body tissues
27
An EKG is a
tracing of the electrical activity of the heart, non-invasive test, inexpensive and painless.
28
how many leads are in an EKG
12
29
What does an EKG determine
any abnormalities of the heart's rhythm or conduction system
30
Exercise EKG measures
the hearts response to exercise
31
Exercise EKG is helpful in the diagnosis and prognosis of what?
CAD
32
Abnormal responses during an Exercise EKG include (3)
1. development of angina 2. extreme change in BP (decrease in BP especially worrisome) 3. Ventricular premature contractions
33
Exercise capacity is
the metabolic equivalent of task
34
how is exercise capacity determined
by duration of exercise and protocol used
35
Myocardial perfusion imaging (MPI) improves what
specificity and sensitivity of exercise EKG
36
MPI is
is more accurate in diagnosis of CAD and better able to assess severity by localizing and quantifying the amount of the myocardium in jeopardy
37
Normal perfusion scan shows
the same concentration of tracer throughout the heart
38
A defect is
an area devoid of tracer
39
A reversible defect is
visualized with exercise but not at rest, generally indicates an area of hypoperfused but viable myocardium
40
A fixed defect is
present both at exercise and rest, and indicates a prior myocardial infarction
41
The echocardiogram, the radionuclide angiogram (RNA) - also known as a multi gated acqusition scan (MUGA) and the Gated SPECT allow for what?
the assessment of the cardiac chambers
42
Myocardial ischemia is detected as
a decrease in LV ejection fraction or the development of a regional wall motion abnormality with exercise
43
Coronary Angiography is the
Gold Standard in the diagnosis of CAD
44
Coronary Angiography is and what does it determine
an invasive test where the dye is injected directly into the coronary arteries to determine the site, extent and percentage of the coronary obstructiion
45
Intravacular US
is able to image atheroma with the vessel wall directly
46
EBCT
ultra fast CT scans which are used to detect deposits of calcium in the arterial walls
47
BNP is
a hormone produced by the heart in response to stretching of myocardial cells due to volume and/or pressure overload
48
Elevated BNP is associated with
higher cardiac and all cause mortality
49
Nitrates cause what and improve what
Cause coronary arteries to dilate and improves blood flow and relieves angina
50
How do beta-blockers prevent angina
by slowing the HR and decreasing force of contraction which decreases the need for myocardial oxygen
51
Calcium channel blockers
some increase blood flow (nifedipine) and some decrease oxygen demand (verapamil)
52
Statins main function is to
lower LDL levels
53
Statins can be in the ______ or _______ prevention of _____
Primary Secondary CAD
54
What is a PTCA
Balloon tipped cath inserted into peripheral artery and it is inflated at the site of obstruction, fractures plaques which increases the lumen of the blood vessel
55
CABG is
revascularization where a new connection is made from the aorta to the coronary artery by use of a graft. (detour for blood flow)
56
Left ventricular function is
the assessment of the hearts ability to pump and adequate amount of blood to meet the bodys metabolic needs
57
LVEF is
the % of blood in the ventricle delivered to the body with each heartbeat
58
Best Case CAD risk profiles (10)
1. Onset of CAD at later ages 2. Stable angina 3. Normal LV function and EF 4. Mild, single vessel disease excluding LM 5. No arrhythmias 6. No progression of the disease 7. No diabetes or other chronic disease 8. well controlled cardiovascular risk factors including the use of a statin and asprin 9. good exercise capacity 10. Negative stress test
59
High Risk CAD profile includes (11)
1. Early onset (before 40) 2. Unstable or worsening of disease 3. CHF or poor LV function 4. reduced EF 5. severe 3-vessel disease or LM disease 6. Presence of arrhythmias 7. Significant progression over a short period of time 8. poorly controlled cardiac risk factors 9. CHD in the setting of valvular heart disease 10. poor exercise tolerance 11. Severe stress testing abnormalities (drop in BP with exercise)

CAD (1 decks)

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