Cardiac Flashcards
RCA Supplies: (In Order)
SA Node
RV
AV Node
Left Posterior Wall
Left Inferior Wall
V1-V6 chest leads are categorized as:
Unipolar Leads
ST Elevation= ST Depression= Q waves present that measurer >25% of the r wave=
Injury Ischemia Infarction (necrosis)
_____ is characteristic of the 12-lead ECG for pt with history of WPW.
Delta Wave
On 12 Leak EKG, posterior wall MI manifest as:
ST depression in V1-V4 with abnormally tall R waves
Second Degree Type I Heart Block is also known as:
Wenckebach
Diagnosis of right ventricular MI includes:
Right Sided 12 Lead ECG with ST elev in V4
The IABP balloon has dislodged. What is the most common site that will be affected?
Left Radial
The primary trigger used for most IABP operation is
EKG
Which of the following is the most potentially harmful timing errors?
Late Deflation
How many coronary arteries?
2
Left Coronary Artery bifurcates into:
LAD and LCX
LAD Supplies:
Left Anterior wall Left Anterior 2/3 of Septum
LCX Supplies:
Left Lateral Wall
RCA becomes:
The PDA
The Major Intraaterial Pathway
Bachmanns Bundle
What enzyme elevates first in MI
Myoglobin
The enzyme that elevates last in MI is:
Troponin I
Septal Wall MI Vessel Occlusion
LAD
Anterior Wall MI Vessel Occlusion
LAD
Lateral Wall MI Vessel Occlusion
LCX
Inferior Wall MI Vessel Occlusion
RCA
Posterior Wall MI Vessel Occlusion
RCA
Which Ventricle is more prone to Blunt Force Trauma
Define Transmural infarct
Extends through the full thickness of the myocardium including the endocardium and epicardium
Define Non-transmural/subendocardial Infarct
Damage is limited to the subendocardial region
Pt having a Left Anterior Septal MI and then experience acute pulmonary edema. What just happened
Papillary Muscle Rupture
ST Elevation = __________MI
Transmural MI
J-point notch is indicative of _________
Stable Angina
Unstable Angina
Stable Angina that has changed in frequency, quality, duration or intensity
Varient Angina
Spontaneous episodes of CP frequently noted at rest or upon rising.
Mixed Angina
Combanation of Stable and Unstable Angina
CorPP=
DBP-wedge
carvedilol=
Coreg
G-IIb/IIIa Inhibitors
Integrilin
ReoPro
Agg
Thrombolytics absolute contraindiction
- Active Internal Bleeding
- Suspected Aortic Dissection
- Known Intracranial Neoplasm
- Previous hemorrhagic stroke at anytime or any stroke within the last year.
Oversensing
Sensing things that are not there such as a t-wave
Pacer will not fire or not fire enough
Failure to Sense
Pacer misses the R-wave
More lethal
Fires more often
With pacing what is the opitimal way to you have mechanical capture
Ausc of Heart Tones
With a venous pacer wire you always have to think of ________ as a risk
Cardiac Tamponade
Dilated Cardiomyopathies is secondary to _________ overload
Volume
Dilated Cardiomyopathies is _________ failure
Hypertrophic Cardiomyopathies is secondary to a ________ overload
Hypertrophic Cardiomyopathies is a __________ failure
Restrictive Cardiomyopathies is secondary to _________
Ischemic Tissue
Restrictive Cardiomyopathies is a ________ failure
Systolic Murmur _____
Diastolic Murmur
Lub Dub Murmur Lub Dub Murmur
Aortic Stenosis is a ______ murmur and is auscultated at the _____ intercostal space, _____ ______ margin
Systolic
2nd
Right Sternal
Aortic Regurgitation is a ______ murmur.
Diastolic
Mitral Stenosis is a _____ murmur and ausciltated at the _____ intersostal space mid-_______ line
Diastolic
5th
Clavicular
Mitral Regurgiation is a _______ murmur
Systolic
Pulmonic Stenosis is a ______ murmur and is ausculatated at the ____ intercostal, _______ margin
Systolic
2nd
Left Sternal
Wide Mediastinum with Diffuse infiltrates =
Triple A
For HTN management you are trying to dial BP to their normal within the ____ to ____ min
30 to 60
CHF Goals:
- Decrease Preload
- Decrease Afterload
- Decrease Rate
- Inhbit RAA System
- Improve Contractilty
Normal CVP
2-6 mmHg
CVP is ______ to the ______ side of the heart
Positive Pressure ventilation always drops _______
RVP= ______
Normal Systolic 15-25
Normal Diastolic 0-5
*****Not normally monitored
PA Pressure=
PAS= 15-25
PAD= 8-15
Wedge Pressure reflects _____ on the _____ side of ther heart
Never inflate the swan balloon with more then _____ ml
Normal PCWP:
8-12 mmHg
PCWP approximates _______
LVEDP
You only inflate the balloon until you see _______
Two causes of inadvertent wedge:
- Migration
- Balloon Inflation
How to correct inadvertent wedge:
- Deflate the balloon
- Have the pt cough
- Have pt roll to side and then back
- Withdraw catheter till you get a PA waveform
Inadvertent RV waveform causes
Catheter whipping around in the RV ventricle
Inadvertent RV waveform correction
- Balloon up look for waveform to go away
- Deflate Waveform
- Pull back to CVP waveform
Cardiac Output Calculation
HR x SV
Normal Cardiac Output
4-6 L/min
Cardiac Index Calc
CO/BSA
Normal Cardiac Index
2.5-4.2