Cardiac Flashcards
What are the effects of Beta Blockers
Beta Blockers decrease HR, blood pressure, and myocardial contractility in order to decrease sympathetic cardiac stimulation.
What types of conditions are beta blockers good for?
angina pectoralis, arrhythmias, heart failure, recovery from an MI
how much does Beta blockers reduce maximum total HR by?
20-30 beats
what are some common side effects of beta blockers?
Bradycardia and Orthostatic Hypotension
What may cause a PVC
PVC’s are caused by ectopic heart beats which are caused by :
anxiety
tobacco
alcohol
caffine
any condition causing myocardial ischemia
What may cause a PVC
PVC’s are caused by ectopic heart beats which are caused by :
anxiety
tobacco
alcohol
caffine
any condition causing myocardial ischemia
What may cause ST segment Depression?
myocardial ischemia
What are the primary muscles of inspiration?
Diaphragm and External intercostals
What are the primary muscles of expiration
Abdominals and Internal intercostals
Which position is best to initially strengthen the muscles of inspiration?
Supine
Which position is best to initially strengthen the muscles of inspiration?
Supine
chest expansion during inspiaration in supine is directly related to the strength of what muscle
Intercostals (probably more the external )
chest expansion during inspiaration in supine is directly related to the strength of what muscle
Intercostals (probably more the external )
What pathologic changes are seen in the lungs with a patient who has emphysema?
Hyperinflation of the lungs due to lack of elastic recoil.
increase in total lung capacity residual volume and functional residual capasity
what pulmonary changes can be expected with neurologic dysfunction
decrease in vital capacity, total lung volume, and inspiratory capacity
What is the rate pressure product or double product
It is the product of heart rate and systolic blood pressure. It is an indicator of myocardial oxygen consumption.
What is the rate pressure product or double product
It is the product of heart rate and systolic blood pressure. It is an indicator of myocardial oxygen consumption.
What do ACE inhibitors do?
decrease blood pressure and afterload by suppressing the enzyme that converts angiotensin 1-> angiotensin 2
Due effect of ACE inhibitors what is a likely side effect
Orthostatic Hypotension due to decreased Blood pressure.
what are some medications that would cause an increased fall risk
ACE inhibitors
Antiepileptic Drugs
Antispasticity Drugs
What are some side effects of anticoagulant medication
Hemorrhage
Increased risk of bleeding
GI distress (with oral medication)
What is critical limb Ischemia
Refers to severe obstruction of the arteries which markedly reduces blood flow to the extremities. It is an advanced stage of PAD (peripheral artery disease)
What can cause critical limb ischemia?
increased plaque build-up that blocks blood flow
symptoms of PAD/ critical limb ischemia
- decreased limb temp
- increased limb pain at rest
- weak or absent peripheral pulse
- shiny smooth dry skin
how can you decrease pain from critical limb ischemia?
Walk around
Put limb in dependant position
How do you categorize lymphedema?
Mild: less than 3 cm diff between sides
Mod: 3-5 cm difference betwn sides
Severe: 5+ cm diff betwn sides
What is an Ejection fraction?
The percentage of the end-diastolic volume ejected during subsequent systole.
What causes increase and decrease in ejection fraction?
When force of contraction increases ejection fraction increases (ex: exercise)
When force of contraction decreases then ejection fraction decreases (ex: cardiomyopathy or ischemic heart disease)
What causes increase and decrease in ejection fraction?
When force of contraction increases ejection fraction increases (ex: exercise)
When force of contraction decreases then ejection fraction decreases (ex: cardiomyopathy or ischemic heart disease)
What causes increase and decrease in ejection fraction?
When force of contraction increases ejection fraction increases (ex: exercise)
When force of contraction decreases then ejection fraction decreases (ex: cardiomyopathy or ischemic heart disease)
what is preload?
Preload refers to the amount of myocardial stretch that is put on the heart before contraction.
what is afterload?
The load against which the ventricles must pump to eject blood. (aka how much resistance are the ventricles up against
What is an indicator to use meds to decrease afterload?
ventricular dysfunction/ decreased contractility or force production of the heart.
What are the primary determinants of the heart’s performance as a pump?
- Preload
- Afterload
- Heart Rate
- Contractility
What is the Karvonen Formula?
method of calculating target HR
TargetHR=[(HRmax-HRrest) x %low]+ HRrest
must also be done with the higher percent to achieve range
What is another name for the Karvonen Formula method of reaching target HR
Heart rate reserve method
How does a valsalva maneuver increase blood pressure?
it decreased venous blood flow to the heart due to increased intrathoracic and increased intra-abdominal pressure
What causes the increased pressure in a valsalva maneuver
contraction of the abdominals, chest wall, and diaphragm causing forced expiratory effort but against a closed glottis.
What causes the increased pressure in a valsalva maneuver
contraction of the abdominals, chest wall, and diaphragm causing forced expiratory effort but against a closed glottis.
What signs warrant immediate medical attention for angina pain
Angina pain that is not relieved by stopping exercise.
If pain persists after 3 Nitro tabs (1 evert 5 mins)
What is the proper release rate for BP measurement?
2-3 mmHg per second
How much should you inflate the BP cuff?
20 mmHg above the estimated BP
Why does a graded exercise exam using a bike utilize more oxygen ( increased maximal oxygen consumption)
LE muscle mass is larger requiring greater oxygen consumption
Why does a graded exercise exam using a bike utilize more oxygen ( increased maximal oxygen consumption)
LE muscle mass is larger requiring greater oxygen consumption
What is polycythemia
Polycythemia is an increase in the number of Red blood cells and the concentration of hemoglobin
What are side effects of Polycythemia
- increased BP
- fatigue
- dyspnea
- headache
- dizziness
- irritability
- blurred vision
- decreased mental acuity
- sensory disturbances
What are side effects of Polycythemia
- increased BP
- fatigue
- dyspnea
- headache
- dizziness
- irritability
- blurred vision
- decreased mental acuity
- sensory disturbances
How do you find the age estimated target HR?
220 - Age = Target HR
What does the American College of SPorts recommend for target HR? (VO2max & HR)
VO2max - 50-70%
HRmax - 70-85%
What range of FEV1/FVC is normal for patients with restrictive lung disease?
80-90%
What range of FEV1/FVC is normal for patients with obstructive lung disease
less than 70%
What is cystic fibrosis?
An obstructive lung disease in which there is increased production of/ decreased clearance of secretions. It is genetic and causes limited lifespan
What is idiopathic pulmonary fibrosis?
A resistive lung disease that is characterized by inflammation within the alveolar walls and the resulting fibrosis of those structures. The lung capacity decreases due to resistance but flow rates stay the same (so FEV1/FVC = 80-90%)
What is Chronic Bronchitis?
An obstructive lung disease that is characterized by hypersecretion of mucus in the airways.
What is Emphysema?
An obstructive lung disease where the distal airways become enlarged and destructive changes take place to the alveolar walls. Collapse of airways causes obstruction.
What is the purpose of a swan-Ganz-catheter (central line) ?
Measures:
Central venus pressure
pulmonary artery pressure
pulmonary capillary wedge pressure
What is the norm and when is PT contra indicated due to prothrombin time
norm: 11-15 sec
contraindicated if 2.5 x that amount (27.5-37.5)
what differentiates Congestive heart failure from Heart failure?
The presence of edema will turn heart failure in to congestive heart failure
what can cause heart failure?
L ventricular dysfunction or impairments, coronary artery disease, congenital heart disease,hypertension , or infection.
What is Arteriosclerosis Obliterans
Chronic occlusive arterial disease of medium- and large sized blood vessels, resulting i peripheral atherosclerosis.
What is common in the early stages of Arteriosclerosis Obliterans ?
Intermittent claudication ( pain is described as burning, searing, aching, tightness, or cramping.
What is common in the late stages of Arteriosclerosis Obliterans ?
Ischemia and pain at rest, ulcerations, gangrene, trophic changes.
What is Thromboangiitis Obliterans ?
Chronic inflammatory vascular occlusive disease of small arteries and veins.
Demographics of Thromboangiitis Obliterans ?
young men who smoke
Signs and symptoms of Thromboangiitis Obliterans ?
Paresthesisas or pain, cyanotic cold limb, decreased temperature sensation, fatigue risk of ulcerations or gangrene
