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CCRN > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Prinzmetal angina

A

“Variant” or “vasoapastic angina”

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2
Q

AICD

A

Automatic implantable cardioverter/ defibrillator

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3
Q

Inferior wall MI

A

12 lead: II, III, and aVF
-reciprocal: I, AVL

-affects the RCA (supplies blood to the AV node) = conduction deficits and heart blocks

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4
Q

Anterior wall MI

A 
12 lead: V2-V4 (anterior)
   -reciprocal: II, III, AVF
V1 & V2 (septal)
May see BBB, and AV block type II
   -reciprocal: V5-V6

-affects the LAD (left main/ widow maker)

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5
Q

Lateral wall MI

A

12 lead: I, aVL, V5& V6
Reciprocal: II, III, AVF

-affects the left circumflex and the obtuse marginal artery (a branch of the circumflex)

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6
Q

Posterior wall MI

A

12 lead: V7-V9 (right sided 12 lead)
Reciprocal: V1-V3

-affects RCA

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7
Q

CARDIAC INDEX

A

2.5-4.5 L/min

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8
Q

CARDIAC OUTPUT

A

5-6 L/min

*stroke volume x HR

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9
Q

PRELOAD

A

“Filling”
-pressure generated by the volume of blood at the end of diastole

*RV: 
       CVP (N: 0-5 mmHg, optimal 0-10)
       RAP 
*LV: (by arterial pressure monitors) 
     -PAD, LVEDP

-affected by venous return, total blood volume, atrial kick, and ventricle compliance

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10
Q

AFTERLOAD

A

“Resistance”
-pressure and stress the ventricle faces

  • RV: PVR (pulmonary vascular resistance)
    • more sensitive

*LV: SVR (systemic vascular resistance)

  • *⬆️afterload = ⬆️ myocardial O2 demand
  • *⬇️afterload by ⬇️SVR (vasodilator, ⬇️ blood volume, repair leaky valve)
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11
Q

RAP

A

Right atrial pressure

2-6mmHg

*measures pressure in the right atrium by a PA cath

Elevated in RV failure

*reflective of RV preload

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12
Q

CVP

A

Central venous pressure, catheter in superior vena cava

*measures pressure in the great vessels as blood returns to the heart

Normal: 0-5mmHg
Optimal: varies- 10 mmHg

-depends on MD

Tells about preload in the RV

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13
Q

PAOP

A

Pulmonary arterial occlusion pressure (wedge pressure)

Normal: 6-12 mmHg
Optimal: 14-18 mmHg

Tells about preload in the LV

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14
Q

SVR

A

Systemic vascular resistance

Normal: 800-1200 dynes/sec/cm

SVRI: 1970-3900

Measures afterload

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15
Q

PVR

A

Pulmonary vascular resistance

Normal: <250 dynes/sec/cm

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16
Q

Pulmonary artery pressure

A

Normal:
Sys:15-25/
Dia: 6-12

PAs: reflective of RV (pressure needed to open the pulmonic valve)

PAd: reflective of the pulmonary vasculature

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17
Q

Difference between PAD and PAOP

A

“Right to left gradient”

PAD > PAOP by 5 mmHg or less

If difference>5 =pulmonary HTN

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18
Q

CARDIAC Tamponade

A
  • equalization of pressures (RAP, PAD, PAOP)
  • large A waves and V waves=M pattern on waveform
  • hypotension
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20
Q

Pulmonary hypertension

A

⬆️PAD, and PAOP= normal

21
Q

Mitral regurg

A
  • large V waves in PAOP waveform

* due to acute MI

21
Q

Classes of antidysrhythmics

A

I: block the movement of sodium during depolarization
-ex: quinidine, procainamide, lidocaine

II: block beta receptors (affect automaticity)
-ex: metoprolol, propranolol

III: block the movement of potassium (during late depolarization)
-ex: amiodarone

IV: blocks movement of Ca (during early depolarization)
-ex: diltiazem, verapamil

21
Q

Nesiritide (Natrecor)

A

Vasodilation

Is a brain-type naturiuretic peptide (BNP)

Causes excretion of sodium and water
(Diuretic effect)

22
Q

First line therapy for HTN

A

Diuretics

Then BB

Then ACE inhibitor

23
Q

Stenosis & Regurgitation

A

REMEMBER BLOOD DOES NOT TRAVEL UPHILL

24
Q

ABI

A

Ankle Brachial INDEX

Ankle artery pressure (normally is higher) divided by brachial artery pressure

Normal= >1

*ankle artery pressure decreases long before pulses are lost

25
Q

Dilated cardiomyopathy

A

S& S:

  • mitral regurg (dt vent dilation and stretching of mitral valve ring)
  • hypotension
26
Q

Restrictive cardiomyopathy

A

S& S:

-elevated sedimentation rate (dt inflammatory response from connective tissue disorders)

27
Q

Hypertrophic cardiomyopathy

A

Heart muscle enlarges causing ventricle walls to thicken

  • can cause regurg
  • associated with obstruction and poor outflow

S& S: syncope

Treatment: decrease contractility and afterload

29
Q

S3

A

Ventricular gallop

“ken-tuc-KY”

Cause: left ventricular failure (earliest finding)

Indicates HF and fluid overload

Occurs at the beginning of diastole

30
Q

S4

A

Occurs during the end of diastole
-when the atria contract but the ventricle is noncompliant

Atrial gallop
“TEN-nes-see”

Cause:
-myocardial ischemia, infarction, severe hypertension, and hyper trophy

*normally heard in acute MI for the first 48 hours

31
Q

Atrial enlargement

A

*leads II, and V1 are the best P wave leads

R atrial enlargement: P waves tall and peaked in lead II (P PULMONALE), dominate initial half of biphasic P in V1

L atrial enlargement: P waves wide and notched (P MITRALE), dominant terminal half of biphasic P

32
Q

Automaticity

A

Ability of certain CARDIAC cells to initiate impulses regularly and spontaneously

Enhanced automaticity: causes ectopic beats and is associated with catecholamines

33
Q

Triggered activity

A

Related to depolarization problems

Causes torsades de pointes

34
Q

Accessory pathways

A

Causes palpitations, tachydysrhythmias

35
Q

Reentry

A

Most common mechanism for tachydysrhythmias

36
Q

Propranolol

A

Non cardio selective BB

Not to be used in PTs with COPD or asthma (causes further bronchospasms

Cardioselevctive BB: metoprolol, atenolol, and esmolol

37
Q

Diacritic notch

A

Arterial waveform= closure of the aortic valve

Pulmonary artery waveform= closure of the pulmonic valve

38
Q

Transient systolic murmur

A

Papillary muscle ischemia and dysfunction

39
Q

Midsystolic click

A

Mitral valve prolapse

40
Q

Paradoxical split of S2

A

L BBB, RV premature ventricular contraction, transvenous endocardial pacemaker, valvular problem

41
Q

Split S2

A

Normal: only split on inspiration
Abnormal: split in expiration

More common than a split S1

42
Q

Supra ventricular tachycardia with aberrancy

A

A run of wide QRS complexes triggered by a PAC

vTach= a run of wide QRS complexes triggered by a PVC

43
Q

R BBB

A

Wide QRS (>.12)

V1: QRS has rsR “M” or bunny ear pattern

V6: slurred S wave

44
Q

L BBB

A

QRS wide (>.12)

V1: QRS is negative

V6: QRS is rsR

45
Q

Barorecptors

A

PRESSURE RECEPTORS!!

Vasodilators= stimulation of barorecetors
-can cause reflex tachycardia

CCRN (1 decks)

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