Cardiac Flashcards
Anti-arrhythmic drugs
Control or prevent cardiac arrhythmias that could be fatal
Lidocaine, Dilantin, Norpace, quinidine
Anti-cholinergic drugs
Used with IV or heart block or bradycardia
Side effects: palpitations, H/A, restlessness, ataxia, dry mouth, blurred vision
Beta-Andrenergic blocking agents
Beta blockers ending in -“olol”
Decrease HR, BP, contractile try and stroke volume
Allow for increase in exercise tolerance
Cannot use HR for ex tolerance. Use Rate of perceived exertion scale.
Calcium channel blockers
Vasodilation and relieve coronary artery spasm
Could reduce blood flow to the heart muscle creating an ischemic response
Digitalis
Slows HR and increases contractility
Heart Failure:
R vs L
When the heart is unable to adequately pump to maintain proper circulation
Right affected- peripheral edema
Left affected- pulmonary edema
Severe- widespread edema
Lipoproteins
Proteins that carry fat in the blood for delivery to cells
LDL: associated with arterial damage
HDL: promote the removal of cholesterol by the liver
Nitrates
Dilate blood vessels –> reduce BP and preload –> reduced oxygen demand on heart
Nitroglycerin
Raynaud’s Phenomenon
An abnormal vasoconstrictor reflex Exacerbated by cold and emotional stress Mostly females Pallor and cyanosis at tips of fingers Numbness, tingling and burning when exacerbated
Serum Enzymes
Appear in circulation foal closing the death of cardiac muscle cells
CPK- Creatine Phosphate
LDH - lactate dehydrogenase
SGOT- serum glutamic oxalacetic transaminase
Angina Pectoralis
Pain in chest jaw or left arm secondary to localize ischemia - usually from atherosclerosis (ECG changes)
Other S&S: dyspnea, indigestion, dizziness,syncope and anxiety
Causative factors: ex, cold/windy weather, emotional stress
Managed with nitroglycerin and rest
Coronary artery disease
CAD
Narrowing of the lumen of the coronary arteries resulting in ischemia to myocardium
Risk factors: age, sex,race, family Hx, smoking, high BP, obesity, inactivity, stress, high cholesterol or LDL’s
Can lead to angina, ischemia, infarction, HF or sudden death
Cor pulmonale
Failure or hypertrophy of the right ventricle resulting from disorders of lungs, pulmonary vessels, or chest wall.
Lung pathology produces pulmonary artery hypertension–> stresses R ventricle
Usually chronic but reversible when acute
Left heart failure
Reduced cardiac output reduces systemic circulation due to left ventricle not being able to adequately pump. Tachycardia Intolerance to cold Othopnea, dyspnea Fatigue
Right heart failure
Reduced venous return to the heart from the systemic circulation due to failure of the R ventricle. Peripheral edema Venous hypertension and stasis Weight gain Fullness in abdomen Fatigue
What medications are used to treat CHF?
Digitalis (Digoxin)- increases cardiac pumping ability, decreases HR
Diuretics (Lasix)- decrease vascular fluid volume, preload and after load, control hypertension
MI
Myocardial infarction
Ischemic myocardial necrosis usually resulting from abrupt reduction in coronary blood to the myocardium
Causes: range from athersclerotic HD with thrombus formation to cocaine toxicity
S&S of MI
Deep visceral pain (aching/pressure) radiating to jaw and L arm
Similar to angina but worse and not improved with nitroglycerin
Pt restless, pale, diaphoretic, and cool
BP
Adult 120/80
Child 125/80
Infant 80/45
Cardiac cycle
P wave- atrial depolarization
QRS wave- ventricular depolarization
ST segment- beginning of ventricular repolarization
T wave- ventricular repolarization
ECG abnormalities
Premature ventricular contractions PVC’s- premature beat from ventricle. 5+ consecutive during ex is serious
Vent. Tachycardia- 3+PVC’s- wide QRS wave, no P wave
Vent. Fibrillation- erratic activity w/o QRS complex
ST depression indicates ischemia is down sloping 2-3mm
ST elevation- shows new infarct/injury
Wide QRS with heart block
Inverted T wave indicates ischemia
