Cardiac Flashcards
What is the definition of acute coronary syndrome?
A collection of disorders due to decreased blood flow in the coronary arteries leading to a decreased oxygen supply to the myocardium.
What is the definition of angina?
A coronary artery disease caused by a narrowing of the coronary artery leading to a decreased blood flow to myocardium. Usually relieved by nitrates.
What is the definition of NSTEMI?
Myocardial infarction caused by a partial occlusion of the coronary arteries. Does not show ST elevation on ECG.
What is the definition of a STEMI?
Myocardial infarction caused by a complete occlusion of the coronary artery. Shows ST elevation on the ECG.
What is the treatment goal for acute coronary syndrome?
To facilitate timely reperfusion of the myocardium, reduce cardiac workload and reduce pain.
What is SVT?
Supraventricular tachycardia is a tachy-arrhythmia caused by a re-entry pathway in the atrial conduction system.
What characterises an SVT rhythm?
Fast, regular rhythm with narrow QRS complex and no p waves (p waves not related to QRS)
What is the rationale behind the valsalva manoeuvre?
Increased intrathoracic pressure leads to decreased venous return. When the pressure is released, a sudden shunt of blood enters the heart. Sudden stretch of aorta leads to profound vagul response. This slows the AV node conduction and will hopefully revert SVT.
What is the process of APO/ LVF?
Left ventricle dysfunction leads to a decrease in stroke volume. This leads to increased Left Venticular End Diastolic Pressure and increased left atrial pressure. This leads to increase pulmonary hydrostatic pressure which forces water into the alveoli washing away surfactant leading to alveoli collapse, decreased gas exchange and respiratory distress.
What is the definition of cardiac output?
Is the volume of blood pumped through the circulatory system in one minute.
What is the definition of stroke volume?
Stroke volume is the volume of blood ejected from heart in one heart beat.
What is the definition of vascular resistance?
Is the resistance that needs to be overcome by the heart to achieve adequate cardiac output. Increased vascular resistance is due to narrowing/ tightening of vessels.
What is blood pressure?
Blood pressure is the amount of pressure exerted on the vessel walls.
What is the relationship between CO, BP, SV, VR, and HR?
CO = SV x HR BP = CO x VR
What is MAP and how do you calculate it?
Mean arterial pressure is the average blood pressure during a full cardiac cycle.
MAP = 1/3 (SBP- DBP) + DBP
What is the process of an atheroma formation?
- Atherosclerosis is a chronic inflammatory process which begins from childhood.
- Lipid proteins called LDLs build up in the intima of the coronary artery.
- LDLs are then engulfed by macrophages leading to the formation of foam cells.
- Eventually the contents protrude in the lumen of the artery eventually leading to formation of a fibrous cap.
- This results in narrowing and hardening of the arteries which decrease blood flow.
What are the 6 most common types of medications for cardiac patients?
Anticoagulant Antiplatelet Antihypertensives/ACE inhibitors Beta blockers Statins/ cholesterol Diuretics
What are the common drug names for anticoagulants?
Warfarin, xeralto, eliquis, pradoxa
How do you recognise ACE inhibitors?
The generic name will have “pril” at the end of it.
How do you recognise if a drug is a beta blocker?
The drug will have “olol” at the end of the name.
What are some common names for diuretics?
Lasix and frusemide
How do you recognise cholesterol controlling medications?
Drugs that’s have the word “statin” in them.
What is the definition and function of the pericardium?
Membrane that surrounds and protects the heart and allows freedom of movement for contractions.
What is the definition of the myocardium?
Middle layer of the heart muscle responsible for contraction.
What is the definition of the endocardium?
Inner layer of the chambers which smooth lining.
Describe the order of the cardiac cycle.
Blood enters the right atrium via the vena cavas.
Then from the right atrium into the right ventricle through the tricuspid valve.
Then through the right ventricle to the lungs through the pulmonary artery.
Then blood enters left atrium from the lungs through the pulmonary vein.
Then from the left atrium to the left ventricle through the mitral valve.
Then from the left ventricle to the body through the aorta.
What is collateral circulation?
Is when alternative pathways are created to allow for declined circulation to an area. Works best when the decrease in circulation is gradual.
What are the main risk factors that contribute to ACS?
Age Gender Family history Race Obesity Smoking Inactivity Diet Diabetes
What are the phases of STEMI development?
- 0-30mins peaked T waves
- 0-6hrs hyperacute ST elevation
- 6-12hrs STEMI with small Q waves
- 12-24hrs STEMI with pathological Q waves
- > 24hrs STEMI reduced with Q wave and T wave inversion.
What area of the heart do leads II, III, and AVF look at? And what Coronary artery supplies blood to that region?
Inferior supplied by the RCA
What area of the heart do leads I, AVL, V5, and V6 look at? And what Coronary artery supplies blood to that region?
Lateral position supplied by Cx/LAD.
What area of the heart do leads V1 and V2 look at? And what Coronary artery supplies blood to that region?
Septal LAD
What area of the heart do leads V3 and V4 look at? And what Coronary artery supplies blood to that region?
Anterior supplied by the LAD
How do you identify a posterior STEMI?
Reciprocal ST changes to leads V1, V2 and V3.
What are the signs and symptoms of LVF?
SOB, respiratory distress, crackles, pink/ white frothy sputum, tachycardia, hypertension (common), diaphoresis, low SPO2
What is pericarditis?
Inflammation of the pericardium. Usually caused by infection or AMI.
How do you identify pericarditis?
Hx of recent infections, worse supine, better sitting up and leaning forward, sharp pleuritic pain, global STEMI.
What is a pericardial effusion?
Accumulation of fluid in the pericardial cavity.
What is a pericardial tamponade?
Increased fluid accumulation will cause pressure on the heart which will inhibit diastolic filling of chambers.
What are the inherent rates for: SA node
AV node
Bundle of his
Perkinje fibres
SA node: 60 -100
AV node: 40-60
Bundle of his: 30-40
Perkinje fibres: 15-40
