Cardiac Flashcards
What decreases preload
Hypovolemia
Arrhythmia
Venous dilation
Loss of atrial kick
What increases preload in the left heart
Atrial or mitral disease
Volume overload
LV failure or dysfunction
Cardiac tamponade or effusion
What increases preload in the right heart?
RV failure due To ischemia Increase pulmonary resistance Cardiac tamponade or effusion Volume overload LV failure
What decreases after load
Vasodilation
Sepsis
Vasodilator therapies
What increases after load in the right heart
Pulmonary hypertension,
hypoxemia,
Pulmonic stenosis
What increases after load in the left heart
Vasoconstriction
Vasopressors
Hypothermia
Aortic stenosis
What decreases myocardial contractility
Parasympathetic stimulation
Negative inotropic therapies
.. BB
.. Calcium channel blockers
Metabolic states
1. Hyperkalemia
2. Myocardial ischemia/ infarct
3. AcidosisWhat increases contractility
Sympathetic stimulation Inotropic therapies 1. Epi 2. Dopamine 3. Digoxin 4. Calcium Metabolic state 1. Hypercalcemia
What major complications are scene with an obstruction of the LAD
Cardiogenic shock
Bundle branch block
Ventricular dysrhythmias
What area is affected by a block in the LED. What leads can you see this in?
Location is the anterior heart. Leads are v 1, v2, v3 v4
What are the major complications of a black in the RCA
Bradycardia and heart blocks
What area is affected put a block in the RCA what leads do you see this in
When are CA is blacked you can see an inferior of the heart. Seen in Leads II, III and a VF
What major complications are seen with a circumflex block?
Some heart blocks
What area is affected with a infarction of the circumflex artery. What leads is it seen in?
The lateral aspect of the heart. Seen in Leeds I, V5, V6 and AVL
Contraindications to giving thrombolytic agents in an AMI….
Active bleeding
Aortic dissection
Cerebral neoplasm
Hx of intracranial hemorrhage
Recent(2 month) intracranial or intraspinal sx or trauma
Cerebral vascular d
Severe uncontrolled hypertension >180/110
What are some interventions should bleeding occur while giving anti thrombotics?
Stop infusion
Administer cryoprecipatite, FFP, platelets
Aminocaproic acid ( Amicar)
What are signs and symptoms of a PE?
Dyspnea, plueritic CP
Tachypnea
Refractory hopoxemia
Hypoxemia with respiratory alkalosis
Fat emboli.....petechia in thorax and upper extremities
Cardiac.... tachy
Cyanosis
jVD
Rev failure .... increased resistance/afterload and load s2
T wave abnormalities
What are the normal lab values for phosphate?
2.5-4.5
What are normal chloride values?
96-109
What are signs of hyponatremia?
HA Fatigue Apathy Seizures Confusion Drop in CVP Orthostatic hypotension N/D abdominal cramps Muscle weakness
What are signs of hypernatremia?
Restlessness Irritability Lethargy Seizures Tachycardia Degydration Orthorstatic hypotention
What are the signs of hypokalemia?
Decreased reflexes Confusion Dropnin BP Dysrhythmias-ventricular V/N Dilute urine Water loss Thirst Weak and flaccid muscles Depressed st segments Inverted t wave
What are the signs of hyperkalemia?
Numbness Paresthesias Hyporeflexia Vfib N/V/D Oliguria, Anuria Flaccid paralysis Tall twaves Flat or absent p waves Wide QRS
Signs of hypocalcemia
Calcium helps relax Tingling/convultions Laryngeal and bronchispasm Dysrhythmias, brushing, bleeding Muscle spasms Tetany Prolonged st segment Prolonged Qt segment Torsades de pointe Decreased HR
