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Connor Final Focused > Cardiac All > Flashcards

Cardiac All Flashcards

1
Q

(STE) in aVR w/ other ischemic findings can indicate:

A

= LMCA occlusion, proximal LAD occlusion, or triple vessel disease

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2
Q

Einthoven’s triangle: Lead 1 & view:
Lead 2 & view:
Lead 3 & view:

A

= negative RA → positive LA (Left lateral camera view)
= negative RA→ positive LL (Inferior camera view)
= negative LA→ positive LL (slight lateral Inferior camera view)

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3
Q

Einthoven’s triangle: green electrode:
Blue electrode:
Red electrode:

A

= neutral/ground
= Negative
= Positive

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4
Q

Poiseuille’s law:

Example:

A

= vessel w/ relative radius of 1 would transport 1mL per min at BP difference of 100mmHg. Keep pressure constant
= Less blood = vaso-press

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5
Q

Arrhythmias) causes: 1.
2.
3.
4.
5.
6.
7.
8.

A

1.= Blood gas abnormalities (hypoxia & abnormal pH (haldane & Bohr)
2.= Electrolyte imbalances (Ca++, K+, Mg++)
3.= Trauma to myocardium
4.= Drug effects / toxicity
5.= Digoxin- can cause multitude of dysfunctions
6.= Myocardial ischemia, necrosis, infarction,
7.= ANS imbalance
8.= Chamber/s Distention

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6
Q

AV pace impulses relation w/ P waves)Atriums fire 1st then ventricles:
Atriums & Ventricles fire at same time:
Ventricles fire 1st then atriums fire 2nd:

A

= inverted P wave before QRS
= P wave hidden w/in QRD
= P wave after QRS (before T wave)

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7
Q

(Coronary) left coronary artery supplies:

Left coronary artery 2 major branches are:

A

= L-ventricle, Intraventricular septum, part of R-ventricle & lower conductive system
= anterior descending artery and the circumflex artery

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8
Q

CAD):
CVD):

A

= Coronary Artery disease: disease affecting coronary vessels
= Cardiovascular disease: affecting heart, peripheral blood vessels, or both

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9
Q

Einthoven’s triangle(Bipolar/limb leads) leads 2 views:
Lead 2 Negative:
Lead 2 Positive:

A

= Inferior wall diagonally towards left foot
= Right Arm
= Left Leg

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10
Q

Einthoven’s triangle(Bipolar/limb leads) leads 1 views:
Lead 1 Negative:
Lead 1 Positive:

A

= Left Lateral wall
= Right Arm
= Left Arm

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11
Q

Einthoven’s triangle(Bipolar/limb leads) leads 3 views:
Lead 3 Negative:
Lead 3 Positive:

A

= inferior (down & rightward) 50% MI has R ventricle Infarction
= Left Arm
= Left Leg

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12
Q

If the R is far from the P, then you have a:

A

FIRST DEGREE!

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13
Q

If some Ps don’t get through, then you have a:

A

= MOBITZ II!

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14
Q

If Ps and Qs don’t agree, then you have a:

A

= THIRD DEGREE!

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15
Q

Longer, longer, longer, drop, then you have a

A

= WENCKEBACH!

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16
Q

~⅔ heart’s mass:
Bottom of heart aka:
Top of heart aka:
Great vessels:
Aorta diameter:

A

= L of midline w/ remainder to right
= apex: just above diaphragm, left of midline 5th rib
= Top of heart/base: ~2nd rib.
= connect to the heart through the base.
= ~2 inch

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17
Q

Limb leads) placement:
Negative to positive makes wave:
positive to negative makes wave:

A

= mid forearm on M. & inside of calf (if amputee/ go less distally)
= positive wave
= negative wave

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18
Q

P wave) Limb leads amplitude:
Precordial “chest” leads amplitude:

A

= <2.5mm in limb leads Avl (2.5mV)
= <1.5mm in precordial (1.5mV)

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19
Q

PVC) Bigeminy:
Trigeminy
Quadgeminy

A

= 2rd beat uni/PVC regularly “boom PVC” (1:1 pattern)
= 3rd beat is uni/PVC regularly “boom boom PVC)
= 4rd beat is uni/PVC regularly “boom boom boom PVC” 2-3x

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20
Q

PVC) Unifocal:
Multifocal:

A

= same fire site & shape
= dif fire spots & shape

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21
Q

Refractory periods) Absolute:
Relative:

A

= end of P to apex of T wave- cells absolute Beginning of repolarization
= “some really could happen” lot of cells repolar but not all so can throw out of rhythm Commodo cordis

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22
Q

T wave) Precordial “chest” leads amplitude:

A

= <10mm in precordial

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23
Q

T wave) Limb leads Amplitude:

A

= <5mm in LL

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24
Q

Vaughn-Williams Antiarrhythmics) Procainamide & Lidocaine:
Aminodrone:
“lol” Labetalol:
Aminodrone:
Diltiazem:
Adenosine & Digoxin:

A

= Class I: Na Channel Blockers:
= Class 3: K+ Channel Blockers (“phase 3 repolar”):
= class 2 beta blockers
= class 4 Ca blockers
= miscellaneous

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25
Q

+ STE in V1 is occlusion of =

A

= LMCA or proximal LAD occlusion

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26
Q

1 TDP) Twisting of points

2 Definer:
3 Rules:

4 Rhythm Etiology:
5 Symptomology:
6 stable Treatment:

7 unstable Treatment:
8 Wrong treatment:

A

1= most common polymorphic VT “teeter toter of de & re /polarization of ventricles” (twisting ribbon)
2= Changes in shape w/ size (note w/ change of conduction)
3= 100-250BPM, usually irreg/ Rhythm, if Ps present, don’t associate w/ QRS, No PRI, QRS varies beat-beat, many ventricular pace/sites, QRS >0.12secs, morphology & size changes
4= women>men chance, certain/ mixing antiarrhythmics
5= Can cause severe hypoperfusion in perfusing rhythm,
6= (rare) MAG-SULFATE 1-0.5Gs, Overdrive pacing (ER) pacemaker faster than HR) Correct underlying electrolyte prob/s (hyperK) Ca-Cl, Na-Bicarb, LVN
7= Defib! (only time defib/ pulse) few mins before gone
8 = Amio will prolong QT & kill PT, Rx w/ antiarrhythmics usually used for treatment of VT can have disastrous consequences

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27
Q

Fixed pacer:

Demand pacer:

A

=NONDEMAND PACER Fires continuously at preset rate, regardless of heart’s electrical activity, TC pacing nondemand
= non-fixed, Sensing device; fires only when natural HR drops

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28
Q

1 cause of death when having a MI

A

is from a lethal dysarrhythmia

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29
Q

12/15 Lead ECG Kev Approach) 1st.
2nd.

3rd.
4th.

5th.
6th.

7th.

8th

A

1st} Is there a clear isoelectric baseline? (Skin prep correctly)
2nd} Are QRSs upright leads I, II & III (Check attachment correctly)
3rd} good R wave progression? (Check lead placement)
4th} Is the monitor in the correct mode(diagnostic)? (0.05 to either 40 or 150 Hz)
5th} Is the axis normal? Any axis deviation present?
6th} Is there any ST elevation present? If yes, do you see it in 2 or more contiguous leads?
7th} Is there any ST depression? If yes, do you see it in 2 or
more contiguous leads?
8th} any pathological Q waves present? Yesterday’s news!

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30
Q

A Lateral Wall high view:
B Left Lateral low view:
C Inferior wall view:
D Septal wall view:
E L-Anterior view:

A

A= Lead I & aVL= LA
B= Lead 1, aVL, V5 & V6: views LCX & LAD
C= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs
D= V1 & V2: Along sternal borders blockages from LAD commonly
E= V3 & V4: left anterior wall : LAD & LMCA blocks

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31
Q

Lateral Wall high lead view:

A

Lead I & aVL= LA

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32
Q

Left Lateral low lead view:

A

Lead 1, aVL, V5 & V6: views LCX & LAD

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33
Q

Inferior wall leads view:

A

2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs

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34
Q

Septal wall view leads:

A

V1 & V2: Along sternal borders blockages from LAD commonly

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35
Q

L-Anterior wall view leads:

A

= V3 & V4: LAD & LMCA blocks

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36
Q

A Lateral Wall high view:
B Left Lateral low view:
C Inferior wall view:
D Septal wall view:
E L-Anterior view:

A

A= Lead I & aVL= LA
B= Lead 1, aVL, V5 & V6: views LCX & LAD
C= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs
D= V1 & V2: Along sternal borders blockages from LAD commonly
E= V3 & V4: left anterior wall : LAD & LMCA blocks

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37
Q

1Paroxysmal Supraventricular Tachycardia (PSVT)
2Rules:
3Causes:
4 Can precipitate:

A

1= “ SVT sudden start & stop” not associated w/ underlying Cdisease
2= same as SVT but sudden onset, terminates abruptly
3= Stress, overexertion, smoking, ingestion of caffeine.
4=angina, hypotension, congestive heart failure.

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38
Q

1Paroxysmal Supraventricular Tachycardia (PSVT)
2 Definer

A

1= “ SVT sudden start & stop” not associated w/ underlying Cdisease
2= same as SVT but sudden onset/ends abruptly

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39
Q

3 Is of cardiac) Ischemia:
“Infarct” Injury:
Infarction:

A

= Ischemia: ST depres/, Hyperacute T waves>5chest avf >10 precordial
= “Infarct” Injury: ST elevation 50%,
= Infarction: old MI; >25% Q or QRS >1SB

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40
Q

3 I’S of cardiac) Pathologic Q

A

Infarction

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41
Q

3 I’S of cardiac) ST Elevation:

A

Injury

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42
Q

A blockage of which of the following would result in the entire left ventricle not receiving blood supply?

A

Left Main Coronary Artery (LMCA)

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43
Q

Blood cell travels from the left atrium, through what & into where?

A

= Mitral/Bicuspid valve & into Left Ventricle

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44
Q

Blood cell travels from the right atrium, through what & into where?

A

= Tricuspid valve & into Right ventricle

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45
Q

Blood cell travels from the right ventricle, through what & into where?

A

= Pulmonic valve & into Pulmonic arteries

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46
Q

A-Flutter w/ RVR shock dose

A

Cardiovert 50-100/200/300/360J

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47
Q

Cardiac Arrest

A
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48
Q

pVT/VF) Repeated dos

A

Immediate Defib (initial 200J), CPR, Antiarrhythmic & EPI

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49
Q

Stable vs Medical PT assessment

A
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50
Q

ACS

A
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51
Q

NCT stable vs unstable

A

Stable} Vagal, medicate, SVT (Adeno & Diltiazem) other NCT (Diltiazem, Verapamil, Beta-Blockers)
Unstable} Cardiovert SVT 50-100 (AFib RVR 120-200)

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52
Q

WCT stable vs unstable

A

Stable} Med (Procain
Unstable} usually cardiovert 100-200

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53
Q

ROSC

A

Dopamine, Infusion if needed, TCP probably

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54
Q

Adult Bradycardia

A

Unstable) TCP
Stable) Medicate (atropine)

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55
Q

Bradycardia stable vs unstable

A

Stable} medicate (Atropine)
Unstable} TCP

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56
Q

Abdominal Aortic Aneurysm (AAA):
S/S:
Ligament:

A

= Bulging of abdominal aorta.
= Pulsatile abdominal mass, back/ABDMN pain, hypoBP if ruptured
= Ligamentum arteriosum

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57
Q

VSD=

A

Right side balloon out & hypertrophic

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58
Q

Abdominal situs Inversus=

A

Spleen & Liver flipped but H normal

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59
Q

Absolute refractory period:
Relative refractory period:

A

= Apex of T wave Q-T wave apex of wave: ventricle not ready to work
= T wave top to end of T wave: (commodo cordis) cells not repolarized (torsades de pointes more dead from repolarization not in sync)

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60
Q

Class IV Antiarrhythmic of Vaughan-Williams Class is:
Class I Antiarrhythmic of Vaughan-Williams Class is:
Class III Antiarrhythmic of Vaughan-Williams Class is:
Class II Antiarrhythmic of Vaughan-Williams Class is:

A

= Calcium channel blocker
= Sodium channel blocker
= Potassium channel blocker
= Beta-Blocker

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61
Q

Vaughan-Williams Classification Ca-channel blocker is a:
Vaughan-Williams Classification Na-channel blocker is a:
Vaughan-Williams Classification K-channel blocker is a:
Vaughan-Williams Classification Beta-Blocker is a:

A

= Class IV Antiarrhythmic
= Class I Antiarrhythmic
= Class III Antiarrhythmic
= Class II Antiarrhythmic

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62
Q

AFib & Flutter w/ RVR, MAT, Junctional tachycardia stable RX:

A

= DONT VAGAL, Diltiazem 0.25mg/kg (M20mg) 0.35/kg (M25mg), Verapamil 2.5-5mg, Beta-Blockers

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63
Q

AFib w/ RVR shock dose

A

Cardiovert 120-200/300/360J

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64
Q

Afterload:

A

= resistance against which the heart must pump against afterload become increased w/ increased ventricular workload

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65
Q

Amiodarone class & indication

A

Class 3 K channel blocker> VF/Pulseless VT unresponsive to shock, CPR & Epi, BradyCs to include AV blocks, Recurrent, hemodynamically unstable VT w/ pulse

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66
Q

Normal T Wave in any chest lead should have max amplitude:

A

= 10 mm

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67
Q

Normal T Wave in any limb lead should have a max amplitude:

A

= 5 mm

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68
Q

ANP Atrial natriuretic peptide:

A

made, stored, & released by atrial M> cells in response to atrial distension & Sympathetic stim & counters RAAS system, Decreases afterload pressure

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69
Q

ECG Camera views) Anterior

A

Lead V3 V4

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70
Q

Anterior MI: ST elevation in V1–V4what artery:

A

LAD involvement.

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71
Q

Leads V3 & V4 view
Leads V1 & V2 view
Leads 2,3, & aVF view
Leads 1, aVL, V5, V6 view

A

= Anterior
= Septal
= Inferior
= Lateral

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72
Q

Antiarrhythmics for pVT, TdP, VF

A

pVT/ TdP= Lidocaine & Aminodarone
Tdp= Mag-Sulfate

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73
Q

RP of a cardiac autorhythmic cell is:
AP of a cardiac autorhythmic cell is:
Influx of what causes depolarization of autorhythmic cells:
Efflux of what ion causes repolarization:

A

= -60mVs
= -40mVs
= Calcium
= Potassium

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74
Q

What is Acute Coronary syndrome?

A

A spectrum of conditions caused by sudden reduced blood flow to the heart. Includes unstable angina, NSTEMI, & STEMI.

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75
Q

Arteriosclerosis:

A

= General hardening & loss of elasticity in arterial walls, often w/ age.

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76
Q

ARTsclerosis:
ARTHsclerosis:

A

= harding of arternia
= tunica media plaque build up in layers of media & intima pushing & narrowing lumen size,

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77
Q

Artsclerosis:
Atherosclerosis:

A

= stiffening of vessels
= build up in make up of arteries

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78
Q

Aspirin)

A

=160-325mg PO

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79
Q

Asystole & PEA 3 needs

A

CPR, NEVER SHOCK, EPI

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80
Q

Atherosclerosis:

A

= Type of arteriosclerosis involving plaque buildup (fat, cholesterol, etc.) narrowing arteries.

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81
Q

Atrial appendages:

A

(abnormal heart birth defect) pockets that form clots on either atrium from uterine dev/,

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82
Q

Atrial Kick

A

the contraction “kick” @ end of systole to give more blood to ventricles accounts for 20-30%

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83
Q

Atrioventricular valves aka & leaflets# & aka:
Atrioventricular valves Fn:

A

= R-Tricuspid valve beeu w/ 3 cusps & L-Bicuspid/Mitral valve w/ 2 cusps
= control blood flow between atria & ventricles via connection to specialized papillary muscles in ventricles.

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84
Q

AV node Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

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85
Q

Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

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86
Q

Axis

A
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87
Q

Axis normal

A
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88
Q

Axis normal

A
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89
Q

Axis Path L cause:

A

Anterior Hemiblock

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90
Q

Axis QRSs) normal axis leads & Degrees

A

= all Up) 0° to +90°

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91
Q

Axis QRSs) Pyscio Left leads & Degrees

A

= U, U, D) 0° to -30°

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92
Q

Axis QRSs) Patho Left leads & Degrees

A

= U,D,D) -30° to -90°

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93
Q

Axis QRSs) RIght axis leads & Degrees

A

= D, U/D, U) +90° to +180°

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94
Q

Axis QRSs) Extreme right leads & Degrees

A

=All down )+180° to -90°

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95
Q

Axis QRSs) all Up

A

Normal

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96
Q

Axis QRSs) U, U, D

A

physcio L

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97
Q

Axis QRSs) U, D, D

A

Patho Left

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98
Q

Axis QRSs) D, U/D, U

A

RIght

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99
Q

Axis QRSs) D, D, D

A

Extreme Right

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100
Q

Axis pys L

A
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101
Q

Axis) pys L cause:

A

Normal

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102
Q

Benign Early Repolarization:

A

Concave ST elevation, no reciprocal changes.

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103
Q

Beta-Blocker:
Cardio-Selective Beta-Blockers:–
Non-selective Beta-blockers:

A

= blocks β adrenergic receptors
= Atenolol, Esmolol, Metoprolol
= Propranolol, Nadolol, Labetalol, Sotalol.

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104
Q

BNP Brain Natriuretic peptide:

A

secreted by ventricles in response to stress to excessive stretching of myocytes & Counter RAAS

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105
Q

BP form/s:
BP is related to:

A

= (SV x HR) x SVR or CO x SVR
= CO & peripheral resistance

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106
Q

Bradycardia Stable Rx

A

Atropine 1mg/3-5mins

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107
Q

Bradycardia Stable vs Unstable

A
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108
Q

Bundle Branch A&P) Fascicle of the conduction system:
Bundle branch blocks:

A

= Facilitates syncytium
= ventricles out of sync

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109
Q

Cardiac artifacts:
Causes of artifacts:

A

= hard to decipher iso-electrical lines w/ 0 & skewed
= M. tremors/shivering, PT mnt(moves baseline), Loose electrodes, 60-hertz interference(ungrounded electricity near you (AC current alternating in house), Machine malfunction (Dotted flat line),& electrode bad connection/ off

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110
Q

Cardioversion for:
higher start:
lower start:

A

= VT, SVT, ASVT, PSVT, too fast HR “convert down”
= ST>100J, 200J, 300J, 360J
= ASVT, PSVT, SVT> 50-100J (AF w/ RVR 120-200J)

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111
Q

Cardioversion or pharmacological intervention is only usually required for patients that present in A-Fib at what ventricular rate?

A

Above 150 beats per minute

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112
Q

Cardioversion/vert) Indication
Rhythms
intial & after Doses:

A

= UNSTABLE} SBP <90 & AMS
= Bradycardia, AF w/ SVR,
= 50-100J then 200J 300J 360J

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113
Q

Cardiovert is for:

A

“conVERT to normal” too fast

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114
Q

Cardiovert dose

A

Inital 100J
200, 300, 360J

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115
Q

Chordae Tendineae:

Heart regurgitation:

A

= connect valves’ leaflets to papillary-M.s to prevent valves from prolapsing into atria & allowing backflow during ventricle contraction
= papillary not working &/or valve doesn’t correctly opens so prolapse

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116
Q

Chronotropy:

A

Refers to heart rate (EX: positive chronotropes like epinephrine increase HR).

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117
Q

Chromotropy goes in hand w/:

A

= dromotropy Speed of impulse transmission, usually goes w/ Inotropy

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118
Q

Chrontropy:
Inotropy:
Dromotropy:

A

= HR, + tropic +HR vice versa
= Contraction force
= Speed of impulse transmission, usually goes w/ Inotropy

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119
Q

Circumflex Artery (LCx) feeds what parts of heart:

A

= L-Lateral wall of ventricle, Posterior wall of L-ventricle (some cases)
SA node (in about 40% of people)
AV node (in about 15% of people)

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120
Q

(Electrolytes affects) Cl
Na
K
Ca
Mg

A

= Cl picks up Co2 (shift) to keep neutrality
= depolarizing myocardium
= depolarization & majority myocardial contractile
= influences repolarizations
= regulates contractility & rhythm

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121
Q

1) Common findings after getting ROSC:
2) Every min in Cardiac arrest:
3) 1st line med in cardiac arrest:
4) Compressions needed to overcome afterload:
5) Epi & reason for admin:

6) Goals during Rx of Cardiac arrest:

A

= ventricular rhythms,
= knocks 10% of your life
= 02
= 8-10 human compression to overcome afterload P.
= Perfuse heart & coronary arteries more so RCA in arrest for A1Vasoconstrict & +afterload P. to perfuse
= Perfusion & vent: prevent arrest again w/ supporting perfusion b/c heart is weak

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122
Q

Communication or the connecting of two or more vessels is known as:

A

= Anastomosis

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123
Q

Conductivity:

A

= Ability of cardiac cells to transmit an impulse to neighboring cells

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124
Q

Congestive Heart Failure (CHF):

A

= Weakened heart unable to efficiently pump blood from L-ventricle
= May be acute or chronic, May occur suddenly, during an MI, Flash Pulmonary Edema

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125
Q

Congitual:
Reciprocal changes:
Spodicks sign:

A

= same view leads
= mirrored effect in oppisute/corresponding leads for sure MI
= pericarditis PR slopes down aka STEMI imposter

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126
Q

Contractilititly factors electrolyte & receptor:

A

= Calcium & +Beta1 effects

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127
Q

Contractility:

A

= ability of CM. cells to contract, or shorten (Actin Myosin)

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128
Q

Coronary Artery Spasm:
Commonly caused by:

A

= Prinzmetal Angina
= Stimulants ex cocaine energy drinks ect

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129
Q

CPR tasks/delegating

A

2 people) 30:2, Airway, IO access, self scribe & timer
4-5 people) Pit crew, 2 rotating CPR, 1 BVM, partner checking pulse sites, Medicate, Self shock & admin

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130
Q

CPR) simple cycle

A
  1. Rhythm pulse check
  2. Defib if needed
  3. CPR 30:2
  4. Medicate appropriately
  5. RHYTHM/PULSE CHECK
  6. SHOCK IF NEEDED IF NOT CPR
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131
Q

De Winter’s T Waves:

A

V2 V3 most commonly but can happen any lead
ST depression at the J-point & upsloping ST-segments w/ tall, symmetrical T- waves in the precordial leads (LMCA or LAD occlusion)
“Hyper T w/ STD”

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132
Q

Defib for:
amounts:

A

= pulseless arrhythmias VFib, Pulseless VT
= 120-200 joules for biphasic defibrillators & 300-360 joules for monophasic

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133
Q

Defib initial dose:
Cardiovert initial dose:
TCP initial dose:

A

= 100-200
= 50-100 (120-200 AF RVR)
= 80BPM, mA till capture ~50 to 85mA (start 50mA like BP)

134
Q

Defib) indication
Contra:
Rhythms
Initial & after doses:

A

= “Dead fibers” TdP (only rhythm defib awake)
= Asystole VT w/ Pulse stable
= pVT, VF, TdP
= 100J 200J 300J 360J

135
Q

Diazepam/Versed) Adult Dose:

A

2.5-10 mg in 2.5 mg increments slow IV/IO/IM

136
Q

Digoxin) Typically for:
Dynamics
works bc

A

= CHF
= allows more Ca for better contraction
= confuses K/Na pumps

137
Q

Dromotropy:

A

Refers to conduction velocity in the heart (EX: positive dromotropes like isoproterenol increase conduction speed)

138
Q

ECG Camera views) Septal

A

Lead V1 V2

139
Q

ECG Camera views) Left Lateral

A

Lead I, aVL, V4, V5

140
Q

ECG Camera views) LMCA - 3 vessel disease

A

Lead aVR

141
Q

ECG Camera views) Posterior

A

Lead V5 V6

142
Q

ECG Camera views) Right

A

Lead V4R

143
Q

ECG Heart waves – P wave:
QRS complex:
T wave:

A

= Atrial depolarization
= Ventricular depolarization
= Repolarization of ventricles

144
Q

ECG Lead coronary arteries) Lateral

A

(LCX) Left Circumflex

145
Q

ECG Lead coronary arteries) Anterior

A

(LAD) Left Anterior Descending

146
Q

ECG Lead coronary arteries) Inferior

A

(RCA) Right Coronary Artery

147
Q

ECG Lead coronary arteries) Posterior

A

(RCA) Right Coronary Artery &/or (LCX)

148
Q

ECG Lead coronary arteries) Right

A

(RCA)

149
Q

ECG Lead views) Lead aVR

A

LMCA - 3 vessel disease

150
Q

ECG Lead views) Lead V5 V6

A

Posterior

151
Q

ECG Lead views) Lead V3 V4

A

Anterior

152
Q

ECG Lead views) Lead V1 V2

A

Septal

153
Q

ECG Lead views) Lead I, aVL, V4, V5

A

Left Lateral

154
Q

ECG Lead views) Lead V4R

A

Right

155
Q

Ejection Fraction (EF):

<45% usually indicates:
<30%:

A

= Ratio of blood pumped from the ventricle to the amount remaining @ the end of diastole/ %of blood pumped out from ventricle (60-70%)
=<45% usually indicates in or going to CHF
=<30% in CHF & chronic cardiac crip on oxy

156
Q

Endocardium:

A

= Innermost layer, Lines heart chambers & is in contact w/ blood.

157
Q

Equation for cardiac output:
Heart & SV volumes:

Equation for BP:
How can you make a + & - effect on it?

A

= CO= SV x HR
= usually squeezes 70mLs & heart holds 100-110mL
= BP=(SV X HR) X SVR
= Meds: diuretics, vaso-constructors

158
Q

Excitability:

A

= Ability of cardiac cells to respond to a stimulus.

159
Q

Fascicular Block (Hemiblock):

A

A block of 1 of the 2 fascicles of the left bundle

160
Q

Fastest way to effect preload:

A

= IV bolus Afterload affect vaso-med

161
Q

Foramen Ovale:
Pulmonary stenosis:

A

= hole in the atrial septum that is part of the fetal blood circulation
= pulmonic valve/arteries rigid

162
Q

Frank Starling’s Law) meds that affect it:
nitrates
vasodilators
inotropes

A

= preload afterload & vaso size
= reduce preload)
= reduce afterload)
= increase force of contraction).

163
Q

Heart’s ENdocrine organ horomones:

A

stores & secretes 2 hormones, when released failings heart} BNP & ANP

164
Q

Heart’s Endocrine hormones’:
ANP:

BNP:

A

= store & secretes 2 hormones released when somewhere in heart fail
= Atrial Natriuretic Peptide: made, stored, & released by atrial-M cells response to atrial distension & Sympathetic stim (counter RAAS & lessen afterload pressure)
= Brain Natriuretic peptide: secreted by ventricles response to stress to excessive stretching of myocytes & Counter RAAS

165
Q

Heart’s 3 tissue layers:

A

= Endocardium, myocardium, & pericardium.

166
Q

Horizontal Boxes: Each small box ?secs:
5 small boxes equal:
Each large box is ?secs:

A

= 0.04 sec
= 1 large box
= 0.20 sec

167
Q

Hypothermia affect on heart:

A

= Osborn waves (J waves), <90 core usually, So irritable will/can throw to AFIB

168
Q

most common causes of cardiac arrest:

A

= Hypoxia 1st & 2nd Hypovolemia

169
Q

Identifying a RBBB:

A

= RBBB can produce a classic rsR’ (r prime)
R prime “2nd version of wave”, NO BUNNY EARS,

170
Q

Identifying a LBBB:

A

= produce a concordance QRS complex w/ STE (opposite)

171
Q

IF RAAS freaks out:

A

= BP & afterload increases

172
Q

Inferior MI: ST elevation in II, III, aVF what artery:

A

RCA involvement.

173
Q

Posterior MI: ST depression in V1–V3 (mirror technique) what artery:

A

posterior descending artery.

174
Q

Inotropy

A

: Refers to myocardial contractility (EX: positive inotropes like dopamine increase contraction strength).

175
Q

Intercalated discs:

Discs speed Vs standard cell membrane:
Syncytium:

A

= Special tissue bands inserted between myocardial cells that increase the rate(400x) in which AP is spread from cell-cell thus Syncytium
= 400x faster than standard cell membrane drom/Inotropy
= Group of cardiac cells physiologically function as a unit, “working together in sync” “top in syncytium to bottom”

176
Q

Isoelectric line:
Used for:

A

= Down 1mV of calibration bar/ line (bottom of cal)
= ST seg depress/elevation, Hypertrophy, amplitude

177
Q

Isolated Dextrocardia:
Abdominal situs Inversus:
Situs Inversus Totalis:

A

= Heart on right side/flipped “Right = Left” so mirror leads, AEDs
= Spleen & Liver flipped but H normal
= “EVERYTHING WRONG” H right side

178
Q

Isolated Dextrocardia=

A

(Hearts on right side) Heart is flipped “Right is Left”, so have to mirror leads, AEDs,

179
Q

Side of heart has most myocardium:
Epicardium makes what & how:
Pericardium holds what, w/ what color & Fn.:

A

= L side of heart (muscle)
= folds over self to make pericardium
= holds 25-50mLs straw color fluid to reduce friction, 150mL = heart can squeeze,

180
Q

L)

A
181
Q

L)

A
182
Q

L)

A
183
Q

L)

A
184
Q

L)

A
185
Q

L)

A
186
Q

L)

A
187
Q

Labetalol):

A

10mg IV/IO push over 1-2mins & May repeat every 10mins to a max dose of 150mg

188
Q

Lateral MI: ST elevation in I, aVL, V5, V6what artery:

A

Left Circumflex artery.

189
Q

LBBB Definer Turn criteria

A

Down deflection before J point “turning left”

190
Q

STE leads criteria) Lead V1
Lead V2-3

A

Lead V1 ≥ 1mm
Lead V2-3}≥ 2mm M>40, 2.5mm M<40 1.5 all women

191
Q

STE leads criteria) Lead V4R
Lead V8-9

A

Lead V4R ≥ 1mm
Lead V8-9 ≥ 0.5mm

192
Q

Leads 2, 3, aVF reciprocal leads

A

leads 1, aVL, V1-6

193
Q

Leads 1, aVL, V1-6 reciprocal leads

A

2, 3, aVF reciprocal leads

194
Q

Leads II, III and aVF look at what part of the heart?

A

Inferior wall (most common blockacke(RCA)

195
Q

Leads V1 and V2 look at what part of the heart?

A

Septal (blockages from LAD commonly)

196
Q

Leads 1, aVL, V5, V6 look at what part of heart:

A

L-Lateral (low view : views LCX & LAD)

197
Q

Leads V3 and V4 look at what part of the heart?

A

L-Anteriorwall (LAD & LMCA blocks)

198
Q

Left & Right BBB

A
199
Q

Left Anterior Descending (LAD) feeds what parts of heart:

A

= Anterior wall of L-ventricle, Interventricular septum & Apex

200
Q

Left Anterior Fascicle (LAF):
Pathway of conducting impulses:

A

= THIN Located in the anterior & superior portion of the left ventricle
= Conducts impulses to the anterior and lateral walls of the L-ventricle

201
Q

Left Main Coronary Artery) Splits into two main branches:

A

= Left Anterior Descending (LAD) & Circumflex Artery (LCx)

202
Q

Left Posterior Fascicle (LPF):
Pathway of conducting impulses:

A

= THICK Found in the posterior & inferior portion of the left ventricle
= Conducts impulses o the inferior & posterior walls of the L-ventricle

203
Q

Left Ventricular Failure:
S/S:

A

Fluid backs up from the left ventricle to the lungs
= Rales, orthopnea, pink frothy sputum, crackles.

204
Q

Lidocaine) Class:
Dynamics:

A

= Ib Antiarrhythmic
= Blocks Na channels in cardiac cells thus depolarization slows & decreases automaticity in ventricles

205
Q

Lown-Ganong) definer:
Pathway name & path:

A

= has short PRI interval
= Bundle of James connects posterior internodal pathway to bundle of his

206
Q

Mahaim

A

Accessory connects to Below bundle of his (wide QRS) looks like VTach

207
Q

Major vessels of the body:
3 main Major Vessels) 1:
2:
3:

A

= all branch off of the aorta
= Ascending: comes directly from the heart.
= Thoracic: curves inferiorly & goes through the chest (or thorax).
= Abdominal: goes through diaphragm & enters the ABDMN

208
Q

Match the Labels

A

H= Aorta
I= Pulmonary Artery
J= Left Pulmonary Veins
K= Left Atrium
L= Bicuspid Valve
M= Aortic Valve
N= Left Ventricle
O= Papillary Muscle

209
Q

Match the Labels

A

A= SA Node
B= AV Node
C= Interventricular Septum
D= Right Bundle Branch
E= Purkinje System
F= Purkinje Fibers
G= Left Bundle Branch
H= Bundle of His
I= AV Junction
J= Internodal Pathways
K= Bachmann’s Bundle

210
Q

Match the labels

A

A= Superior Vena Cava
B= Pulmonary Valve
C= Right Pulmonary Veins
D= Right Atrium
E= Tricuspid Valve
F= Chordae Tendineae
G= Right Ventricle
H= Inferior Vena Cava

211
Q

Medical PT) Unstable:

Stable:

A

= AMS, Rapid assess, Basline V/S, Hx of present illness & SAMPLE
= SBP >90, Hx of present illness (HPI), Perform Focused, Assessment, Hx of present illness & SAMPLE

212
Q

Mirror Criteria

A

V1&2 leads (v2 most sensitive w/ R): ST depression w/ big R wave (accompany 15-20% inferior or lateral STEMI)

213
Q

VT with pulse &unstable shock dose
pVT & VF shock

A

cardiovert 100/200/300/360J
Defib 200J 300/360J

214
Q

Monophasic monitor Jules max
Biphasic monitor Jules max

A

360J
200J

215
Q

1st & 2nd most common heart defect:
ASD Atrial Septum Defect:

VSD Ventricle Septum Defect:

A

= ASD atrial septum defect then VSD ventricle septum defect
= hole in atriums’ septum; when breaths & closes, CAUSES L-R SHUNT, overloads right side decreases BP
= hole in ventricle’s septum L→R shunt, R-side balloons > hypertrophic

216
Q

Most common reason for MI & Stroke

A

ARTHsclerosis: Scab of artery can break open from intima, Body constricts, hemostasis, blocks blood flow (Asprin biggest helper antiplatelet) (R side of heart only) L side Lungs filters clots)

217
Q

Myocardium:

A

= Thick middle layer, Resembles skeletal muscle but has electrical properties like smooth muscle, Conducts electrical impulses for heart contraction.

218
Q

Norm/ ventricle ejects ~2/3s blood it contains @ after systole, known as

A

Ejection Fraction

219
Q

Ondansetron (Zophran):

A

= 4-8mg IV (slow), IM, PO

220
Q

Antidromic Re-entry loop

A

= counterclockwise reentry conduction loop > wide QRS

221
Q

Orthodromic Re-entry loop:

A

= Clockwise rentry conduction loop >narrow QRS

222
Q

Which part of the heart has the most muscle:
Oxygenated blood returns to left atrium via:
Blood cell travels from L-ventricle, through what valve & into What:
Deoxy/ blood travels from R-ventricle to lungs through what:

A

= Left Ventricle
= Pulmonic Vein
= Aortic valve & aorta
= Pulmonic artery

223
Q

Pacing is for:

A

“picking up the pace” too slow

224
Q

Pacing) indication
Rhythms
Initial & after:

A

= “pick up the pace” <50BPM UNSTSBLE} SBP <90 & AMS
= BPM <50
= 80BPM mA till’ capture

225
Q

R-atrial enlargement:

Upside down P wave cause:

A

= changes P wave “P Pulmonele” b/c ventricle backing up or vasodialation, L-Pump failure P mitria “P wave double humps”,
= impulse comes from AV or below atrias

226
Q

Fossa Ovalis:
Patent Foramen Ovale (PFO):

Forman Ovale A&P:

A

= depression in R-Atrium remnant of Foramen Ovale
= ASD; hole in atriums septum that didnt close after out of uterus in fetus
= b/c fetus fluid in lung/heart & closes w/ 1st breath b/c lungs neg/ pressure

227
Q

Pectinate ”comb” muscles L. & Fn:
Chordae Tendineae L. & Fn:

A

= @ Atriums’ to contract for Mitral & Tricuspid valves
= heart tendons connect to Papillary-M.s, down to open atria valves

228
Q

Pericardium:
Visceral pericardium (epicardium):
Parietal pericardium:

A

= Protective sac around the heart w/ 2 layers:
= Inner layer, in contact w/ heart muscle
= Outer, fibrous layer

229
Q

Phases 0, 1, 2, 3, 4 of CC: Phase0:

Phase1:
Phase2:

Phase3:
Phase4:

A

= depolarization Cell gap Junction rapid Na influx by an impulse gen/ed elsewhere in heart. Na then stops entering cell once inside +
= K slowly leaves cell slowly returning cell to normal negative charge
= “plateau” M contraction: Ca+ interrupts w/ influxing into cell. (M.s ussing Ca for contraction). This plateau phase slows repolarization
= Repolarization: cessation Ca influx & rapid K efflux
= Refractory & moving ions back to original seats for RP

230
Q

Posterior MI w/o post leads

A

V1 V2leads Mirror test

231
Q

Precordial Posterior Lead Placement) V8(5)
V9(6):

A

= Mid-Scapular
= ½ way in-between the Scapula & Spine

232
Q

Preexcitation Disorders of Conduction)Most Common:
2nd:
3rd

A

= – 1st Wolff Parkinson White (WPW) syndrome
= 2nd Lown-Ganong Levine Syndrome
= 3rd Mahaim Fiber Tachycardia

233
Q

Preexcitation Syndromes SVT (AVRT)) Know:
2nd Accessory Pathway:

A

1= needs accessory pathway & “Ventricles’ back-door w/o passing AV”
3= 2nd lown ganong Levine

234
Q
  1. (Preexcitation Syndromes SVT (AVRT)) Know:
  2. Most common PS & Etiology:
  3. 2nd Accessory Pathway:
  4. 3rd APS:
  5. Orthodromic Re-entry loop:
  6. Antidromic Re-entry loop
  7. Treat:
A

1= needs accessory pathway & “Ventricles’ back-door w/o passing AV”
2= WPW most common Wolff-Parkinson bundle of Kent (allows SA fired impulse use accessory path to pass AV to prefire) usually R-side dif/ wave morph ) delta wave “2nd P wave slides/slurs to QRS” to pre excite
3= 2nd lown ganong Levine
4= 3rd Mahaim Fiber Tcardia
5= Clockwise rentry narrow complex
6= counterclockwise- QRS wide
7 =procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion 50-100J

235
Q

PRI:
ST segment:
P-T is:
RR:

A

= AV holding impulse for sync
= ventricular contraction
= 1 full cardiac cycle
= gives rate & rhythm

236
Q

Printz metal angina

A

Coronary artery spasm usually w/ stimulant (cocaine) & then occlusion arteries

237
Q

Procainamide & Lidocaine) class

A

= class 1A&B Na Channel Blockers
= Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF
= V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width

238
Q

Procainamide)class:
Dynamics:

A

= 1a antiarrhythmic
= Blocks Na channels in cardiac cells which causes depolarization to slow & decrease automaticity

239
Q

Procainamide) max dose:
Recurrent VF/VT:
Urgent situations:
Maintenance Infusion:

A

= (max total dose: 17mg/kg)
= 20mg/min (max total dose: 17mg/kg)
= up to 50mg/min may admin/ to total dose (max 17mg/kg)
= 1-4mg/min

240
Q

Procainamide)effect:

4 ending points:

A

= Drowsy, Slurred speech, Confusion, Seizures, HypoBP
= 1. Termination of rhythm, 2. HypoBP, 3. Widening QRS>50%, 4. Meet the max total 17mg/kg/min dose

241
Q

TCP
Defib
Cardiovert

A

= “pick up the pace” unstable bradycardias
= “for dead fibbers” pVT, VF, TdP
= “Convert to regular speed” Unstable Tachycardias

242
Q

Propranolol, Labetalol, Metoprolol) class
Labetalol
Metoprolol

A

= class 2 Beta Blockers
= 2nd line med for SVT after Adenosine, A-fib/flutter w/RVR, Reduce myocardical ischemia in AMI PT’s w/elevated HR, Antihypertensive
= Hypertension, 2nd line med for A-Fib/A-Flutter w/ RVR, & SVT

243
Q

PSNS w/ the heart & its chemical transmitter:
Located at:

A

= Muscarinic receptors & use Acetylcholine (ACh)
= SA & AV node

244
Q

pVT/VF treatment

A
245
Q

QRS complex:
T wave:
U wave:
QT segment:

A

= ventricular depolarization
= ventricular depolarization
= “late bloomer
= all ventricle’s action

246
Q

Rapid influx of ion causes a autorhythmic cell to depolarize:
Rapid influx of ion causes a contractile cell to depolarize:
Efflux of what ion causes both cardiac cells to repolarize:

A

= Calcium
= Sodium
= Potassium

247
Q

RBBB Definer turn criteria

A

Up defelection before J point “turning right”

248
Q

RCA feeds:
more in depth:

A

the inferior, posterior, and right side of heart
= Feeds R-atrium & ventricle & part of inferior wall of L-ventricle (in most cases) SA node (~60% of people) AV node (~85% of people)

249
Q

Re-entry loops

A

= stuck in nascar loop in a chambers pathway causing commonly SVT / no P waves

250
Q

RP of the cardiac contractile cell occurs at:
AP of the cardiac contractile cell occurs at:
ion causes contractile cell to depolarize?
ion contractile cell to repolarize?

A

= -90mV
= -85mv
= Sodium
= Potassium

251
Q

Right BBB can produce:
LBBB can produce a

A

a classic rsR’ (r prime) R prime “2nd version of wave”, NO BUNNY EARS
QRS complex Discordis (oppisite)

252
Q

Right Coronary Artery (RCA) feeds what parts of the heart:

A

= Right atrium & ventricle &Part of the inferior wall of L-ventricle (in most cases)

253
Q

Right Ventricular Failure:
S/S:

A

= Fluid backs up from the right ventricle to the systemic circulation
= +JVD kussmaul’s sign, peripheral edema, ascites, JVD, hepatomegaly.

254
Q

Role of Sodium on the heart:
Role of Calcium on the heart:
Role of Potassium on the heart:

A

= Depolarizes myocardium & keeps fluid balance; excess can increase BP
= Depolarize myocardium & key for contraction & myocardial contraction strength (inotropy)
= Reg/s repolarization & resting potential; imbalance can cause arrhythmias.

255
Q

ROSC

A
256
Q

S/S of a MAN having a myocardial infarction:

A

= Crushing chest pain, radiating to jaw/left arm, diaphoresis, nausea, SOB.

257
Q

S/S of a WOMAN having a myocardial infarction:

A

= Subtle symptoms like fatigue, indigestion, SOB, neck/jaw/back pain., Period pain, Tooth ache

258
Q

S3 is heard when
S4 is heard when

A

S3 after S2
S4 before S1

259
Q

SA node rate:
AV node rate:
Purjunkie rate:

A

=100-60BPM
=60-40BPM
=40-15BPM

260
Q

Scgarbossa criterias

A
261
Q

Scgarbossa criterias

A
262
Q

Semilunar valves:

Semilunar valves Fn:

A

= L-Aortic valve: connects L-Ventricle to Aorta to body & R-Pulmonic valve: R-Ventricle to pulmonic artery to lungs
= reg/ blood flow between ventricles & arteries into which empty. They permit 1-way m-nt of blood & prevent backflow

263
Q

Severe CHF Rx:

A

= Open the drain! (NTG), Squeegee fluid out of lungs w/ CPAP, ACE Inhibitor if Hypertensive

264
Q

Sgarbossa criteria 2:

A

Concordant ST depression ≥ 1 mm in V1-V3.

265
Q

Sgarbossa criteria 1:

A

Concordant ST elevation ≥ 1 mm in leads w/ a positive QRS.

266
Q

Sgarbossa criteria 3:

A

Discordant ST elevation > 5 mm in leads w/ a negative QRS.

267
Q

Sgarbossa smith modified criteria 3:

A

Discordant ST elevation > .12 QRS amp in leads w/ negative QRS
ST/QRS #= 0.12

268
Q

Spodicks sign:

A

sloping down P wave into QRS (evidence of pericarditis)

269
Q

3 I’S of cardiac) ST depression, Hyperacute or flipped T Wave:

A

Ischemia

270
Q

ST Elevation: = Myocardial injury.
ST Depression:
Hyperacute T Waves:
Pathological Q Waves:

A

= Myocardial injury.
= Ischemia.
= Early ischemia.
= Permanent infarction marker.

271
Q

ST segment:
QT segment:
U wave:
P-T segment:
RR segment:

A

= Ventricle contraction
= Any action in ventricles
= “late bloomer”
= 1 cardiac cycle
= provides Rate & Rhythm

272
Q

Stable Angina:

A

= Predictable chest pain w/ exertion, relieved by rest or nitroglycerin.

273
Q

Starling’s Law of heart:

A

= states that the more the myocardium is stretched, up to a certain amount, the more forceful the subsequent contraction will be

274
Q

STE in aVR & aVL =

A

= LMCA occlusion

275
Q

STE in aVR > STE V1 is occlusion of=

A

= LMCA occlusion

276
Q

Stroke volume:

3 factors that affect stroke volume:

A

= amount of blood ejected by heart in 1 contraction, varies 60-100mLs w/ average 70mL
= preload, afterload, & contractility

277
Q

Subendocardial damage aka
ECG changes:

A

= Ischemia
= ST Depression, Flipped T Waves, Hyperacute T Waves

278
Q

SVT shock dose

A

Cardiovert 50-100/200/300/360J

279
Q

SVT stable RX

A

Vagal, Adenosine 6mg 12mg, Diltiazem 0.25mg/kg (M20mg) 0.35/kg (M25mg)

280
Q

Sync Cardioversion:
TCP:
Cardioversion

A

= “defib in sync”
= “Pick up the pace”
= “Convert/ to slower & normal”

281
Q

Systemic vascular resistance:
Nitro dynamics:

A

= how dilated arteries are
= decreases afterload pressure > decreases workload & O2 demand

282
Q

TCP dose & check:

A

= ~60-80Ma (80BPM 1st) Mechanical beat w/ every electrical beat & increase by 2Mili-Amps

283
Q

TCP) doing

A
  1. Turn Pacer on
  2. 80BPM
  3. mA sync till capture
  4. check mechanical
  5. Increase 2-5mA
284
Q

TDP med & dose

A

= Mag-Sulfate} 1-2Gs mixed in 50-100mL/5-60mins & maintaince 0.5-1G/Hr

285
Q

Tdp shock dose

A

defib 200/300/360J

286
Q

The SA Node is found where in the heart?
The AV Node is found where in the heart?
Purjunkie System found where in the heart?

A

= Upper right of atrium
= In the lower right of atrium
= Septum to bottom of ventricles

287
Q

The coronary vessels A&P

A

coronary vessels receive blood during diastole when the heart relaxes b/c aortic valve leaflets cover the coronary artery openings (ostia) during systole.

288
Q

Coronary) Right coronary artery (RCA) supplies:
Right Coronary arteries’ 2 major branches:

A

= part R-atrium & ventricle, upper part conduction system
= posterior descending artery & marginal artery

289
Q

The upward slurring of the isoelectric line after the P wave up into the QRS complex that is associated with Wolff Parkinson White Syndrome (WPW) is known as the:
The accessory pathway associated with Wolff Parkinson White Syndrome (WPW) is known as the:

A

= Delta wave
= Bundle of Kent

290
Q

Thoracic Aortic Aneurysm (TAA) aka :
S/S:
Ligament & fixation point:

A

= Bulging of thoracic aorta. DeBakey Tear
= “TEARING PAIN INTO BACK”, SOB, hoarseness, dysphagia
= Ligamentum arteriosum, fixed between aorta & pulmonary artery.

291
Q

Transmural cardium damage aka:
ECG changes:

A

= Active Injury
= ST Elevation

292
Q

Triplicate method:

A

= for HR> Big box RR descends 300,150,100,75,50,50,43,38

293
Q

6 sec method:

A

= Count # of complexes in a 6-sec strip X 10

294
Q

R to R small box method:

A

Count small boxes between R waves then /1500 EX: 1500 / 22 = 68

295
Q

Tunica intima:
Tunica media:
Tunica adventitia/externa:
Lumen:

A

= inside layer/ tissue of heart
= middle layer/muscle of heart
= external layer of heart
= where blood flows throughs

296
Q

U wave:

A

= “late bloomers” repolarization (hypothermic PTs)

297
Q

Unipolar leads:
Unipolar lead camera:

A

= 1 polarity(need 4 LL) aVR, aVL, aVF(Wilson’s central terminal)
= Starts at middle point of lines look to center terminal

298
Q

Unipolar Limb Leads:
aVR:
aVL:
aVF:

A

= Augmented by the cardiac monitor
= Right Arm positive (inferior)
= Left Arm positive (lateral )
= Left Leg positive (inferior)

299
Q

Unstable Angina:

A

= Unpredictable, occurs at rest, more severe, precursor to MI.

300
Q

V8 & V9 STEMI criteria:

A

0.5mm or greater

301
Q

Vaughn Williams Classification System:
Class I meds:
Class II meds:
Down regulation:
Never mix what w/ what b/c:
Class III meds:
Class IV meds:
Miscellaneous meds:

A

= Antiarrhythmic med classes by pharmacodynamics
= Sodium channel blockers
= Beta-Blockers
= takes away/blocks CA cells channels:
= Never mix Ca blocker w/ Beta blockers→ stops heart
= Potassium channel blockers “phase 3 K”
= Calcium channel blockers
= Miscellaneous EX Adenosine→ dif/ & adenosine receptors

302
Q

Verapamil) indications:

Contraindications:

A

= 2nd med for A-Fib/Flutter w/ RVR, May use as alterative med (after adenosine), narrow QRS complex Tcardia w/ preserved LV function
= HypoBP (SBP<90), CHF/cardio/ shock, Wide-complex Tcardia, WPW
Hypersensitivity to med

303
Q

Verapamil): 1st:
2nd:
Max dose:

A

=2.5-5mg IV/IO bolus over 2-3mins
= 5-10mg over 2-3 mins
=20mg

304
Q

VT treatment

A
305
Q

w/ (PJC) Premature Junctional Contraction) 1Rules:

2CANNOT HAVE B/C:
3Compensatory pause
4Non-compensatory pause

A

1= rate by rhythm, usually slightly irregular, P waves are either inverted before, +after, or hidden w/in QRS
2=have upright P wave (up P= PAC)
3= keeps cadence
4= doesn’t keep cadence

306
Q

w/ A/V Sequential regain:

A

atrial kick

307
Q

Wellen’s wave type A:

A

Biphasic T waves in V2 or V3, min STE <1mm (V2 usually biggest shower
Highly specific for for a critical blockage of the LAD

308
Q

Wellen’s wave type B:

A

DEEP inverted T waves V2 or V3,

309
Q

Wellen’s wave type B:

A

DEEP inverted T waves V2 or V3,

310
Q

What is considered the normal max amplitude of a P wave in lead II?
What is considered the normal max amplitude of a P wave in lead V1?

A

= 2.5mm
= 1.5mm

311
Q

What is considered the normal max amplitude of a T wave in lead I?
What is considered the normal max amplitude of a T wave in lead V1?

A

= 5mm
= 10mm

312
Q

What is driving forcing to push blood down to feed coronary arteries

A

Aortic kick & diastolic P

313
Q

What is the most important medication to administer if PT is having S/S of AMI?

A

Aspirin

314
Q

What meds we commonly use “tank” the blood pressure:

A

Nitroglycerin (nitrates), metoprolol (beta-blocker), diltiazem (Ca-channel blocker), & furosemide (diuretic), Amiodorone (K-Channel blocker)

315
Q

What would directly decrease systolic#:

A

= hypovolemia, Decreased contractility, PSNS, meds (diltizem, morphine, ect)

316
Q

What would directly increase systolic#:

A

= Increased contractility, preload, or afterload (EX: exercise, stress), meds (EPi)

317
Q

What would directly increase diastolic #:

A

= Vasoconstriction, increased vascular resistance, SNS, Meds (Levaphed)

318
Q

What would directly decrease & diastolic #:

A

= Vasodilation or hypovolemia.

319
Q

When obtaining a 12 lead ECG, where do you place V1?
When obtaining a 12 lead ECG, where do you place V2?

A

= Right of Sternum 4th ICS
= 4th ICS just left of Sternum

320
Q

When obtaining a 12 lead ECG, where do you place V3?
When obtaining a 12 lead ECG, where do you place V4?

A

= ½ in between V2 & V4
= 5th ICS left Midclavicular

321
Q

When obtaining a 12 lead ECG, where do you place V5?
When obtaining a 12 lead ECG, where do you place V6?
When obtaining a 15 lead ECG, where do you place V4R?

A

= Left 5th ICS anterior of auxiliary
= 5th ICS midaxillary
= Right ICS midclavicular

322
Q

Which coronary artery feeds the anterior wall of the left ventricle?

A

Left Anterior Descending (LAD)

323
Q

Which coronary artery feeds the inferior wall of the heart?

A

Right Coronary Artery (RCA)

324
Q

Which coronary artery feeds the left lateral wall of the heart?

A

Left Circumflex (LCX)

325
Q

Which ion has the greatest influence on muscular contraction:

A

= Calcium

326
Q

ECG change represents active myocardial injury:

A

ST-Segment Elevation

327
Q

Which of the following ECG changes represents myocardial ischemia:

A

Hyperacute T-Waves

328
Q

WPW) Orthodromic loop;
Antidromic loop:
Treatmeats:

A

= Clockwise reentry w/ narrow complex
= Counterclockwise reentry w/ wide QRS
= procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion

329
Q

What? secreted by the ventricles of the heart in response to excessive stretching of the ventricle myocytes.

A

Brain Natriuretic Peptide (BNP)

330
Q

“Three I’s of Cardiac” & what them mean when identified on an ECG

A

Ischemia: = Lack of oxygen, ST depression, inverted T waves.
Injury: = Acute damage, ST elevation.
Infarction: = Necrosis, pathological Q waves.

Connor Final Focused (4 decks)

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