Cardiac Assessment Flashcards
What is the pacemaker of the heart?
SA Node
At top of R atrium
What is the electrical impulse through the heart called?
Action potential
Where is the pulmonic valve?
Between R ventricle and pulmonary artery
Where is the tricuspid valve?
Between R atrium and R ventricle
Where is the aortic valve?
Between L ventricle and aorta
Where is the mitral or bicuspid valve?
Between L atrium and ventricle
Which artery that feeds the heart is responsible for most defects in cardiac conduction?
Right coronary artery
This feeds the AV node and the bundle of His
What is depolarization/repolarization?
Depolarization is movement of Na into heart that causes heart to become excited and ready to beat
Repolarization is when Na moves out and heart relaxes
What part of EKG corresponds to depolarization of atria?
P wave
This starts with firing of SA node and pump of atria
What part of EKG corresponds to depolarization of ventricles?
QRS
Starts with firing through AV node through pump of ventricles
What part of EKG corresponds to repolarization of ventricles?
T wave
What is cardiac output?
Amount of blood pumped by each ventricle in 1 min
It is stroke volume x Heart rate
What is stroke volume?
Amount of blood ejected from ventricle with each heartbeat
What is a healthy ejection fraction?
70%
Ejection fraction is similar to stroke volume except it is a percentage
What is Frank Starling law?
The more the heart is stretched, the harder the contraction.
What is preload?
The end of diastole before the next contraction
What is after load?
The resistance the ventricle has to pump against
How does HTN lead to atherosclerosis?
BP pressure causes damage to endothelium over time. Plaque build up.
Where are baroreceptors and what do they detect?
Aortic arch
Carotid sinus
They detect stretch or pressure in arteries.
Causes the autonomic NS to adjust
What is pulse pressure?
Difference between systolic and diastolic. Represents the force of contraction.
Normally about 1/3 of systolic
What is MAP?
Average pressure within the arterial system.
Represents the pressure felt by organs.
Calculated by
SBP + DBP + DBP divided by 3
How should jugular veins be assessed for JVD? What may JVD indicate?
With patient moving from lying supine to sitting up. At 30-45 degree angle
Right sided HF
What is a bruit?
Turbulent blood flow
Sounds like buzzing/humming with bell of stethoscope
What is a thrill?
Vibration of vessel
This is felt not heard.
Suspect aneurysm or fistula
Where is PMI (point of maximal impulse)?
Apical pulse
Over apex of heart
Midclavicular line
4-5 intercostal space
What does S1 sound indicate?
Closure of tricuspid and mitral valves
What does S2 indicate?
Closure of aortic and pulmonic valves
What does S3 indicate?
Low intensity vibration of ventricular walls.
Usually means decreased compliance of ventricles
Could indicate Left HF or mitral valve regurgitation.
Called ventricular gallop
Sounds like Ken-TUCK-ee
What does S4 indicate?
Low frequency vibration from atrial contraction.
Called atrial gallop
CAD, cardiomyopathy
How are heart murmurs graded?
Roman numeral 1-6
(So 6/6 is worst, 1/6 is least)
What is most definitive lab for suspected MI?
Tropinin
What does an elevated BNP indicate?
Heart failure
This is used to figure out if dyspnea is respiratory or cardiac cause
What is CK-MB lab?
Test for myocardial injury
High levels indicate MI
Not as helpful as troponin
What is CRP lab?
C-reactive protein
Marker for inflammation
May help predict cardiac disease and events
