Cardiac Exam Lecture 6 Flashcards

1
Q

Draw Wiggers Diagram

A
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2
Q

Identify the phases of the cardiac cycle as delineated by valve openings and closings

A
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3
Q

Explain the mechanisms responsible for “a, c, and v” waves of the venous pulse

A

Venous Pulse:

a wave: atrial contraction/ atrial kick

c wave: contraction of ventricles

v wave: as blood accumulates on venous side, mitral valve opens,

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4
Q

Explain the causes of the first and second heart sounds and their position in the cardiac cycle

A

First Heart Sound: Mitral Valve Closing (loud and violent because ventricles are contracting/ “isovolumetric contraction”)

Second Heart Sound: Aortic Valve Closing (start of isovolumetric relaxation)

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5
Q

Draw and explain a normal LV pressure-volume diagram and how changes in preload, afterload, and contractility affect stroke volume

A
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6
Q

Define systolic heart failure

A

Heart Failure: a condition in which the heart fails to provide cardiac output to meet the needs of the body (decreased ventricular contractility)

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7
Q

Define ejection fraction

A

Ejection Fraction:

The fraction of blood ejected during one stroke of the heart

Normal is about 60%

Clinical index of LV contractility

(EDV-ESV)/EDV x 100

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8
Q

Define the various factors that determine and affect preload, afterload and contractility

A

Preload:

  • pressure gradient btw atria and ventricles
  • time for ventricular filling
  • ventricular compliance
  • atrial kick

Afterload:

  • aortic pressure (hypertension)
  • Ventricular outflow tract resistance (stenosis or insufficiency)
  • Ventricular size (dilated hearts have higher tension, larger afterload)

Contractility:

  • SNS and PSNS
  • Drugs (positive inotropic agents)
  • Disease
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9
Q

Define heart failure

A
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