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CPD Vocab II > Cardiac I > Flashcards

Cardiac I Flashcards

0
Q

Diastole

A

Ventricles fill up, pressure is low

Aortic and pulmonic valves close–> S2. Mitral and tricuspid valves open

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1
Q

Systole

A

Ejection, squeezing. Mitral and tricuspid valves close–> S1. Aortic and pulmonic valves open.
Pressure in ventricles is high

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2
Q

Normal sinus rhythm

A

R atrium/ SA node to AV node, to ventricles/Bundle of His, to bundle branches/R and L ventricles
SA node= pacemaker

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3
Q

Emergency heart rates

A

Extreme tachycardia: 150-250/ min

Extreme bradycardia: less than 30/ min

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4
Q

Escape rhythm

A

Heart rhythm initiated by lower centers when problem in SA node

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5
Q

Hx questions

A 
Pain (worse w exertion?)
Palpitations
Syncope, dizziness, lightheaded ness
SOB, DOE, PND, Orthopnea, breathlessness 
Edema
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6
Q

Hepatojugular reflex

A

Press on liver, see if jugular v bulges (>1cm). Suggest RCHF, constrictive pericarditis, SVC obstruction

(Peripheral edema and ascites also suggest RCHF)

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7
Q

Left lateral decubitus

A

Position if pt heart difficult to hear (eg obese). Or can lean forward. Or can exhale and hold.

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8
Q

Clicks

A

Higher pitched than S1, shorter duration. Heard in mitral or tricuspid prolapse from abnormal tension of chordae tendinae

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9
Q

Aortic stenosis murmur

A

Open. Dilation of aorta (or pulmonary in pulmonary stenosis) artery

Mid systolic, gets louder as flow becomes more obstructed

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10
Q

Regurgitant murmurs

A

Closed. Retrograde or abnormal blood flow. Mitral or tricuspid.
Tend to be holosystolic–longer duration than ejection murmurs

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11
Q

Diastolic murmurs

A

Always abnormal. Aortic/pulmonic regurgitation or mitral/tricuspid stenosis.

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12
Q

Neck veins

A

Inspect for height ~ to R atrial pressure. Jugular v evaluated with pt at 45* (normal <3-4cm)
Increase P= RCHF, constrictive pericarditis, SVC obstruction
Flat veins= vol depletion

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13
Q

Chest inspection and palpation

A

Deformities, congenital abnormalities; visible precordial impulses, heaves; thrills; apex/PMI

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14
Q

Chest auscultation

A

Diaphragm: high pitched sounds
Bell: low pitched sounds

Characterize sounds by location, timing, radiation, pitch, quality

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15
Q

Diastolic sounds

A

S2: lower pitched, due to closure of A and P valves (commonly split)
S3: early diastole, dt non compliant, dilated ventricle (may be normal in children)
S4: late diastole, augmented ventricular filling caused by atrial contraction, more common than S3
OS: opening snap, early diastole, high pitched

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16
Q

Shunt murmurs

A

Dt abnormal openings bet vessels or heart chambers.

E.g. Patent ductus arteriosis: ventricular or atrial septal defects

17
Q

Diastolic murmurs

A

Always abnormal/heart disease. A or P regurgitation; M or T stenosis

18
Q

Pericardial friction rub

A

Inflamed visceral and pericardial layers. High pitched squeak.
Best heard w pt leaning forward on hands or knees during expiration.

19
Q

Abdomen exam

A

Palpate liver and edge.
Assess for fluid waves, ascites
Splenomegaly
Assess aorta for bruit, aneurysm

20
Q

Leg exam

A

Inspect for edema, peripheral vasc dz
Femoral pulse, varicose veins
Stasis dermatitis, ulcers

21
Q

Chest pain DDX

A

MI, unstable angina, pulmonary embolism, pericarditis, tumor, pneumothorax, pneumonia, anxiety/emotions, MS, herpes zoster, GI disease

22
Q

Hx questions w palpitations

A

Duration, character, triggers, onset/offset
Ask or to tap out beat
Weakness, lightheaded ness, syncope
Other concomitants? Substance use? Caffeine?

23
Q

Palpitations DDX

A

Normal with exercise, exertion. W arrhythmia: cardiac dz
Non cardiac: anxiety, anemia, fever, thyrotoxicosis, hypoglycemia, allergy, pheochromocytoma, aortic aneurysm, migraine, drugs, coffee, tobacco, panic disorder

24
Q

Orthostatic / postural hypotension DDX

A

Hypovolemia dt dehydration, drug side effects or hemorrhage

25
Q

Orthostatic/postural hypotension

A

Fall in BP > 20/10 mmHg when assuming upright position .
Sxs: faintness, lightheadedness, dizziness, autonomic insufficiency (visual impairment, incontinence, constipation, heat intolerance, impotence), CV/neuro/malignant disorders

26
Q

Orthostatic/postural hypotension PE

A

Pt supine for 5 min, have pt stand and measure BP at 1 min and 3 mins
If no increased HR…autonomic impairment
> 100 bpm…hypovolemia

27
Q

Postural tachycardia syndrome

A

POTS. Big HR increase with posture change wo increase in BP

May be related to increased sympathetic tone

28
Q

Syncope

A

LOC dt inadequate cerebral perfusion

Tests: vitals, resting ECG, pulse ox, HCT, electrolytes, cardiac emzymes

29
Q

Syncope DDX

A

Circ issues: vasovagal rxns, carotid sinus syncope, vol or electrolyte depletion
Cardiac: arrhythmias, output obstrxn
Neuro: seizures, CV dz
Metabolic: hypoglycemia, hyperventilation, hypoxia
Drugs: antidepressants, antihypertensives

30
Q

What will plain radiography show?

A

(CXR). Shadow of heart..fluid? Hypertrophic?

31
Q

What does ECG assess for?

A

Arrhythmias, myocardial ischemia, enlarged chambers

Use with orthostatic hypotension, syncope

32
Q

Why do Echocardiography?

A

if pt has a murmur!

(Looking at valves, blood flow, size of chambers)

To assess valvular disorders, chamber hypertrophy/dilation, cardiomyopahties, heart failure, pericarditis, K+ levels

33
Q

Why do EBCT?

A

(Look at coronary arteries)

Quantification of calcification, assessment of atherosclerosis

34
Q

Edema DDx

A

CHF, liver dz, myxedema, trichinosis, protein-losing enteropathy, pericardial dz, nephrotic syndrome, hemiplegia, lymphedema, idiopathic

35
Q

MRI/MRA tests for?

A

Mediastinal evaluation, aorta

36
Q

PET tests for?

A

Assess for myocardial perfusion, was there a past MI?

37
Q

Radionuclide imaging

A

Myocardial perfusion studies, thallium, technetium

When stress vs resting compared can dx CAD

38
Q

Stress test

A

ECG when exercising. Used to screen CAD.

39
Q

Invasive tests

A

Cardiac catheterization, CABG

CPD Vocab II (9 decks)

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