Cardiac Interventions, cath, CABG, and Aortic Aneurysm

Question 1

Atherectomy

Answer 1

cutting, shaving, grinding the plaque

Question 2

Beck’s Triad

Answer 2

fluid fills the cardiac space so the heart cannot beat– it is being compressed; Cardiac Tamponade

muffled heart sounds, distending neck veins, widened pulse pressure

Question 3

cardiac tamponade

Answer 3

blood accumulated in the mediastinal space, impairs pumping

S/S: decreased cardiac output, hypotension, JVD, pulsus paradoxus, muffled heart sounds, sudden cessation of CT drainage

surgical repair to remove the clot

Question 4

Pacemakers

Answer 4

epicardial pacemaker wires are common after cardiac surgery

ventricular and atrial wires are loosely sewn to epicardium

be careful when removed, watch for bleeding and cardiac tamponade

Question 5

Aortic Aneurysms

Answer 5

an aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel

• thoracic aortic
• abdominal aortic
• thoracoabdominal aortic
• treat based on size and symptoms
• false verses true

Greater than 5cm = operating!!!

Question 6

aortic aneurysm risk factors

Answer 6

greatest risk >65yrs and have peripheral atherosclerotic vascular disease, smoking hx, COPD

Question 7

S/S of Aortic Dissection

Answer 7

may be similar to those of other heart problems such as MI

sudden severe chest pain or upper back pain, often described as a tearing, ripping or shearing sensation that radiates to the neck or down the back
loss of consciousness(fainting)
SOB
weakness/paralysis
sweating
Hyptertension
different pulse rates in each arm

Question 8

Open AAA repair

Answer 8

requires direct access to the aorta through an abdominal incision. Use of dacron or Gore-tex patch tube

Question 9

Endovascular repair

Answer 9

involves gaining access to the lumen of the abdominal aorta, involves the placement of an endovascular stent via a percutaneous technique (usually through the femoral arteries) into the diseased portion of the aorta