Cardiac rehab Flashcards
What is cardiac output?
The amount of blood the heart can pump through ventricles in one minute. It is calculated by multiplying HR x SV. Increase as exercise increases.
What is stroke volume ?
The volume of blood ejected from the heart with each contraction.
Does SV increase or decrease during maximal exercise intensity?
It slightly decreases
How is myocardial demand calculated?
HR x systolic blood pressure
What effect do Beta blockers have on HR during exercise?
They will limit the increase in HR during increased activity, but will not prevent a rise from occurring.
What is the hallmark sign of acute coronary syndrome?
ischemic chest pain because of the imbalance between myocardial oxygen supply and demand.
What is the most common cause of a myocardial infarction?
atherosclerosis
What are some complications after a myocardial infarction?
Complicated myocardial infarction- ventricular arrhythmias
Cardiogenic shock- left ventricle failure and cannot produce enough cardiac output.
What is the order of the normal sinus rhythm of the heart.
1) SA node
2) Atria
3) AV node
4) Bundle of his
5) Perkinje fibers
6) Septum
7) Ventricles
What does the P wave represent?
Sinus node and atrial depolarization
What does the PR segment represent?
Conduction through the AV node
What does the QRS complex represent?
Electrical flow through the ventricles and ventricular depolarization.
What does the ST segment represent?
initiation of the ventricular repolarization
What does the T wave represent
The completion of the ventricular repolarization
What disease effects the myocardial oxygen supply?
Coronary Artery Disease
What are indications of exercise intolerance that warrant modification or termination of exercise?
angina
marked dyspnea
dizziness
cyanosis
excessive fatigue
leg cramps
falilure for systolic pressure to rise with ex.
Drop in systolic pressure 10-15 mmHg
A hypertensive BP response
A significant change in Cardiac rhythm
What are two complications after a MI?
Complicated MI- ischemia, left vent failure or arrhythmias
Carcinogenic Shock- extreme complication after MI. Left ventricle failure.
What is the levine sign?
Pt. clinches fist on sternum angina
What are two medical procedures for acute coronary artery syndrome?
PTCA- stent uses balloon and compresses plaque
CABG- uses donor artery to bypass blockage
What do Beta-blockers do and what are some common medications?
↓ in HR ,contractility and BP ; ↓ energy demand
Acebutolol (Sectral)
Atenolol (Tenormin)
Bisoprolol (Zebeta)
Metoprolol (Lopressor, Toprol-XL)
Propranolol (Inderal LA, InnoPran XL)
What do Calcium Channel blockers do and what are some common medications?
↓ BP
Prevent coronary smooth muscle spasm
(↑ myocardial blood supply)
Amlodipine (Norvasc)
Diltiazem (Cardizem, Tiazac, others)
Felodipine
Isradipine
Nicardipine
Nifedipine (Adalat CC, Afeditab CR, Procardia)
Nisoldipine (Sular)
Verapamil (Calan, Verelan)
What do Vasodilators, ACE inhibitors, angiotensin II blockers, alpha-adrenergic blockers do?
↓ BP. Effect on HR varies per classification
What is the effects of nitrates and some examples?
Vasodilator (↓ preload and afterload)
↓ BP
Nitroglycerin (multiple methods of delivery)
What are the effects of nicotine?
↑ BP, Possible ↑ in HR
What is the most common cause of heart failure?
Cardiac muscle dysfunction. It is altered systolic and or diastolic activity of the myocardium.
Causes of cardiac muscle dysfunction?
hypertension, coronary artery disease, cardiac dysrhythmias, valve abnormalities, pericardial pathology and cardiomyopathies
Signs and symptoms of Left sided Heart Failure
Reduced cardiac output leads to backup of fluid into left atrium and lungs
Hallmark signs: shortness of breath and cough
2 Main Goals of Pharmacological Intervention for Patients with CHF and common medications?
Increase pumping ability of the heart (contractility) to relieve congestion
Decrease workload on heart by reducing total volume of fluid (preload) or vascular resistance (afterload)
Common medications:
Digoxin (increase contractility)
ACE inhibitors (afterload reducer)
Diuretics (preload reducer)
Right-sided Heart Failure?
Blood is not ejected from the right ventricle and backs up into the right atrium and venous vasculature
Hallmark signs: jugular venous distention and peripheral edema
What condition is this?
Bradycardia
What condition is this?
Premature Atrial Contraction (PAC)
What condition is this?
Premature Ventricular Contration (PVC)
What condition is this?
Ventricular Ectopy
What condition is this?
Ventricular Tachycardia (V TACH)
What condition is this?
Tachycardia
What condition is this?
Ventricular fibrillation
What Condition is this?
Atrial Fibrillation
What condition is this?
ST depression
Pacemaker. What is happening?
Occasional electrcal pulse to set pace due to non constant impulse
Pacemaker. What is happening?
Complete reliance on pacemaker due to consistent abnormality.
