Cardiac rehab

Question 1

What is cardiac output?

Answer 1

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.

Question 2

What is stroke volume ?

Answer 2

The volume of blood ejected from the heart with each contraction.

Question 3

Does SV increase or decrease during maximal exercise intensity?

Answer 3

It slightly decreases

Question 4

How is myocardial demand calculated?

Answer 4

HR x systolic blood pressure

Question 5

What effect do Beta blockers have on HR during exercise?

Answer 5

They will limit the increase in HR during increased activity, but will not prevent a rise from occurring.

Question 6

What is the hallmark sign of acute coronary syndrome?

Answer 6

ischemic chest pain because of the imbalance between myocardial oxygen supply and demand.

Question 7

What is the most common cause of a myocardial infarction?

Answer 7

atherosclerosis

Question 8

What are some complications after a myocardial infarction?

Answer 8

Complicated myocardial infarction- ventricular arrhythmias
Cardiogenic shock- left ventricle failure and cannot produce enough cardiac output.

Question 9

What is the order of the normal sinus rhythm of the heart.

Answer 9

1) SA node
2) Atria
3) AV node
4) Bundle of his
5) Perkinje fibers
6) Septum
7) Ventricles

Question 10

What does the P wave represent?

Answer 10

Sinus node and atrial depolarization

Question 11

What does the PR segment represent?

Answer 11

Conduction through the AV node

Question 12

What does the QRS complex represent?

Answer 12

Electrical flow through the ventricles and ventricular depolarization.

Question 13

What does the ST segment represent?

Answer 13

initiation of the ventricular repolarization

Question 14

What does the T wave represent

Answer 14

The completion of the ventricular repolarization

Question 15

What disease effects the myocardial oxygen supply?

Answer 15

Coronary Artery Disease

Question 16

What are indications of exercise intolerance that warrant modification or termination of exercise?

Answer 16

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

Question 17

What are two complications after a MI?

Answer 17

Complicated MI- ischemia, left vent failure or arrhythmias
Carcinogenic Shock- extreme complication after MI. Left ventricle failure.

Question 18

What is the levine sign?

Answer 18

Pt. clinches fist on sternum angina

Question 19

What are two medical procedures for acute coronary artery syndrome?

Answer 19

PTCA- stent uses balloon and compresses plaque
CABG- uses donor artery to bypass blockage

Question 20

What do Beta-blockers do and what are some common medications?

Answer 20

↓ in HR ,contractility and BP ; ↓ energy demand

Acebutolol (Sectral)
Atenolol (Tenormin)
Bisoprolol (Zebeta)
Metoprolol (Lopressor, Toprol-XL)
Propranolol (Inderal LA, InnoPran XL)

Question 21

What do Calcium Channel blockers do and what are some common medications?

Answer 21

↓ 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)

Question 22

What do Vasodilators, ACE inhibitors, angiotensin II blockers, alpha-adrenergic blockers do?

Answer 22

↓ BP. Effect on HR varies per classification

Question 23

What is the effects of nitrates and some examples?

Answer 23

Vasodilator (↓ preload and afterload)
↓ BP
Nitroglycerin (multiple methods of delivery)

Question 24

What are the effects of nicotine?

Answer 24

↑ BP, Possible ↑ in HR

Question 25

What is the most common cause of heart failure?

Answer 25

Cardiac muscle dysfunction. It is altered systolic and or diastolic activity of the myocardium.

Question 26

Causes of cardiac muscle dysfunction?

Answer 26

hypertension, coronary artery disease, cardiac dysrhythmias, valve abnormalities, pericardial pathology and cardiomyopathies

Question 27

Signs and symptoms of Left sided Heart Failure

Answer 27

Reduced cardiac output leads to backup of fluid into left atrium and lungs

Hallmark signs: shortness of breath and cough

Question 28

2 Main Goals of Pharmacological Intervention for Patients with CHF and common medications?

Answer 28

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)

Question 29

Right-sided Heart Failure?

Answer 29

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

Question 30

What condition is this?

Answer 30

Bradycardia

Question 31

What condition is this?

Answer 31

Premature Atrial Contraction (PAC)

Question 32

What condition is this?

Answer 32

Premature Ventricular Contration (PVC)

Question 33

What condition is this?

Answer 33

Ventricular Ectopy

Question 34

What condition is this?

Answer 34

Ventricular Tachycardia (V TACH)

Question 35

What condition is this?

Answer 35

Tachycardia

Question 36

What condition is this?

Answer 36

Ventricular fibrillation

Question 37

What Condition is this?

Answer 37

Atrial Fibrillation

Question 38

What condition is this?

Answer 38

ST depression

Question 39

Pacemaker. What is happening?

Answer 39

Occasional electrcal pulse to set pace due to non constant impulse

Question 40

Pacemaker. What is happening?

Answer 40

Complete reliance on pacemaker due to consistent abnormality.