Cardiology

Question 1

What direction ids the heart pushed in

Answer 1

Upwards by the diaphragm so the apex moves from the 5th to 4th intercostal space

Question 2

What does the heart volume do

Answer 2

Increase from 70 to 80ml over pregnancy

Question 3

What. Does the size of the heart do

Answer 3

Increase through increased Venus filling but its muscle mass does not
During pregnancy there is enhanced myocardial performance

Question 4

Why does the total blood volume increase

Answer 4

Increases y 45-50%
Meds demand of enlarged uterus and to provide extra blood floe for placenta perfusion
Upply exra metabolic needs of the fetus
Protect the woman and fetus against the potential harmful effects of impaired venos return
Provide extra perfusion of maternal organs
Counterbalance the effects of increased retrial and venous capacity
Safeguard against adverse effects of excessive maternal blood loss at birth

Question 5

How much does plasma volume increase by

Answer 5

45%

Question 6

How much do red blood cell increase by

Answer 6

20%

Question 7

What stimulates the real ease of erthropoietin

Answer 7

Prolactin, human placental lactose and oestrogenstimulate relese

Question 8

What is erythropoietin

Answer 8

Produced by kidney
Stimulates increased production of red blood cells

Question 9

What may result in anaemia

Answer 9

Plume of plasma increases more Han the amount of red bloood cells meaning they are diluted - haemodilution

Question 10

What are the changes in regional blood distribution

Answer 10

Uterus - increase 1000%
To kidneys - in early pregnancy
T o th skin- hands and feet may feel warmer
Or liver
To breasts for growth

Question 11

What is peripheral vasodilation

Answer 11

Increase diameter of peripheral blood vessels
Results in - increased fingernail growth nasal congestion in ease rate of hair growth

Question 12

What does vasodilation cause

Answer 12

Undereffects of progesterone and oestrogen it may cause or exacerbate varicosities in the leg veins or Vila and haemorrhoids as the smooth muscle around the veins relax

Question 13

What happens to te o2 consumption

Answer 13

Increases by 20-30%
Increasing o2 demand of fetus

Question 14

What happens to blood volume cardiac output and peripheral resistance

Answer 14

Increase bloood vol and cardiac output
Reduced peripheral resistance

Question 15

What happens to cardiac output

Answer 15

Increases your 30-50% during pregnancy reaching peak levels between 28 and 32 weeks
Mostly increased by stroke volume

Question 16

What happens to systemic vascular r resistance

Answer 16

reduces by 20-30%

Question 17

What happens to blood pressure

Answer 17

Possible decease of 10mmHg
Decrees begins at 5 weeks gestatiooon reaches lowest in second trimester then gradually rises at term approaches
Early pregnancy is associated with a marked decrease in diastolic blood pressure of 10-15mmHg by 24 week gestation but minimal reduction in systolic pressure, dropping just 5 - 10 mpg below the baseline levels
Thereafter blood pressure gradullay rises returning o pre pregnant state at term

Question 18

WhAt is supine hypotension

Answer 18

When supine the vena cava is compressed by the gravid uterus
This lead to a 25-30% decrease in the cardiac output which in turn increases Herat rate

Question 19

What are the symptoms of supine hypotension

Answer 19

Dizzy light headed faint after laying

Question 20

What to do to prevent supine hypotension

Answer 20

Maintain semi recumbent when palpating
Encourage to fall asleep on left side
When doing life support displac the uterus so it does not impair blood flow to the heart