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Ontario PCP 2019/2020 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

cardiovascular disease (CVD)

A

disease affecting the heart, peripheral blood vessels or both

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2
Q

where is the heart located in the chest?

A

in the centre of the chest in the mediastinum

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3
Q

endocardium

A

the innermost layer that lines the chambers

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4
Q

myocardium

A

the middle layer with its unique ability to generate and conduct electrical impulses causing the heart to contract

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5
Q

pericardium

A

the protective sac surrounding the heart

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6
Q

what do valves control?

A

the flow of blood through the heart

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7
Q

where is the aortic valve located

A

between the left ventricle and aorta

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8
Q

where is the pulmonary valve located

A

between the right ventricle and the pulmonary artery

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9
Q

what does the right atrium receive

A

deoxygenated blood from the body via the superior and inferior vena cava

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10
Q

what does the right atrium send

A

deoxygenated blood to the lungs via the pulmonary artery

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11
Q

oxygenated blood is returned from…

A

lungs to the left atrium via the pulmonary veins

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12
Q

the left ventricle pumps …

A

oxygenated blood to the body via the aorta

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13
Q

oxygenated blood is pumped from …

A

the heart to the tissues via the arteries

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14
Q

deoxygenated blood is transported from the tissues back..

A

to the heart via the veins

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15
Q

what do the capillaries connect?

A

arteries and veins

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16
Q

where do the exchange of oxygen and carbon dioxide with the body tissues take place?

A

through the very thin capillary walls

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17
Q

what does the left coronary artery supply?

A

left ventricle, interventricular septum, part of the right ventricle, and the conduction system.

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18
Q

what does the right coronary artery supply?

A

a portion of the right atrium and right ventricle and part of the conduction system.

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19
Q

diastole

A

the relaxation phase that takes place at the end of a cardiac contraction

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20
Q

systole

A

the contraction phase

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21
Q

stroke volume depends on three things

A

preload, cardiac contractility and afterload

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22
Q

bipolar leads

A

ECG leads applied to the arms and legs that contain two electrodes of opposite ( + and - ) polarity; leads i, ii, iii

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23
Q

einthoven’s triangle

A

the triangle around the heart formed by the bipolar leads

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24
Q

augmented leads

A

another term for unipolar leads, reflecting the fact that the ground lead is disconnected which increases the amplitude of deflection on the ECG tracing

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25
Q

unipolar leads

A

ECG leads applied to the arms and legs, consisting of one polarized (+) electrode and a nonpolarized reference point that is created by the ECG machine combining two additional electrodes; also called augmented limb leads; leads a aVR, aVL, and aVF

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26
Q

precordial leads

A

ECG leads applied to the chest in a pattern that permits a view of the horizontal plane of the heart; leads V1, V2, V3, V4, V5, and V6

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27
Q

Normal interval durations

A 
P-R = 0.12 - 0.20 sec
QRS = 0.08 - 0.12 sec
QT = 0.33 - 0.42 sec
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28
Q

refractory period

A

the period of time when myocardial cells have not yet completely repolarized and cannot stimulate again

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29
Q

absolute refractory period

A

the period of the cardiac cycle when stimulation will not produce any depolarization whatever

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30
Q

relative refractory period

A

the period of the cardiac cycle when a sufficiently strong stimulus may produce depolarization

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31
Q

coupling interval

A

distance between the preceding beat and the PVC

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32
Q

bundle of kent

A

an accessory AV conduction pathway that is thought to be responsible for the ECG findings of pre-excitation syndrome

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33
Q

Angina Pectoris

A

chest pain that results when the blood supply’s oxygen demands exceed the hearts

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34
Q

prinzmetal’s angina

A

variant of angina pectoris caused by vasospasm of the coronary arteries, not blockage per se; also called vasospastic angina or atypical angina

35
Q

Assessing a patient with Angina

A
  • chief complaint - sudden onset of chest discomfort
  • the pain may radiate or be localized to the chest
  • patient usually denies chest pain, as they have had the pain before.
  • usually last 3-5 minutes but sometimes as long as 15 minutes
  • relieved with rest/nitroglycerin
  • MOST common ECG finding is S-T depression.
36
Q

management for angina

A
  • place patient in comfortable position
  • administer high flow oxygen
  • establish an IV but without delayed transport
  • can give ASA or a spray of nitro
37
Q

myocardial infarction

A

death and subsequent necrosis of the heart muscle caused by inadequate blood supply; also acute myocardial infarction. often associated with atherosclerotic heart disease

38
Q

transmural infarction

A

myocardial infarction that affects the full thickness of the myocardium and almost always results in a pathological Q wave in the affected leads

39
Q

subendocardial infarction

A

myocardial infarction that affects only the deeper levels of the myocardium; also called non-Q-wave infarction because it typically does not result in a significant Q wave in the affected lead

40
Q

assessing a patient with a MI

A
  • breathing may be laboured or not
  • look for evidence of shock
  • take blood pressure; usually elevates during the episode and normalizes later
  • Chief complaint is CHEST PAIN
  • chest discomfort usually lasts longer than 30 minutes
  • pain can radiate to the arms (primarily the left), the neck and posterior to the back or down to epigastric region of the abdomen
  • often confirm of an acute onset of nausea and vomiting
  • pallor and diaphoresis
41
Q

managing a patient with an MI

A
  • administer high-flow oxygen
  • establish at least 1 IV
  • administer medication as protocol
42
Q

heart failure

A

clinical syndrome in which the heart’s mechanical performance is compromised so that cardiac output cannot meet the body’s needs.

43
Q

left ventricular failure

A

occurs when the left ventricle fails as an effective forward pump, causing back pressure of blood into the pulmonary circulation, which often results in pulmonary edema. the left ventricle cannot eject all of the blood that the right heart delivers to it via the lungs. left atrial pressure rises and is subsequently transmitted to the pulmonary veins and capillaries. when pulmonary pressure becomes to high, it forces the blood plasma in the alveoli resulting in pulmonary edema. progressive fluid accumulation in the alveoli decreases the lungs’ oxygenation capacity and can cause death from hypoxia.

44
Q

right ventricular failure

A

the right ventricular fails as an effective forward pump, resulting in back pressure of blood into the systemic venous circulation and venous congestion. the MOST common cause of right ventricular failure is LEFT ventricular failure. pulmonary hypertension and cor pulmonale result from the effects of COPD. These problems are related to increased pressure in the pulmonary arteries, which results in right ventricular enlargement, right atrial enlargement, and if untreated, right heart failure.

45
Q

Pulmonary embolism

A

blood clot in one of the pulmonary arteries

46
Q

congestive heart failure

A

condition in which the heart’s reduced stroke volume causes an overload of fluid in the body’s other tissues

47
Q

what is the most common symptom of CHF

A

laboured breathing

48
Q

assessing a CHF patient

A

history of patient will usually consist of SOB and PND
laboured breathing
usually in the tripod position
if the patient sleeps with A LOT of pillows, the problem is worse.

49
Q

managing CHF

A

dont let the patient lie flat
administer high flow oxygen
connect ECG
administer nitro if meets ALS requirements

50
Q

cardiac tamponade

A

accumulation of excess fluid inside the pericardium

51
Q

what is the chief complaint in a patient who is suffering from a cardiac tamponade

A

chest pain or dyspnea

52
Q

hypertensive emergency

A

an acute elevation of blood pressure that requires the blood pressure to be lowered within on hour; characterized by end-organ changes, such as hypertensive encephalopathy, renal failure, or blindness

53
Q

hypertensive encephalopathy

A

a cerebral disorder of hypertension indicated by severe headache, nausea, vomiting, and altered mental status. neurological symptoms may include blindness, muscle twitches, inability to speak, weakness and paralysis.

54
Q

what would systolic be in a hypertensive emergency?

A

usually anything >130mmHg

55
Q

what are some symptoms that come with hypertensive emergencies?

A 
restlessness
confusion
blurred vision
nausea
vomiting
56
Q

what are some symptoms that come with hypertensive encephalopathy?

A 
severe headache
vomiting
visual disturbances
paralysis
seizures
stupor
coma
57
Q

can you give nitro if BP contraindict’s the conditions in the ALS even after you correct the BP issue?

A

No, you can correct BP but once a contraindication is fixed you would need to patch and ask.

58
Q

cardiogenic shock

A

the inability of the heart to meet the metabolic needs of the body, resulting in inadequate tissue perfusion. it is the MOST SEVERE for of pump failure.

59
Q

when does cardiogenic shock usually occur?

A

usually happens after extensive myocardial infarction

60
Q

what is the body doing in cardiogenic shock

A

the body tries to compensate either by increasing the contractile force, by improving preload, by reducing the peripheral resistance or by all three.

61
Q

sudden death

A

death within one hour after the onset of symptoms

62
Q

down time

A

duration from the beginning of the cardiac arrest until effective CPR is established

63
Q

total down time

A

duration from the beginning of the cardiac arrest until the patients delivery to the emergency department

64
Q

resuscitation

A

provision of efforts to return a spontaneous pulse and breathing

65
Q

return of spontaneous circulation (ROSC)

A

resuscitation results in the patient’s having a spontaneous pulse

66
Q

Atherosclerosis

A

a progressive degenerative disease of the medium-sized and large arteries

67
Q

what does atherosclerosis affect?

A

aorta and its branches, the coronary arteries and the cerebral arteries among others.

68
Q

arteriosclerosis

A

a thickening, loss of elasticity, and hardening of the walls of the arteries from calcium deposits.

69
Q

claudication

A

severe pain in the calf muscle due to inadequate blood supply. it typically occurs with exertion and subsides with rest

70
Q

aneurysm

A

the ballooning of an arterial wall, resulting from a defect or weakness in the wall

71
Q

dissecting aortic aneurysm

A

aneurysm caused when blood gets between and separates the layers of the aortic wall

72
Q

cystic medial necrosis

A

death or degeneration of a part of the wall of an artery

73
Q

acute pulmonary embolism

A

blockage that occurs when a blood clot or other particle lodges in a pulmonary artery

74
Q

acute arterial occlusion

A

the sudden occlusion of arterial blood flow

75
Q

Signs and Symptoms of Abdominal Aortic Aneursym

A

abdominal pain
back and flank pain
hypotension
urge to defecate, caused by the retroperitoneal leakage of blood

76
Q

signs and symptoms of acute pulmonary embolism

A

sudden onset of severe and unexplained dyspnea that may or may not be associated with chest pain.
MAY have a recent history of immobilization from a hip fracture, surgery or other debilitating illness

77
Q

vasculitis

A

inflammation of blood vessels

78
Q

peripheral arterial atherosclerotic disease

A

a progressive degenerative disease of the medium-sized and large arteries

79
Q

deep venous thrombosis

A

a blood clot in a vein

80
Q

varicose veins

A

dilated superficial veins, usually in the lower extremity

81
Q

what are the 5 P’s of acute arterial occlusion

A 
pallor
pain
pulselessness
paralysis
parethesia
82
Q

signs/symptoms of peripheral arterial atherosclerotic disease

A

extremity usually appears normal, but pulses will be reduces or absent. as ischemia worsens the extremity becomes painful, cold, numb, ulceration, gangrene and necrosis. there will be no edema

83
Q

signs/symptoms of deep venous thrombosis

A

gentle palpation of the thigh and calf may reveal tenderness.
discomfort behind the knee
the skin may be warm and red

84
Q

signs/symptoms of varicose veins

A

usually lower extremities

Ontario PCP 2019/2020 (8 decks)

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