Cardiology Chapter Flashcards
What is the leading cause of death in the US?
Heart disease
What disease is the leading cause of premature, permanent disability among working adults is called
Coronary heart disease
There are three different types of risk factors for heart disease, what are they?
Nonmodifiable: Heredity, race, gender
Modifiable: High BP, Diabetes, tobacco use
Contributing factors: Stress, Alcohol intake
A group of disorders related to body metabolism that appear to promote the development of artherosclerotic cardiovascular disease is called?
Metabolic Syndrome High BP Elevated insulin levels Excess body weight And one or more Abnormal cholesterol levels
Where are baroreceptors found?
In the carotid artery and aortic arch
What does a small box or 1mm box represent in seconds?
.04 seconds
A large box has 5 small boxes and represents how many seconds?
.20 seconds
Five large boxes represent how many seconds?
1 second
Fifteen small boxes represent how many seconds?
3 seconds
Thirty small boxes represent how many seconds?
6 seconds
The vertical access measures what on an ECG?
Voltage
Voltage is measured in what?
Millivolts
The height of a waveform is usually measured in what?
Millimeters
Normal p wave in height are how high?
2.5 mm
Normal p wave in length are no more than how long?
.11 seconds in duration
A normal Q wave is how long and how high?
.04 seconds in duration and <1/3 of the height of the R wave.
In adults what is the normal duration of the QRS complex?
.11 seconds or less
T waves are usually how high?
5mm or less in a chest lead and 10mm or less on any limb lead
Peaked t waves are commonly seen in what?
hyperkalemia
Low amplitude t waves may be seen in what?
hypokalemia
The point where the QRS complex and the ST segment meet is called what?
J point or ST junction
The j point is considered to be elevated in men over 40 when it is how high?
2mm above the isoelectric line in leads v2 and v3 and 1mm in all others
The j point is considered to be elevated in men under 40 when it is how high?
2.5mm above the isoelectric line in leads v2 and v3 and 1mm in all others
The j point is considered to be elevated in women under when it is how high?
1.5mm above the isoelectric line in leads v2 and v3 and 1mm in all others
When assessing the rhythm how much variation can be between A P-P or R-R interval?
10% or 1 box per 10
A normal PR interval is how long?
.12 - .20 seconds
The QRS is considered normal at how many seconds?
.11 seconds or less
The QRS complex is considered wide at how many seconds?
> .11 seconds
Less than .11 seconds on the QRS complex is considered to be what?
Supraventricular
A wandering atrial pacemaker is also known as what?
Multiformed atrial rhythm
What is the most common cause of cardiovascular disease death?
Coronary heart disease
The risk of cardiovascular disease doubles every ___ point increase in diastolic BP and every ____ point increase in systolic BP?
10; 20
_____ are bad cholesterol and carry most of the cholesterol in the blood?
LDL’s
_____are good cholesterol and prevent buildup of cholesterol in the arterial walls?
HDL’s
Quitting smoking reduces the risk of heart attack up to ____% after the first year?
50
Where is the base of the heart in correlation to the ribs?
2nd rib
Where is the apex of the heart in correlation to the ribs?
In between the 5th and 6th ribs in the midclavicular line
What is the anterior surface of the heart mostly composed of?
The right ventricle as the heart is slightly turned towards the left
Refers to a change in heart rate?
Chronotropic
Refers to a change in myocardial contractility?
Inotropic
Refers to the speed of conduction through the AV junction?
Dromotropic
How is stroke volume determined?
preload, afterload, and myocardium contractile state
The main electrolytes that affect the heart are?
Sodium, Potassium, Calcium and Chloride
What are the phases of cardiac action potential?
Phase 0: rapid depolarization Phase 1: early rapid repolarization Phase 2: Plateau Phase 3: Final rapid repolarization Phase 4: Resting membrane potential
Relative refractory period is also known as?
The vulnerable period
A weaker than normal stimulus can cause cardiac cells to depolarize during this period is called?
Supernormal period
A record of electrical activity between two electrodes is called?
A lead
Chest leads are also called?
precordial leads
What does the vertical axis on ECG paper represent?
Amplitude
What does the horizontal axis on ECG paper represent?
Time
A normal p wave is no more than ___mm in height and ____seconds in duration?
2.5 and .11
The p wave is positive in what leads?
1, 2, aVF, and V2-V6
Normal duration of the QRS is what?
.11 seconds or less
Low amplitude t waves or Peaked t waves are commonly seen in what?
Hypokalemia or hyperkalemia
A normal PRI is how long?
.12-.20 seconds
A normal QT interval is how long?
.38 seconds however many clinicians don’t consider it long unless the QTc exceeds .44
What segments should be used to estimate the position of the isoelectric line?
TP and PR segments
To evaluate regularity look at what?
P-P or R-R
In general a variation of ____% is considered acceptable when measuring regularity or irregularity?
10
The most inaccurate way to count rate is?
count the QRS complexes in 6 seconds and multiply by 10
What is the most common type of tachycardia?
AVNRT
Monomorphic VT with a ventricular rate greater than 200 beats/min is called?
Ventricular Flutter
When should procainamide be avoided in tachycardic rhythms?
If the patient has a prolonged QT segment or signs of heart failure
True or false, VT is a potentially life threatening dysrhythmia?
True
Polymorphic VT that is triggered by stress or exercise and occurs in the absence of QT prolongation or structural heart disease is called?
chatecholaminergic PMVT
Polymorphic VT that is caused by acute myocardial ischemia or infarction and occurs in the absence of QT prolongation is called?
Ischemic PMVT
What interval is the key to differentiating the type of AV block.
The PR interveral
What artery is associated with AV block occuring in the AV node?
RCA
True or false, Second-degree type II is usually an indication for a permanent pacemaker?
True
What does a pacemaker system consist of?
Pacing lead and pulse generator
A pacemaker malfunction that occurs when the pacemaker fails to deliver an electrical stimulus or when it fails to deliver the correct number of electrical stimulations per minute is called?
Failure to pace
The inability of the pacemaker stimulus to depolarize the myocardium is called?
Failure to capture
When the pacemaker fails to recognize the patients’s ECG waveforms this is called?
Failure to sense
A pacemaker malfunction that results from inappropriate sensing of unrelated electrical signals is called?
Oversensing
Blockage of the left main coronary artery is nicknamed what?
The “Widow Maker”
True or false, Posterior wall infarctions usually occur in conjunction with an inferior or lateral infarction.
True
Inferobasal wall refers to what?
posterior wall
If a patient is having an inferior infarction what should also be checked for infarction?
Right sided MI
Right ventricular infarction involves three main areas, what are they?
hypotension, jugular venous distention, and clear breath sounds
During normal ventricular depolarization, what side of the interventricular septum is stimulated first?
Left side
The best lead to determine right and left bundle branch blocks is what?
V1
A QRS duration between between ___mm and ___mm is called an incomplete block?
.10 and .12
In adults a QRS measuring more than ___mm is considered a complete BBB.
.12
RSR pattern (also known as an M or rabbit ear pattern) is characteristic of what?
Right BBB
A QS pattern is characteristic of what?
Left BBB
A fib can occur when the body reaches less than ____degrees Celsius?
32
Patients with a temperature less than 32 celsius can form a unique ECG pattern called a what?
J wave or Osborn wave (the wave follows the QRS segment or is in the junction of the QRS complex and ST segment. It increases in size with temp depression and disappears with rewarming).
What should be done under the primary survey?
General impression, appearance, work of breathing, and circulation. (ABC’s)
Airway and C-spine, Breathing, Circulation/Bleeding control, LOC, Expose/Environment
Dyspnea that occurs on inspiration suggests what?
obstruction of the upper airway including an allergic reaction, foreign body, laryngeal infection or chemical or thermal injury.
Dyspnea that occurs on expiration suggests what?
lower airway obstruction including pulmonary embolism, pneumothorax, acute pulmonary edema, pneumonia, asthma, and emphysema
Dyspnea relieved by squatting is most often caused by what?
Tetralogy of Fallot, a congenital heart condition
Dizziness with or without blackout is called?
Gray-out (with syncopal episodes)
Prescribed antiarrhythmics are?
digitalis, procainamide, amiodarone, Verapamil
Prescribed anticoagulants are?
enoxaprin, Clopdogrel (plavix), warfarin (coumadin)
Prescribed Angiontensin converting enzyme inhibitors are?
Captopril, enalapril, and Lisinopril
Prescribed beta blockers are?
atenolol, metoprolol, and propranolol
Prescribed diuretics are?
furosemide (lasix)
Prescribed vasodilators are?
Nitroglycerin
Pulsations in the epigastric area is a sign for what?
aortic aneurysm
Clubbing of the fingernails is associated with what?
a variety of respiratory and cardiovascular conditions
S1 occurs when?
during ventricular contraction when the tricuspid and mitral valves are closing
S2 occurs when?
Ventricular relaxation when the when the pulmonic and aortic valves are closing.
S3 is also called what?
Ventricular gallop
The usual cause of an ACS is what?
the rupture of atherosclerotic plaque
Prinzmetal’s Angina results in what and often at what time?
Spasm of a segment of artery and occurs usually at rest or night from midnight to eight am
MI usually results from what?
Thrombus
A type of myocardial infarction caused by a sharp, direct blow to the chest such as by a baseball is called?
Commodio cordis
The severest form of blunt cardiac injury is what?
Cardiac rupture
Complications of MI can be categorized into five categories what are they?
ischemic, electrical, mechanical, inflammatory, and embolic
When is the incidence of VF highest after a STEMI?
the first 4 hours after onset
Angina means squeezing or tightening not what?
Pain
What is the most common symptom of MI?
Chest discomfort
For patients with ACS a 12 lead should be obtained how quickly?
Within 10 minutes of patient contact
Right ventricular failure is often a result of what?
LVF
Cardiac output is calculated how?
stroke volume x heart rate
Heart failure accompanied by hypotension is called?
Cardiogenic shock
What does treatment of heart failure focus on?
correcting hypoxia, reducing preload, reducing afterload, and improving myocardial contractility
A patient with heart failure should weigh themselves every day and should call a physician if he or she gains ____lbs in 1 day or ____over 3-4 day period.
2; 5
The most common cause of cardiogenic shock is what?
MI
The silent killer is called?
hypertension
Normal BP is what?
120/80 and less
Pre-hypertension is what?
120-140/80-90
Hypertension is considered?
Above 140/90
