Cardiology/ Hemodynamics/ Invasive Lines Flashcards
If you detect an inferior MI what coronary artery do you suspect is injured?
RCA
The distal portion of RCA is called the PDA
If you detect an anterior MI, what coronary artery do you suspect is injured?
LAD
If you detect a Lateral MI, what coronary artery do you suspect is injured?
LCX
If you detect a posterior MI, what coronary arteries do you suspect is injured?
RCA or LCX ( RCA is slightly more common)
What drug do you avoid in a symptomatic bradycardia Pt that has had a heart transplant?
Do not give atropine
It won’t work due to the vagus nerve being cut.
What do you give to treat a wide complex tachycardia in the presence of TCA ingestion?
Sodium Bicarbonate
How to treat a wide complex dysrhythmia where you suspect hyperkalemia?
Calcium
What is S1Q3T3 and what does it represent?
S wave in lead I, a small Q and flipped t wave in lead III
Pulmonary Embolism
What’s the difference between endocarditis and myocarditis/ Pericarditis?
Endocarditis is inflammation of the inner walls of the heart. Caused most often by valvular repair and surgery. Look for peds with CHD’s receiving surgery. Bacterial.
Myocarditis/pericarditis is caused by a viral infection.
Any polymorphic Vtach that involves prolonged QTc of 500 or more, should receive what drug?
Magnesium
CVP parameter
2-6 mm/Hg
PAP parameters
Systolic 20-30
Diastolic 8-15
Wedge parameter
8-12 mm/Hg
MAP parameter
65-100 mm/Hg
Cardiac Output parameter
4-8 L/min
Cardiac Index (CI) parameter
2.1-4 L/min/m2
Stroke volume parameter
60-100 mL
Ejection Fraction parameter
55-70%
Calculate MAP
2x diastolic
Add the systolic
Divide by 3
The balloon tip of the PAC is measured with how much air?
1.5 mL
The balloon should always be ____ during transport?
Deflated
IABP
Tip of balloon is placed where?
2-4 cm from aortic arch
Where is the balloons location in the body?
Above the renal artery and below subclavian
When should the balloon inflate?
Just prior to the dicrotic notch
What are the two lethal timing errors?
Early inflation
Late deflation
What does it indicate if you notice rust colored flakes in the supply tubing?
Balloon Rupture
What do you do in case of IABP failure?
Manually inflate the balloon once every 30 minutes
Where to auscultate the aortic valve?
2nd intercostal to the right of the sternum
Where to auscultate the Pulmonic valve?
2nd intercostal to the left of the sternum
Where to auscultate the Mitral valve?
4th or 5th intercostal mid-clavicular line
If you hear an S3 heart tone what is it and what does it indicate?
Ventricular gallop
Indicates dilated cardiomyopathy
If you hear an S4 heart tone what does it indicate?
Hypertrophy, pulmonary hypertension, CHF.
Diastolic problem
What is Debakey
Classifications of thoracic aneurysms
How can an aneurysm present?
Wide mediastinum on CXR
Weak/absent pulses on one side
Tearing like back pain
First line treatments for aneurysm with hypertension
Beta blockers
Esmolol, Metoprolol, Labetalol
Second line of aneurysm with hypertension treatments
Vasodilators
Nicardipine and nitroprusside
Manage the pain
SVR parameters
800-1200
What could be wrong if there is a low or decreased SVR?
Anaphylaxis, neurogenic shock, septic shock, vasodilatory drugs
Increased SVR could mean?
Hypothermia, hypovolemic shock, decreased CO
As far as hemodynamics go, when would dobutamine be used?
Pts with low CI and high PAWP with SBP above 80
