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My CCRN > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What causes an S3 heart sound, and when would it occur in the cardiac cycle?

A

Caused by a rapid rush of blood into a dilated ventricle, during early diastole; ventricular gallop, ‘kentucky’

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2
Q

Common causes of an S3 heart sound:

A

HF, pHTN, mitral/aortic/tricuspid insufficiency

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3
Q

What causes an S4 heart sound, and when would it occur in the cardiac cycle?

A

Caused by atrial contraction of blood into a non-compliant ventricle, during diastole just before S1

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4
Q

Common causes of an S4 heart sound:

A

myocardial ischemia, infarction, HTN, ventricular hypertrophy, AORTIC STENOSIS

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5
Q

What is pulse pressure and what is the normal range?

A

systolic - diastolic = pulse pressure
normal: 40-60 mm Hg

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6
Q

What do systolic and diastolic blood pressure approximate ?

A

SBP - indirect measure of CO + SV
DBP - indirect measure of SVR

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7
Q

During what part of the cardiac cycle are the coronary arteries perfused?

A

Diastole

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8
Q

Which valves are open during diastole?

A

mitral + tricuspid (open during ‘fill’ time)

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9
Q

Which valves are open during systole?

A

pulmonic + aortic (open during ‘eject’ time)

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10
Q

What type of murmurs are heard during systole?

A

-AV stenosis
-Pulmon. valve stenosis
-MV insuff/regurg
-TV insuff/regurg
-VSD

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11
Q

What type of murmurs are heard during diastole?

A
  • AV insuff/regurg
  • Pulmon insuffic/regurg
  • MV stenosis
  • TV stenosis
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12
Q

Which murmur can result from ongoing atrial fibrillation?

A

mitral stenosis s/t atrial enlargement

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13
Q

What murmurs might result from an acute MI?

A
  • Mitral regurg ( s/t papillary muscle dysfunction/rupture–medical emergency)
  • VSD
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14
Q

List some atypical symptoms of MI (commonly seen in women, pt’s > 75 y.o., diabetics).

A
  • nausea
  • SOB
  • extreme fatigue
  • syncope/falls
  • acute delirium
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15
Q

What distinguishes a STEMI and NSTEMI?

A

NSTEMI – positive trop, ST depression, T wave inversion, unrelenting CP

STEMI – positive trop, ST elevation in 2 or more contiguous leads, unrelenting CP

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16
Q

What are the features of unstable angina?

A

negative trop, CP at rest, unpredictable CP that may be relieved w/ nitro, ST depression or T wave inversion

17
Q

Describe variant/Prinzmetal’s angina.

A
  • transient ST elevation
  • caused by coronary artery spasm (may or may not be atherosclerotic)
  • negative troponin
  • nitro helps
  • occurs at rest
18
Q

When would you not give beta-blockers for acute chest pain?

A
  • ACS related to cocaine use
  • hypoTN, bradycardia
  • taking phosphodiesterase inhibitors
19
Q

Changes in leads II, III, aVF indicate an MI where?

A
  • RCA
  • inferior LV
20
Q

Changes in leads V1, V2, V3, V4 indicate an MI where?

A
  • LAD
  • anterior LV
21
Q

Changes in V5, V6, I, aVL indicate an MI where?

A
  • circumflex
  • lateral LV
22
Q

Changes in V5, V6 indicate an MI where?

A
  • low lateral LV
23
Q

Changes in I, aVL indicate an MI where?

A
  • high lateral LV
24
Q

Changes in V1, V2 indicate an MI where?

A
  • RCA
  • posterior lV
25
Q

Changes in V3R, V4R indicate an MI where?

A
  • RCA
  • RV infarct
26
Q

What are the characteristics of an inferior wall MI?

A
  • RCA occlusion
  • ST changes in II, III, aVF
  • AV conduction issues: 2nd deg AV block I, 3rd deg AV block, sick sinus, brady (use BB and nitro w/ caution)
  • systolic murmur associated with MVR ( if acute, could be papillary wall rupture/dysfunction)
27
Q

What are the characteristics of an RV infarct?

A
  • JVD at 45 degrees
  • elevated CVP
  • hypotension
  • brady-arrhythmias
  • caution w/ BB, avoid nitrates + diuretics
28
Q

What are the characteristics of an Anterior wall MI?

A
  • LAD occlusion
  • ST changes in V1-V4
  • Possible rhythms: 2nd deg AV block II, RBBB
  • Possible systolic murmur (VSD)
29
Q

What is the most common complication of an acute MI?

A

Arrhythmias (VT, Vfib, afib, bradycardia, heart blocks, sick sinus)

30
Q

What are the signs of a vasovagal response?

A
  • hypotension
  • pallor
  • nausea
  • yawning
  • diaphoresis
31
Q

How long should you hold pressure after an arterial sheath pull?

A

20-30 minutes

32
Q

How do you know re-perfusion has occurred after a PCI?

A
  • CP relief
  • Resolution of ST changes
  • Trop elevation d/t myocardial ‘stunning’ after return of blood flow
  • May see arrhythmias (VT, VF, accelerated idioventricular rhythm) also d/t myocardial ‘stunning’
33
Q

Name 2 complications of a PCI (that Barron says will most likely be on test, lol).

A
  1. stent thrombosis (either acutely–within 24 hr, or sub-acutely–within 30 days)
  2. retroperitoneal bleed

My CCRN (1 decks)

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