Cardiovascular Flashcards
Diastole can be roughly divided into early ________ _________ and late filling that is altered primarily by compliance (1/stiffness).
myocardial relaxation
Diastole can be roughly divided into early myocardial relaxation and ________ __________ that is altered primarily by compliance (1/stiffness).
late filling
Diastole can be roughly divided into early myocardial relaxation and late filling that is altered primarily by ______________ (1/stiffness).
compliance
Most ventricular diastolic dysfunction severe enough to cause heart failure is due to _________ __________.
myocardial fibrosis
When a ventricle is less compliant or stiffer than normal, for any given volume of blood that fills the chamber in diastole, the pressure is ___________.
higher
Causes of diastolic dysfunction (3)
- Hypertrophic cardiomyoptathy
- Restricive cardiomyopathy
- Pericardial diseases (pericardial effusion, constricitive pericarditis)
With pericardial disease, right heart failure (eg, ascites) predominates because systemic (eg, hepatic) capillaries leak more easily (leak profusely at a pressure of ____ mmHg) than pulmonary capillaries (which can generally withstand a pressure up to 20 mmHg without leaking).
10 mmHg
With pericardial disease, right heart failure (eg, ascites) predominates because systemic (eg, hepatic) capillaries leak more easily (leak profusely at a pressure of 10 mmHg) than pulmonary capillaries (which can generally withstand a pressure up to ____ mmHg without leaking).
20 mmHg
With pericardial disease, _________ heart failure (eg, ascites) predominates because systemic (eg, hepatic) capillaries leak more easily (leak profusely at a pressure of 10 mmHg) than pulmonary capillaries (which can generally withstand a pressure up to 20 mmHg without leaking).
Right
Dilated cardiomyopathy is an example of ______________ dysfunction in which an inherent myocardial disease results in a _______________ in _____________.
- systolic
- decrease in myocardial contractility (myocardial failure)
What is the low dosage of Epinephrine used in CPR?
0.01 mg/kg
High dosage is 0.1 mg/kg after prolonged CPR, and 10 times the dosage may be required when given intratracheally.
How often should Epinephrine be administered during CPR?
Every 3-5 minutes early in CPR (every other cycle)
Used for asystole, ventricular fibrillation, and pulseless electrical activity (PEA).
What is the alternative to Epinephrine, and how frequently is it administered for BLS?
Vasopressin; every 3-5 minutes (every second BLS cycle)
Used for asystole, bradycardia, and PEA.
Indications for Atropine administration in CPR?
Sinus bradycardia, asystole, or PEA associated with high vagal tone
Dosage is 0.04 mg/kg or 0.1 mL/5 lb (0.5 mg/mL solution).
What is the dosage of Lidocaine for pulseless ventricular tachycardia?
2-4 mg/kg
Effective for ventricular fibrillation resistant to defibrillation.
When is Sodium bicarbonate indicated during CPR?
Severe metabolic acidemia (pH < 7.0) and hyperkalemia
Dosage is 1 mEq/kg and must be adequately ventilated to be effective.
What is the recommended dosage of Calcium gluconate, and when is it used?
1 mL/5-10 kg (2% soln w/out epi); used for documented hypocalcemia or severe hyperkalemia
Routine use is not recommended.
Calcium gluconate treats hyperkalemia by stabilizing the cardiac cell membrane, which helps to prevent or reduce the risk of life-threatening arrhythmias caused by high potassium levels, without directly lowering serum potassium
What is the dosage of Amiodarone used in CPR?
5 mg/kg
Indicated for refractory ventricular fibrillation or pulseless ventricular tachycardia.
Indications for Magnesium sulfate administration?
Hypomagnesemia, torsades des pointes
Dosage is 30 mg/kg.
What are the defibrillation energy levels for external monophasic?
4-6 J/kg
For external biphasic: 2-4 J/kg; internal monophasic: 0.5-1 J/kg; internal biphasic: 0.2-0.4 J/kg.
What should be done immediately after a defibrillation shock?
Resume CPR efforts for one cycle (2 minutes) and reassess ECG
Dosage escalation by 50% may occur after reassessment, with a maximum dosage of 10 joules/kg.
True or False: Dosage should be doubled if given via the intratracheal route.
True
This applies to certain medications during CPR.
What is first degree AV block characterized by?
Prolongation of PR interval: p-R > 140 msec
First degree AV block indicates a delay in conduction through the AV node.
What usually causes first degree AV block?
Fibrosis in the AV node
Fibrosis can result from various systemic diseases or aging. First degree AV block also leads to low conduction in the AV node
