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CCRN > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Which heart sound is associated with heart failure?

A

S3

  • may occur before crackles
  • caused by rush of blood into dilated ventricle
  • occurs early in diastole
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2
Q

S3 is caused by:

A
  • pulmonary hypertension and cor pulmonale

- mitral, aortic, or tricuspid insufficiency

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3
Q

Systolic blood blood pressure is and indirect measurement of what?

A

cardiac output and stroke volume

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4
Q

Diastolic blood pressure is an indirect measurement of what?

A

systemic vascular resistance (SVR)

-A decrease in diastolic pressure (wider pulse pressure) may indicate vasodilation, drop in SVR (sepsis, septic shock)

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5
Q

When are coronary arteries perfused?

A

during diastole

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6
Q

Murmurs of insufficiency occur when the valve is open or closed?

A

closed

acute or chronic

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7
Q

Murmurs of stenosis occur when the valve is open or closed?

A

open

chronic

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8
Q

Difference between Unstable Angina and NSTEMI?

A

NSTEMI: positive troponin, unrelenting chest pain

  • Both will have ST depression or T-wave inversion
  • (Unstable angina can be relieved by nitro)
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9
Q

What is Prinzmetal’s angina, aka variant

S/S of Variant or Prinzmetal’s Angina:

A
  • Unstable angina with transient ST elevation (pain and ST relieved by nitro)
  • Due to coronary artery spasm
  • Occurs randomly, or at rest, or same time each day
  • Can be due to nicotine, ETOH, or cocaine
  • Troponins are negative
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10
Q

Treatment/Management of Chest Pain

A
  • Stat EKG
  • (MONA)
  • Anticoagulant
  • Antiplatelet
  • Beta blocker
  • Treat the pain (nitro/morphine)
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11
Q

Types of antiplatelet agents:

A
  • Clopidogrel (Plavix)
  • Abciximab (Reopro)
  • Eptifibatide (Integrilin)
  • Tirofiban (Aggrastat)
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12
Q

Contraindications of beta blocker for ACS

A

-cocaine, hypotension, bradycardia, use of phosphodiesterase inhibitor drugs like sildenafil (Viagra)
(Metoprolol is cardioselective but propranolol isn’t)

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13
Q

What labs would you check for ACS/Chest Pain?

A

cardiac biomarkers, lipid profile, CBC, electrolytes, BUN, creatinine, mag, PT, and PTT

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14
Q

ECG lead changes in RCA and inferior LV

A

II, III, and aVF

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15
Q

ECG lead changes in LAD and anterior LV

A

V1, V2, V3, V4

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16
Q

ECG lead changes in circumflex and lateral LV

A

V5, V6, I, and aVL

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17
Q

ECG lead changes in low lateral LV

A

V5 and V6

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18
Q

ECG lead changes in high lateral LV

A

I and aVL

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19
Q

LOOK up videos and stuff for page 27, lead changes based on location of CAD

A

ugh (the last two bullets I didn’t make cards for)

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20
Q

Circumflex supplies what part of the heart? Which ECG leads?

A

lateral

I, aVL, V5, V6

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21
Q

RCA supplies what part of the heart? Which ECG leads?

A

Inferior

II, III, aVF

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22
Q

LAD supplies what part of the heart? ECG leads?

A

anterior wall and septum (bundle of His)

-Vleads 1-4 (V1, VII, VIII, V4)

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23
Q

Where in the heart is conduction located? Which wall?

A

Inferior (AV node and SA node)

24
Q

Circumflex supplies the ____ part of the heart

A

Lateral wall

25
Q

RCA supplies the ______ part of the heart

A

Inferior wall

26
Q

LAD supplies the ____ part of the heart

A

Anterior wall and septum

27
Q

S1 sounds
caused by closure of ____ valves
loudest at the ____
marks the end of ______

A

closure of AV valves
loudest at the apex
end of diastole, beginning of systole

28
Q

S2
caused by closure of _____ valves
loudest at the ____
marks the end of ____

A

closure of semilunar valves (aortic/pulmonic)
loudest at the base
end of systole, beginning of diastole

29
Q

S3 is caused by….?

A

heart failure, pulmonary hypertension, cor pulmonale, or mitral/aortic/or tricuspid insufficiency

30
Q

what’s a normal pulse pressure?

A

40-60

systolic - diastolic

31
Q

What is the evidence of reperfusion (post fibrinolytic therapy for MI)?

A

relief of chest pain
no more ST deviations
Increased troponin and CK-MB
Reperfusion arrhythmias (VT, VF, accelerated ICR)

32
Q

review page 29 (infarcts)

A

vbn,

33
Q

look up

A

Sic Sinus Syndrome

34
Q

what are two complications of PCI?

A

Stent thrombosis (chest pain, ST elevation) and retroperitoneal bleed

35
Q

prolonged QT interval can lead to

A

torsades de point

36
Q

Causes of prolonged QT :

and treatment?

A

Drugs: amio, quinidine, haldol, procainamide
Electrolyte problems: hypokalemia, hypocalcemia, hypomagnesmia

tx: magnesium

37
Q

failure to pace:
failure to capture:
failure to sense:

A

pace: no spike (at all) when expected
capture: spike without a QRS (for vent pacing)
sense: pacing in native beats

38
Q

systolic dysfunction (heart failure): associated with EF of …

A

40% of less

39
Q

which heart failure shows an enlarged heart on x-ray

A

systolic HF

40
Q

s/s of right sided heart failure (7)

A 
hepatomegaly
splenomegaly
dependent edema
venous distention
elevated CVP/JVD
tricuspid insufficiency 
abdominal pain
41
Q

s/s of left sided heart failure

A 
orthopnea, dyspnea, tachypnea
hypoxemia
tachycardia
crackles
cough with pink, frothy sputum
elevated PA diastolic/PAOP
Diaphoresis
Anxiety, confusion
42
Q

what are the differences between dilated and hypertrophic cardiomyopathy?

A

Dilated: Systolic dysfunction, thinning, enlargement of LV; mitral valve regurge common d/t vent dilation

Hypertrophic: Diastolic dysfunction, thickening of heart muscle and septum (at the expense of the LV chamber)

43
Q

How is left ventricular preload and afterload affected by cardiogenic shock?

A

preload is elevated with associated pulmonary symptoms (high PAOP)

left ventricular afterload (SVR) is elevated d/t vasoconstrictive compensatory mechanisms

44
Q

what are 3 positive inotropes used to treat cardiogenic shock

A

norepi
dopamine
dobutamine, milrinone

45
Q

In treatment of cardiogenic shock, what will enhance the effectiveness of the “pump”?

A

positive inotropes (levo, dopa, milrinone/dobutamine)

46
Q

In treatment of cardiogenic shock, what will decrease the demand on the “pump”?

A 
preload reduction
afterload reduction
optimize oxygenation
mechanical ventilation
treat pain
IABP for short term support
VAD (ventricular assist device), may be used for longer periods of time than IABP
47
Q

VAD are used in which conditions?

A

ventricular heart failure, cardiogenic shock, and cardiac myopathies, pts awaiting heart transplant

48
Q

What are the benefits of IABP therapy?

A

increases coronary perfusion and decreases afterload

49
Q

What are 2 life threatening complications of a CABG?

A

tamponade and pericarditis

50
Q

look up mediastinum

A

asdf

51
Q

Which leads show the circumflex ?

A

lateral leads (I, AVL, V5, and V6)

52
Q

which leads show the RCA?

A

inferior leads (II, III, and AVF)

53
Q

Which leads show the LAD?

A

septum and anterior leads (V1-V4)

54
Q

Which coronary artery supplies the SA and AV nodes?

A

RCA

55
Q

An occlusion in the bundle of His would result in what heart block?

A

second-degree type II

56
Q

What part of the heart does the RCA supply?

A

left ventricle

57
Q

Where is the mitral valve attached on the heart?

A

left ventricle

CCRN (4 decks)

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