CARDIOVASCULAR ASSESSMENT Flashcards
the part of the ventral surface of the body overlying the heart and stomach and comprising the epigastrium and the lower median part of the thorax
Precordium
2nd ICS to right of sternum (closure of the aortic valve loudest here).
Aortic area
2nd ICS to left of sternum (closure of the pulmonic valve loudest here).
Pulmonic area
5th ICS left of sternal border (closure of tricuspid valve).
Tricuspid
5th ICS left of the sternum just medial to MCL (closure of mitral valve).
Mitral
When ______ is increased as in anemia, anxiety, HTN, fever, the impulse may have greater force - inspect for lift or heave.
cardiac output
Events in the cardiac cycle generate sounds that can be heard through a _______ over the ______. These include normal heart sounds and, occasionally, extra heart sounds and murmurs.
stethoscope over the chest wall
The first heart sound
systolic S1
Consists of mitral M1 and tricuspid T1 components.
Systolic (S1)
Systolic (S1), the first heart sound, is
is loudest at the _____
apex
The second heart sound, diastolic S2,
signals the closure of _______ and the end of systole.
semilunar valves
Consists of aortic Az and pulmonic P2 components.
diastolic S2
The second heart sound - diastolic S2, is loudest at the _____.
base
S1 & Se correspond respectively to the familiar “_____” often used to describe the sounds.
“lub dub”
is the result of vibrations produced during ventricular filling.
S3
is normally heard only in some children and young adults, but it is considered abnormal in older individuals.
S3
is caused by the recoil of vibrations between the atria and ventricles following atrial contraction, at the end of diastole.
S4
is rarely heard as a normal heart sound; usually it is considered indicative of further cardiac evaluation
S4
______ of blood per min throughout the body
4 to 6 Liters
venous return
Preload
the opposing pressure the ventricles must generate to open aortic valve.
Afterload
Transition from fetal circulation to postnatal circulation. By 9 months anatomical closure of ________ occurs.
foramen ovale
S1 and Sa sounds similarly on auscultation. Pulse rate is _____
120/min.
For infants, Horizontal position of the heart is only until_____ years-old
7 years old
By the end of pregnancy blood volume increases by _____ %.
30 to 40 %
Stroke volume and cardiac output are ______ in pregnant females.
BP decreases due to vasodilation.
increased
Pulse rate increases of _____ beats/min in pregnant females.
10 to 15 beats/min
Is the need to assume a more upright position to breathe.
Orthopnea
occurs with myocardial infarction or low cardiac output.
Cyanosis or pallor
Swelling of legs or dependent body part due to increased interstitial fluid.
Edema
Occurs with heart failure in the person who is ambulatory during the day.
Nocturia
the pulsation created as the left ventricle rotates against the chest wall during systole.
apical impulse
Is used to estimate approximately heart borders and configuration.
percussion
Recently is displaced by the chest x-ray or EchoCG and Helps to detect heart enlargement
percussion
The diseases and conditions affecting the heart are collectively known as _____
heart disease.
These are diseases of the arteries that supply the heart muscle with blood. It is one of the most common forms of heart disease and the leading cause of heart attacks.
Coronary artery disease (CAD)
It generally means that blood flow through the coronary arteries has become obstructed. It can lead to other heart problems, such as chest pain (angina) and heart attack (myocardial infarction).
Coronary artery disease
In Coronary artery disease (CAD), the most common cause of such obstructions is a condition called ______, a largely preventable type of vascular disease.
atherosclerosis
a disease of the heart itself caused by the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium
Coronary heart disease
another disease of the heart
itself, characterized by reduced blood supply to the organ.
Ischaemic heart disease
a sub-umbrella term for a number of diseases that that affect the heart itself and/or the blood vessel system, especially the veins and arteries leading to and from the heart. Causes of this disease include diabetes mellitas, hypertension and hypercholesterolemia.
Cardiovascular disease
a failure of the right side of the heart.
Pulmonary heart disease
heart disease caused by inavoidable genetic factors
Hereditary heart disease
heart disease caused by high blood pressure, especially localised high blood pressure
Hypertensive heart disease
heart disease that involves inflamation of the heart muscle and/or the tissue surrounding it.
Inflammatory heart disease
heart disease that affects the valves of the heart.
Valvular heart disease
These are diseases of the sac that encases the heart (pericardium). These can occur alone or together. The causes of this disease vary, as do the problems they may lead to. For instance, pericarditis(inflammation) can occur after a heart attack and, as a result, lead to pericardial
effusion or chest pain
Pericardial disease,
fluid accumulation
pericardial effusion
stiffness
constrictive pericarditis
These are forms of heart disease that develop before birth. Congenital heart disease is a broad term and includes a wide range of diseases and conditions. These diseases can affect the formation of the heart muscle or its chambers or valves. They include such conditions as narrowing of a section of the aorta (coarctation) or holes in the heart (atrial or ventricular septal defect).
Congenital heart disease
These blood vessels carry blood away from the heart and out to the body, delivering oxygen and nutrients. The aorta is the largest blood vessel of all.
Arteries
These blood vessels carry deoxygenated blood back to the heart. Lacking oxygen, they have a bluish cast on the skin
Veins
These tiny vessels connect arteries and veins.
Capillaries
Fluid leaks out of capillaries to bathe cells. They are delicate vessels that carry this fluid back into the body’s central circulation.
Lymphatics
are conditions in which the walls of the arteries become thick and stiff. This can sometimes restrict blood flow to the organs and tissues.
Arteriosclerosis and atherosclerosis
The process of this thickening and stiffening is ________. ________ is the most common form of it.
arteriosclerosis;
Atherosclerosis
________ refers to hardening of the arteries caused by accumulation of fatty deposits (plaques) and other substances. The heart is one of the organs commonly affected by it.
atherosclerosis
is the excessive force of blood pumping through the blood vessels. It’s perhaps the most common form of cardiovascular disease in the Western world, affecting about one in four Americans. Although potentially life-threatening, it’s one of the most preventable and treatable types of cardiovascular disease.
High blood pressure (hypertension)
_____, is a sudden loss of brain function. It occurs when blood flow to the brain is interrupted (ischemic stroke) or when blood vessels in the brain rupture (hemorrhagic stroke). These, in turn, cause the death of brain cells in the affected areas. This is often thought of as a neurological disorder because of the many complications it causes.
Stroke
______, is a bulge or weakness in the wall of an artery or vein. This usually enlarge over time. Because of that, they have the potential to rupture and cause life-threatening bleeding. It can occur in arteries in any location in the body.
Aneurysm
The most common sites of aneurysm include the _____ and _____.
abdominal aorta;
the arteries at the base of the brain.
Detects heart abnormalities, disease and
damage by measuring the heart’s rhythms and electrical impulses.
Electrocardiography (EKG / ECG)
It can assess the heart’s reaction under
physical stress.
Stress Test/ Exercise tolerance test (ETT) / treadmill test
Doctors inject a radioactive substance into the blood, then use gamma-ray cameras to see how the blood moves through the heart. The test shows how well the heart is doing at keeping itself saturated with oxygen-rich blood. The test is often done twice, to check cardiac performance at rest and under physical stress.
NUCLEAR STRESS TESTING
Harmless ultrasound waves, similar to the ones used to take sonograms of a fetus, are directed at the chest and bounce off the heart’s walls and valves.
A computer analyzes these rebounding waves and calculates the size, shape and movement of structures inside the heart. Doctors often take two echoes - one of the heart at rest and another of the heart under stress (e.g., after the patient exercises on the treadmill or after technicians have injected a drug to make the heart race).
ECHOCARDIOGRAM (ECHO)
This test combines rapid X-ray
scanning with multiple computed topography (CT) to produce the most detailed images available of the heart’s arteries without surgery. Patients receive an injection of contrast dye to highlight the blood vessels and X-rays create images of the heart in slices. A computer assembles the slices into an image of the heart that reveals calcium and fat-filled plaques lodged in the arteries.
CT SCAN
Powerful magnets create a field that sets the nuclei of atoms in heart cells vibrating. The oscillating atoms emit radio signals, which are converted by computer into either still or moving 3-D images. The arrow at left points to a plaque filled spot in the artery; the scan also reveals the layer of fat that envelops most hearts.
MAGNETIC RESONANCE IMAGING (MRI)
