Cardiovascular Disturbances Flashcards
High levels can irritate blood vessels, raise LDL Levels Marker for Irritation and Inflammation
Homocysteine
ECHO–> Lateral motion & spatial relationship
2-D
Pace Maker of the Heart
SA Node
initiates electircal impulse
Pulses Alterans
Weak and Strong beats arnateltrnate
(depression of LV decreases)
–> info about abnormalities of valvular structure & motion, chamber sz/ contents, ventricular & septal motion/ thickness, pericardial sac, ascending aorta
ECHO
TEE
Transesophageal Echocardiogram
Frank Starlings Law
*Fiber stretch during diastole -> increased force of contraction (systole) *
Transesophageal Echocardiogram
more precise echo of heart than 2-d less interference from chest wall structures –> high quality of images of thoracic aorta (except superior ascending)
Troponin I
Fastest, longest, most specific –> MI
T wave
Repolarization of ventricles
Firing of the SA nodes/ depolarization of the atrial fibers
Impulse through atria
P wave
Xanthomas
Yellow plaque cholesterol filled nodules on eyelids and ears
S1
closure of tricuspid & mitral valves
beginning of systole
sumulataneous w/ carotid pulse
heard best at mitral valce (5th ics, mcl)
=CO
SV x HR
Normal (4-8L/min)
Pulse Deficits are caused by
incomplete filling of the ventrical prior to contraction –> unable to produce a palpable pulse
Volume of blood ejected with each contraction
Stroke volume
=Cardiac Index
CO/BMI
M-mode (Echo)
Motion view –> precise views
McCarthy’s Sign
Diagonal earlobe crease
may predict heart disease/ heart attack?
Troponin T Norm. Level
C-Reactive Protein
Indicates inflammation Correlation of CRP to CAD Woman W/ Increased Levels More likely to die
Murmur
I/VI
II/VI
III/VI
IIII/VI
V/VI
VI/VI
Soft, faint, barely audible
Quiet, soft but audible
Easily audible
Loud asc w/ thrill
Extremely Loud w/ palpable thrill
Loudest w/ Visible Thrill
Measures heart’s electrical activity as wave
electrodes on chest & Limbs Standard = 12 leads
ECG/EKG
Coronary arteries are perfused during
diastole
Medications that reduce both preload and after load
Nipride
Morphine
Natrecor
(Vasodilators)
Homocysteine (High)
>15 umol/l
Hyperkinetic
Bounding
Widend pulse pressure
Doppler technology –> direction and flow of blood through heart
Echo
S3
Ventricular Gallop
early systole
d/t vibrations during rapid early ventricular filling
CHF, Mitral Regurg, Constrictive Pericardium, L to R Shunts
(Ken tuc KY)– Lub Dub Dee
Normal BNP Level
< 100pg/ml
Troponin Time Frames
3-12, 24-48 (peak) norm (5-14days)
S2
Closure of **aortic & pulmonic valves **
Sharp
Beginning of diastole
- RSB 2nd ICS*
- Repolarization*
Myoglobin Time Frame
Rise 30-60min, peak 6-7hrs, returns to norm 24hrs
30-6-24
Infraction of the RCA affects
Condution
* supplies SA&AV nodes, Bundle of His
Creatnine Kinase
Rise 4-6 hrs after onset of MI 3-12 hrs, peak 18-24hrs, norm (2-3days) Confirm/ rule out MI
Pressure against which left ventricle must pump to overcome higher pressure in aorta to eject blood
After-load
Cardiac Markers
Troponins
BNP
CK Myoglobin Homocysteine CRP
Pulses Paradoxus
>10mmHg SBP during norm inspiration
NPO Time (TEE)
6 hours before
needed DD
Holter Monitor
Ambulatory ECG 24-48 HRS *Pt keeps diary of activities & symptoms* No shower/ bath wearing monitor
Pharmacological Echo
Sub for exercise
Widow Maker
LAD
BNP***
increased ventricular volume & pressure (heart failure) Accurately dx and grade heart failure
Myoglobin Normal Level (Male)
Homocysteine (Normal)
Most important dx test to determine extent and treatment for MI
Serial ECG’S
High CRP Indicates
MI Angina Lupus Trauma Post-op Heatstroke
S4
Atrial Gallop
blood forced into a ventricle that resist filling
HTN, MI, CAD, L Vent Hypertrophy, Aortic Stenosis
Dee Lub Dup
Murmur Grading
6 pt scale of loudness (soft to loud)
Recorded as Roman Numeral Ratio
Numerator= (intensity)
Always over VI
Paracardial Friction Rub
Inflammation of Paricardial Sac
scratchy sound @ erbs point
Myoglobin Normal Level (Female)
Pulsations of the epigastric region may reflect…
abdominal aortic aneurysm
Myoglobin
Early indicator–> NOT specific Released into blood w/ ischemia, trauma, & inflammation of muscle Angina/ Cardioversion –> elevation
Homocysteine (Mod)
12-15 umol/l
CRP Levels
Norm 3mg/L
Left Anterior Descending Artery supplies
Anterior interventricular septum
Anterior Wall of the Left Ventricle
Apex
*Anterior wall MI
Differences in left ventricular wall motion and thickening before & after exercise
Stress Echo
QRS complex
depolarization from AV node through the ventricles
Tamponade
Fluid around the heart –>constricts the heart
Ultrasound waves record movement of structures of heart
Echocardiogram
Troponin I Normal Level
0.4 ng/ml
Hypokinetic
(Weak) Narrowed Pulse Pressure
Veins
Low pressure, high volume, thin walled
Affect After-load
Ventricle Size
Wall Tension
BP
Infraction of the Left Cicumflex Coronary Artery affects
lateral & posterior wall of LV & posterior IVS (interventricular septum)
Affect Stroke Volume
Preload
Contractility
After-load
U wave (electrocardiograph)
May –> repolarization of the Purkinje Fibers or hypokalemia
Nursing Considerations (TEE)
bite block, spray throat, remove dentures
sedation –>No eating/ drinking until gag reflex returns
Monitor V/S, O2 Sats
Suction