Cardiovascular Emergencies Flashcards
What is a bruit? What does it indicate?
Abnormal whooshing sound heard over main blood vessel
Indicates turbulent flow within blood vessel
What is a bruit usually a sign of?
Localized arteriosclerotic disease
What is arteriosclerotic disease?
Thickening or hardening of arteries
What is atherosclerosis?
Disorder in which cholesterol and other fatty substances build up and form plaque inside walls of blood vessels
What is angina pectoris?
When heart tissue isn’t getting enough oxygen and causes chest pain for a brief time
What is angina pain described as?
I
Crushing
Squeezing
Someone standing on my chest
Chronotroptic state refers to?
Hearts rate
Dromotropic state refers to?
Hearts conduction
Inotropic state refers to?
Hearts strength of contraction
What supplies oxygen and nutrients to the heart?
Coronary arteries
What is a class of clot busting drugs used to remove plaque from the coronary artery?
Fibrinolytics
What are three ways pain from an AMI differs from angina?
May or may not be caused by exertion
Doesn’t resolve in a few minutes
May or may not be relieved
What are two classes of drugs that will help cardiogenic shock?
Inotropics
Antiarrhythmias
What happens during congested heart failure?
The heart fails to pump blood effectively and it backs up into the pulmonary veins
What color sputum occurs with pulmonary edema?
Pink frothy sputum
Chronic pedal edema may indicate what?
Underlying heart disease (right sides heart failure)
How should you position a patient with congestive heart failure?
Sitting up
Not laying down
What is cardiomegaly?
Enlarged heart
What can continued hypertension lead to?
Stroke
What are some signs of hypertension?
Vertigo Epistaxis Tinnitus Vision changes Nausea Seizures
What are four drugs used or cardiac chest pain?
Oxygen
Aspirin
Nitroglycerin
Morphine
What does the left coronary artery subdivide into?
Left anterior descending artery
Circumflex coronary artery
What electrolyte flows into the cell to initiate depolarization?
Sodium (NA+)
What electrolyte flows out of the cell to initiate repolarization?
Potassium (K+)
Hypokalemia can lead to what?
Increased myocardial irritability
Hyperkalemia can lead to what?
Decreased automaticity/conduction
Hypocalcemia can lead to what?
Decreased contractility and increased myocardial irritability
Hypercalcemia can lead to what?
Increased contractility
Which electrolyte maintains depolarization and involved in heart tissue contraction?
Calcium (Ca++)
What electrolyte stabilizes cell membrane and opposes action of calcium?
Magnesium (Mg++)
Hypomagnesium can lead to?
Decreased conduction
Hypermagnesium can lead to?
Increased myocardial irritability
What agents will affect only the heart?
Beta agents
The arteries have receptors for what agents?
Alpha and beta
Alpha agents will cause what?
Vasoconstriction
Beta agents will cause what?
Vasodilation
Beta 1 drugs act primary on the?
Cardiac beta receptors
Beta 2 drugs act primarily on the?
Pulmonary beta receptors
What kind of agent is norepinephrine (levophed)?
Sympathetic agent (primarily alpha)
Causes vasoconstriction
S1 heart sounds occur when which valves close?
Tricuspid and mitral valves
S2 heart sounds occur when which valves close?
Semi lunar valves:
Pulmonary and aortic valve
When s3 heart sounds are heard in older adults, what does that indicate?
Heart failure
Which lead tracing is most useful on an ECG?
Lead 2
What are two main groups of leads?
Limb leads
Precordial leads
What leads are limb leads?
I II III aVR aVL aVF
What are bipolar leads?
Leads that contain a positive and negative pole
Which leads are bipolar?
I
II
III
What are augmented unipolar leads?
Has one true pole while the other end of the lead is referenced against a combination of other leads
What leads are augmented unipolar leads?
aVR
aVL
aVF
What is the j point?
Point in ECG where QRS complex ends and ST segment begins
It depresses or elevates if myocardium is ischemic
What are precordial leads?
6 limb leads you attach with 12 lead
V1-V6
What leads look at the septum?
V1
V2
What leads look at the anterior wall of left ventricle?
V3
V4
Which leads look at the lateral wall of the left ventricle?
V5
V6
I
aVL
Which leads look at the inferior wall of the left ventricle?
II
III
aVF
What is a vector?
Term to describe the direction and force of an electrical charge
What is an electrical axis?
The sum of all the vectors
What’s the axis if lead 1 is positive and aVF is positive?
Normal axis
What is the axis if lead 1 is positive and aVF is negative?
Left axis deviation
What is the axis if lead 1 is negative and aVF is positive?
Right axis deviation
What is the axis if lead 1 is negative and aVF is negative?
Extreme right axis deviation
What happens to axis deviation if one of the ventricles is enlarged?
More electrical energy is contributed with larger ventricle and causing the vector to point in the direction of enlargement
What happens to axis deviation if one of the ventricles is infarcted?
No electrical activity is being contributed to dead tissue and vector with point away from it
Which leads do you look at to determine axis deviation?
I
aVF
What is collateral circulation?
Physiological response during 4-5 decade that creates different pathways for blood flow in case of an occlusion
ST segment that that depresses below the isoelectric lines is considered?
Ischemia
ST segment that elevated above the isoelectric line is considered?
Myocardial injury
What are two primary causes for left atrial enlargement?
Systemic hypertension
Mitral/aortic stenosis
What primarily caused right atrial enlargement?
Chronic pulmonary disorders
How do you see right atrial enlargement on an EKG?
P wave has amplitude greater than 2.5mm in lead 2 and/or higher than 1.5 in V1
How do you determine left atrial enlargement on EKG?
P wave longer than 110 ms in lead II
Notched P wave
P wave in V1 primarily negative
What is a murmur? What does it indicate?
Abnormal whooshing sound heard over heart
Indicators turbulent blood flow within heart
