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536 Body Systems > Cardiovascular Examination > Flashcards

Cardiovascular Examination Flashcards

1
Q

S/S indicating cardiovascular examination necessary

A

chest pain, SOB, palpitations
fatigue
syncope/dizziness
Hx smoking/drugs/alcohol
symptoms brought on by exertion
onset/progression, nature, aggravating/alleviating factors

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2
Q

chart review for cardiac examination

A

imaging/procedures/lab values/ABGs
PMH/PSH
medications
nutrition
social history

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3
Q

General components of cardiac exam for PT

A

observe posture, breathing, cough
skin color/diaphoresis
pulse rhythm/quality
vitals
heart/lung sounds
chest wall motion/palpation
rhythm -EKG
circulation/lypmhatic system

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4
Q

pericarditis: condition/causes

A

inflammation of pericardium or serous fluid, self limited 1-3 weeks
most often viral, can be bacterial/inflammation induced from other cause
systemic disease can also onset or trauma

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5
Q

pericarditis: S/S

A

sharp/dull retrosternal pain
worse with cough/breathing/supine
relieved by sitting up/forward
dyspnea/cough
malaise/fever
EKG usually normal or ST elevation
friction rub on auscultation as layers rub together

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6
Q

pericarditis management

A

rest, pain relief, high dose antibiotics, pericardial drainage

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7
Q

constrictive pericarditis

A

chronic form, results in thickening pericardium restricting heart expansion

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8
Q

constrictive pericarditis s/s

A

dyspnea, fatigue from decreased CO
syncope/dizzyness
retrosternal chest pain
JVD

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9
Q

pericardial effusion

A

accumulation of fluid in pericardial space beyond normal 15-50 mL
stiff pericardium doesn’t tolerate fluid fluctuations

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10
Q

pericardial effusion s/s

A

fullness in chest, cough, dysphagia
muffled heart/lung sounds, dull percussion L lung
enlarged cardiac silhouette on xray
ECHO

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11
Q

pericardial effusion treatment

A

pericardiocentesis to drain fluid

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12
Q

cardiac tamponade

A

overaccumulation of pericardial fluid exerts pressure on heart
caused by pericarditis especially from cancer, viral, trauma, aortic aneurysm
results in poor filling of the heart, decreased BP, death

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13
Q

cardiac tamponade s/s

A

hypotension, shock, decreased CO like dyspnea/syncope, cough, tachycardia/pnea
JVD, decreased heart sounds
Beck’s triad: hypotension, JVD, muffled heart sounds

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14
Q

cardiac tamponade treatment

A

pericardial window to relieve pressure and drain fluid
pericardiocentesis

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15
Q

endocarditis

causes, tests

A

endocardium infection
often travels from other part of the body
eg dental work, GI/urinary procedure, catheter, tattoo
at risk those w artificial valve/damaged valve
can travel in body
test for w labs for inflammation, EKG, ECHO/TEE

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16
Q

endocarditis s/s

A

flu like rapid onset
mitral valve regurgitation

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17
Q

endocarditis treatment

A

long term antibiotics
cardiac supportive measures
may need valve replacement

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18
Q

myocarditis

causes and possible effects

A

inflammation of heart muscle
drug induced bac/viral infection
weakens pump/conduction
can lead to MI/CVA/arrhythmia/heart failure

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19
Q

myocarditis s/s

A

fever, diffuse chest pain, fatigue, SOB, edema

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20
Q

modifiable risk factors for cardiovascular disease

A

cholesterol
stress
diabetes
diet
HTN
weight BMI>30
activity level
tobacco

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20
Q

coronary artery disease

A

coronary arteries damaged or diseased
atherosclerotic plaque formed in vessel lumen
caused by fat or cholesterol build up in the blood

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21
Q

Non modifiable risk factors for CV disease

A

age >65 men >55 women
family history in 1st degree relative
genetics
male>female
african-american
chronic kidney disease
low SES

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22
Q

How does kidney function generally impact the heart?

A

manages fluid volume and releases humoral regulatory mechanisms

23
Q

primary vs secondary hypertension

A

primary - idiopathic, 90-95%
secondary - from kidney or endocrine disease

24
Q

hypertension BP guidelines

A

normal <120/80
elevated 120-129/<80
stage 1 130-139/80-89
stage 2 >140/90
hypertensive emergency >180/>20 or >160/>100 w CV risk factors

25
Q

additional risk factors for HTN beyond CV risks

A

stress
sleep apnea
birth control pill
mod alc use

26
Q

White coat HTN

A

BP elevated in office but normal at home
13-35%

27
Q

Masked HTN

A

office BP readings normal while at home are elevated

28
Q

effect of HTN on the heart

A

overload L ventricle increaeses stiffness, can lead to heart failure w/ EF, predisposed to MI

29
Q

Manage HTN

A

weight loss
aerobic exercise
limit sodium
reduce alc
stop smoking
treat sleep apnea
pharm agents
treatment depends on degree of HTN and risk factors

30
Q

PT considerations for ther ex/treatment of pt w HTN

A

monitor BP
beta blockers blunt HR response, decrease exercise tolerance, + increased risk of hypoglycemia
avoid valsalva
extend warm up/cool down
hypotension post exercise

31
Q

orthostatic hypotension

A

drop in BP with position change supine - sit - stand
sustained BP reduction >20
caused by autonomic dysfx, volume depletion, CV disease, meds, neurogenic dx, paraneoplastic syndrome

32
Q

orthostatic hypotension s/s

A

lightheadness, dizziness, falls, LOC, visual/cog disturbance, weakness, fatigue

33
Q

POTS

A

postural orthostatic tachycardic syndrome
increase in HR >30bpm, HR >120 bpm standing
relieved by laying down

34
Q

POTS treatment

A

target low blood volume
Na+, hydration, meds

35
Q

PT implications of orthostatic conditions

A

caution when standing, move LE before standing, Valsalva, pressure garments
CV training for those who have avoided exercise

36
Q

CAD risk factors

A

men >45, women >55
family history primary relatives
smoker
BMI>30
HTN 140>90
dyslipidemia
diabetes
chronic inflammation

37
Q

HDL

A

good cholesterol
high density lipoproteins
increase with stopping smoking, weight loss, increasing aerobic exercise
elevated triglycerides reduce HDL

38
Q

LDL

A

bad cholesterol
predict MI better than total level
ideal <100 or <75 w risk factors

39
Q

PT role in CAD

A

prevention w exercise prescription
improve event free survival
prescribe >150 min mod exercise over the week, resistance training

40
Q

ischemic heart disease

A

mismatch myocardial O2 demand and supply
hypoxia
ventricular wall stress, preload, HR and contractility determine O2 demand

41
Q

angina pectoris

A

discomfort in chest due to myocardial ischemia
burning/pressure

42
Q

stable angina

A

predictable pattern of discomfort that goes away and is triggered by activity and improves with rest or short time
tachycardia, diaphoresis, nausea, dyspnea

43
Q

levine’s sign

A

clenched fist over sternum
stable angina sign

44
Q

triggers of stable angina

A

high BP
anemia - lacking Hb
stress
extreme cold
heavy meals
physical exertion

45
Q

Anginal scale

A

1+ light
2+ mod/bothersome
3+severe/v uncomfy
4+most severe pain

46
Q

PT implications of stable angina

A

anginal picture - what causes and relieves pain
How much exertion can pt take/exercise tolerance
know meds and impact
goal to increase tolerance of ADLs
mod intensity 40-60%

47
Q

variant or Prinzmetal angina

A

coronary artery spasm, not ischemia
at rest/nighttime
active patients, may/may not have CAD

48
Q

silent ischemia

A

asymptomatic episodes, detected on EKG

49
Q

unstable angina

A

progression of ischemic heart disease
precursor to MI
increase in frequency or duration
lower threshold to trigger symptoms
chest pain not relieved by rest
changing pattern

50
Q

PT implications of unstable angina

A

extended warm up and cool down
know anginal picture so you know if it changes
pt education on symptom monitoring
pt meds
30-40% intensity
take vitals!

51
Q

Myocardial infarction

A

ischemia, often caused by thrombus/occlusion
chest pain > 20 min not relieved by rest
necrosis can occur

52
Q

clinical features of MI

A

unstable angina
severe substernal crushing pain
dyspnea
diaphoresis
nausea/weakness/vomiting
EKG abnx
serum biomarkers troponins/CK

53
Q

MI medical management

A

revascularization ASAP - cath lab <90 min
CABG
supplemental O2, bedrest, monitor EKG/ECHO, control arrhythmias

54
Q

TIMI score

A

thrombolysis in MI risk score
1. age >65
2. 3+ CAD risk factors
3. CA stenosis>50%
4. ST elevation
5. 2 angina episodes in 24 hours
6. aspirin use in last week
7. elevated serum troponin or CK
indicates ischemia/mortality risk

55
Q

Time table for reperfusion of heart tissue

A

within 20 min - full salvage of tissue
within 2-4 hours - partial salvage of tissue
beyond this point, necrosis and tissue is not salvagable

56
Q

MI complications

A

recurrent ischemia
arrhythmias
heart failure
cardiogenic shock
R ventricular infarction
acute pericarditis
thromboembolism

536 Body Systems (13 decks)

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