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Year 3 Cardiac physiology > CC1: Introduction > Flashcards

CC1: Introduction Flashcards

1
Q

How to access left heart with catheter?

A

-Femoral artery
-Aortic arch
-Left ventricle

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2
Q

How to access right heart with catheter?

A

-IVC
-Right atrium
-Right ventricle
-Pulmonary artery (PCW)

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3
Q

Is left or right side of heart harder to access via catheter?

A

-Right side is harder to access via catheter

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4
Q

What is the Seldinger technique?

A

-Method of accessing vein/artery using a catheter

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5
Q

Which chamber cannot be accessed by a catheter?

A

-Left atrium

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6
Q

How is left atrium accessed?

A

-Directly by transeptal method
-Indirectly by pulmonary capillary wedge (PCW)

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7
Q

Theory behind PCW

A

-Pressure in lungs is low
-Any pressure picked up is from left atrium

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8
Q

What is a common consequence of valvuloplasty?

A

-Valve gets stretched
-Regurgitation

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9
Q

Why do cardiac catheterisation?

A

-Provides anatomical information through angiography
-Provides physiological information through haemodynamic data, pressure measurement, cardiac output and blood
-Accurate and immediate pressure and ECG recording during cath procedure
-Information is coupled with images to confirm diagnosis

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10
Q

What is point of access for catheter?

A

Radial/femoral artery - left side
Radial/femoral vein - right side
-Femoral requires 6 hours of bed rest afterwards

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11
Q

Indications for cardiac catheterisation

A

-STEMI - PCI
-Valve repair/replacement - TAVI
-EP study - ablation
-Congenital defects - ASD, VSD, ToF

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12
Q

What are the 4 features of Tetralogy of Fallot

A

-RVH
-VSD
-pulmonary stenosis
-Overriding aorta

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13
Q

Contraindications for cardiac catheterisation

A

-End stage heart failure
-Kidney disease
-Systemic infection
-Severe bleeding
-Unstable arrhythmias

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14
Q

Risk factors for CAD

A

Behavioural:
-Smoking
-Diet
-Physical inactivity
-Alcohol consumption

Medical:
-Blood pressure > 140/90
-Obesity (BMI>30)
-Diabetes
-Cholesterol

Irreversible:
-Age
-Gender

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15
Q

Investigations for CAD

A

-ECG - to detect changes
-Blood test - elevated cardiac biomarkers
-Stress test - ST elevation/depression
-Stress echo - regional wall abnormality
-Cardiac catheterisation
-PET scan
-Cardiac MRI

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16
Q

Risk of death in cardiac catheterisation

A

<0.2%

17
Q

Major and minor risks of cardiac catheterisation

A

Major:
-MI
-CVA
-Life threatening arrhythmias

Minor:
-Contrast reaction
-Haemorrhage
-Infection

18
Q

What is the role of physiologist in cardiac catheterisation?

A

-Putting leads on patient
-Take resting HR/rhythm and BP
-Responsible for defibrillator

19
Q

Steps of preparation in cath lab

A
20
Q

What is an Allen’s test?

A

-Checks blood flow through radial and ulnar arteries

21
Q

Before cardiac catheterisation procedure:

A

-Patient is starved and sedated
-Performed in x ray or cardiac lab with facilities for angiography
-Pressure measurement, monitoring and life support

22
Q

Which view is x ray taken in?

A

Posterior - anterior projection

23
Q

List some left heart procedures

A

-Coronary study/Graft study
-LV angiogram
-Aorta gram
-Pressure measurement
-Pressure wire

24
Q

List some right heart procedures

A

-Valve assessment - pressure measurement (one or two transducers)
-Coronary study/Graft study
-LV angiogram
-Aorta gram

25
Q

Describe the Seldinger technique of catheter insertion

A

1) Syringe into vessel
2) Guide wire through syringe
3)Syringe is removed
4) Sheath is put in (sheath has dilator)
5)Dilator is removed

26
Q

Which coronary artery is nearest the spine on imaging?

A

Circumflex

27
Q

Which arteries come off the LAD and Circumflex?

A

-LAD -> Diagonal
-Circumflex -> Obtuse marginal

28
Q

What are the phases in the cardiac cycle?

A

-Atrial contraction
-Iso-volumetric ventricular contraction
-Rapid ventricular ejection
-Reduced ventricular ejection
-Isovolumetric ventricular relaxation
-Rapid ventricular filling
-Reduced ventricular filling

29
Q

What is and how do you calculate the ejection fraction?

A

-The ratio of the stroke volume to the end-diastolic volume
-Stroke volume/EDV
~60%

30
Q

What is and how do you calculate stroke volume?

A

-Amount of blood ejected from the ventricle during systole
-LVEDV-LVESV
~70ml

31
Q

What happens during atrial contraction?

A

-Atrium contracts forcing blood into the ventricle
-Atrioventricular valves open

32
Q

What happens during Iso-volumetric ventricular contraction?

A

-Atrioventricular valves close
-Pressure is not enough to open semi lunar valves
-No change in EDV

33
Q

What happens during ventricular ejection?

A

-As pressure in ventricles exceeds pressure in atria, semi lunar valves open and blood leaves the ventricle

34
Q

What is the ESV?

A

-Amount of blood in the ventricle at the end of systole
~50ml

35
Q

What is EDV?

A

-Amount of blood in the ventricle before contraction
~120ml

Year 3 Cardiac physiology (30 decks)

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