Ch. 17 Cardiovascular Emergencies Flashcards
1
Q
A term describing the shape of the QRS complex in aberrantly (abnormally) conducted beats.
A
aberration
2
Q
The early phase of cardiac repolarization, wherein the heart muscle cannot be stimulated to depolarize; also known as the effective refractory period.
A
Absolute Refractory Period (ARP)
3
Q
A series of cardiac conditions caused by an abrupt reduction in coronary artery blood flow.
A
acute coronary syndromes (ACSs)
4
Q
Cardiac ischemia that occurs when sudden narrowing or complete occlusion of a coronary artery leads to death (necrosis) of myocardial tissue.
A
Acute Myocardial Infarction (AMI)
5
Q
The Right Atrium and Left Atrium are divided by a wall called the ____________ ________.
A
The two upper chambers, the Right Atrium and Left Atrium, are divided by a wall called the INTERATRIAL SEPTUM.
6
Q
The two lower chambers, the Right Ventricle and Left Ventricle are divided by a wall called the _________________ _______.
A
The Right Atrium and Left Atrium are divided by a wall called the INTERVENTRICULAR SEPTUM.
7
Q
The _____ heart pumps arterial blood through the AORTA and on to all parts of the body.
A
The LEFT heart pumps arterial blood through the AORTA and on to all parts of the body.
8
Q
The _____ heart pumps ______ (deoxygenated) blood through the _____________ _________ into the lungs.
A
The RIGHT heart pumps VENOUS (deoxygenated) blood through the PULMONARY ARTERIES into the lungs.
9
Q
A ventricular rate of less than 20 beats/min; this rhythm is seen just before the heart stops beating altogether.
A
Agonal Rhythm
10
Q
A term describing the shape of the QRS complex in aberrantly (abnormally) conducted beats.
A
Aberration
11
Q
The sudden pain that occurs when the oxygen supply to the myocardium is insufficient to meet demand, causing ischemic changes in the tissue.
A
angina pectoris
12
Q
An outpouching or bulge in the wall of a portion of the aorta, caused by weakening and dilation of the vessel wall; a ruptured aortic aneurysm is life threatening.
A
aortic aneurysm
13
Q
The absence of any cardiac rhythm or organized activity; asystole or ventricular standstill.
A
arrhythmia
14
Q
A pathologic condition in which the thickening and stiffening of the arterial walls makes the arteries less elastic.
A
arteriosclerosis
15
Q
An artificial product; in cardiology, used to refer to noise or interference in an ECG tracing.
A
artifact
16
Q
The absence of ventricular contraction or electrical activity; a straight-line or flat-line ECG.
A
asystole
17
Q
A mass of fatty tissue that gradually calcifies, hardening into an atheromatous plaque that infiltrates the arterial wall, diminishing its elasticity.
A
atheroma
18
Q
An accumulation of fat inside a blood vessel that narrows the diameter of the lumen.
A
atherosclerosis
19
Q
A group of cells that slows the electrical impulses from the sinoatrial node before relaying it to the ventricles; located in the floor of the right atrium immediately behind the tricuspid valve and near the opening of the coronary sinus.
A
atrioventricular (AV) node
20
Q
On an ECG, leads aVR, aVL, and aVF. They contain only one true pole; the other is a combination of information from other leads. A standard12-lead ECG consists of the three augmented leads, along with the three standard limb leads and the six precordial leads.
A
augmented limb leads
21
Q
A smart defibrillator that can analyze the patient’s ECG rhythm, determine whether a defibrillating shock is needed, and guide the user through the resuscitation effort via voice commands.
A
automated external defibrillator (AED)
22
Q
Movement of the heart’s QRS axis to the right or left of its normal position. Beck triad The classic trio of signs associated with cardiac tamponade: narrowed pulse pressure, muffled heart tones, and jugular vein distention.
A
axis deviation
23
Q
Blockage of any two fascicles or conduction pathways: a right bundle branch block (RBBB) with anterior hemiblock, RBBB with posterior hemiblock, or anterior hemiblock and posterior hemiblock (a combination known as LBBB).
A
bifascicular block
24
Q
A dysrhythmia in which every other complex is a premature complex, causing a normal–early beat–normal–early beat pattern; can be atrial, junctional, or ventricular.
A
bigeminy
25
On an ECG, leads that contain both a positive and a negative pole: leads I, II, and III.
**bipolar leads**
26
Abnormal whooshing sounds indicating turbulent blood flow within a narrowed vessel; usually heard in the carotid arteries.
**bruits**
27
An intraventricular conduction disturbance involving impedance of electrical impulses from the bundle of His to the right or left bundle branch.
**bundle branch block (BBB)**
28
The portion of the heart’s conduction system located in the upper portion of the interventricular septum that conducts electrical impulses from the atrioventricular junction to the right and left bundle branches; also called the AV bundle.
**bundle of His**
29
The cessation of cardiac mechanical activity, as confirmed by the absence of signs of circulation; also called cardiopulmonary arrest.
**cardiac arrest**
30
A minimally invasive procedure performed under fluoroscopic guidance, a balloon, stent, or other device is advanced through a peripheral artery catheter and into an obstructed coronary vessel to diagnose and treat coronary artery obstruction; also known as percutaneous coronary intervention and percutaneous transluminal coronary angioplasty.
**cardiac catheterization**
31
The period from one cardiac contraction to the next. Each _______ \_\_\_\_\_\_ consists of ventricular contraction (systole) and relaxation (diastole).
cardiac cycle
32
A pathologic condition characterized by restriction of cardiac contraction, falling cardiac output, and shock as a result of pericardial fluid accumulation.
**cardiac tamponade**
33
One of the two branches of the left main coronary artery; branches of the Cx supply the left atrium, part of the lateral surface of the left ventricle, the inferior surface of the left ventricle in about 15% of people, the posterior surface of the left ventricle in 15%, the sinoatrial node in about 40%, and the atrioventricular bundle in 10% to 15%.
**circumflex artery (Cx)**
34
Pain, cramping, muscle tightness, fatigue, or weakness of the legs during physical activity as a result of increased oxygen demand by the muscle tissue of the legs, hips, and buttocks.
**claudication**
35
An ECG pattern in which the QRS complexes are all in the same direction in the precordial leads as a result of improper lead placement, anterior wall MI, VT, or other variables.
**concordant precordial pattern**
36
Leads that view geographically similar areas of the myocardium, such as leads II, III, and aVF; useful for localizing areas of ischemia.
**contiguous leads**
37
The blood vessels that supply blood to the tissues of the heart.
**coronary arteries**
38
Disease of the coronary arteries and its associated signs, symptoms, and complications, such as angina pectoris and acute myocardial infarction.
**coronary heart disease (CHD)**
39
Two consecutive (paired) premature ventricular complexes.
**couplet**
40
The process by which of an unsynchronized direct current (DC) electric shock is delivered to the heart to terminate ventricular fibrillation or pulseless ventricular tachycardia.
**defibrillation**
41
The process of discharging resting cardiac muscle fibers by means of an electrical impulse that stimulates contraction.
**depolarization**
42
The process by which the intimal and medial layers of a vessel separate (dissect) after a tear occurs in an aneurysmal portion of the arterial wall. With each ventricular systole, a jet of blood is forced into the torn arterial wall, creating and propagating a false channel.
**dissection**
43
Cardiac rhythm disturbances. ectopic An impulse or rhythm that originates from a site other than the SA node.
**dysrhythmias**
44
In the heart, the specialized cardiac tissue that initiates and conducts electric impulses; includes the SA node, internodal conduction pathways, atrioventricular node, bundle of His, and the Purkinje network.
**electrical conduction system**
45
Inflammation of the endocardium as a result of infection.
**endocarditis**
46
Failure of the anterior or posterior fascicles of the heart to conduct electrical impulses because of disease or ischemia.
**fascicular block (hemiblock)**
47
The process of dissolving blood clots. fibrinolytic therapy The use of medications that act to dissolve blood clots.
**fibrinolysis**
48
A delay in the conduction of the depolarizing impulse from the SA node to the ventricles, prolonging the PR interval; also called first-degree heart block.
**first-degree AV block**
49
A syndrome that occurs when the heart is unable to pump powerfully enough or fast enough to empty its chambers; as a result, blood backs up into the systemic circuit, the pulmonary circuit, or both.
**heart failure**
50
A high concentration of potassium in the blood. hypertension High blood pressure, usually a diastolic pressure of greater than 90 mm Hg.
**hyperkalemia**
51
An acute elevation of blood pressure with evidence of end-organ damage.
**hypertensive emergency**
52
A condition that may complicate any form of hypertension, and which is usually signaled by a sudden, marked rise in blood pressure to levels exceeding 200/130 mm Hg; also known as acute hypertensive crisis.
**hypertensive encephalopathy **
53
A genetic condition in which the heart muscle wall is unusually thick, requiring the heart to pump harder to eject blood from the left ventricle.
**hypertrophic cardiomyopathy**
54
A low concentration of calcium in the blood. hypokalemia A low concentration of potassium in the blood.
**hypocalcemia**
55
Related to only the ventricles; produced by the ventricles. infarction Death (necrosis) of a localized area of tissue caused by ischemia.
**idioventricular**
56
The three atrial pathways of electrical conduction that transmit impulses from the SA node to the AV node.
**internodal pathways**
57
Tissue anoxia caused by diminished blood flow, usually as a result of narrowing or occlusion of an artery.
**ischemia**
58
The baseline of the ECG; isoelectric means neither positive nor negative.
**isoelectric line**
59
A dysrhythmia arising from the atrioventricular junction with an intrinsic rate of 40 to 60 beats/min; also called junctional rhythm.
**junctional escape rhythm**
60
The electrical potential difference between two points. For example, lead I represents the difference in electrical potential between the right and left arm electrodes.
**lead**
61
One of the two branches of the left main coronary artery; branches of the LAD supply the left ventricle, interventricular septum, and part of the right ventricle.
**left anterior descending artery (LAD)**
62
Dilation of the left atrium that can occur in patients with valvular heart disease (particularly mitral or aortic valve stenosis), hypertensive disease, cardiomyopathy, or coronary artery disease; it can also occur in an athlete.
**left atrial abnormality**
63
A condition in which the left ventricle must work harder to pump blood throughout the body; with systolic failure, the left ventricle doesn’t contract normally and has trouble pumping all the blood in the chamber out to the body; with diastolic failure, the left ventricle contracts normally but it has become stiff, impeding its ability to relax and fill with blood between each contraction of the heart.
**left ventricular failure (LVF)**
64
A cardiac condition in which the left ventricle becomes enlarged, most often as a result of hypertension.
**left ventricular hypertrophy (LVH)**
65
The ECG leads attached to the limbs; together, the standard limb leads (I, II, and III) and augmented limb leads (aVR, aVL, and aVF) form the hexaxial reference system along the frontal plane.
**limb leads**
66
A condition characterized by a QT interval exceeding approximately 0.45 seconds (450 milliseconds).
**long QT syndrome**
67
A disorder that causes preexcitation of ventricular tissue and is characterized on ECG by a short PR interval and a normal QRS duration.
**Lown-Ganong-Levine syndrome**
68
The hollow interior space within an artery or other hollow structure.
**lumen**
69
A device that requires the paramedic or other trained rescuer to interpret the cardiac rhythm and determine whether defibrillation is needed (rather than the relying on a device to make that determination automatically).
**manual defibrillator**
70
Having a common shape.
**monomorphic**
71
Arising from or pertaining to many foci or locations.
**multifocal**
72
Inflammation of the myocardium.
**Myocarditis**
73
The death of tissue, usually caused by a cessation of its blood supply.
**necrosis**
74
The normal rhythm of the heart that has an intrinsic rate of 60 to 100 beats/min; the rhythm is regular, with minimal variation between R-R intervals, and all measurements are within normal limits.
**normal sinus rhythm**
75
Severe dyspnea experienced when lying down that is relieved by a change in position, such as sitting up or standing.
**orthopnea**
76
The first wave of the ECG complex, representing depolarization of the atria.
**P wave**
77
Severe shortness of breath occurring at night after several hours of recumbency, during which fluid pools in the lungs; the person is forced to sit up to breathe; caused by left heart failure or decompensation of chronic obstructive pulmonary disease.
**paroxysmal nocturnal dyspnea (PND)**
78
Inflammation of the pericardial sac. plasmin A naturally occurring clot-dissolving enzyme.
**pericarditis**
79
The palpable beat of the apex of the heart against the chest wall during ventricular contraction; normally palpated at the fifth left intercostal space along the midclavicular line.
**point of maximal impulse (PMI)**
80
The distance between the beginning of the P wave (atrial depolarization) and the beginning of the QRS complex (ventricular depolarization), signifying the time required for the atria to depolarize and the excitation impulse to pass through the atrioventricular junction.
PR interval (PRI)
81
A term used to describe the chest leads in an ECG.
**precordial leads**
82
Early depolarization of ventricular tissue by means of an accessory pathway between the atria and ventricles.
**preexcitation**
83
A type of angina that occurs when a person is at rest, when oxygen needs are minimal; also called vasospastic angina.
**Prinzmetal angina**
84
Congestion of the pulmonary air spaces with exudate and foam, often secondary to left ventricular failure.
**pulmonary edema**
85
Obstruction in one or more pulmonary arteries by a solid, liquid, or gas that has swept through the right side of the heart into the lungs.
**pulmonary embolism**
86
An organized cardiac rhythm (other than ventricular tachycardia) on an ECG monitor that is not accompanied by any detectable pulse.
**pulseless electrical activity (PEA)**
87
A network of cardiac muscle fibers distributed throughout the inner surfaces of the ventricular walls that conducts the excitation impulse from the bundle branches to the ventricular myocardium.
**Purkinje fibers**
88
A single vector that represents the mean (or average) of all vectors created by the ventricles during depolarization.
**QRS axis**
89
Deflection of the ECG produced by ventricular depolarization.
**QRS complex**
90
Mirror-image J-point, ST-segment, and T-wave changes seen on the ECG during an ACS.
**reciprocal changes**
91
Spread of an impulse through tissue already stimulated by that same impulse.
**reentry**
92
A short period immediately after depolarization during which the myocytes have not yet repolarized and are unable to fire or conduct an impulse (the absolute refractory period) or have partially repolarized and may depolarize in response to an electrical stimulus (the relative refractory period).
**refractory period (RP)**
93
The portion of the cardiac action potential that extends from the middle of phase 3 to the beginning of phase 4; during this time, the heart muscle has been partially repolarized and may depolarize in response to an electrical stimulus.
**relative refractory period (RRP)**
94
Treatment intended to facilitate the resumption of blood flow through a blocked vessel; therapy may be either procedural, such as cardiac catheterization, or pharmacologic, such as administration of a fibrinolytic agent.
**reperfusion therapy**
95
An inflammatory disease caused by streptococcal bacteria; the disease can cause mitral or aortic valve stenosis.
**rheumatic fever**
96
Dilation of the right atrium that occurs when returning venous pressure is elevated or pulmonary pressure is high.
**right atrial abnormality**
97
Artery that provides oxygenated blood to the walls of the right atrium and ventricle, a portion of the inferior part of the left ventricle, and portions of the conduction system.
**right coronary artery (RCA)**
98
A condition in which the right side of the heart must work increasingly hard to pump blood into engorged pulmonary vessels; eventually, it is unable to keep up with the increased workload.
**right ventricular failure (RVF)**
99
A cardiac condition in which the right ventricle becomes enlarged, usually as a result of pulmonary hypertension.
**right ventricular hypertrophy (RVH)**
100
The period between the onset of one QRS complex and the onset of the next QRS complex.
**R-R interval**
101
A disease caused by the bacterium Streptococcus pyogenes and characterized by a sore throat, fever, rash, and “strawberry tongue.”
**scarlet fever**
102
A thick wall that separates the right and left sides of the heart.
**septum**
103
The dominant pacemaker of the heart, located at the junction of the superior vena cava and the right atrium.
**sinoatrial (SA) node**
104
A sinus rhythm characterized by a heart rate of less than 60 beats/min.
**sinus bradycardia**
105
A variation of cycling of a sinus rhythm that is often associated with respiratory cycle fluctuations; the rate increases during inspiration and decreases during expiration.
**sinus dysrhythmia**
106
A sinus rhythm characterized by a heart rate greater than 100 beats/min.
**sinus tachycardia**
107
The interval between the end of the QRS complex (the J point) and the beginning of the T wave; when there is significant myocardial ischemia or injury, the ST segment is often depressed or elevated with respect to the isoelectric line.
**ST segment**
108
Angina pectoris characterized by periodic pain with a predictable pattern.
**stable angina**
109
A type of acute myocardial infarction in which the ischemic process affects only the inner layer of muscle.
**subendocardial myocardial infarction**
110
The use of a synchronized direct current (DC) electric shock to convert a tachydysrhythmia (such as supraventricular tachycardia) to a normal sinus rhythm.
**synchronized cardioversion**
111
Fainting; brief loss of consciousness caused by transiently inadequate blood flow to the brain.
**syncope**
112
The upright, flat, or inverted wave following the QRS complex of the ECG, representing ventricular repolarization.
**T wave**
113
The utilization of cool fluids to get the patient to a targeted hypothermic state during various critical conditions.
**targeted temperature management (TTM)**
114
A blood clot that initially formed within a blood vessel but is now circulating through the bloodstream.
**thromboembolism**
115
A fixed blood clot that can obstruct passage of blood flow through an artery.
**thrombus**
116
A device that depolarize myocardial tissue by sending a small electrical charge through the skin of the chest between one externally placed pacing pad and another.
**transcutaneous pacemaker**
117
A type of acute myocardial infarction in which the infarct extends through the entire wall of the ventricle.
transmural myocardial infarction
118
Blockage or impairment of all three components of the ventricular conduction system, with one working occasionally to provide AV conduction.
**trifascicular block**
119
A dysrhythmia in which every third complex is a premature complex, causing a normal–normal–early beat pattern ; can be atrial, junctional, or ventricular.
**trigeminy**
120
A small, flat wave sometimes seen after the T wave and before the next P wave. unifocal Arising from a single site.
**U wave**
121
Angina pectoris characterized by a variable, unpredictable pattern of pain, which may signal an impending acute myocardial infarction.
**unstable angina**
122
Straining or forced exhalation against a closed glottis, the effect of which is to stimulate the vagus nerve, thereby slowing the heart rate.
**Valsalva maneuver**
123
A preexcitation syndrome characterized by a short PR interval, a delta wave, a widened QRS complex, and nonspecific ST-T wave changes, indicating the presence of an accessory pathway.
**Wolff-Parkinson-White (WPW) syndrome**
124
The atrial complexes in atrial flutter are known as flutter waves or _ \_\_\_\_\_ rather than P waves.
The atrial complexes in atrial flutter are known as flutter waves or **F waves** rather than P waves.
