Chapter 1 - Cardiovascular Concepts

Question 1

Coronary arteries are perfumed during

Answer 1

Diastole

Question 2

Caused by a rapid rush of blood into a dilated ventricle

Answer 2

S3

Question 3

Abnormal heart sound associated with heart failure, may occur before crackles

Answer 3

S3

Question 4

Common causes of S3 heart sounds

Answer 4

Heart failure, pulmonary HTN, cor pulmonale, mitral, aortic, or tricuspid insufficiency

Question 5

Chest pain at rest, unpredictable, troponin negative, ST depression, or T-wave inversion on ECG.

Answer 5

unstable angina

Question 6

Troponin positive, ST depression, T-wave inversion on ECG, unrelenting chest pain

Answer 6

Non-STEMI

Question 7

Troponin positive, ST elevation in 2 or more contiguous leads, unrelenting chest pain

Answer 7

STEMI

Question 8

Chest pain (CO) with activity, predictable, lesions usually fixed and/or calcified

Answer 8

Stable angina

Question 9

A type of unstable angina associated with transient ST segment elevation, troponin negative, occurs at rest, may be cyclical, caused by coronary artery spasm with or without atherosclerotic lesions

Answer 9

variant angina (AKA Prinzmetal’s angina)

Question 10

Medications used for management of acute chest pain

Answer 10

Aspirin, anticoagulants, antiplatelets, analgesics, betablocker (A4B)

Question 11

Cardioselective betablockers such as _________ should be used for management of acute chest pain.

Answer 11

metoprolol

Question 12

Contraindications for use of betablockers during acute CP (4).

Answer 12

ACS d/t cocaine use, hypotension, bradycardia, Viagra use

Question 13

Changes in leads II, III, aVF

Answer 13

Right coronary artery (RCA), inferior LV

Question 14

Changes in leads V1, V2, V3, V4

Answer 14

Left anterior descending artery (LAD), anterior LV

Question 15

Changes in leads V5, V6, I, and aVL

Answer 15

Circumflex, lateral LV

Question 16

Changes in leads V5, V6

Answer 16

low lateral LV

Question 17

Changes in leads I and aVF

Answer 17

high lateral LV

Question 18

Changes in leads V1 and V2

Answer 18

RCA, posterior LV

Question 19

Changes in leads V3R, and V4R

Answer 19

RCA, RV infarct

Question 20

After percutaneous coronary intervention (PCI) the patient should be monitored for _______(5).

Answer 20

Reocclusion, vasovagal reaction during sheath removal, bleeding (at sheath site as well as retroperitoneally), and vascular complications.

Question 21

Hypotension without compensatory tachycardia, pallor, nausea, yawning, and diaphoresis are all S/S of _________.

Answer 21

Vasovagal reaction

Question 22

S/S (2) and treatment (2) of retroperitoneal bleeding post sheath removal

Answer 22

S/S: Hypotension, severe low back pain

Tx: fluids and blood products

Question 23

How far above the sheath puncture site should you apply pressure if bleeding occurs? How long should you apply manual pressure?

Answer 23

2 finger breadths above the puncture site. Manual pressure should be held for 20 minutes (30 if still on GP IIb/IIIa inhibitors).

Question 24

The gold standard for PCI is ____ minutes from the patient arriving to the hospital to the inflation of the balloon.

Answer 24

90