Chapter 1 - Cardiovascular Concepts Flashcards
Coronary arteries are perfumed during
Diastole
Caused by a rapid rush of blood into a dilated ventricle
S3
Abnormal heart sound associated with heart failure, may occur before crackles
S3
Common causes of S3 heart sounds
Heart failure, pulmonary HTN, cor pulmonale, mitral, aortic, or tricuspid insufficiency
Chest pain at rest, unpredictable, troponin negative, ST depression, or T-wave inversion on ECG.
unstable angina
Troponin positive, ST depression, T-wave inversion on ECG, unrelenting chest pain
Non-STEMI
Troponin positive, ST elevation in 2 or more contiguous leads, unrelenting chest pain
STEMI
Chest pain (CO) with activity, predictable, lesions usually fixed and/or calcified
Stable angina
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
variant angina (AKA Prinzmetal’s angina)
Medications used for management of acute chest pain
Aspirin, anticoagulants, antiplatelets, analgesics, betablocker (A4B)
Cardioselective betablockers such as _________ should be used for management of acute chest pain.
metoprolol
Contraindications for use of betablockers during acute CP (4).
ACS d/t cocaine use, hypotension, bradycardia, Viagra use
Changes in leads II, III, aVF
Right coronary artery (RCA), inferior LV
Changes in leads V1, V2, V3, V4
Left anterior descending artery (LAD), anterior LV
Changes in leads V5, V6, I, and aVL
Circumflex, lateral LV
Changes in leads V5, V6
low lateral LV
Changes in leads I and aVF
high lateral LV
Changes in leads V1 and V2
RCA, posterior LV
Changes in leads V3R, and V4R
RCA, RV infarct
After percutaneous coronary intervention (PCI) the patient should be monitored for _______(5).
Reocclusion, vasovagal reaction during sheath removal, bleeding (at sheath site as well as retroperitoneally), and vascular complications.
Hypotension without compensatory tachycardia, pallor, nausea, yawning, and diaphoresis are all S/S of _________.
Vasovagal reaction
S/S (2) and treatment (2) of retroperitoneal bleeding post sheath removal
S/S: Hypotension, severe low back pain
Tx: fluids and blood products
How far above the sheath puncture site should you apply pressure if bleeding occurs? How long should you apply manual pressure?
2 finger breadths above the puncture site. Manual pressure should be held for 20 minutes (30 if still on GP IIb/IIIa inhibitors).
The gold standard for PCI is ____ minutes from the patient arriving to the hospital to the inflation of the balloon.
90
