CV Conditions Flashcards
agonal rhythm
- irregular heartbeat
- below 20 bpm
- near death
atrial tachycardia
- HR > 100 bpm
- usually associated w increased HR or product of exertion
ventricular tachycardia
- HR > 100 bpm
- usually a regular rhythm
when is ventricular tachycardia most common?
after acute MI
which tachycardia is more pathologic?
ventricular
atrial fibrillation (a-fib)
- most common arrhythmia
- can lead to syncope bc no atrial kick
ventricular fibrillation (v-fib)
chaotic rate and rhythm, will lead to death if not treated
multifocal VT (torsades de pointes)
irregular rhythm and rate > 150 bpm
AV blocks
rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked
what amount of ST depression indicates ischemia?
1-2 mm
ST elevation indicates what?
MI
T-wave inversion indicates what?
MI
prominent Q-wave indicates what?
MI
wide QRS indicates what?
bundle branch block
what is normal PaO2?
> 80 mm Hg
what is normal PaCO2?
35-45 mm Hg
what are 3 good functional outcome measures to assess endurance?
- chair rise
- 2MWT
- 6MWT
how many PVCs should you see to stop and reassess vitals?
> 6/min
what type of heart disease is cardiac tamponade?
pericardial
what is an acute management strategy for pts experiencing MI?
thrombolytics
what are 3 indications for thrombolytic therapy?
- chest pain suggesting an MI
- elevated ST segment
- bundle branch block
what is the timing of administration for thrombolytics?
- within 3 hrs of onset of chest pain
- within 6-24 hrs of onset of symptoms
what is a PTCA?
- percutaneous transluminal coronary angioplasty
- endoluminal stent to open up occluded artery
what is a CABG?
- coronary artery bypass graft
- used to revascularize the myocardium when a coronary artery is occluded
what are the 3 vascular structures used for a CABG? (SIR)
- saphenous veins
- internal mammary artery
- radial artery
what is the standard approach for a CABG?
median sternotomy
what are 3 post-op possibilities to be seen with a CABG?
- mediastinal chest tube
- external pacemaker
- intravascular catheters
what 6 factors put a pt at risk for experiencing dehiscence after a median sternotomy?
- obestity
- COPD
- DM
- smoking
- PVD
- repeat thoracotomy
- pendulous breasts
what is the purpose of an ablation procedure?
to remove or isolate ectopic foci (abnormal pacemakers) in order to reduce rhythm disturbance
maze procedures are used to ablate ____ fibrillation
atrial
the leg used in an ablation procedure must remain straight and immobile for how many hours?
3-4
what is the purpose of cardioversion?
to restore normal heart rhythm in tachycardia arrhythmic conditions
what are the 2 types of cardioversion procedures?
- cardiac pacemaker implantation
- automatic implantable cardiac defibrillator (AICD)
what kind of arrhythmia does the AICD help with?
ventricular
what are 3 PT considerations for pts with pacemakers or AICDs?
- closely monitor activity response w HR and BP
- know if device has rate modulation
- pts can’t do any lifting or resistive exercise on L side post-op
what type of pts would wear a life vest external defibrillator?
- high risk of sudden cardiac arrest
- need a heart transplant
what are 3 precautions for someone with an LVAD/RVAD?
- know emergency procedures in case battery dies
- maintain patency of drive lines w external pump
- monitor hemodynamics
what are the complications with LVAD/RVAD? (5)
- thrombus formation
- CVA
- hemorrhage
- line infections
- renal or hepatic insufficiency
what phase should a pt with an LVAD/RVAD be at in order for you to refer them to cardiac rehab to initiate exercise?
phase I-II
why would a pt have an LVAD/RVAD?
- if they need a heart transplant
- can also be a terminal treatment
what does the Marburg Heart Score predict?
likelihood of dx of CAD
what are the 3 goals for cardiac PT interventions?
- asses hemodynamic response during self-care and functional mobility
- maximize activity tolerance
- pt/caregiver edu for activity or behavior modifications
what are the 6 absolute indications to withhold tx for an unstable cardiac pt?
- decompensated CHF
- 2nd degree heart block with PVCs
- 3rd degree heart block
- > 10 PVCs/min at rest
- chest pain w new ST segment changes
- new onset of A-fib w rapid ventricular response at rest (HR > 100 bpm)
what are the 6 precautions to modify or withhold tx for an unstable cardiac pt?
- RHR > 100
- resting HTN > 160/90
- hypotension at rest (systolic < 80)
- ventricular ectopy at rest
- A-fib w rapid ventricular response at rest (HR > 100)
- psychosis/unstable psych condition
if pt is on beta blockers, do not exceed ___ beats above their normal RHR
20
what is the target HR for someone with an AICD?
20-30 beats below threshold rate on defibrillator
if someone has had a heart transplant, can you use their HR to prescribe exercise?
no bc the nerves aren’t connected the way they used to be
what should the HR recovery be with a cool down?
greater than 12 bpm
what is the normal systolic BP response to activity?
increase by 5-12 mm Hg
what are the 3 abnormal BP responses you might see during activity?
- systolic dec of 10 mm Hg below resting
- systolic > 180
- diastolic > 110
use BP to gauge activity intensity for pts who have what?
pacemakers without rate modulation
what is the general guideline for mRPE and RPE when monitoring activity tolerance?
- mRPE: 5 or less
- RPE: 13 or less
