CV System Part 3

Question 1

Angioplasty is the mechanical widening of

Answer 1

Narrow or obstructed arteries

Question 2

If angioplasty is performed 10 time then

Answer 2

Bypass surgery

Question 3

Percutaneous Transluminal Coronary Angioplasty (PTCA) is associated with

Answer 3

Stenosis (women)

Question 4

Percutaneous Transluminal Coronary Angioplasty (PTCA) has a balloon at its tip which is inflated and deflated to stretch the narrowing and improve the

Answer 4

Passage for blood flow
Can be done by laser

Question 5

Coronary Artery Bypass Graft (CABG) involves taking a portion of artery or vein from the

Answer 5

Leg, chest, arm and grafting it onto the coronary artery

Question 6

CABG most used arteries

Answer 6

Mammary and radial arteries
Saphenous vein
Mammary has least amount of sclerosis with time

Question 7

Angina Pectoris
With narrowed arteries, blood flow to the heart is

Answer 7

Compromised

Question 8

Ischemia
Results in ______
Described as ______
Can radiate to ________
Usually only lasts for _______

Answer 8

Cardiac workload > O2 supply
Angina
Squeezing or crushing pressure
Areas of the body
A few minutes (stable angina)

Question 9

4 known triggers for angina include

Answer 9

Exertion (walking, stairs)
Emotional stress/attachment
Exposure to cold or wind
A large meal

Not as common but can happen
Sleep
Sex
Rest

Question 10

Stable angina definition
Ceases with

Answer 10

Artery has accumulated deposits that narrow it
Ceases with rest or nitroglycerin

Question 11

Unstable angina caused by

Answer 11

Blood clot in the blood vessels
15 min or more

Question 12

Unstable angina is predictable and not related to the usual demand for

Answer 12

Myocardial O2
Doesn’t go away with rest

Question 13

Variant angina is _______ and due to ______

Answer 13

Transient ischemia, coronary spasm

Question 14

Variant angina occurs at ______ and is often relieved with ______

Answer 14

Rest, minor activity

Question 15

Pain patterns associated with angina

Answer 15

Left shoulder/arm

Ulnar nerve

Jaw

Scapula

Question 16

Diagnosis of Angina Pectoris

Answer 16

Suspected with history and response to nitroglycerin

Question 17

The Zone of Infarction

Answer 17

Area of myocardium that was completely deprived of O2 resulting in cell death

Elevated ST Segment

Question 18

The zone of hypoxic injury

Answer 18

Immediately surrounds the area of Infarction

Will recover if blood flow is restored quickly

Question 19

The adjacent zone of ischemia

Answer 19

Drop in T wave

Usually reversible

Question 20

Hyperacute (elevated T waves)

Answer 20

Only seen early after the onset of the MI

Question 21

ST segment elevation

Answer 21

may persist for some days

Question 22

ST Depression

Answer 22

myocardial ischemia

Question 23

Cardiac troponin

Answer 23

better indicator of MI

Question 24

Complications Post-MI
Can include

Answer 24

Arrhythmias

Pericarditis

Congestive Heart Failure

Sudden Death

Question 25

MI Activities that increase intra abdominal pressure can lead to

Answer 25

Bradycardia (contraindicated)

Question 26

6 weeks post MI avoid anything

Answer 26

hot

Question 27

Congenital Cardiomyopathy

Answer 27

Muscular Dystrophy

Question 28

Acquired Cardiomyopathy

Answer 28

Myocarditis

Question 29

Cardiomyopathy Affects heart muscle itself (fibrous tissue) so contraction and relaxation phases are

Answer 29

Impaired

Question 30

- Cardiomyopathy Classifications - Dilated

Answer 30

Ventricle wall: very thin Most common Mostly affect contraction

Question 31

Cardiomyopathy Classifications Hypertrophic

Answer 31

Young athletes Most common cause of death in young athletes Effect relaxation

Question 32

Cardiomyopathy Classifications Restrictive

Answer 32

Effect relaxation

Question 33

Clinical manifestations Dilated

Answer 33

Fatigue and weakness with normal or low BP

Question 34

Clinical Manifestations Hypertrophic

Answer 34

Frequently asymptomatic, with sudden death being a presenting sign Dyspnea is common

Question 35

Clinical Manifestations Restrictive

Answer 35

Decreased Cardiac Output (CO) leading to intra ventricular pressure and signs of CHF

Question 36

Cardiomyopathy Avoid

Answer 36

strenuous exercise alcohol

Question 37

Congestive Heart Failure Compensatory Mechanisms

Answer 37

Low blood pressure releases ADH SNS Renin-Angiotensin system activation Increased HR Myocardial Hypertrophy

Question 38

CHF Risk Factors

Answer 38

Ischemic Heart Disease Cigarette Smoking HTN Obesity Diabetes Valvular Heart Disease (much higher in older populations)

Question 39

The number of patients with each form is approximately 60% with ______ and 40% with ____

Answer 39

Systolic failure and diastolic failure

Question 40

Patients with systolic heart failure have a low

Answer 40

Left ventricular ejection fraction

Question 41

Patients with diastolic heart failure have a normal

Answer 41

LV ejection fraction but abnormal LV elasticity and abnormal diastolic function

Question 42

Left Sided HF

Answer 42

- Dyspnea Exertional Paroxysmal Nocturnal Dyspnea Orthopnea - Productive Cough - Daytime upright posture decreases blood flow to kidney resulting in Oliguria (pee less than normal) - Nocturia - Hypoxia, fatigue, muscle weakness - sleep disturbance

Question 43

Right Sided Heart Failure

Answer 43

Cyanosis Jugular Vein distention Hepatomegaly Ascites Dependent Edema (pitting edema) Anxiety

Question 44

Right sided HF Other

Answer 44

Splenomegaly Pitting edema in ankles and sacrum RUQ pain

Question 45

In right sided HF, if Gain 2 or more pounds per day or 5 or more per week

Answer 45

Contact physician immediately

Question 46

Right sided HF, ACSM recommends

Answer 46

Moderate intensity 2-6 min exercise 2 minute rest