FINALS: Cardiac Evaluation Flashcards
What is Cardiovascular Disease (CVD)?
A pathological process involving atherosclerosis that affects the entire arterial circulation.
A form of atherosclerosis affecting coronary arteries, including conditions like angina, myocardial infarction (MI), silent ischemia, and sudden cardiac death.
Coronary Artery Disease (CAD)
What causes atherosclerosis?
Lipid-laden plaques form within the intimal layer of medium and large arteries, narrowing the lumen and reducing blood flow.
What is heart failure, and how is it classified as congestive?
Heart failure is impaired left ventricular (LV) function. It is called congestive heart failure (CHF) when accompanied by edema (congestion).
What are examples of malignant arrhythmias?
Sustained ventricular tachycardia (V-tach) and ventricular fibrillation (V-fib).
What blood pressure defines hypertension (HTN)?
Systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg.
What are the three tissue layers of the heart?
Pericardium: Outer double-walled sac (parietal and visceral layers).
Myocardium: Thick muscular middle layer.
Endocardium: Inner endothelial lining.
What are the main coronary arteries?
Right coronary artery
Left anterior descending artery
Left circumflex artery
What are the atrioventricular valves, and their functions?
Tricuspid valve (RA → RV)
Mitral (bicuspid) valve (LA → LV)
Function: Prevent backflow into the atria during systole.
What are the semilunar valves, and their functions?
Pulmonic valve: Prevents backflow from pulmonary artery.
Aortic valve: Prevents backflow from aorta.
What is cardiac output (CO), and how is it calculated?
CO = Stroke Volume (SV) × Heart Rate (HR). Normal CO is 4–6 L/min at rest.
What are the three factors influencing stroke volume (SV)?
Preload: LVEDV at the end of diastole.
Contractility: Strength of ventricular contraction.
Afterload: Resistance the LV must overcome during systole.
What are the phases of the cardiac cycle?
Systole: Contraction phase.
Diastole: Filling phase.
What do the components of the ECG represent?
P wave: Atrial depolarization.
PR segment: AV node conduction.
QRS complex: Ventricular depolarization.
ST segment: Ventricular repolarization starts.
T wave: Ventricular repolarization completes.
What is VO2max?
Maximum oxygen consumption during intense aerobic exercise, expressed in mL/kg/min.
What electrolyte imbalances affect cardiac function?
Hypokalemia: Causes arrhythmias, muscle cramping, flattened T waves, and U-waves.
Hypocalcemia: Increases ventricular ectopy.
Hypomagnesemia: Increases risk of arrhythmias.
: What is 1 MET?
The amount of oxygen consumed at rest, approximately 3.5 mL O2/kg/min.
What are common symptoms of cardiovascular disease (CVD)?
Chest pressure, dyspnea, fatigue, syncope, and palpitations.
What factors influence activity limitations in heart disease?
Peripheral muscle strength.
Compensatory mechanisms.
Pharmacological management.
What are common cardiac biomarkers elevated in ACS?
Troponins I & T: Most sensitive markers of myocardial damage.
CK-MB: Isoenzyme specific to myocardial damage.
Define White Coat Hypertension.
Blood pressure consistently elevated in a medical office but normal in out-of-office readings.
List two main types of hypertension and their key characteristics.
Primary (Essential) HTN: No identifiable cause (90–95% cases); influenced by genetics, stress, obesity, etc.
Secondary HTN: Caused by identifiable medical conditions (renal disease, endocrine disorders, etc.).
What is the hallmark sign of Acute Coronary Syndrome (ACS)?
Ischemic chest pain due to an imbalance between myocardial oxygen supply and demand.
Differentiate between unstable angina, stable angina, and Prinzmetal (variant) angina.
Unstable angina: Occurs at rest, increases in severity/frequency, refractory to treatment.
Stable angina: Triggered by activity, relieved by rest or reducing oxygen demand.
Prinzmetal angina: Caused by coronary artery vasospasm, managed with NTG or calcium channel blockers.
What are the three clinical presentations of ACS?
Angina
Injury (acute MI)
Infarction (old MI with irreversible dead tissue)
Define compensated and decompensated heart failure.
Compensated HF: Symptoms are relieved by medical intervention.
Decompensated HF: Symptoms worsen with congestion and require urgent treatment.
What are hallmark signs of left-sided heart failure?
Shortness of breath (SOB) and cough due to fluid backup in the lungs.
What clinical findings indicate heart failure on auscultation?
Presence of crackles/rales in the lungs and an S3 heart sound.
What are the hallmark symptoms of CHF-related pulmonary edema?
Crackling lung sounds, dyspnea, and visible fluid accumulation in alveoli on chest X-ray.
Alterations in the electric conduction of the heart, caused by impaired electrical impulse formation or conduction.
arrhythmias
What are ectopic beats?
Beats originating from a site other than the sinus node, such as premature atrial contractions (PACs) or premature ventricular contractions (PVCs).
What are the hallmark ECG features of a premature ventricular contraction (PVC)?
Absence of a P wave.
Wide and bizarre QRS complex.
What is ventricular bigeminy and trigeminy?
Bigeminy: Every other beat is a PVC.
Trigeminy: Every third beat is a PVC.
What is ventricular tachycardia (V-tach)?
A run of four or more PVCs in a row, which may be sustained or nonsustained.
A life-threatening arrhythmia characterized by quivering ventricles, resulting in no effective cardiac output. Requires immediate defibrillation.
ventricular fibrillation (V-fib)
What is first-degree heart block?
Prolonged conduction time through the AV node, shown by an increased PR interval on ECG.
What is the function of an Automatic Implantable Cardiac Defibrillator (AICD)?
: Detects life-threatening arrhythmias like V-tach or V-fib and delivers an electrical shock to restore rhythm.
What is atrial fibrillation (A-fib)?
An irregularly irregular rhythm caused by uncoordinated atrial contractions, reducing cardiac output by 15–20%.
Complete mismatch between atrial and ventricular conduction, with no relationship between P waves and QRS complexes.
third-degree heart block
What is the difference between Mobitz I and Mobitz II second-degree heart block?
Mobitz I (Wenckebach): Gradual PR interval lengthening before a dropped beat.
Mobitz II: Normal PR intervals with sudden dropped beats
What are the four primary functions of a pacemaker?
Sense intrinsic cardiac activity.
Stimulate cardiac depolarization when intrinsic activity fails.
Provide rate-responsive pacing.
Store diagnostic information.
What are the primary indications for pacemaker placement?
Symptomatic bradycardia.
Chronotropic incompetence (HR fails to increase with exercise).
AV delays or bundle branch blocks.
How can heart rate be calculated using ECG strips?
Count complexes in a 6-second strip and multiply by 10.
Divide 300 by the number of large boxes between two R waves.
What psychological issues may arise with cardiac disease?
Patients may face emotional issues, such as anxiety or depression, and require reassurance and counseling support.
