Introduction to Cardiology - Brown Flashcards
Functional Classification of Heart Disease
New York Heart Association Classification of Heart Disease: CLASS 1
- no limitations of physical activity
- ordinary physical activity does not cause undue fatigue, dyspnea or anginal pain
Describe the specific testing modalities used to further evaluate cardiac patients
ECHOCARDIOGRAM
provides more accurate information on:
- chamber size
- global systolic function
- chamber wall thickness
- valve motion & function
- pericardial fluid
- blood flow and pressure gradients
types:
- transesophageal echo (TEE)
- stress echo
Describe the specific testing modalities used to further evaluate cardiac patients:
ELECTROCARDIOGRAM
used to evaluate for:
- cardiac rhythms
- conduction abnormalities
- evidence of LVH, MI, ischemia
** compare changes to old EKGs
** not used for routine screening for cardiac disease
Describe the specific testing modalities used to further evaluate cardiac patients
CHEST X-RAY
provides information about:
- heart size
- pulmonary circulation
- primary pulmonary disease
- aortic abnormalities
** compare with old films **
Functional Classification of Heart Disease
New York Heart Association Classification of Heart Disease: CLASS 3
- marked limitation of physical activity
- comfortable at rest, but less than ordinary activity causes symptoms
Functional Classification of Heart Disease
New York Heart Association Classification of Heart Disease: CLASS 4
- unable to engage in any physical activity without discomfort
- symptoms may be present at rest
Describe the specific testing modalities used to further evaluate cardiac patients:
CORONARY ARTERY CALCIUM SCORE
measures amount of calcium in coronary arteries
Describe the specific testing modalities used to further evaluate cardiac patients:
STRESS TESTING
useful to elicit ischemia due to fixed coronary lesions
limited usefulness in asymptomatic patients
follow protocols
useful in diagnosis and follow-up with CAD
Describe the specific testing modalities used to further evaluate cardiac patients:
ANKLE BRACHIAL INDEX
- measure pt’s brachial BP
- measure ankle BP
- divide ankle by brachial
- 0.9-1.0 = normal
- 0.7-0.9 = mild
- 0.5-0.7 = moderate
- < 0.5 = severe
Describe the specific testing modalities used to further evaluate cardiac patients:
ELECTROPHYSIOLOGIC TESTING (EP)
catheter-delivered electrodes induce rhythm disorders, identify structural basis for problem
more accurate than an EKG
Describe the specific testing modalities used to further evaluate cardiac patients:
PERCUTANEOUS INTERVENTION (PCI)
- treatment modality for coronary artery stenosis
- typically a stent is placed in the affected vessels
- performed in cath lab, results are good
Describe the specific testing modalities used to further evaluate cardiac patients:
CT
- original use to quantify amount of calcium in coronary vessels
- allows for non-invasive coronary angiography
Common Symptoms of Possible Cardiac Origin
- chest pain
- chest pressure
- dyspnea (+/- exertion)
- orthopnea
- paroxysmal nocturnal dyspnea
- syncope or near syncope
- transient neurologic deficits
- edema
- palpitations
- cough
Describe the specific testing modalities used to further evaluate cardiac patients:
CARDIAC CATH & ANGIOGRAPHY
- invasive procedure - performed in Cath Lab by interventional cardiologist
- visualizes coronary vasculature
- measures wedge pressures of valves and pulmonary capillaries
- significant complications can develop
general approach to the evaluation and diagnosis of cardiac disorders
- from the hx - develop a ddx which will direct your exam and need for further testing
- EXAM
- vital signs:
- BP in 2 positions
- pulse rate
- weight
- lungs
- heart
- peripheral vascular findings
- jugular venous pulse
- vital signs:
- DIAGNOSTIC TESTS
- Chest X-ray
- Echocardiogram
- ECG or EKG
- Stress Testing
- MRI & Fast CT
- Cardiac Catheterization
- Percutaneous Coronary Intervention
- Blood Chemistry Tests
- rule out life-threatening disorders first
