Lecture 3

Question 1

What information do you want to know when evaluating pt with cardiovascular disorders?

Answer 1

If….
presence of chest pain, palpitations, cardiac risks
medical treatments sought and outcomes
Hx of dizziness or syncope (fainting)
previous MI, cardiac studies or procedures

Question 2

If a pt has hyperinflated lungs it can __________ the heart.

Answer 2

enlongate

Question 3

Define normal heart sounds S1-S4.

Answer 3

S1 - mitral & tricupid closure (ventricular systole)
S2 - aortic & pulmonary areas
S3 - “ventricular gallop” associated with early rapid diastolic filling of ventricles.
S4 - “atrial gallop” associated with ventricle filling due to atrial contraction, its a low pitched sound heard late in diastole just before S1.

Question 4

What is a ETT?

Answer 4

ETT examines the ability of the CV system to accommodate to increasing oxygen demands (VO2).

Question 5

What is a MET?

Answer 5

A MET is the metabolic equivalent of energy expenditure.

Question 6

What does a MET mean?

Answer 6

An activity can be expressed in comparison to resting, for example 5METS requires 5x the energy expended at rest.

Question 7

What are the 2 major goals of ETT?

Answer 7

Detect the presence of ischemia = angina

Determine functional aerobic capacity

Question 8

The Bruce protocol starts at how many METS?

Answer 8

5 METs

Question 9

Explain the 4 ETT findings.

Answer 9

Positive ETT - there is a point where myocardial oxygen supply is not meeting the demand = ischemia.
Negative ETT - balance of oxygen supply & demand.
False-negative ETT - the ETT is interpreted as (-) but there is ischemia.
False-positive ETT - the ETT is interpreted as (+) but there in NO ischemia.

Question 10

Name the functional task that require 2METs, 4METs, 6METs, and 10METs.

Answer 10

2METs = Bed exercises
4METs = walking (level surfaces)
6METs = stair climbing
10METs = jogging

Question 11

Thallium Stress test can help diagnose?

Answer 11

extent of coronary artery blockage
prognosis of pt who’ve suffered heart attack
effectiveness of cardiac procedures done to improve circulation in coronary arteries
causes of chest pain
level of exercise that a pt can safely perform

Question 12

What test is used if a pt is unstable, deconditioned, unable to ambulate of cycle for stress test?

Answer 12

Persantine test.
persantine is a chemical given via IV, then 4 min later thallium is given via IV. A nuclear scan for myocardial perfusion is used to assess the distribution of thallium. looking at:
- vasodilates arterioles
- coronary arteries w/atherosclerosis do not dilate
- can detect areas of decreased blood flow