Lecture 4 - CDV Flashcards
What happens during each waveform of the ECG?
P - Depolarization of atria
QRS Complex - Depolarization of Ventricles
T wave - Repolarization of Ventricles
U Wave (if present) - Repolarization of purkinje fibers, may be associated with hypokalemia
What is the formula for MAP? What would be a concerning mean arterial pressure?
[SBP + 2(DBP)] / 3
Anything less than 60 requires immediate intervention because tissues are not being adequately perfused.
What is the range for blood calcium? What does it do for the heart?
2.25-2.75 mmol/l
Controls force of contraction
What can decrease blood pressure?
PNS stimulation
–> Valsalva maneuver
–> Muscarinic receptors/vagal nerve
What are S1,2,3,4?
S1 - Closure of tricuspid and mitral
S2 - Closure of aortic and pulmonic valve
S3 - Ventricular vibration (mitral regurg)
S4 - Occurs w left vent hypertrophy or aortic stenosis
Extra sounds are best heard with the bell of stethoscope.
Why might a stress test with an echocardiogram be used?
To determine ejection fraction in HR, valve health, and chamber size.
What can an MRI be used to detect?
Aneurism
What is a CT scan used to test with CDV health?
Coronary artery disease
What does elevated creatinine kinase indicate? CKMB? Troponin?
CK indicates muscle damage - elevation seen within a few hours
Troponin I or T, CKMB indicates cardiac muscle damage - elevation seen within 6 hours
What might cause an increased troponin that is not related to heart health (false high)?
Kidney damage
What might cause an elevated C-reactive protein read?
Inflammation
What is hemodynamic monitoring?
Monitoring vitals and heart health more directly
Who is at risk for hypertension?
Age, women, Indigenous people
HTN is known as the silent killer.
What is isolated systolic hypertention?
Sustained elevated SBP w/o DBP elevation.
More common in older persons, related to loss of elasticity of large arteries
What might cause primary HTN?
–> Increased SNS activity
–> Increased sodium retaining hormones and vasoconstrictors, increased sodium intake
–> DM
–> Excessive alcohol
–> High weight
What clinical findings might indicate secondary hypertension?
–> Unprovoked hypokalemia
–> ABD bruit
–> Variable pressures with a history of tachy, sweating, and tremor
–> Family history of renal disease
What are some common symptoms of hypertension?
Headaches, blurred vision, fatigue
What diagnostic studies are used for HTN?
–> Urinalysis for protein
–> Blood work for K, Na, urea, creat
–> Fasting BGL, cholesterol & triglycerides
–> 12 lead ECG
What diet can be helpful to people with HTN?
Orange veg - K + Mg rich
Whole grains reduce cholesterol
>1500 Mg sodium daily
What is considered a hypertensive crisis? When does it occur?
Abrupt increase in DBP >120-130 mm HG
Occurs in patients with a history of HTN who have failed to adhere to their medication regiment or who have been undermedicated
Which artery is most commonly affected by coronary artery disease?
Left anterior descending
How can nutritional therapy help people with coronary artery disease?
Can reduce serum triglycerides by keeping cholesterol intake to under 200 mg/day. Can help person reach ideal body weight.
What kind of fats are best for people with cardiovascular disease?
monosaturated - fish oil, avocados, canola, peanut, and olive oil
Polysaturated - vegetable oils, margarine, seeds and nuts
What medical history should you be aware of in a person with valve disease?
Rheumatic fever
What might cause valve stenosis?
Rheumatic fever, calcification, congenital factors
How does mitral stenosis affect the rest of the heart?
Can precipitate atrial fib, cause decreased cardiac output, and can cause tachycardia that will decrease filling time
What are the classic s/s for heart failure?
–> Orthopnea
–> Dyspnea
–> Paroxysmal nocturnal dyspnea
May also see fatigue, JVD, edema, crackles, S3 noises