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Cardio > Lecture #6-1 > Flashcards

Lecture #6-1 Flashcards

1
Q

What can we learn from catheterization?

A

Information about intracardiac hemodynamics and coronary circulation by injecting radio-contrast substance

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2
Q

Name of catheter with balloon at end.

A

Swan-Ganz Catheter

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3
Q

CO is increased by… (2)

A

Symp. stimulation

Myocardial Hypertrophy w/ SV increase

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4
Q

CO is reduced by… (5)

A 
Arrythmias
Valvular insufficiency
Inc. afterload
Reduced contractility
Preload elecation beyond starling law
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5
Q

Name the Gold Standard for CO measurement.

A

The Fick Method

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6
Q

What happens in the Fick Method?

A

Measure Oxygen Consumption
Measure O in mixed venous blood
Measure O in arterial blood

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7
Q

Mixed venous blood oxygen equation

A

(2SVC+IVC)/3

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8
Q

Equation used with Fick’s Ingo

A

CO = (Oxygen Consumption)/Arteriovenous Oxygen Difference)

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9
Q

Equation for cardiac index.

A

CI = CO / Body Surface Area

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10
Q

Most commonly used method to measure CO?

A

Thermal Dilution

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11
Q

How does thermal dilution work?

A

Injection of cold saline
Degree of warming measured downstream
Area Under Curve = Flow In Pulmonary/LV Output

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12
Q

benefits of CO measurement with cold saline?

A

No recirculation bump

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13
Q

Alternative ways of measuring CO

A

Doppler Method

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14
Q

What measurements are performed in the doppler method?

A

Echo used to measure aortic root cross sectional area
ultrasound used to measure doppler shift/blood velocity

Flow = V X Area

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15
Q

Doppler velocity profile can also help estimate…

A

Inotropic State, Preload, and Afterload

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16
Q

Double alternative method of measuring CO?

A

3D Echo Ventriculography

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17
Q

How can intracardiac pressures be measured?

A

Swan-Ganz catheter

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18
Q

What is pulmonary capillary wedge pressure?

A

Catheter is passes into br. of Pulmonary Artery, Balloon expanded

Approximates Atrial Pressure

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19
Q

Intracardiac pressure measurements should be performed while patient is….

A

finishing expiration

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20
Q

Pulmonary Artery Occlusion Presure (PAOP) is ________ related to Pulmonary Capillary Wedge Pressure

A

Closely

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21
Q

Relationship of flow through tube to radius of tube?
to length of tube?
to viscosity?
to change in pressure?

A

r^4
Inverse
Inverse
Proportional

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22
Q

In Vascular System…Resistance= (equation)

Again with new words.

A

(MAP-MVP)/Blood Flow

(Pulm Art - Wedge Pressure) / Flow

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23
Q

Systemic Vascular Resistance =

A

(Pa-Pv)/CO

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24
Q

PVR =

A

(Ppulm-Pla) / CO

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25
Q

With a constant CO, any change in resistance will….

A

Change the pressure drop across the circuit

26
Q

Five examples of pressure drop…

A 
Pulmonary Hypertension
Systemic Hypertension
Mitral Stenosis
Aortic Stenosis
Hepatic Portal Hypertension
27
Q

Equation or Pulmonary Artery Pressure with elevated resistance.

A

PA - PAWP = CO x Rp = Differential

PA = PAWP + Differential

28
Q

Perks of echocardiography?

A

Widely Available
Inexpensive
Performed at Bedside

29
Q

Transthoracic M-Mode Echo used to observe…(3)

A

Mitral Valve Leaflets
Myocardial Shortening
Radial Thickening

30
Q

Transthoracic 2-dimensional echo used to observe…

A

Pie shaped heart section

31
Q

Why do 3D Echo?

A

Quantification of LV volume and EF

Quantification of Mitral Valve Area

32
Q

Doppler echo is used to show?

A

Blood Turbulence and Flow

Ventricular Wall motion and valve function

33
Q

Pressure gradient across a stenosis is ____ times the maximum velocity across the stenosis.

A

4 X the square of Vmax

34
Q

What should you look for when nuclear imaging?

A

Hemodynamically significant coronary artery stenoses

35
Q

What does gated radionuclide imaging show?

A

Visualization of heart chambers by detecting gamma emissions from blood after isotope injection

Evaluates CAD, Valvular Heart Disease, Conjenital Heart Disease, Cardiomyopathy.

36
Q

What does Radionuclide myocardial perfusion imaging (MPI) do?

A

Heart cells take up radionuclide (SPECT, Thallium)
Shows regional variation in myocardial perfusion/viability
Often done with stress test

37
Q

Review Pics on 14

A

Pretty please.

38
Q

Gold standard test for EJF?

A

MRI

39
Q

What does PET imaging show?

A

Blood flow through specific regions of the heart.

Myocardial Metabolism

40
Q

What is a CT?

A

Many X ras used in morphoogical analysis of an organ

41
Q

What is an MRI?

A

Measures H1 activity when exposed to a large magnet.

42
Q

What is the gold-standard for myocardial viability assessment?

A

PET scan

43
Q

What is heard in the 4 heart sounds

A

S1 – Closure of AV
S2 – Closure of Semilunar Valves
S3 – Rumble of distending ventricles pulling AV taut
S4 – Atrial Contraction

44
Q

Distance between two S1 or two S2 sounds may indicate…

A

Right Bundle Branch Block

45
Q

Who should have an audible S3?

A

People age 20-25

46
Q

S3 sounds like? S4 sounds like?

A

S3 – Tennessee

S4 – Kentucky

47
Q

Which patients do you hear S4 in?

A

Individuals with ventricles with low compliances.

48
Q

What is an opening snap?

A

A sound from stenotic AV valves opening during diastole

49
Q

When are murmurs normal?

A

Small children and exercise.

Blood flows through fast enough to generate turbulence.

50
Q

Typical cause of murmurs?

A

Turbulent Blood Flow

51
Q

How would you distinguish a regurg. vs a stenotic murmur?

A

Regurg would be heard with valves closed

Stenotic with valves open

52
Q

Example of a systolic murmur? a diastolic murmur?

A

Mitral valve fails to close fully

Aortic valve fails to close fully

53
Q

Another way of saying insufficient mitral valve?

A

Insufficient Mitral Valve

54
Q

Aortic Valve Stenosis causes an increase in ____ pressure. Mitral valve stenosis causes an increase in ______ pressure.

A

Left Ventricular Pressure

Left Arterial Pressure

55
Q

Mitral Valve regurg. causes ______

Aortic Valve regurg causes ________

A

Tall V Wave in Arterial Pressure

Tall LVP, higher systolic (Austin Flint mid-diastolic Murmur)

56
Q

Machinery Murmur relates to…

A

Patent Ductus Arteriosus

57
Q

Review PV loops on Pg. 25

A

You’ll be glad you did.

58
Q

Four types of Systolic Murmur

A

Aortic Stenosis/Pulmonic Stenosis
Atrial Septal
Mitral Regurg/Tricuspid Regurg
Mitral Valve Prolapse

59
Q

Four Types of Diastolic Murmur

A

Aortic/Pulmonic Regurg
Austin-Flint

Mitral/Tricuspid Stenosis

Patent Ductus Arterosus

60
Q

Mitral Valve Prolapse Makes what sound?

A

Click

61
Q

What is Austin Flint Mid Diastolic Murmur

A

In aortic regurg, blood pushes back agains mitral valve, creating a mitral stenosis effect

62
Q

Murmur heard through systole and diastole?

A

Patent Ductus Arteriosus

Cardio (10 decks)

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