Quiz number 3 Flashcards
what does the P-wave on an EKG represent
Atrial depolarization
what does QRS complex on an EKG represent
Ventricular depolarization
what does the t wave on an EKG represent
ventricular repolarization
where does atrial repolarization occur on an EKG
it happens within the QRS complex
What are signs and symptoms of pulmonary embolism
-Hemoptysis
-SUDDEN SHARP chest pain that is worse on INSPIRATION
-Dyspnea/SOB
-tachypnea/Fast breathing
-pale skin/sweating
What is the only unfractionated heparin
IV heparin
What are the low molecular weight heparins
Anything that ends in “-parin”
-Enoxaparin
-Dalteparin
-Nadroparin
which factors decrease myocardial O2 supply for perioperative patients
-Hypoxia
-Lower BP
-Coronary vasospasms
what factors increase myocardial demand
-myocardial wall stress (more stress the heart needs to contract harder)
-Dysrhythmias
-change in body temperature
what is the ideal LDL level
below 2.0 mmol
What is the ideal HDL levels
Should be above 1.03 mmol
what is the earliest cardiac enzyme to peak
myoglobin
what is the onset and peak of troponin
Onset: 4-6 hours
Peak: 10-24 hours
in what order do the cardiac enzymes peak
- Myoglobin
- CK
- Troponin and CK-MB
what part of the heart does a 12 lead EKG examine
examines the left ventricle
if you wanted to examine the right side of the heart what kind of ECG would you need
15 lead ECG
What does burning chest pain usually indicate
GI chest pain
What does a sharp stabbing chest pain usually indicate
Respiratory chest pain
What does a crushing chest pain usually indicate
Cardiac chest pain
what is the process of atherosclerosis
-Endothelial injury (from things like HTN smoking)
-Fatty streak (fat gets passed the endothelium into the smooth muscle)
-Fibrous plaque (collagen tries to contain the fat as it builds up occlusion of vessel occurs)
-Complicated lesion (plaque ruptures blood clots to the rupture and then can break off)
what are three factors that lead to the development of a clot
-Hypercoagulability
-Vascular damage
-Circulatory stasis
if someone has a history of cardiac issues what should there LDL level be
should be below 1.8
What are the three types of Acute Coronary Syndromes
-unstable angina
-NSTEMI’s
-STEMI’s
What is Prinzmetal or variant angina
lack of myocardial blood flow that causes pain but is not due to a clot
What is the most specific cardiac enzyme
Troponin
What is the most effective medications to prevent an MI
P2Y12 receptor antagonists and aspirin
What are absolute contraindications of thrombolytic treatment
-Brain problems (problems that could make you more susceptible to a brain bleed)
-Recent trauma or surgery (within the last three months
-Uncontrolled hypertension (they are not taking meds)
What are relative contraindications for thrombolytic treatment
-Stroke but may be able to if it was more than 3 months ago
-Anticoag use/high INR
-Controlled hypertension (They are taking meds)
What is primary PCI
when PCI is used as the first intervention to treat an MI
What is secondary PCI
fibrinolytic therapy fails and PCI is used as a secondary intervention
What is planned PCI
when a patient has not had an acute event but blockages are known from an angiogram
When are P2Y12 inhibitors and Aspirin given during a heart attack
right away because they prevent the clot from getting bigger and the ischemia from getting worse
