RCIS Flashcards
What is the purpose of the pericardium
It fits snugly around the heart stretches when the heart gets bigger during diastole and vice versa. it protects the heart
What will happen to stroke volume and cardiac output in constrictive pericarditis
They will decrease
How do inotropes work on BP
They work on the stroke volume
How does chronotrope work on blood pressure
They increased heart rate
What is the normal range of respiratory variation
0 to 10 mmHg
What is the pericardium
The protective sack that covers the base of the great vessels as well as the heart. normal volume is 5 to 50 mL
What is the treatment of cardiac Tamponade.
Pericardiocentesis
If a patient is on Coumadin what would you do different for a pericardiocentesis
Ultrasound guided needle stick
What is the cause of constrictive pericarditis
Unknown
What is cardiac Tamponade
Blood is leaking into the pericardial sac
What happens during Tamponade
Heart rate increases, pulse ox decreases, alertness decreases, chest pain. Stroke volume goes down due to losing blood to PS and venous constriction. Right and left EDP goes up proportionally
Where is the needle place during a pericardiocentesis
Sub xiphoid
What are the signs and symptoms of constrictive pericarditis
Tired, decreased concentration, sleeps a lot, equalization of the RVE DP and LVED P, so sv decreases so heart rate increases, this is what causes fatigue
What is the formula for blood pressure
Heart rate X stroke Volume X SVR
Which leads show septal anterior wall infarct? Which artery is this
V1-V4. LAD
What are the three areas where you can affect the blood pressure
Heart rate, stroke volume, SVR
What leads show inferior wall infarct? Which artery is this?
Two, three, AVF
RCA
What is preload
How full the heart is prior to systole
What leads show anterior wall infarct? Which artery is this?
V2 through V5, LAD
What is afterload
How much force does each cardiac muscle fiber have to contract to move blood across the bow
Fick CO
O2 consumption/ (hgb x constant x AO sat) - (hgb x constant x PA sat) x 10
What is the normal CO range?
4-8 L/min
Which leads show anterior lateral wall infarct? Which artery is this?
V2-V6, 1, AVL
LAD, Circ
Pulsus paradoxes
Respiratory variation greater than 10 mm hg
Caused by Tamponade
Which leads show lateral wall infarct? Which artery is this ?
V5 V6 1 and AVL
CIRC
What happens to RVEDP & LVEDP in constrictive pericarditis?
The equalize.
Regurgitant Fraction
SV (angio) - SV (thermo) ---------------------------- SV (angio) Or CO (angio) - CO (thermo) ----------------------------- CO(angio)
What is the term used when using angiography to determine CO?
LVMF. Left ventricular minute flow
Ejection fraction (EF)
EDV-ESV/EDV
Stroke volume
EDV - ESV
Angiographic CO
SV (ml) x HR/ 1000
Which lead shows posterior wall infarct? Which artery is this?
V7-V9
Circ
What is the normal O2 consumption of an adult and child?
Adult 250 ml/min
Child 150 ml/min
What is resistance
The Amojnt of work necessary to push blood out of the systemic or pulmonary systems
Cardiac Index (CI)
CO/BSA
AVF (aortic valve flow)
SEP (Sec/min)
What is the gorlin formula aortic valve constant
44.5
SEP. Systolic Ejection Period
The amount of time the AO valve is open for blood to be ejected out of the Aortic valve
DFP (diastolic filling period)
Amount of time the mitral valve leaflets are open for blood to eject out.
AVA (aortic valve area)
AVF
- 5 x square root of mean gradient
What is concentric plaque
The plaque covers the entire inside if the artery.
MVF (mitral valve flow)
DFP (sec/min)
Haaki formula for valve are
Square root of the peak to peak lv AO pressure gradient.
What is the mitral valve gorlin constant?
37.7
SBF (systemic blood flow)
Systemic arterial 02 - MO2 content x10
(RAo2 or RVo2) is MO2
How do you convert hybrid resistance units to absolute resistance units?
Multiply by 80
What does AA Araqadonic acid do in the clotting cascade.
Helps platelets stick together.
PBF (pulmonary blood flow)
Pulmonary venous o2 - pulmonary artery o2 x 10
If the shunted blood flow is a negative number, does that indicate a R-L shunt or L-R shunt
R-L shunt
Calculate Qp/Qs ratio
(PV o2 - PA o2)
What is the gold standard for figuring valve area?
Gorlin formula
How do you calculate shunted blood flow?
PBF-SBF
What is esentric plaque?
Does not cover the entire inside of the artery
A Qp/Qs ratio greater that 1 indicates what?
PBF exceeds SBF or L-R shunt
What is a covered stent used for?
Perforation
What’s are most closure devices made of.
Collagen
What is the normal mitral valve area?
4-5cm2
What is the normal aortic valve area?
3-4 cm2
What does ADP do in the clotting cascade.
Finds 2b3a and allows it to accept fibrin which allows platelets to stick together.
Where does Coumadin work
Vitamin k
Thrombin a2 (tax2)
Causes muscle fibers to contract a tiny bit so there will be less are to cover by clot
What is the normal pulmonic valve area?
7cm2
Factor 10a
Changes prothrombin to thrombin
What does factor vIII do for clotting
Helps platelets to collegen
What is the normal tricuspid valve area?
8-10 cm2
How long does it take for the artery to realize this is my new form?
14 sec
What was the original stent? What was the RR?
JJ Stent
43-45%
What is the rotoblader used for? What is the RPM range?
Calcified lesions
180,000-220,000
What was the original elastic recoil of ballooning?
44-46%
What is ICE?
Intracardiac echo
What are the contraindications to using a closure device.
Below the bifurcation
Disease in the artery
Immune compromised
What pressures does COPD affect?
PCW, LA, LVEDP
What is a cutting balloon used for?
Calcified lesions.
When do you calibrate the laser?
Every use
What is the inoue balloon used for?
Valvioplasty.
Mitral valve only.
What is the normal stroke volume for an adult
60-100 cc per beat. Avg is 70
How quickly do you pull back the Ivus?
O.5 mm per sec
What is the normal RV systolic and diastolic pressure?
Systolic 25
Diastolic 5
What is the normal BP?
120/80
What is the angiojet used for?
Fresh clot. Peripheral or coronary.
What is the angiojet used for?
Fresh clot. Peripheral or coronary.
When do you use a filter wire
Carotids and grafts
The skeletal muscle pump moves venous blood at what pressure
Same as RA. 0-5 mm hg
What is the pulmonary artery pressure?
Systolic 25
Diastolic 7-12
What is the normal RA pressure?
5 mm hg
If the RA pressure increases, where would this be visible on the pt?
Increases HR due to lactic acid
As the valve size increases, how does this affect the pressure
The larger the valve the less pressure it takes to cross it
What would increase RA pressure?
Anything that makes the valve smaller or work harder
What is the normal LA pressure
7-12
What would cause the LVEDP to increase and not the LV systolic pressure.
LVMI
If a pt has Pulmonic Stenosis how does it affect the RV Systolic pressure
PS increases RV Systolic pressure
What would cause LV systolic pressure to increase?
Valve stenosis
What is the PA pressure of COPD?
Increase PA pressure
What is the RA pressure of tricuspid Regurg?
Increases pressure due to more volume
What is the PCWP of LVMI
Increased LVEDP, LA, PCWP
What is the best way to decrease blood pressure?
Increase the diameter of the vessels
What is the PCWP of MS
increased pressure.
Dopamine
1-5 mg/kg/min dilates Renal arteries to increase urine output. A
5-10 mg/kg/min increases heart rate
Greater than 10 = vasoconstriction to increase BP
Dobutamine
Increases contractibility to increase SV
What is the best way to increase blood pressure.
Decrease the diameter of the vessels
Is the LV EF = RV EF
Yes.
What is the normal HR for an adult
75-80
What is the best position to put a pt in with cardiac Tamponade?
Sit up 45 degrees
What is the normal CO for and adult.
4-8 L/min
What do chronotropic drugs affect
Heart rate
What is the PCWP of MS
Increased pressure
How does the body control blood pressure?
The aortic arch has baroreceptors that stretch. If the stress too much or not enough the brain recognizes and tries to fix.
Pulmonary vascular resistance
PBF X 80
PBF = CO as long as ther isn’t a shunt
What will happen to SV & CO in constrictive pericarditis.
They will decrease
If the brain senses a decrease in BP how does the body react?
Basins tells the kidneys to release renin and the liver to release angiotensin. Combined these make angiotensin 1. Angiotensin 1 + ACE makes Angiotensin 2. Angiotensin 2 constricts blood vessels which increases BP. Also tells kidneys to hold into salt. This increases volume which increases SV which increases BP
What do inotropic drugs affect.
Stroke volume.
What is another name for verapamil
Isoptin
What areas does inderal work
Beta blocker that affects heart and lungs.
True or False.
Pt develops Tamponade. The LVEDP and RVEDP will equalize.
F. The will increases proportional from where they started but will not be the same.
Systolic vascular resistance
SBF. X 80
SBF = CO as long as there isn’t a shunt
When is a PTs heart rate the highest in their life.
In the womb
How does increased stenosis of the tricuspid valve affect the pressure?
RA systolic pressure will increase
How does adrenaline work.
Works on beta sites to increase HR. also works on beta sites in airway when exercising.
What is the normal respiratory variation range.
0-10 mm hg
How does angiotensin 2 work
Tells the kidneys to keep salt. This will increase volume. Increases vine will increase SV. increased SV will increase BP
Angiomax
Decrease the dose for dialysis dependent PTs or renal insufficiency. ACT usually greater than 350. Half life approx 25 mins.
Isuprel
Iv infusion for bradycardia
What is respiratory variation
When a pt takes in a deep breath the left lung surrounds the SVC & RA which briefly pushes back blood into the vena ceva. When that happens the SV will decrease. So when you take a deep breath in the pressure will decrease and vice versa.
Can you give lidocaine to bradycardia
No
Atropine
For vasovagal or symptomatic bradycardia
Nipride
Decreases blood pressure. Mimics nitric oxide that endothelial cells produce to decrease BP. Decreases preload and after load. Work on arteries and veins but mostly arteries. Given in hypertensive emergencies.
Amiodarone
Choice drug for v-fib v-tach.
Causes potassium channels to move less efficiently. Does most of work in ten conduction system. Makes conduction system less sensitive.
Epinephrine
Stimulates beta sites to increase HR but can also work on Alpha sites to increase BP
What is heparin reversed with?
Protamine.
Heparin
Bolus with infusion. Keeps ACT around 250-300. Bolus is reduced when giving 2b3a inhibitor. Act is then around 200-250.
Ca channel blockers
Prevents artery from constricting and dilates them by preventing ca channels which decrease HR
What happens in an RVMI
RV muscle loss causes systolic pressure and diastolic pressure to decrease. Does not affect the pulmonary valve but RVEDP goes up due to contractability. Remaining muscle gets bigger due to more work which is what decreases contractability do to decreased flexibility.
Narcan
Reversal for narcotics
Adenosine
To convert Svt
Used during pressure wire to dilate micro vessels
During an intervention the ACT should be kept at what level
Over 250
INR
.8–1.2
Procainamide
VF-VT
Beta blockers
End in lol
Can you give lidocaine to heart block PTs.
No
Lidocaine.
Decreases sensitivity to electrical impulses in entire electrical system.
What are two antibiotics that are used in the Cath Lab
Ancef And vancomycin
Antibiotics find invading bodies and turn off DNA and damage bacterial walls
How many mm is a 8 f catheter
2.6 mm
T or F. In PTs with a short or narrow AO root, a 3.5 mm tip catheter may be needed.
T
What is the other name for versed
Midazolam
Nitro
For CP
Where the baroreceptors located
Aortic arch and carotid bulb. Or carotid bifurcation
Chronotrope
+ Chronotrope increases HR
- Chronotrope decreases HR
Where is the SA node located
Atrial side of the wall by the SVC
PT/PTT
11 - 16 seconds
What do you give for contrast allergies.
Prednisone, hydrocortisone, Benadryl.
Metformin
A byproduct of cellular function is lactic acid. Lactic acid is excreted via the kidneys. Metformin prevents the kidneys from eliminating lactic acid. Therefore if lactic acid builds up in the body it changes the pH
Name to benzodiazepines used in the Cath Lab
Versed and Valium
Name 2 vasodilators
Nipride
Nitroglycerin
Where is the AV node located
Av junction
Romazicon
For over sedation with benzodiazepines
What is the other name for Valium
Diazepam
What catheter would you use for dilated root
Anything greater than a 4.0
Inotrope
Changes force of contraction.
Example: dobutamine = + inotrope
What is another name for PLAVIX
Chlopidogrel
Anti platelets
ASA
PLAVIX (chlopidogrel)
Effient (prasagrel)
Brilinta (Ticagrelor)
What is it called when the pH is less than 7.35
Acidosis
What is the normal range for HCO3
22-26
What is the purpose of bicarb
It creates a bond with lactic acid and carries it to the liver
What is another name for Effient
Prasagrel
What is a normal pH range
7.35–7.45
What is another name for Coumadin
Warfarin
What is another name for cardizem
Diltiazem.
Name non-cardio selective beta blocker
Inderal (propanolol)
Name 2 thrombin inhibitors
Coumadin (warfarin)
Pradexa
Name 2b3a inhibitors
Reopro (abciximab)
Integrelin (eptifibatide)
What areas does inderal work
Beta blocker that affects heart and lungs.
Name cardio selective beta blockers
Metoprolol (lopressor)
Atenolol (tenormin)
What is another name for Brilinta
Ticagrelor
What is another name for inderal
Propanolol
What is the normal range PaCo2
35-45
What is the other name of Angiomax
Bivalrudin
If the bicarb is decreased how will this affect the pH
PH will be decreased
If there is an increased CO2 how does this affect the pH
PH will be decreased
If the bicarb is increased how will this affect the pH
PH will increase
If there’s a decrease in CO2 how this affect the pH
PH will be increased
If the pH abnormality is caused by bicarb is this metabolic or respiratory
Metabolic
If the bicarb is decreased how will this affect the pH
PH will be decreased
What is it called when the pH is greater than 7.45
Alkalosis
Respiratory acidosis
Retain CO2, and inadequate ventilation’s, narcotics, barbiturates, cardiac arrest,
Must be compensated via the kidneys
In an AV pacer, the first spike is responsible for what?
Atrial contraction
PH 7.52, CO2 32, HCO3 34
Uncompensated metabolic alkalosis
If the pH abnormality is caused by CO2 is this metabolic or respiratory
Respiratory
PH 7.18, CO2 68, HCO3 29
Uncompensated respiratory acidosis
PH 7.5, CO2 26, HCO3 21
Uncompensated respiratory alkalosis
PH 7.21, CO2 32, HC 03 14
Uncompensated metabolic acidosis
Metabolic acidosis
Caused by strenuous exercise /lactic acid
Compensated via the kidneys(slow)
PH 7.02, CO2 60, HCO3 12
Uncompensated respiratory and metabolic acidosis
What is the goal of the pacemaker
Max cardiac output
Can you defibrillate a patient with a PPM
Yes
Respiratory alkalosis
Hyperventilation, psych/asthma decrease and respiratory rate/kidneys
PH 7.36, CO2 54, HCO3 32
Compensated respiratory acidosis
If the respiratory rate increases how does this affect the CO2
Decreases CO2
Metabolic alkalosis
Vegetarians, inc. vomiting, decreased respiratory rate.
Compensated via the kidneys
Why do paced beats look like PVCs
Bc of the time it takes the electrical impulse to do its job
If there is a lead only in the atrium, where is the problem
Sa, av area
Do the leads enter in the subclavian or jugular vein.
Subclavian
If there is a lead only in the ventricle then where is the problem
Sa, av area
What are the components of a pacemaker
Generator, leads, electrodes
Two PTs, one with a BMI of 20 and BMI with a BMI OF 30
Which pt will give you an image with less contrast
BMI of 30
Cyonotic
W/o oxygen. (Blue)
What is the intrinsic rate of the AV node
40-60. BPM
Define capture
When the heart response to the pacer
What is the purpose of a biventricular pacemaker.
Timing between right and left ventricle
What does the second letter in pacemaker coding mean
Chamber in which the pacer is sensing the hearts natural intrinsic activity
What does pulse width represent
MA and time
Ostium secundum ASD
Most common. Occurs in the center of septum. A variant of this is a PFO and is very small.
What does the first letter in pacemaker coding mean
Chamber being paced
Ostium Primum ASD
2nd most common type and is located in the lower portion of the atrial septum. This type will often have a mitral valve defect associated with that called mitral valve cleft. A mitral valve cleft is a slit like or elongated hole in one of the leaflets
What is sensing threshold measured in
Milli volts
What is the intrinsic rate of the bundle of his
40– 60 BPM
What is the intrinsic rate of the Purkinje fibers
20–40 BPM
True or false
Collimating reduces the skin dose
True
What is a safe distance to stand back from xray
6ft
Define isocenter
The position at which the object being imaged remains in the center of the field view, minimizing table height and table movement
Isocenter minimizes the need to reposition the patient when the intensifier is rotated
What is the best way to minimize radiation dose
Decrease time
True or false
Collimating reduces scatter radiation
True
What are the 2 components of an X-ray tube
Cathode (-)
Anode (+)
What is the best view to minimize radiation
AP
Two exactly identical patients, same BMI:
Patient #1 image from LAO 60, cranial 30
Patient #2 image from LAO 30
Which image will give clearer detail
Patient #2
Two exactly identical patients, same BMI:
Patient #1 image from LAO 60, cranial 30
Patient #2 image from LAO 30
Which view will result in more scatter
Patient #1
Which imaging delivers a higher amount of energy to the patient? Flouro imaging or Cine imaging?
Cine
True or false
Collimating reduces total radiation to the patient
True
True or false
0.5 mm lead equivalent or protection provides approx. 95% shielding from X-ray scatter.
True
True or false
Collimating improves image quality
True
True or false
Dose is the amount of energy absorbed by tissue from the X-ray beam
True
True or false
Collar badges give a good measurement of eye exposure
True
True or false
An object can be delineated in an image only if the X-ray absorbance is sufficiently different from That of it’s surrounding structures to produce different exit beams intensity.
T
True or false
As X-ray passes through a person there is less available to the deeper tissues.
True
What is a good sign of an ostial lesion
Lack of reflux
Which imaging results in an image with more noise. Cine or flouro
Flouro
The best view for visualization of a stent
- LAO 60, cranial 30
- LAO 30, cranial 0
LAO 30, cranial 0
Which ever view is closest to AP
True or false
Cine acquisition generates a lower dose to the pt than flouro imaging
False
Why do you give nitroglycerin during an MI
Nitroglycerin dilates the veins so more blood is stored in them which decreases preload causing the heart to work less giving it a break
Osmolality
of particles , increase Osmolality = increased pulling power of fluid out of anatomy
Damping
Sustoly goes down
Hypertonic
of particles
What piece of anatomy does the circumflex always lie next to.
The spine
What do you do with the BP cuff and mammary arteries
Ipsilateral side (same side)
Name the components of the LCA
LAD - Septals - Diagonals CIRCUMFLEX - marginals
Name the components of the RCA
Conus
Acute marginal
PDA
Ventricularization
Small decrease in systolic pressure and a significant decrease in diastolic pressure. Almost gets even with LVEDP
Same principle as a wedge balloon. The catheter gets wedges and measures capillary pressure
Generally how many ml of contrast does it take to fill the LCA
7-10 ml
T or F. The benefit of advancement of a catheter over a guide wire is reducing trauma to arch atheroma off sets the risk of introducing debris,clot,or air into the aortic arch by performing the first catheter flush in the ascending aorta.
T
When the spine is on the right side what view does this indicate
LAO
When the spin is on the left side of an X-ray what view does this indicate
RAO
T or F complications at the procedure site are the most common problems seen after a cardiac cath procedure
T
T or F. The main cause for catheterization related strokes is embolic
T
What is the avg size of a circ.
3.4 mm
What is the avg Size of a Left Main
4.5 mm
How many mm is a 6f catheter tip
2 mm
Generally how many ml of contrast does it take to fill the RCA
4-8 ml
What is the avg flow rates of a hand injection
2-4 ml /sec
What is the avg size of an RCA
2.8 mm
True or false. A significant rise in the PA pressure mean or diastolic pressure should prompt temporary suspension of angiography to prevent pulmonary edema
True
T or F. The risk of stroke is higher with an intervention
T
T or F. Vigorous or hard injection despite a dampened or ventricularized pressure waveform predisposes a patient to vfib or dissection of the proximal coronary artery
T
T or F. Procedure site complications are the single greatest source of procedure related morbidity.
T
True or false. The diagonal branches supply the anterior lateral free wall of the LV
True
Is dampening more common in the LCA or RCA
RCA
T or F most common grafts to LCA arise from the left anterior surface of the aorta
T
T or F. Grafts to the RCA usually originate from the right anterior surface of the AO
T
Is Ventricularization more common in the RCA or LAD
LAD
Do the RCA and circumflex coronary arteries run between The AV sulcus or the intraventricular sulcus
A V sulcus
True or false. Cannulation of the RIMA my be difficult because of the need to avoid right internal carotid artery
True
True or false. The conus branch supplies the AV outflow tract
True
True or false the acute marginal supplies the free wall of the LV
True
What size is this one wire
0.25 or smaller
True or false. The obtuse marginal supplies the lateral free wall of the LV
False
What is the best wire to Cross a stenotic valve
Straight wire
What is the Rotablator wire size
.009
Where would you position the wire in relation to the lesion
2 to 3 cm
What catheter is best used for LV angiogram
Multi- hole catheters
Which solution are myocardial biopsy samples placed in
Formalin
How long can a wire/catheter be left in place before removing it to wipe it and flush it
2-3 mins.
If a patient has an LV aneurysm should an LV angiogram be performed
No, there’s usually a clot in the aneurysm
What is the best way to view an aortic dissection
LAO or LAO cranium
What are the indications for a pacemaker
Sick sinus syndrome, AV conduction delays due to handling in surgery - handling of the heart can sometimes cause disturbance in conduction system
When would you not use a balloon pump
Aortic regurgitation, aortic aneurysm
How should a sterile pack be open
Away first
Where should A balloon pump be placed
Above the renals and below the subclavian
If a patient’s white blood count is high would use A closure device
Out
What chemical is used for sterilization
Ethylene oxide
What is asynchronous or fixed pacemaker
Set rate and doesn’t check patient’s own heart rate
What is the intrinsic rate of the SA node
100–115 Bpm (60-80)
What does a balloon pump to
Decreased afterload, increase coronary perfusion, increase stroke volume, increase cardiac output, decrease extent of an M I
Does a balloon pump and inflate from the top-down or bottom-up
From the bottom up
How does the swan fanzine catheter work.
There is a temp sensor on the tip of the catheter. It is placed in the PA. the injection port is 30 cm from the tip and is placed in the RA. Room temp. Saline is injected into the RA. The sensor read the temp change and how long it takes to go back to normal
The side port on a swan ganz catheter is how far from the tip
30 cm
Is the balloon pump inflation during diastole or systole
Diastole
Does the balloon pump deflate from the top down or from the bottom up
It deflates from the top down creating a vacuum to pull oxygenated blood from the LV which increases stroke volume and cardiac output making the heart rate go down so the heart can rest
When would you use a balloon pump
Large MI, cardiogenic shock
What is in Allen’s test
The Allen’s test is performed during radial artery heart caths to make sure that the hand has adequate blood flow through the ulner artery during the test.
Is done by holding pressure on the ulner and radial artery while simultaneously having O2 oxygen sat hooked up to the hand until oxygen saturation reads zero. Then remove pressure from ulner artery to see if oxygen saturation returns
ASD
Acyonotic problem allowed oxygenated blood flow to escape to deoxygenated system
If the patient has aortic insufficiency does the hold time increase or decrease
Increase
What do you look for during cardiovascular assessment
Check pulses bilaterally, if patient can’t breeze lying flat ejection fraction could be low, be careful how much food is given. If Neck veins are distended while setting up 30° or higher than the right heart pressures are high
How is the battery preserved on a pacemaker
Ma and time are set as low as possible
If the transducer is too low will the PTs pressure read higher or lower than normal
Higher
Acyonotic
With oxygen
What allergy do you check for before a right heart cath
Latex allergy, the balloon is made of latex
Sinus venous ASD
A sinus venous defect is the least common type of ASD, often has an abnormal pulmonary vein connection associated with it. 4 pulm veins. 2 from rt lung and 2 from lt lung normally return red blood to the left atrium. Usually with a sinus Venus ASD, A pulmonary vein from the right lung will be abnormally connected to the right atrium instead of the left atrium. This is called an anomalous pulmonary vein
What is Truncus arteriosis
Rv and LV share the aortic trunk
Define threshold
Lowest Amount of electricity needed for the heart to respond, delivers the lowest amount of electricity to increase battery life
T or F Every muscle fiber has the same threshold. As muscle enlarges the amount of electricity required to go through it increases
T
What is a synchronous or demand pacemaker
Senses whether patient will produce a beat, if not, it will in order to keep a certain rate
First-degree AV heart block
PR interval measures greater than .20
The conduction delay takes place in the AV node
Patients are usually asymptomatic
Two PTs, one with a BMI of 20 and one with a BMI OF 30
Which pt generates more scatter?
Bmi of 30
What are the 4 things associated with tetrology of fallot
Pulmonic stenosis.
Overriding AO
RVH
VSD
What is a normal PR interval
.12–.20
What is the P-wave representing in the QRS
The signal moving from the SA node to the AV node
What are the AC LS monophasic defibrillator settings
200–300 – 360
What is a QRS
The signal moving from the AV node through the bundle of His, down the bundle branches and out the Purkinje fibers
What does the T-wave represent on an EKG
Represents the ventricle returning to its relaxed state
Define atrial fibrillation
Chaotic electrical activity in the atria without organize P waves. No smooth Atrial contraction only quivering of the atria. Irr regular rate of the QRS
What is a normal QRS interval
.08–.12
What are the symptoms of SVT
Blood pressure dropping, sweating, shortness of breath, lightheadedness, fainting, sometimes chest pain.
How would you treat symptomatic supraventricular tachycardia
Sedation and immediate synchronize cardioversion
Second degree heart block type one. (Wenchbach)
P waves occurs regularly however the PR interval increases progressively until one P-wave is not conducted through the AV node. This drops the QRS making the QRS rhythm irregular
Not dangerous. PTs may complain of palpitations or skipped beats
Second degree heart block type 2 ( mobitz 2)
The pr interval remains constant
Some p waves fail to conduct to the ventricle and generate a QRS complex
High risk of progression to complete heart block
3rd degree heart block or complete heart block. Also know as AV Dissociation
Atria and ventricles be independently of one another meaning the atria and ventricles are controlled by independent pacemakers.
- The P2P and the R-R interval will be regular and consistent
- The relationship between the P waves and the R waves are irregular
- The atrial rate(60-80) is usually greater than the ventricular rate(20-40)
- QRS maybe wide or narrow, depending on the origin of the ventricular focus
- The danger in third degree heart block : ventricular contraction will not always be preceded by an atrial contraction. Hence, the ventricles are not guaranteed to contain enough blood for a detectable contraction
Automaticity
Ability to create impulse without external impulse
Reografin
Too many particles, pulled fluid out of every cell in conduction system. Cells would not be able to act and asystole would result. Did same to GI and would cause vomiting
Define synchronize cardioversion
Electrical energy discharge from the defibrillator is synchronize with the large R or S wave of the QRS complex. Synchronization times the electricity in the early part of the QRS complex avoiding energy delivery in the early phase of repolarization when ventricular fibrillation can easily be induced
How do you test a defibrillator
Discharge into a dummy load
Define supraventricular tachycardia
Any rapid heart rate generated above the ventricles
LAD views
RAO caudal - LM/ prox. LAD and CIrc
- RAO cranial - mid and distal LAD
-LAO cranial - mid and distal LAD
LAO - LM , prox. Circ
RCA views
LAO - prox RCA
-RAO - cranial PD
What catheters would use for high takeoff
Amplatz, JL4,JL5
How should a cutting balloon be inflated
One ATM per 5 seconds.
Deflate the same way
Define defibrillation or unsynchronized cardioversion
unsynchronized discharge of energy to an unorganized rhythm. For example. V-fib
How many cm in 1inch
2.54
What’s the formula to covert Celsius to Fahrenheit and vice versa
°F to °C Deduct 32, then multiply by 5, then divide by 9
°C to °F Multiply by 9, then divide by 5, then add 32
Define ventricular fibrillation
Uncoordinated contraction of the ventricles
- Most common cause of sudden-death
- Requires defibrillation, also known as an unsynchronized cardioversion
