Test 3: Cardiac Flashcards
Systole: What happens? Sounds?
- Contraction
- Blood is ejected
-“Lubb”
Diastole: What happens? Sounds?
- Heart is relaxing
- Refilling
- Dubb
Preload: What is it?
Volume of blood returned to R side of heart at end of diastole
Afterload: What is it?
- Pressure/resistance L must pump against
- Systolic Pressure
Cardiac Output: Equation; Amount
Hr x SV
4-8L/min
Ejection Fraction
- % of blood pushed out of L ventricle
- Normal is 50-70%
- BAD = <40%
Systolic HF: What is it? S/Sx?
- Weak heart muscle
- Reduced EF (<40%)
- Blood backs up into lungs causing PULMONARY HTN
S/Sx: SOB, orthopnea, lung crackles, frothy sputum
Diastolic HF: What is it? S/Sx?
- Heart muscle is STIFF & NON-COMPLIANT
- NORMAL EF
- Ventricles do not fill adequately
S/Sx: JVD, dependent edema, decrease CO, weight gain
Stable Angina: What is it, Intervention, Contraindicated
What is it?
- Increased in V/Q needs
- Predictable and occurs with EXERTION
- Resolved w/ rest b/c O2 demand decreased
Intervention:
- Nitro SL q 3-5 minutes
Contraindication:
- Viagra/ed drugs (-afil)
Unstable Angina: What is it, Diagnosed, Medications
What is it?
- Leads to MI
- Occurs at rest and MORE frequent
- NITRO DOES NOT HELP
Dx:
- Troponin (-)
- CABG or PCI
- REPEAT EKG and troponin labs if 1st set shows nothing, but symptoms persist
Post:
- Statin
- Blood thinner
- Nitrates for vasodilation
- BB to decrease MC o2 demand
- CCB to increased O2 supply, decrease workload
Myocardial Infarction: What is it? S/Sx? Dx? MI Treatment
What is it?
- Complete block in 1 or more arteries
S/Sx:
- Pain: substernal, jaw, left arm, midback, shoulder
- SOB/dyspnea, labored breathing
- N/V, abdominal pain
- Diaphoresis
- Pallor
- Fatigue
Dx:
- ECG w/ in 10 minutes to show if STEMI or NSTEMI, t-wave inversion
- Troponin >0.5 (and increase K+)
- If troponin is (-) then stress tests
MI Treatment:
MONA
- Oxygen (if <90%)
- Aspirin - chewable
- Nitroglycerin - (or nitro drip)
- Morphine (decreases workload)
Clotbuster medication w/ in 30-45min - thrombolytics (-teplase, -ase) - monitor for bleeding
Cath Lab for PCI/CABG (D2B is 90 minutes)
Nitroglycerine: What is it? How is it administered? Contraindications?
- Used to vasodilate arteries
- SL 3 doses 3-5 minutes apart
- Must be taken while sitting to prevent fall as it increases HA and OH
- Contraindicated with viagra or ED drugs (-afil)
PCI: What is it? Post Care?
- Must be NPO 6-12 hours before
- Clears clot - arterioplasty/angioplasty or “gram”
- Goal for D2B is 90 minutes
Post:
- Lay flat for several hours
- For bleeding, apply pressure
- Increase fluids to dilute contrast
CABG: What is it? Post care?
- Requires 3-5 day hospital stay
- Requires Cr to be normal (0.9-1.2) & UOP >30mL/hr
- NO if iodine allergy
Post:
- No heavy lifting
- NO baths (shower ok)
- NO crossing legs
- NO blood thinners
- Monitor for infection
S/Sx for Women heart attack
- Fatigue
- Shoulder blade discomfort
- SOB
