The Cardiovascular System Flashcards
What are the 2 distinct groups of heart problems?
- Plumbing problems
- Electrical problems
What are some examples of plumbing problems?
- Acute coronary syndromes
- Myocardial infarction (MI)
- Heart failure
Valve dysfunction
What are some electrical problems?
- Arrhythmias
- Tachycardia
- Bradycardia
What is blood pressure?
- Blood pressure is the strength of blood against the artery walls.
- It rises during and falls in-between heartbeats.
What is systolic blood pressure?
- When blood flows out of the heart.
What is diastolic blood pressure?
When blood flows into the heart.
What are the 3 factors in relation to cardiac function?
- Preload/filling (before the pump)
- Contractility (the pump)
- After load (after the pump)
What is central venous pressure (CVP)?
- CVP is the blood pressure in the vena cava.
- This gives us an idea of fluid status.
What would a low CVP suggest?
- Hypovololaemia
- Vasodilation
- Dehydration
What would a raised CVP suggest?
- Fluid overload
- Heart failure
- Cardiac tamponade
How do you work out the mean arterial pressure (MAP)?
MAP = Diastolic Pressure + Systolic Pressure x 2 divided by 3.
How do you work out cardiac output (CO)?
CO = Stroke Volume x Heart Rate
How do you work out cardiac index (CI)?
CI = CO divided by Body Surface Area
How do you work out systemic vascular resistance (SVR)?
SVR = MAP - CVP divided by CO x 80
How do you work out systemic vascular resistance index (SVRI)?
SVRI = MAP - CVP x 80 divided by CI
What are some examples of cardiac output monitoring?
- Swan Ganz
- PiCCO
- Flotrac
What is a swan ganz catheter?
- Sits within the pulmonary arterial system.
- It provides information on the following:
- Pulmonary arterial pressure
- Pulmonary capillary wedge pressure
- Left arterial pressure
- Mixed venous sats
- Cardiac output
What does Dobutamine and Milrinone do?
- Increases cardiac contractility and pumping function.
What does Noradrenaline and Vasopressin do?
- Increases blood pressure by vasoconstriction through water retention (anti-diuretic hormone).
What does Glyceryl Trinitrate (GTN) do?
- Reduces blood pressure by vasodilation.
What does Adrenaline do?
- It increases heart rate and contractility.
What is cardiac tamponade?
- Cardiac tamponade is the compression of the heart through infiltration of fluid into the pericardial.
What happens to the heart in cardiac tamponade?
- Cardiac tamponade will impair the hearts ability to both fill and pump blood.
- Ultimately reducing cardiac output.
What are some symptoms of cardiac tamponade?
- Reduced blood pressure.
- A rise in CVP.
How do you treat a cardiac tamponade?
- Pericardiocentiusis (to remove the fluid and to relieve the pressure).
What is coronary artery disease (CAD)?
- Coronary artery disease is a common but serious condition where the blood vessels supplying the heart are narrowed or blocked.
Where do the coronary arteries supply oxygenated blood to?
The myocardium.
What is a simplified way of looking at the coronary arteries?
- Right Coronary Artery (RCA) supplies blood to the right side of the heart.
- Left Anterior Descending Artery (LAD) supplies blood to the front of the heart (specifically the left ventricle).
- Circumflex (CIRC) supplies blood to the left ventricle and posterior aspects.
What does NSTEMI stand for?
Non ST Elevation Myocardial Infarction.
What would be present on an ECG if a patient was having an NSTEMI?
- No ST elevation
- ST depression
- T wave inversion
Would need a troponin to diagnose this.
In an NSTEMI is there partial or complete occlusion?
Partial occlusion of the coronary artery, with continuing blood flow.
What does STEMI stand for?
ST Elevation Myocardial Infarction.
What would be present on an ECG if a patient was having a STEMI?
- ST elevation
- Easier to diagnose
In a STEMI is there partial or complete occlusion of the coronary artery?
Complete occlusion of the coronary artery.
What is the percutaneous coronary intervention (PCI)?
- PCI involves the restoration of blood flow within the coronary artery.
- Through the use of balloons and stents.
What is a coronary artery bypass graft (CABG)?
- This is performed when there are narrowing’s to all 3 main coronary arteries.
- Here the blockages are bypassed surgically.
- Using blood vessels to create blood flow past the narrowing or occlusion.
What is Acute Coronary Syndrome (ACS)?
Acute coronary syndrome is an umbrella term for angina, unstable angina (NSTEMI + STEMI).
What is valvular stenosis?
- Where the stenosed valve does not fully open.
- Making it more difficult for blood to pass through.
What is valvular regurgitation?
- The valve does not close fully.
- Allowing blood to flow back through the valve.
What is surgical valve repair/replacement?
- This is via the classical heart surgery route.
- The patients heart is stopped and place onto bypass.
What is a catheter valve repair/replacement?
- Minimally invasive
- Performed without stopping the heart
- Uses a catheter to access and repair/replace the valves
What would Sinus Rhythm look like on an ECG?
- QRS is normal
- P wave visible before every QRS complex
- P R interval is normal
What would Sinus Bradycardia look like on an ECG?
- QRS is normal
- P wave is visible before every QRS complex
- P R interval is normal
What would Sinus Tachycardia look like on an ECG?
- QRS is normal
- P wave is visible before every QRS complex
- P R interval is normal
What would Supra Ventricular Tachycardia (SVT) look like on an ECG?
- QRS is normal
- P wave is often difficult to visualise
- P R interval is often difficult to visualise
What does Atrial Flutter look like on an ECG?
- QRS is usually normal
- P wave is reduced like flutter waves
- P R interval is unmeasurable
What would Atrial Fibrillation look like on an ECG?
- QRS is variable (can be prolonged)
- P wave is not visible
- P R interval is unmeasurable
What would 1st Degree AV Block look like on an ECG?
- QRS is normal
- P wave is visible before every QRS
- P R interval is prolonged
What would 2nd Degree AV Block Mobitz 1 look like on an ECG?
- QRS is normal
- P wave is visible before every QRS
- P R interval has progressive lengthening
What would 2nd Degree AV Block Mobitz 2 look like on an ECG?
- QRS is normal
- P wave is normal but faster than QRS rate
- P R interval is constant typically above 200
What would 3rd Degree Complete Heart Block look like on an ECG?
- QRS may be normal or prolonged
- P wave is visible but faster than QRS rate
- P R interval total variation
What would Bundle Branch Block (BBB) look like on an ECG?
- QRS is prolonged
- P wave may or may not be present
- P R interval is normal or prolonged
What does Bi - Gemini look like on an ECG?
- QRS is normal
- P wave ratio is 1:1 or 1:2
- P R interval is normal
What would Paced Rhythms look like on an ECG?
- QRS is variable
- P wave is normal
- P R interval is normal
What would Ventricular Tachycardia (VT) look like on an ECG?
- QRS is prolonged
- P wave is invisible
What would Ventricular Fibrillation (VF) look like on an ECG?
- QRS is unrecognisable
- P wave is invisible
- Rate is above 300
