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Step 2 Critical Care Course > The Cardiovascular System > Flashcards

The Cardiovascular System Flashcards

1
Q

What are the 2 distinct groups of heart problems?

A
  • Plumbing problems
  • Electrical problems
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2
Q

What are some examples of plumbing problems?

A
  • Acute coronary syndromes
  • Myocardial infarction (MI)
  • Heart failure
    Valve dysfunction
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3
Q

What are some electrical problems?

A
  • Arrhythmias
  • Tachycardia
  • Bradycardia
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4
Q

What is blood pressure?

A
  • Blood pressure is the strength of blood against the artery walls.
  • It rises during and falls in-between heartbeats.
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5
Q

What is systolic blood pressure?

A
  • When blood flows out of the heart.
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6
Q

What is diastolic blood pressure?

A

When blood flows into the heart.

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7
Q

What are the 3 factors in relation to cardiac function?

A
  • Preload/filling (before the pump)
  • Contractility (the pump)
  • After load (after the pump)
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8
Q

What is central venous pressure (CVP)?

A
  • CVP is the blood pressure in the vena cava.
  • This gives us an idea of fluid status.
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9
Q

What would a low CVP suggest?

A
  • Hypovololaemia
  • Vasodilation
  • Dehydration
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10
Q

What would a raised CVP suggest?

A
  • Fluid overload
  • Heart failure
  • Cardiac tamponade
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11
Q

How do you work out the mean arterial pressure (MAP)?

A

MAP = Diastolic Pressure + Systolic Pressure x 2 divided by 3.

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12
Q

How do you work out cardiac output (CO)?

A

CO = Stroke Volume x Heart Rate

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13
Q

How do you work out cardiac index (CI)?

A

CI = CO divided by Body Surface Area

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14
Q

How do you work out systemic vascular resistance (SVR)?

A

SVR = MAP - CVP divided by CO x 80

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15
Q

How do you work out systemic vascular resistance index (SVRI)?

A

SVRI = MAP - CVP x 80 divided by CI

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16
Q

What are some examples of cardiac output monitoring?

A
  • Swan Ganz
  • PiCCO
  • Flotrac
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17
Q

What is a swan ganz catheter?

A
  • 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
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18
Q

What does Dobutamine and Milrinone do?

A
  • Increases cardiac contractility and pumping function.
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19
Q

What does Noradrenaline and Vasopressin do?

A
  • Increases blood pressure by vasoconstriction through water retention (anti-diuretic hormone).
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20
Q

What does Glyceryl Trinitrate (GTN) do?

A
  • Reduces blood pressure by vasodilation.
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21
Q

What does Adrenaline do?

A
  • It increases heart rate and contractility.
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22
Q

What is cardiac tamponade?

A
  • Cardiac tamponade is the compression of the heart through infiltration of fluid into the pericardial.
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23
Q

What happens to the heart in cardiac tamponade?

A
  • Cardiac tamponade will impair the hearts ability to both fill and pump blood.
  • Ultimately reducing cardiac output.
24
Q

What are some symptoms of cardiac tamponade?

A
  • Reduced blood pressure.
  • A rise in CVP.
25
Q

How do you treat a cardiac tamponade?

A
  • Pericardiocentiusis (to remove the fluid and to relieve the pressure).
26
Q

What is coronary artery disease (CAD)?

A
  • Coronary artery disease is a common but serious condition where the blood vessels supplying the heart are narrowed or blocked.
27
Q

Where do the coronary arteries supply oxygenated blood to?

A

The myocardium.

28
Q

What is a simplified way of looking at the coronary arteries?

A
  • 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.
29
Q

What does NSTEMI stand for?

A

Non ST Elevation Myocardial Infarction.

30
Q

What would be present on an ECG if a patient was having an NSTEMI?

A
  • No ST elevation
  • ST depression
  • T wave inversion

Would need a troponin to diagnose this.

31
Q

In an NSTEMI is there partial or complete occlusion?

A

Partial occlusion of the coronary artery, with continuing blood flow.

32
Q

What does STEMI stand for?

A

ST Elevation Myocardial Infarction.

33
Q

What would be present on an ECG if a patient was having a STEMI?

A
  • ST elevation
  • Easier to diagnose
34
Q

In a STEMI is there partial or complete occlusion of the coronary artery?

A

Complete occlusion of the coronary artery.

35
Q

What is the percutaneous coronary intervention (PCI)?

A
  • PCI involves the restoration of blood flow within the coronary artery.
  • Through the use of balloons and stents.
36
Q

What is a coronary artery bypass graft (CABG)?

A
  • 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.
37
Q

What is Acute Coronary Syndrome (ACS)?

A

Acute coronary syndrome is an umbrella term for angina, unstable angina (NSTEMI + STEMI).

38
Q

What is valvular stenosis?

A
  • Where the stenosed valve does not fully open.
  • Making it more difficult for blood to pass through.
39
Q

What is valvular regurgitation?

A
  • The valve does not close fully.
  • Allowing blood to flow back through the valve.
40
Q

What is surgical valve repair/replacement?

A
  • This is via the classical heart surgery route.
  • The patients heart is stopped and place onto bypass.
41
Q

What is a catheter valve repair/replacement?

A
  • Minimally invasive
  • Performed without stopping the heart
  • Uses a catheter to access and repair/replace the valves
42
Q

What would Sinus Rhythm look like on an ECG?

A
  • QRS is normal
  • P wave visible before every QRS complex
  • P R interval is normal
43
Q

What would Sinus Bradycardia look like on an ECG?

A
  • QRS is normal
  • P wave is visible before every QRS complex
  • P R interval is normal
44
Q

What would Sinus Tachycardia look like on an ECG?

A
  • QRS is normal
  • P wave is visible before every QRS complex
  • P R interval is normal
45
Q

What would Supra Ventricular Tachycardia (SVT) look like on an ECG?

A
  • QRS is normal
  • P wave is often difficult to visualise
  • P R interval is often difficult to visualise
46
Q

What does Atrial Flutter look like on an ECG?

A
  • QRS is usually normal
  • P wave is reduced like flutter waves
  • P R interval is unmeasurable
47
Q

What would Atrial Fibrillation look like on an ECG?

A
  • QRS is variable (can be prolonged)
  • P wave is not visible
  • P R interval is unmeasurable
48
Q

What would 1st Degree AV Block look like on an ECG?

A
  • QRS is normal
  • P wave is visible before every QRS
  • P R interval is prolonged
49
Q

What would 2nd Degree AV Block Mobitz 1 look like on an ECG?

A
  • QRS is normal
  • P wave is visible before every QRS
  • P R interval has progressive lengthening
50
Q

What would 2nd Degree AV Block Mobitz 2 look like on an ECG?

A
  • QRS is normal
  • P wave is normal but faster than QRS rate
  • P R interval is constant typically above 200
51
Q

What would 3rd Degree Complete Heart Block look like on an ECG?

A
  • QRS may be normal or prolonged
  • P wave is visible but faster than QRS rate
  • P R interval total variation
52
Q

What would Bundle Branch Block (BBB) look like on an ECG?

A
  • QRS is prolonged
  • P wave may or may not be present
  • P R interval is normal or prolonged
53
Q

What does Bi - Gemini look like on an ECG?

A
  • QRS is normal
  • P wave ratio is 1:1 or 1:2
  • P R interval is normal
54
Q

What would Paced Rhythms look like on an ECG?

A
  • QRS is variable
  • P wave is normal
  • P R interval is normal
55
Q

What would Ventricular Tachycardia (VT) look like on an ECG?

A
  • QRS is prolonged
  • P wave is invisible
56
Q

What would Ventricular Fibrillation (VF) look like on an ECG?

A
  • QRS is unrecognisable
  • P wave is invisible
  • Rate is above 300

Step 2 Critical Care Course (7 decks)

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