Wk 1. Coronary angiography Flashcards

1
Q

what are 10 indications for having a coronary angiography?

A
  1. Positive stress test
  2. To examine CAD
  3. Chronic angina
  4. Ventricular dysfunction on ECG
  5. Pre CABG
  6. Irregular ECG indicating possible stenosis
  7. Breathlessness on exertion
  8. Abnormal ST segment on ECG
  9. Calcification/Plaques
  10. Spasms
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2
Q

What are 6 contra-indications for having a coronary angio?

A
  1. Sensitivity to contrast
  2. Active bleeding
  3. Severe anaemia
  4. Active infection
  5. Renal Failure
  6. Pregnancy
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3
Q

Give an overview of the 6 steps of patient prep for a coronary angio

A
  1. NBM 12 hrs prior
  2. drink clear fluid only
  3. puncture site needs to be cleaned
  4. Appropriate attire
  5. No deodorants etc.
  6. Pre-op CXR if needed
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4
Q

Give an overview of the 8 steps of patient post care for a coronary angio

A
  1. remove catheter
  2. fem stop on puncture site
  3. observe patient for contrast reaction
  4. Patient not to laugh
    (increases pressure)
  5. Clean puncture site
  6. Keep drinking clear fluids –> give patient cup
  7. PAtient given contact number
  8. Kept in coronary care for at least 4 hrs
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5
Q

What is the contraction of the heart called

A

Systole

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6
Q

What is the relaxation of the heart called

A

Diastole

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7
Q

what is a normal systole reading range

A

90-120

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8
Q

what is a normal diastole reading range

A

60-90

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9
Q

what is the normal blood flow of the heart? 7 steps

A
  1. Blood from SVC and IVC into R atrium
  2. R ventricle moves into diastole, the tricuspid valve opens and blood flow into the R ventricle
  3. R ventricle goes into systole, the tricuspid valve closes with the pulmonary valve opening
  4. Blood flows into the lungs to be oxygenated
  5. Blood then flows into the pulmonary veins and into the left Atrium
  6. Left ventricle is in diastole, the mitral valve opens and blood flows into the left ventricle
  7. Left Ventricle then moves into Systole and the mitral valve closes and the aortic valve opens and blood exits the heart and into the peripheral system of the body
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10
Q

What is a sinus rhythm?

A

regular rhythm set by the SA node (60-70 beats per minute)

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11
Q

How do we get the cardiac sinus trace?

A

Both atriums contract and then both ventricles contract and then both ventricles relax

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12
Q

What is the PR interval

A

atrial depolarisation

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13
Q

What is the S wave

A

time for ventricular contraction

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14
Q

What is QRS wave

A

ventricular depolarisation

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15
Q

What is the ST wave

A

period of repolarisation

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16
Q

What is myocardial infarction?

A

The width of the heart muscle in the ventricle lacks a blood supply

17
Q

what is myocardial ischemia?

A

Part of the width of the heart muscle in the ventricle lacks a blood supply

18
Q

What happens to the ECG in myocardial ischemia?

A

the Q section starts higher than the isoelectric point, so it appears as though there is a depression in the ST segment. This is due to the potassium imbalance in the region of the ischemic muscle

19
Q

what happens to the ECG in myocardial infarction?

A

Q section starts lower than the isoelectric point when the whole width of the muscle is affected, so it appears as though there is an elevation in the ST segment. When the whole width of the muscle is affected there is significant electrical imbalance of potassium and also calcium altering the cell membrane potential

20
Q

what is damping? and why does it happen

A

name given to the pressure wave as it wedges into an artery cutting off the blood supply. Occurs when the catheter is too big for an artery and gets lodged in it. The pressure drops and the bottom end ‘dampens’

21
Q

Is self-cardioversion possible? If so, how?

A

Yes. By coughing and valsalva