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127 Cards in this Set
- Front
- Back
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Hallmark of dilated cardiomyopathy
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Heart Failure
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Most common cause of right heart failure
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Left heart failure
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Most common sites of arterial claudication (2 sites)
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Femoral and Popliteal arteries
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Most common & 2nd most common heart mm dz?
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dilated cardiomyopathy & hypertrophic cardiomyopathy
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What type of cardio myopathy is this:
ventricular enlargement w/impaired systolic contractile fnx |
dilated
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Hallmark of dilated cardiomyopathy
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Heart Failure
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Most common cause of right heart failure
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Left heart failure
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Most common sites of arterial claudication (2 sites)
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Femoral and Popliteal arteries
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Most common & 2nd most common heart mm dz?
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dilated cardiomyopathy & hypertrophic cardiomyopathy
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What type of cardio myopathy is this:
ventricular enlargement w/impaired systolic contractile fnx |
dilated
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What type of cardiomyopathy is this:
Abnormal thickened ventricle w/abnormal diastolic relaxation |
Hypertrophic
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What type of cardiomyopathy is this:
Abnormal stiffened myocardium d/t fibrosis/infiltration, decreased diastolic relaxation, but usually preserved systolic contractile fnx |
restrictive
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What type of 2nd degree AV block has a gradually lengthening PR interval until a P wave does not produce a QRS
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Wenckerbach
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A bundle branch block is likely if the QRS is larger than how many squares
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3 tiny squares
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T/F - A Right BBB is likely if the RR' is seen in V1 or V2
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True
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T/F - A Left BBB is likely if the RR' is seen in V5 or V6
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True
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In 1st degree AV block, the PR is consistent & greater than 0.2 sec or ___ large square(s)
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1
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What is normal sinus rhythm
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60-100 bpm
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What is the rate for Bradycardia
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<60 bpm
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What is the rate for Tachycardia
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>100 bpm
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For ECG lead AVF what body part is the "positive electrode"
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the left foot
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Chest pain caused by myocardial ischemia is called ...
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angina
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Dyspnea which occurs when your patient is recumbent or lying down is called
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orthopnia
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What typically happens to the ST segment of your pt's EKG when he is experiencing angina
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depression
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what type of angina involves intense vaso spasm
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variant
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What is the upper limit of normal JVP level when your pt is at 45 deg
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4 cm
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What cardiac condition is dyspnea most commonly a sign of
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congestive heart failure
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what are small dermal growths around the eyes which are associated with hypercholesterolaemia called
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xanthomas
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Coronary ischemia is cased by what two main things
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Fixed vessel narrowing and epithelial cell dysfunction
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Stenosis narrowing of an artery less than what percentage of the maximal potential blood flow is not significantly altered, as the vessels can compensate, dilating in response to exertion
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60%
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S1 corresponds to closure of which valves
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Tricuspid & Mitral
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What are the three tests available for diagnosising stable angina
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Stress test
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What is the heart rate when there are 2 & 3 big boxes separating “R waves” on an EKG strip
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150 & 100
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An EKG can permit you to assess
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Rate, Rhythm, Axis, Hypertrophy and infarction
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What is the inherit rate of the atria
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60-80 bpm
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What is the inherit rate of the AV junction
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40-60 bpm
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What is the inherit rate of the ventricles
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20-40 bpm
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What does several P waves for one QRS complex indicate on an EKG, also known as the "saw tooth" pattern
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Atrial Flutter
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T/F Chest pain, N/V, fever, friction rub, diaphoresis and rales are all sxs fo MI
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T
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T/F with an MI irreversible cell injury happens w/in 1-3 hours
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F - irreversible damage happens btw 7-10 days
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The most common complication with drugs like tPA, rPA & TNK-tPA in tx of MI is
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bleeding
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T/F an elevated CK-MB isoenzyme, always indicates myocardial injury
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False
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T/F CK-MB is the fastest rising cardiac specific enzyme
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False
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Name 4 nutrients that can reduce a pt's BP
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MG, K, Ca, Vit K, Vit E, Vit C, CoQ10
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What are 5 complications to educate patients on for untreated HTN
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Renal dz, Heart dz, Retinal dz, stroke, Peripheral vascular dz
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ONce you've diagnosed your pt w/ HTN, r/o 2ary causes, and begun tx, what must you assess for
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End organ damage
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GIve 3 examples of how you could assess for end organ damage
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Radiographic tomography, biopsy, eye exam
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What agents might interact with antihypertensive drugs to raise BP
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NSAIDs, Asprin, Alcohol
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What are dietary changes you could recommend to your pt w/HTN
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decrease sugar intake, increase fiber
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What category of HTN is a BP of 160-180/100-115
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Moderate
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A pt with a normal EKG axis will have a positive QRS in which leads
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Lead 1 and AVF
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When evaluating axis rotation (not deviation), which leads typically have an isoelectric appearance
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V3 & V4
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What wave on the EKG do you examine for atrial enlargement
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P wave
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What lead is best source for evaluating atrial enlargement
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V1
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With R atrial enlargement, which component of the diphasic P wave is longer
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First
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With L atrial enlargement, which component of the diphasic P wave is longer
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Second
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With RV enlargement, what do you see on an EKG in V1
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Large downward R wave
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IN RV enlargement there is a large downward R wave in V1, what trend is seen in this R wave in subsequent chest leads
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It gets smaller
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What happens in EKG QRS deflection (compared to normal) in LV enlargement
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increases
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LV hypertrophy is suspected if the sum of S in V1 and R in V5 is
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>35
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Most EKG info in hypertrophy is provided with which lead
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V1
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T/F Nitrous oxide, prostacycline, thromboxane & serotonin are potent vasodilators
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F - thromboxane and serotonin are vasoconstrictors
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Is a L ventricular ejection fraction (LVEF) of of 35% normal, low or high
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low
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What is a normal LV ejection fraction?
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40-60 %
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Quiescent, calcified, coronary plaque is best assessed with what test
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EBCT
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What does STEMI stand for
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ST Elevated MI
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What does NSTEMI stand for
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Non ST Elevated MI
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NSTEMI is also referred to as a
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non Q wave MI
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Asprin is often recommended for pts having an MI, what mineral should also be given since it helps cell respiration, can improve mortality, and possibly reduce re-perfusion injury
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Mg
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T/F In STEMI, T wave inversion persists
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False
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The major determinant of prognosis in a pt after MI is
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LV Ejection Fraction
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T/F Post-MI scarring and fibrosis is completed at 4 weeks
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F
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What % of Unstable angina results in the potential complication of death
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5-10%
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What % of Unstable angina results in progression to MI
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30-40%
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T/F CK-MB is the fastest rising cardiac-specific enzyme
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False - Troponin is
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T/F Antioxidant supplementation, antioxidant containing foods adn Mg can all reduce reperfusion injury following MI
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T
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What does a large dip following and QRS segment represent on an EKG
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PVCs
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What does a double spike QRS signify
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R BBB
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What does a double peaked QRS signify
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L BBB
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What are the 3 main categories of arrhythmias
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Atrial, junctional and ventricular
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What is the most life threatening ventricular arrhythmia
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fibrillation
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What are potential consequences of atrial fibrillation
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Risk of thrombosis formation and pulmonary congestion
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What determines myocardial oxygen demand?
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Ventricular wall stress, Heart rate and contractility
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What do quick QRS complexes that do not go below base line represent on EKG
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A-fib
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T/F Crataegus is indicated in dilated cardiomyopathy
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T
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T/F + Inotropic agents are helpful in Hypertrophic cardiomyopathy
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F
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T/F In pts with IHSS, + inotropic agents (which augment the force of contraction) are helpful
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F
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What is standard medical tx (class of drug) for patients with dialated cardiomyopathy
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B-Blockers
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What imaging (non-invasive) can show heart wall motion abnormalitis due to ischemia or infarction
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U/S
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What ht sound (AKA a ventricular gallop) occurs in early diastole, is due to rapid ventricular filling, is normal in kids and young adults due to expansion of the L ventricle, but pathological in middle/older adults indicating volume overload
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S3
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Which pathologic heart sound (AKA atrial gallop) occurs in late diastole, is generated by L/R atrium vigorously contracting against a stiffened ventricle
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S4
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S1 & S2 are best heard with which side of the scope
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Diaphram
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When is S2 splitting normal
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inspiration
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Give an example of a pansystolic murmur
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Mitral regurge
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Give an example of a midsystolic (systolic ejection type) murmur
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Aortic Stenosis
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Give an example of a late systolic murmur
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MVP
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Give an example of a early diastolic murmur
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aortic regurge
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Give an example of a late diastolic murmur
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mitral valve stenosis
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S3 & S4 are best heard with which part of the scope
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bell
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For mitral regurg when exactly would you hear the murmur with respect to systole, diastole the time between
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pan systolic
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in physiologic splitting of S2, which valve is closing later
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pulmonic
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What is paradoxical splitting of S2
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Splitting with expiration
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How can one differentiate splitting of S2 from S3
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Have pt take a breath in, if sound goes away it is S2 split
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3 pathologies that cause pan (holosystolic) murmurs
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Mitral valve regurg
Tricuspid valve regurg Ventricular septal defect |
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2 pathologies that cause "ejection type" systolic (crescendo-decrecendo) murmurs
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aortic stenosis and pulmonary stenosis
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What are 2 late systolic murmurs often followed by a midsystolic click
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Mitral valve prolapse (most common)
Tricuspid valve prolapse |
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What 2 valve problems produce early (decracendo) diastolic murmurs
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aortic and pulonic regurg
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What 2 valve problems produce a prolonged mid to late diastolic murmur
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mitral and tricuspid stenosis
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What is an EKG finding you would expect with atrial hypertrophy
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enlarged P wave
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Name one EKG finding expected in pt w/ventricular hypertophy
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Large R wave in V1 if RV hypertrophy
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Name 3 classes of antihypertensive drugs
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Beta blockers
ACE inhibitors diuretics |
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In what % of pts is HTN 2ary to another cause
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10%
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What wave do you examine for atrial enlargement
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P wave
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What lead is best for examining for atrial enlargement
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V1
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What is the most definitive diagnostic option for chamber dilation
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U/S
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What is the most definitive diagnostic option for Hypertrophy
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U/S
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What is the most definitive diagnostic option to demonstrate blood flow
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Doppler U/S
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What is the most definitive diagnostic option to demonstrate and quantify valve incompetency
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Ultrasonography
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What is the most definitive diagnostic option can identify pericardial dz
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Ultrasonography
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What is the most definitive diagnostic option for measuring intracardiac chamber pressure
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Cardiac catheterization
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What is the most definitive diagnostic option for myocardial tissue perfusion
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Nuclear imaging
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What is the most definitive diagnostic option for pulmonary vascular markings
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chest x-ray
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T/F PA chest x-ray, the adult heart shadow should normally not occupy greater than 60% of the maximal width of the thorax
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F - 50%
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What is the most common pathogen attributed with vascular dz
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streptococcus
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Most common affliction of the pericardium
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acute pericarditis
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Most serious affliction of the pericardium
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cardiac tamponade
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Can differentiate acute pericarditis from myocardial ischemia/infarction as pericardial pain is
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pleuritic & varies w/position
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