Mosby Ch 22 Cardiovascular Disorders

Front 1

abnormal

Back 1

aberrant

Front 2

corresponds with the onset of the QRS complex to approximately the peak of the T wave; cardiac cells cannot be stimulated to conduct an electrical impulse, no matter how strong the stimulus.

Back 2

absolute refractory period

Front 3

an extra bundle of working myocardial tissue that forms a connection between the atria and ventricles outside the normal conduction system

Back 3

accessory pathway

Front 4

a five-phase cycle that reflects the difference in the concentration of these charged particles across the cell membrane at any given time

Back 4

action potential

Front 5

a sudden blockage of arterial blood flow that occurs because of a thrombus, embolus, tumor, direct trauma to an artery, or an unknown cause

Back 5

acute arterial occlusion

Front 6

a term used to describe ischemic chest discomfort. consists of three major syndromes; unstable angina, NSTEMI, and STEMI

Back 6

acute coronary syndrome (ACS)

Front 7

pressure or resistance against which the ventricles must pump to eject blood

Back 7

afterload

Front 8

height (voltage) of a waveform on the ECG

Back 8

amplitude

Front 9

massive generalized body edema

Back 9

anasarca

Front 10

localized dilation or bulging of a blood vessel wall or wall of a heart chamber

Back 10

aneurysm

Front 11

symptoms of myocardial ischemia other than chest pain or discomfort

Back 11

anginal equivalents

Front 12

chest discomfort or other related symptoms of sudden onset that may occur because the increased oxygen demand of the heart temporarily exceeds the blood supply

Back 12

angina pectoris

Front 13

medications used to correct irregular heart beats and slow hearts that beat too fast

Back 13

antiarrhythmic

Front 14

SL valve on the left of the heart; separates the left ventricle from the aorta

Back 14

aortic valve

Front 15

lower portion of the heart, tip of the ventricles (approx level of the 5th left intercostal space); points leftward, downward, and forward

Back 15

apex of the heart

Front 16

term often used interchangeably with dysrhythmia; any disturbance or abnormality in a normal rhythmic pattern; any cardiac rhythm other than a sinus rhythm

Back 16

arrhythmia

Front 17

a chronic disease of the arterial system characterized by abnormal thickening and hardening of the vessel walls

Back 17

arteriosclerosis

Front 18

a total absence of ventricular electrical activity

Back 18

asystole

Front 19

a form of arteriosclerosis in which the thickening and hardening of the vessel walls are caused by a buildup of fatty deposits in the inner lining of the large and middle-sized muscular arteries

Back 19

atherosclerosis

Front 20

distortion of an ECG tracing by electrical activity that is noncardiac in origin (e.g. electrical interference, poor electrical conduction, patient movement)

Back 20

artifact

Front 21

marked abdominal swelling from a buildup of fluid in the peritoneal cavity

Back 21

ascites

Front 22

fixed-rate pacemaker that continuously discharges at a rate regardless of a patient's intrinsic activity

Back 22

asynchronous pacemaker

Front 23

two upper chambers of the heart

Back 23

atria

Front 24

the AV node and the nonbranching portion of the bundle of His

Back 24

atrioventricular junction

Front 25

a group of cells that conduct an electrical impulse through the heart; located in the floor of the right atrium immediately behind the tricuspid valve and near the opening of the coronary sinus

Back 25

atrioventricular node

Front 26

type of dual-chamber pacemaker that stimulates first the atrium, then the ventricle, mimicking the normal cardiac physiology

Back 26

atrioventricular sequential pacemaker

Front 27

valve located between each atrium and ventricle, the tricuspid separates the right atrium from the right ventricle; the mitral separates the left atrium from the left ventricle

Back 27

atrioventricular valve

Front 28

leads aVR, aVL, and aVF; these leads record the difference in electrical potential at one location relative to zero potential rather than relative to the electrical potential of another extremity, as in the bipolar leads

Back 28

augmented limb lead

Front 29

ability of cardiac pacemaker cells to initiate an electrical impulse spontaneously without being stimulated from another source (such as a nerve)

Back 29

automaticity

Front 30

imaginary line joining the positive and negative electrodes of a lead

Back 30

axis

Front 31

straight line recorded on the ECG graph paper when no electrical activity is detected

Back 31

baseline

Front 32

top of the heart; located at approx the level of the 2nd intercostal space

Back 32

base of the heart

Front 33

waveform that is partly positive and partly negative

Back 33

biphasic

Front 34

ECG lead consisting of a positive and negative electrode; a pacing lead with two electrical poles that are external from the pulse generator; the negative pole is located at the extreme distal tip of the pacing lead, and the positive pole is located several millimeters proximal to the negative electrode. the stimulating pulse is delivered through the negative electrode

Back 34

bipolar limb lead

Front 35

PAC not followed by a QRS complex

Back 35

blocked premature atrial complex

Front 36

force exerted by the blood against the walls of the arteries as the ventricles of the heart contract and relax

Back 36

blood pressure

Front 37

heart rate slower than 60 beats/min

Back 37

bradycardia

Front 38

blowing or swishing sound created by the turbulence within a blood vessel

Back 38

bruit

Front 39

abnormal conduction of an electrical impulse through either the right or left bundle branches

Back 39

bundle branch block (BBB)

Front 40

fibers located in the upper portion of the interventricular septum that conduct an electrical impulse through the heart

Back 40

bundle of His

Front 41

three or more sequential ectopic beats; also referred to as a salvo or run

Back 41

burst

Front 42

regulation of an ECG machine's stylus sensitivity so that a 1 mV electrical signal will produce a deflection measuring exactly 10 mm

Back 42

calibration

Front 43

ability of a pacing stimulus to depolarize successfully the cardiac chamber being paced; with one-to-one capture, each pacing stimulus results in depolarization of the appropriate chamber

Back 43

capture

Front 44

absence of cardiac mechanical activity, confirmed by the absence of a detectable pulse, unresponsiveness, and apnea or agonal, gasping respirations

Back 44

cardiac arrest

Front 45

period from the beginning of one heart-beat to the beginning of the next; normally consisting of PQRST wave, complexes, and intervals

Back 45

cardiac cycle

Front 46

amount of blood pumped into the aorta each minute by the heart

Back 46

cardiac output (CO)

Front 47

a condition in which heart muscle function is severely impaired, leading to decreased cardiac output and inadequate tissue perfusion

Back 47

cardiogenic shock

Front 48

a disease of the heart muscle

Back 48

cardiomyopathy

Front 49

a collection of diseases and conditions that involve the heart and blood vessels

Back 49

cardiovascular disorders

Front 50

having the characteristics of the parasympathetic division of the autonomic nervous system

Back 50

cholinergic

Front 51

thin strands of fibrous connective tissue that extend from the AV valves to the papillary muscles that prevent the AV valves from bulging back into the atria during ventricular systole (contraction)

Back 51

chordae tendineae

Front 52

a change in the heart rate

Back 52

chronotropism

Front 53

division of the left coronary artery

Back 53

circumflex artery

Front 54

pause for which the normal beat after a premature complex occurs when expected; also called a complete pause

Back 54

compensatory pause

Front 55

several waveforms

Back 55

complex

Front 56

a system of pathways in the heart composed of specialized electrical (pacemaker) cells

Back 56

conduction system

Front 57

ability of a cardiac cell to receive an electrical stimulus and conduct that impulse to an adjacent cardiac cell

Back 57

conductivity

Front 58

ability of a cardiac cell to shorten, causing cardiac muscle contraction in response to an electrical stimulus

Back 58

contractility

Front 59

disease of the arteries that supply the heart muscle with blood

Back 59

coronary artery disease

Front 60

disease of the coronary arteries and their resulting complications, such as angina pectoris or acute myocardial infarction

Back 60

coronary heart disease

Front 61

venous drain for the coronary circulation into the right atrium

Back 61

coronary sinus

Front 62

right-sided heart failure caused by pulmonary disease

Back 62

cor pulmonale

Front 63

two consecutive premature complexes

Back 63

couplet

Front 64

flow of electrical charge from one point to another

Back 64

current

Front 65

a connective tissue disease in which the elastic tissue and smooth muscle fibers of the middle arterial layer degenerate

Back 65

cystic medial degeneration

Front 66

protein molecules produced by white blood cells that act as chemical messengers between cells

Back 66

cytokines

Front 67

presence of a clot in the deep veins of the extremities

Back 67

deep vein thrombosis (DVT)

Front 68

therapeutic use of electric current to terminate lethal cardiac dysrhythmias

Back 68

defibrillation

Front 69

slurring of the beginning portion of the QRS complex caused by preexcitation

Back 69

delta wave

Front 70

synchronous pacemaker that discharges only when the patient's heart rate drops below the preset rate for the pacemaker

Back 70

demand pacemaker

Front 71

movement of ions across a cell membrane, causing the inside of the cell to become more positive; an electrical event expected to result in contraction

Back 71

depolarization

Front 72

phase of the cardiac cycle in which the atria and ventricles relax between contractions and blood enters these chambers; when the term used without reference to a specific chamber of the heart, the term implies ventricular __________

Back 72

diastole

Front 73

pressure exerted against the walls of the large arteries during ventricular relaxation

Back 73

diastolic blood pressure

Front 74

the speed of conduction through the AV junction

Back 74

dromotropism

Front 75

pacemaker that stimulates the atrium and ventricle

Back 75

dual-chamber pacemaker

Front 76

an uncomfortable awareness of one's breathing; shortness of breath or difficulty breathing

Back 76

dyspnea

Front 77

any disturbance or abnormality in a normal rhythmic pattern; any cardiac rhythm other than a sinus rhythm

Back 77

dysrhythmia

Front 78

impulse(s) originating from a source other than the SA node

Back 78

ectopic

Front 79

a beat-to-beat change in waveform amplitude on the ECG

Back 79

electrical alternans

Front 80

adhesive pads that contain a conductive gel and are applied at specific locations on the patient's chest wall and extremities and connected by cables to an ECG machine

Back 80

electrodes

Front 81

elements or compounds that break into charged particles (ions) when melted or dissolved in water or another solvent

Back 81

electrolytes

Front 82

innermost layer of the heart that lines the inside of the myocardium and covers the heart valves

Back 82

endocardium

Front 83

implies the presence of dilatation or hypertrophy or both

Back 83

enlargement

Front 84

also known as the visceral pericardium; the external layer of the heart wall that covers the heart muscle

Back 84

epicardium

Front 85

term used when the sinus node slows or fails to initiate depolarization and a lower pacemaker site spontaneously produces electrical impulses, assuming responsibility for pacing the heart

Back 85

escape

Front 86

high blood pressure for which there is no cause identifiable; also called primary hypertension

Back 86

essential hypertension

Front 87

ability of cardiac muscle cells to respond to an outside stimulus

Back 87

excitability

Front 88

a brief loss of consciousness caused by a temporary decrease in blood flow to the brain

Back 88

fainting

Front 89

small bundle of nerve fibers

Back 89

fascicle

Front 90

the breakdown of fibrin, the main component of blood clots

Back 90

fibrinolysis

Front 91

VF with fibrillatory waves less than 3mm in height

Back 91

fine ventricular fibrillation

Front 92

asynchronous pacemaker that continuously discharges at a preset rate regardless of the patient's heart rate

Back 92

fixed-rate pacemaker

Front 93

AT that bigins in a small area (focus) within the heart

Back 93

focal atrial tachycardia

Front 94

large vessels that carry blood to and from the heart; superior and inferior venae cavae, pulmonary veins, aorta, and pulmonary trunk

Back 94

great vessels

Front 95

third ECG electrode (the first and second are the positive and negative electrodes), which minimizes electrical activity from other sources

Back 95

ground electrode

Front 96

a broad term referring to conditions affecting the heart

Back 96

heart disease

Front 97

a condition in which the heart is unable to pump enough blood to meet the metabolic needs of the body

Back 97

heart failure

Front 98

portion of the conduction system consisting of the bundle of His, bundle branches, and Purkinje fibers

Back 98

His-Purkinje system

Front 99

pain and tenderness in the calve muscle on dorsiflexion of the foot

Back 99

Homan's sign

Front 100

situations that require rapid (within 1 hr) lowering of blood pressure to prevent or limit organ damage

Back 100

hypertensive emergencies

Front 101

significant elevations in blood pressure with nonspecific symptoms that should be corrected within 24 hrs

Back 101

hypertensive urgencies

Front 102

increase in the thickness of a heart chamber because of chronic pressure overload

Back 102

hypertrophy

Front 103

inadequate tissue perfusion caused by inadequate vascular volume

Back 103

hypovolemic shock

Front 104

ECG changes seen in leads looking directly at the wall of the heart in an infarction

Back 104

indicative change

Front 105

death of tissue because of an inadequate blood supply

Back 105

infarction

Front 106

a change in myocardial contractility

Back 106

inotropism

Front 107

pain, cramping, muscle tightness, fatigue, or weakness of the legs when walking or during exercise

Back 107

intermittent claudication

Front 108

waveform and a segment; in pacing, the period measured in milliseconds, between any two designated cardiac events

Back 108

interval

Front 109

rate at which a pacemaker of the heart normally generates impulses

Back 109

intrinsic rate

Front 110

electrically charged particle

Back 110

ion

Front 111

decreased supply of oxygenated blood to a body part or organ

Back 111

ischemia

Front 112

absence of electrical activity; observed on the ECG as a straight line

Back 112

isoelectric line

Front 113

point where the QRS complex and ST segment meet

Back 113

J-piont

Front 114

a rhythm that begins in the AV junction with a rate of less than 40 beats/min

Back 114

junctional bradycardia

Front 115

electrical connection attached to the body to record electrical activity

Back 115

lead

Front 116

severe hypertension with signs of acute and progressive damage to end organs such as the heart, brain, and kidneys

Back 116

malignant hypertension

Front 117

located in the middle of the thoracic cavity; contains the heart, great vessels, trachea, and esophagus, among other structures; extends from the sternum to the vertebral column

Back 117

mediastinum

Front 118

difference in electrical charge across the cell membrane

Back 118

membrane potential

Front 119

unit of measure of electrical current needed to elicit depolarization of the myocardium

Back 119

milliampere (mA)

Front 120

difference in electrical charge between two points in a circuit

Back 120

millivolt (mV)

Front 121

having the same shape

Back 121

monomorphic

Front 122

cardiac dysrhythmia that occurs because of impulses originating from various sites, including the SA node, the atria, and/or the AV junction; requires at least three different P waves, seen in the same lead, for proper diagnosis

Back 122

multiformed atrial rhythm

Front 123

working cells of the myocardium that contain contractile filaments and form the muscular layer of the atrial walls and the thicker muscular layer of the ventricular walls

Back 123

myocardial cells

Front 124

necrosis of some mass of the heart muscle caused by an inadequate blood supply

Back 124

myocardial infarction (MI)

Front 125

inflammation of the middle and thickest layer of the heart, myocardium

Back 125

myocarditis

Front 126

middle and thickest layer of the heart; contains the cardiac muscle fibers that cause contraction of the heart as well as the conduction system and blood supply

Back 126

myocardium

Front 127

a chemical released from one nerve that crosses the synaptic cleft to reach a receptor

Back 127

neurotransmitter

Front 128

dyspnea relieved by a change in position

Back 128

orthopnea

Front 129

a normal chemical process in the body caused by the release of oxygen atoms created during normal cell metabolism

Back 129

oxidation

Front 130

artificial pulse generator that delivers an electrical current to the heart to stimulate depolarization

Back 130

pacemaker

Front 131

specialized cells of the heart's electrical conduction system capable of spontaneously generating and conduction electrical impulses

Back 131

pacemaker cells

Front 132

an unpleasant awareness of one's heartbeat

Back 132

palpitations

Front 133

muscles attached to the chordae tendineae of the heart valves and the ventricular muscle of the heart

Back 133

papillary muscles

Front 134

AT that starts or ends suddenly

Back 134

paroxysmal atrial tachycardia

Front 135

a sudden onset of difficulty breathing that awakens the patient from sleep

Back 135

paroxysmal nocturnal dsypnea (PND)

Front 136

a regular, narrow-QRS tachycardia that starts or ends suddenly

Back 136

paroxysmal supraventricular tachycardia (PSVT)

Front 137

an increase in the volume and/or character of pericardial fluid that surrounds the heart

Back 137

pericardial effusion

Front 138

a procedure in which a needle is inserted into the pericardial space and the excess fluid is drawn out (aspirated) through the needle

Back 138

pericardiocentesis

Front 139

inflammation of the double-walled sac that enclosed the heart

Back 139

pericarditis

Front 140

protective sac that surrounds the heart

Back 140

pericardium

Front 141

ability of a membrane channel to allow passage of electrolytes once it is open

Back 141

permeability

Front 142

apical impulse; the site where the heartbeat is most strongly felt

Back 142

point of maximal impulse (PMI)

Front 143

period after repolarization of a myocardial cell when outside of the cell is positive and the interior of the cell is negative

Back 143

polarized state

Front 144

varying in shape

Back 144

polymorphic

Front 145

difference in electrical charge between two points in a circuit; expressed in volts or millivolts

Back 145

potential difference

Front 146

term used to described rhythms that originate from above the ventricles but in which the impulse travels by a pathway other than the AV node and bundle of His; thus the supraventricular impulse excites the ventricles earlier than normal

Back 146

preexcitation

Front 147

force exerted by the blood on the walls of the ventricles at the end of diastole

Back 147

preload

Front 148

early beat occurring before the next expected beat; can be atrial, junctional, or ventricular

Back 148

premature complex

Front 149

high blood pressure for which no cause is identifiable; also called essential hypertention

Back 149

primary hypertension

Front 150

blood from the right ventricle is pumped directly to the lungs for oxygenation

Back 150

pulmonary circulation

Front 151

a buildup of fluid in the lungs, usually a complication of LVF

Back 151

pulmonary edema

Front 152

a difference between the apical pulse and the peripheral pulse rates

Back 152

pulse deficit

Front 153

power source that houses the battery and controls for regulating a pacemaker

Back 153

pulse generator

Front 154

organized electrical activity observed on a cardiac monitor (other than VT) without the patient having a palpable pulse

Back 154

pulseless electrical activity (PEA)

Front 155

difference between the systolic and diastolic blood pressures

Back 155

pulse pressure

Front 156

a beat-to-beat difference in the strength of a pulse (also called mechanical alternans)

Back 156

pulsus alternans

Front 157

a fall in systolic blood pressure of more than 10mm Hg during inspiration (also called paradoxical pulse)

Back 157

pulsus paradoxus

Front 158

fibers found in both ventricles that conduct an electrical impulse through the heart

Back 158

Purkinje fibers

Front 159

first wave in the cardiac cycle; represents atrial depolarization

Back 159

p wave

Front 160

several waveforms that represent the spread of an electrical impulse through the ventricles

Back 160

QRS complex

Front 161

mirror image ECG changes seen in the wall of the heart opposite the location of an infarction

Back 161

reciprocal change

Front 162

spread of an impulse through tissue already stimulated by the same impulse

Back 162

reentry

Front 163

period of recovery that cells need after being discharged before they are able to respond to a stimulus

Back 163

refractoriness

Front 164

corresponds with the downslope of the T wave; cardiac cells can be stimulated to depolarize if the stimulus is strong enough

Back 164

relative refractory period

Front 165

movement of ions across a cell membrane in which the inside of the cell is restored to its negative charge

Back 165

repolarization

Front 166

moving backward or moving in the opposite direction to that which is considered normal

Back 166

retrograde

Front 167

traits and lifestyle habits that may increase a person's chance of developing a disease

Back 167

risk factors

Front 168

on an ECG, the first positive deflection in the QRS complex, representing ventricular depolarization

Back 168

R wave

Front 169

high blood pressure that has an identifiable cause, such as medications or an underlying disease or condition

Back 169

secondary hypertension

Front 170

line between waveforms; named by the waveform that precedes and follow it

Back 170

segment

Front 171

valves shaped like half moons that separate the ventricles from the aorta and pulmonary artery

Back 171

semilunar valves (SL)

Front 172

ability of a pacemaker to recognize and respond to intrinsic electrical activity

Back 172

sensing

Front 173

partition

Back 173

septum

Front 174

inadequate tissue perfusion that results from the failure of the cardiovascular system to deliver sufficient oxygen and nutrients to sustain vial organ function

Back 174

shock

Front 175

a normal heart rhythm

Back 175

sinus rhythm

Front 176

amount of blood ejected by either ventricle during one contraction; can be calculated as cardiac output divided by heart rate

Back 176

stroke volume

Front 177

an unexpected death from a cardiac cause that either occurs immediately or within 1 hr of the onset of symptoms

Back 177

sudden cardiac death (SCD)

Front 178

period during the cardiac cycle when a weaker than normal stimulus can cause cardiac cells to depolarize; extends from the end of phase 3 to the beginning of phase 4 of the cardiac action potential

Back 178

supernormal period

Front 179

originating from a site above the bifurcation of the bundle of His, such as the SA node, atria, or AV junction

Back 179

supraventricular

Front 180

rhythms that begin in the SA node, atrial tissue, or the AV junction

Back 180

supraventricular dysrhythmias

Front 181

a brief loss of consciousness caused by a temporary decrease in blood flow to the brain

Back 181

syncope

Front 182

contraction of the heart during which blood is propelled into the pulmonary artery and aorta; when the term is used without reference to a specific chamber of the heart, it implies ventricular ___________

Back 182

systole

Front 183

pressure exerted against the wall of the large arteries at the peak of ventricular contraction

Back 183

systolic blood pressure

Front 184

development of a clot in a vein in which inflammation is present

Back 184

thrombophlebitis

Front 185

blood clot

Back 185

thrombus

Front 186

interval between two successive PQRST complexes during which electrical activity of the heart is absent;

Back 186

TP segment

Front 187

a pacing lead with a single electrical pole at the distal tip of the pacing lead (negative pole) through which the stimulation pulse is delivered. in a permanent pacemaker with a __________ lead, the positive pole is the pulse generator case

Back 187

unipolar lead

Front 188

amount of opposition that the blood vessels give to the flow of blood

Back 188

vascular resistance

Front 189

amount of blood flowing into the right atrium each minute from the systemic circulation

Back 189

venous return

Front 190

either of the two lower chambers of the heart

Back 190

ventricle

Front 191

difference in electrical charge between two points

Back 191

voltage

Front 192

movement away from the baseline in either a positive or negative direction

Back 192

waveform

Front 193

type of preexcitation syndrome characterized by a slurred upstroke of the QRS complex (delta wave) and wide QRS

Back 193

Wolff-Parkinson-White syndrome

Front 194

metabolic syndrome
(syndrome X)

Back 194

1. high BP
2. elevated insulin levels
3. excess body weight
4. one or more abnormal cholesterol levels