Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
43 Cards in this Set
- Front
- Back
Why take BP on right hand?
|
Because most people are right handed
|
|
What is coarctation of Aorta?
|
When Aorta is pinched or narrowed, restricting blood flow to the body
|
|
What can cause difference between left and right BP measurement?
|
Coarctations of aorta
PVD PAOD (peripheral arterial occlusive disease) |
|
precautions/CI against taking braichial BP
(7) |
1 AV grafts & fistulas
2 s/p CVA 3 left right difference >10mm 4 IV line 5 sickle cell trait/crisis 6 too many bP measurement attempts 7 post arm position & maneuvers |
|
What is pulse pressure?
|
difference between diastolic and systolic
|
|
pulse pressure >60mmHg predictive of?
|
CHF
|
|
High pulse pressure indicates:
(5) |
>60 mmHg, CHF
aortic/vascular wall stiffness severe anemia hyperthoryoidism |
|
Lower pulse prsesure indicates:
(3) |
lower cardiac output for those in acute heart failure
left ventricular failure hypovolemia |
|
orthostatic hypotension defined by
|
>20mmHg drop in SBP
>10mmHg drop in DBP within first 3 min of table |
|
what is pulsus paradoxus
|
>10mmHg drop in SBP with deep inspiration
suggests pericardial effusion (ie cardiac tamponade) (and rarely, constrictive pericarditis) |
|
What's a good way to treat CHF in regards to exercise?
|
Interval training with mild(er) pace
start from reasonable MET level that does not overwhelm heart |
|
describe stable angina
|
lumen narrowed by plaque
inappropriate vasoconstriction |
|
describe unstable angina
|
plaque rupture
platelet aggregation thrombus formation unopposed vasoconstriction |
|
described variant angina
|
no overt plaque
intense vaso-spasms |
|
4 E's that precipitate stable angina
|
execise
exertion emotions eating |
|
how many % occlusion that cause stable angina?
|
70%
|
|
hwo to relieve stable angina?
|
rest
nitroglycerine |
|
describe fixed threshold variant for stable angina
|
stable rate -pressure product
(HR x SBP) represents a linear relationship between myocardial O2 uptake and coronary blood flow |
|
pattern of symptoms for UNSTABLE angina
|
+ frequency
+ duration + intensity symptoms during rest! |
|
distinguishing characteristics of variant angina
|
inappropriate vasoplasm
occur mostly at rest or when waking up from sleep may subside with activity |
|
what is ergonovine test?
|
for variant angina:
induce vasoconstriction patient's are more sensitive and experience angina symptoms |
|
who is at risk for silent ischemia
|
diabetics
neuropathy |
|
how is silent ischemia diagnosed?
|
ambulatory EKG, GXT
|
|
what is syndrome X
|
normal coronary arteries?
insufficient vasodilation, or frank constriction of small vessels |
|
what is #1 cause of death in US?
|
myocardial infarction
|
|
signs and symptoms of MI
|
chest discomfort/pressure that does not go away
lasts >30 min can occur at center of chest, one or both arms, back, neck, jaw or stomach |
|
how many % of patients have minimal to no chest discomfort for MI?
|
25%
|
|
Myocardial infarction signs and symptoms
|
restless appearance
cool & clammy skin low grade temp possible crackles and wheezes sudden loss of vision/blurred vision pallor/diaphoresis weakness, numbness faintness SOB |
|
differential diagnosis for MI checks against what other conditions?
|
chest wall (muscular pain)
GI disroder pericarditis cervical osteoarthritis |
|
techniques for differential diagnosis for MI?
|
deep breathing (pericarditis)
palpation ROM physical activity NTG |
|
P wave represents
|
atrial depolarization
|
|
QRS complex represents
|
ventriculra depolarization
|
|
T wave represents
|
ventricular REpolarization
|
|
U wave represents
|
late repolarizing of ventricles/bundle branches
|
|
ST and T wave represent
|
defines entire ventricular REpolarization period
|
|
what wave changes in ECG is a sensitive indicator of MI or infarction?
|
shift in ST segment and T wave inversion
|
|
What does NSTEMI (unstable MI) look like on ECG?
|
ST depression or T inversion
(basically dips down past neutral after the big upward spike) |
|
What does STEMI (stable) look like?
|
ST elevated, extra tall after big spike
|
|
what's the exercise progression/testing for MI patient?
|
2-3 days: ambulate
1-3 weeks: submax stress test 3-6 weeks: return to work 6-8 weeks: max stress test |
|
what is CHF?
|
failure of one or more of the heart chambers, resulting in decreased heart function
|
|
what are causes of CHF?
|
direct: disease, deficiency
overload: volume, pressure restrictive filling: pericarditis, myopathies |
|
Left heat failure
signs/symptoms |
sub: dyspnea, orthonea, paroxysmal nocturnal dyspnea, cough, fatigue
obj: rales, S3 gallop, pleural effusion, peripheral cyanosis, inc. resp rate, dec. urine output |
|
Right heart failure
signs/symptoms |
sub: abdominal pain, anorexia/nausea, bloating, fatigue, bilat ankle edema
obj: JVD, peripheral edema, ascites, dec. urine output, hepatomegaly |