Flashcards in Cardiovascular Emergencies Deck (72):
0
What is a murmur? What does it indicate?
Abnormal whooshing sound heard over heart
Indicators turbulent blood flow within heart
1
What is a bruit? What does it indicate?
Abnormal whooshing sound heard over main blood vessel
Indicates turbulent flow within blood vessel
2
What is a bruit usually a sign of?
Localized arteriosclerotic disease
3
What is arteriosclerotic disease?
Thickening or hardening of arteries
4
What is atherosclerosis?
Disorder in which cholesterol and other fatty substances build up and form plaque inside walls of blood vessels
5
What is angina pectoris?
When heart tissue isn't getting enough oxygen and causes chest pain for a brief time
6
What is angina pain described as?
I
Crushing
Squeezing
Someone standing on my chest
7
Chronotroptic state refers to?
Hearts rate
8
Dromotropic state refers to?
Hearts conduction
9
Inotropic state refers to?
Hearts strength of contraction
10
What supplies oxygen and nutrients to the heart?
Coronary arteries
11
What is a class of clot busting drugs used to remove plaque from the coronary artery?
Fibrinolytics
12
What are three ways pain from an AMI differs from angina?
May or may not be caused by exertion
Doesn't resolve in a few minutes
May or may not be relieved
13
What are two classes of drugs that will help cardiogenic shock?
Inotropics
Antiarrhythmias
14
What happens during congested heart failure?
The heart fails to pump blood effectively and it backs up into the pulmonary veins
15
What color sputum occurs with pulmonary edema?
Pink frothy sputum
16
Chronic pedal edema may indicate what?
Underlying heart disease (right sides heart failure)
17
How should you position a patient with congestive heart failure?
Sitting up
Not laying down
18
What is cardiomegaly?
Enlarged heart
19
What can continued hypertension lead to?
Stroke
20
What are some signs of hypertension?
Vertigo
Epistaxis
Tinnitus
Vision changes
Nausea
Seizures
21
What are four drugs used or cardiac chest pain?
Oxygen
Aspirin
Nitroglycerin
Morphine
22
What does the left coronary artery subdivide into?
Left anterior descending artery
Circumflex coronary artery
23
What electrolyte flows into the cell to initiate depolarization?
Sodium (NA+)
24
What electrolyte flows out of the cell to initiate repolarization?
Potassium (K+)
25
Hypokalemia can lead to what?
Increased myocardial irritability
26
Hyperkalemia can lead to what?
Decreased automaticity/conduction
27
Hypocalcemia can lead to what?
Decreased contractility and increased myocardial irritability
28
Hypercalcemia can lead to what?
Increased contractility
29
Which electrolyte maintains depolarization and involved in heart tissue contraction?
Calcium (Ca++)
30
What electrolyte stabilizes cell membrane and opposes action of calcium?
Magnesium (Mg++)
31
Hypomagnesium can lead to?
Decreased conduction
32
Hypermagnesium can lead to?
Increased myocardial irritability
33
What agents will affect only the heart?
Beta agents
34
The arteries have receptors for what agents?
Alpha and beta
35
Alpha agents will cause what?
Vasoconstriction
36
Beta agents will cause what?
Vasodilation
37
Beta 1 drugs act primary on the?
Cardiac beta receptors
38
Beta 2 drugs act primarily on the?
Pulmonary beta receptors
39
What kind of agent is norepinephrine (levophed)?
Sympathetic agent (primarily alpha)
Causes vasoconstriction
40
S1 heart sounds occur when which valves close?
Tricuspid and mitral valves
41
S2 heart sounds occur when which valves close?
Semi lunar valves:
Pulmonary and aortic valve
42
When s3 heart sounds are heard in older adults, what does that indicate?
Heart failure
43
Which lead tracing is most useful on an ECG?
Lead 2
44
What are two main groups of leads?
Limb leads
Precordial leads
45
What leads are limb leads?
I
II
III
aVR
aVL
aVF
46
What are bipolar leads?
Leads that contain a positive and negative pole
47
Which leads are bipolar?
I
II
III
48
What are augmented unipolar leads?
Has one true pole while the other end of the lead is referenced against a combination of other leads
49
What leads are augmented unipolar leads?
aVR
aVL
aVF
50
What is the j point?
Point in ECG where QRS complex ends and ST segment begins
It depresses or elevates if myocardium is ischemic
51
What are precordial leads?
6 limb leads you attach with 12 lead
V1-V6
52
What leads look at the septum?
V1
V2
53
What leads look at the anterior wall of left ventricle?
V3
V4
54
Which leads look at the lateral wall of the left ventricle?
V5
V6
I
aVL
55
Which leads look at the inferior wall of the left ventricle?
II
III
aVF
56
What is a vector?
Term to describe the direction and force of an electrical charge
57
What is an electrical axis?
The sum of all the vectors
58
What's the axis if lead 1 is positive and aVF is positive?
Normal axis
59
What is the axis if lead 1 is positive and aVF is negative?
Left axis deviation
60
What is the axis if lead 1 is negative and aVF is positive?
Right axis deviation
61
What is the axis if lead 1 is negative and aVF is negative?
Extreme right axis deviation
62
What happens to axis deviation if one of the ventricles is enlarged?
More electrical energy is contributed with larger ventricle and causing the vector to point in the direction of enlargement
63
What happens to axis deviation if one of the ventricles is infarcted?
No electrical activity is being contributed to dead tissue and vector with point away from it
64
Which leads do you look at to determine axis deviation?
I
aVF
65
What is collateral circulation?
Physiological response during 4-5 decade that creates different pathways for blood flow in case of an occlusion
66
ST segment that that depresses below the isoelectric lines is considered?
Ischemia
67
ST segment that elevated above the isoelectric line is considered?
Myocardial injury
68
What are two primary causes for left atrial enlargement?
Systemic hypertension
Mitral/aortic stenosis
69
What primarily caused right atrial enlargement?
Chronic pulmonary disorders
70
How do you see right atrial enlargement on an EKG?
P wave has amplitude greater than 2.5mm in lead 2 and/or higher than 1.5 in V1
71