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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

How do you determine left atrial enlargement on EKG?

P wave longer than 110 ms in lead II
Notched P wave
P wave in V1 primarily negative