Cardiology Flashcards
1
Q
Indications of Reperfusion following PCI or fibrinolysis
A
- Pain cessation
- Reversal of ST segment elevation with return to baseline
- short runs of ventricular tachycardia
2
Q
Anterior Wall MI
A
- Acute Anterior STEMI
- LAD occlusion
- Likely results in ventricular septal defect (VSD)
- Murmur at Left Sternal Border
- ST elevation in V2, V3, and V4
- Rhythm change
- Second degree, Type II heart block possible (Mobitz)
- Medications
- Beta Blocker (cardioselective) beneficial (Metoprolol)
- Anti-platelet (aspirin)
- Anticoagulant (heparin)
3
Q
Propanolol (Inderal)
A
- Beta-adrenergic blocker (NOT cardioselective)
- Affects beta receptors in heart muscle and lung tissue
- More likely to cause bronchoconstriction
4
Q
Second Degree, Type II (Mobitz)
A
- Often develops after acute anterior MI, generally due to occlusion of LAD (left anterior descending artery)
- LAD supplies the HIS-Purkinje system (HIS bundle)
- Conduction disease in HIS bundle is irreversible (not subject to autonomic tone or AV blocking medications)
- Permanent pacemaker indicated
5
Q
Inferior Wall MI
A
- Acute inferior STEMI
- RCA occlusion may result in an RV infarct
- Right Coronary Artery (RCA) occlusion
- Result in papillary muscle dysfunction or rupture of the mitral valve
- Supplies area of the left ventricle where mitral valve is attached
- Acute mitral regurgitation
- Does NOT result in systolic murmur at apex of heart or lung crackles
- RIght-sided ECG may help confirm RV infarct
- Rhythm change
- Due to SA node or AV node ischemia
- Sinoatrial block
- Second degree, type I (Wenkebach)
- Third degree, complete
- Due to SA node or AV node ischemia
- Treatment
- Development of complete heart block : Assess. If serious S/S develop, begin transcutaneous pacing (TCP)
6
Q
Dilated Cardiomyopathy
A
- Results in systolic dysfunction
- ↓ contractility
- Compensatory arterial constriction
- Results in higher left ventricular preload
- Therapy aimed at…
- ↑ contractility
- ↓ afterload (arterial constriction)
- ↓ preload that is too high
7
Q
Electrolytes that may cause QT prolongation
A
- ↓ magnesium
- ↓ potassium
- ↓ calcium
- QT prolongation may result in torsades de pointes ventricular tachycardia
- If self limiting, may result in transient syncopal episode
8
Q
Retroperitoneal Bleeding
A
- Causes signs of hypovolemia and hypovolemic shock
- Complication of a PCI
- Femoral artery access site
- Back Pain
9
Q
Dressier’s Syndrome
A
- Type of pericarditis
- Inflammation of the sac surrounding the heart (pericardium)
- Results after an acute MI
- Believed to be an immune system response after damage to heart tissue or to pericardium
10
Q
Mitral Valve Regurgitation
A
- Murmur at the apex of the heart (midclavicular, 5th ICS)
- Occurs when the valve should be closed
- S/S
- Shortness of breath
- Recurrence of chest pain
- Loud systolic murmur at apex of heart
- Mitral valve should be closed during systole
11
Q
Permanent Pacemaker
A
- First letter indicates chamber paced
- Second letter indicates chamber sensed
- Third letter indicates response to sensing
12
Q
Cardiogenic Shock
A
- Results in ↓ CO with resultant drop in coronary artery perfusion and compensatory vasoconstriction
- IABP therapy
13
Q
Intra Aortic Balloon Pump (IABP Therapy)
A
- Deflation of balloon placed into descending aorta is beneficial
- Deflation = ↓ afterload & ↓ work of the left ventricle
- Inflation of the balloon is beneficial because it “boluses” blood into the coronary arteries
- Inflation = ↑ diastolic augmentation & ↑ perfusion
14
Q
Percutaneous Coronary Intervention (PCI)
A
- Addresses cause of the problem, not only treat signs and symptoms
15
Q
Hypertrophic Cardiomyopathy
A
- Problem with filling
- Diastolic dysfunction
- NOT a problem with ejection, EF is normal
- Drug therapy
- Beta blocker (Metoprolol)
- Decrease heart rate to ↑ filling time
- Beta blocker (Metoprolol)
22
Q
NYHA Heart Failure Class
A
