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Cardio conditions
PANCE
13
Medical
Graduate
01/07/2008

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Term
Cardiogenic Shock; sx tests tx
Definition
heart is unable to meet the demands of the body. This can be caused by
conduction system failure or heart muscle dysfunction.

Symptoms of Shock:
Rapid breathing
Rapid pulse
Anxiety
Nervousness
Thready pulse
Mottled skin color
Profuse sweating
Poor capilary refill

Tests:
Nuclear Scans
Electrocardiogram
Echocardiogram
Electrocardiogram

ABG
Chem-7
Chem-20
Electrolytes
Cardiac Enzymes

Treatment:
Amrinone
Norepinephrine
Dobutamine
IV fluids
PTCA
Extreme cases-pacemaker, IABP
Term
Aortic insufficiency- causes sx, tests, monitoring
Definition
Heart valve disease that prevents the aortic valve from closing completely.
Backflow of blood into the left ventricle.

Causes:
Rheumatic fever
Congenital abnormalities
Endocarditis
Marfan’s syndrome
Ankylosing spondylitis
Reiter’s syndrome

Symptoms:
Fainting
Weakness
Bounding pulse
Chest pain on occasion
SOB
Fatigue

Tests:
Palpation
Increased pulse pressure and diastolic
pressure
Pulmonary edema present
Auscultation
Left heart cathereterization
Aortica angiography
Dopper US
Echocardiogram
Treatment:
Digoxin
Dieuretics
Surgical aorta valve repair

Monitor patient for:
PE
Left-sided heart failure
Endocarditis
Term
Aortic aneurysm- causes, sx, test, tx, monitoring
Definition
Expansion of the blood vessel wall often identified in the thoracic region.

Causes:
Htn
Marfan’s syndrome
Syphilis
Atherosclerosis (most common)
Trauma

Symptoms:
Possible back pain may be the only indicator

Tests:
Aortogram
Chest CT
X-ray

Treatment:
Varies depending on location
Stent
Circulatory arrest
Surgery

Monitor patient for:
Bleeding
Stroke
Graft infection
Irregular Heartbeats
Heart Attack
Term
Hypovolemic shock
Definition
Poor blood volume prevents the heart from pumping enough blood to the
body.

Causes:
Trauma
Diarrhea
Burns
GI Bleeding
Term
Cardiogenic shock: sx, tests, tx
Definition
Enough blood is available, however the heart is unable to move the blood in
an effective manner.

Symptoms:
Anxiety
Weakness
Sweating
Rapid pulse
Confusion
Clammy skin

Tests:
CBC
Echocardiogram
CT scan
Endoscopy with GI bleeding
Swan-Ganz catheterization

Treatment:
Increase fluids via IV
Avoid Hypothermia
Epinephrine
Norepinephrine
Dobutamine
Dopamine
Term
Myocarditis: causes, tests, sx, tx, monitoring
Definition
nflammation of the heart muscle.

Causes:
Bacterial or Viral Infections
Polio, adenovirus, coxsackie virus

Symptoms:
Leg edema
SOB
Viral symptoms
Joint Pain
Syncope
Heart attack (Pain)
Fever
Unable to lie flat
Irregular heart beats

Tests:
Chest X-ray
Echocardiogram
ECG
WBC and RBC count
Blood cultures

Treatment:
Diuretics
Pacemaker
Antibiotics
Steroids

Monitor the patient for:
Pericarditis
Cardiomyopathy
Term
Heart valve infection- sx, tests, tx, monitoring
Definition
endocarditis (inflammation), probable valvular heart disease. Can be
caused by fungi or bacteria.

Symptoms: Weakness
Fever
Murmur
SOB
Night sweats
Janeway lesions
Joint pain

Tests:
CBC
ESR
ECG
Blood cultures
Enlarged speen
Presence of splinter hemorrhages

Treatment:
IV antibiotics
Surgery may be indicated

Monitor the patient for:
Jaundice
Arrhythmias
CHF
Glomerulonephritis
Emboli
Term
Pericarditis: causes, sx, tests, tx, monitoring
Definition
Inflammation of the pericardium.

Causes:
Viral- coxsackie, adenovirus, influenza, rubella viruses
Bacterial (various microorganisms)
Fungi
Often associated with TB, Kidney failure, AIDS, and autoimmune disorders.
Surgery

Symptoms:
Dry cough
Pleuritis
Fever
Anxiety
Crackles
Pleural effusion
LE swelling
Chest pain
Unable to lie down flat

Tests:
Auscultation
MRI scan
CT scan
Echocardiogram (key test)
ESR
Chest x-ray
Blood cultures
CBC

Treatment:
NSAIDS
Pericardiocentesis
Analgesics
Pericardiectomy

Monitor the patient for:
Constrictive pericarditis
A fib.
Supraventricular tachycardia (SVT)
Term
Arrhythmias: types, sx, tests, tx, monitoring
Definition
Types:
Bradycardia
Tachycardia
Ventricular fibrillation
Ectopic heart beat
Ventricular tachycardia
Wolff-Parkinson-white syndrome
Atrial fib.
Sick sinus syndrome
Sinus Tachycardia
Sinus Bradycardia

Symptoms:
SOB
Fainting
Palpitations
Dizziness
Chest pain
Irregular pulse

Tests:
Coronary angiography
ECG
Echocardiogram
Holter monitor

Treatment:
Defibrillation
Pacemaker
Medications

Monitor the patient for:
Heart failure
Stroke
Heart attack
Ischemia
Term
Arteriosclerosis: causes, sx, tests, tx
Definition
: hardening of the arteries.

Causes:
Smoking
Htn
Kidney disease
CAD
Stroke

Symptoms:
Claudication pain
Cold feet
Muscle acheness and pain in the legs
Hair loss on the legs
Numbness in the extremities
Weak distal pulse

Tests:
Doppler US
Angiography
IVSU
MRI test
Poor ABI (Ankle brachial index) reading

Treatment:
Analgesics
Vasodilation medications
Surgery if severe
Ballon surgery
Stent placement

Monitor the patient for:
Arterial emboli
Ulcers
Impotence
Gas gangreene
Infection of the lower extremities
Term
Cardiomyopathy- causes, types, sx, tests, tx
Definition
poor hear pumping and weakness of the myocardium.

Causes:
Htn
Heart attacks
Viral infections

Types:
Alcoholic cardiomyopathy- due to alcohol consumption
Dilated cardiomyopathy-left ventricle enlargement
Hypertrophic cardiomyopathy-abnormal growth left ventricle
Ischemic cardiomyopathy- weakness of the myocardium due to heart attacks.
Peripartum cardiomyopathy- found in late pregnancy
Restrictive cardiomyopathy-limited filling of the heart due to inability to relax heart tissue.

Symptoms:
Chest pain
SOB
Fatigue
Ascites
LE swelling
Fainting
Poor Appetite
Htn
Palpitations

Tests:
ECG
CBC
Isoenzyme tests
Coronary Angigraphy
Chest X-ray
MRI
Auscultation

Treatment:
Ace inhibitors
Dieuretics
Blood thinners
LVAD – Left Ventricular Assist Device
Digoxin
Vasodilators
Term
Heart Sounds: S1, S2, S3, S4
Definition
S1- tricuspid and mitral valve close
S2- pulmonary and aortic valve close
S3- ventricular filling complete
S4-elevated atrial pressure (atrial kick)
Term
EKG Wave Review
Definition
Wave Review Indepth:

1. P WAVE - small upward wave; indicates atrial depolarization
2. QRS COMPLEX - initial downward deflection followed by large upright wave followed by small
downward wave; represents ventricular depolarization; masks atrial repolarization; enlarged R
portion - enlarged ventricles; enlarged Q portion - probable heart attack.
3. T WAVE - dome shaped wave; indicates ventricular repolarization; flat when insufficient
oxygen; elevated with increased K levels
4. P - R INTERVAL - interval from beginning of P wave to R wave; represents conduction time
from initial atrial excitation to initial ventricular excitation; good diagnostic tool; normally < 0.2sec.
5. S-T SEGMENT - time from end of S to beginning to T wave; represents time between end of
spreading impulse through ventricles and ventricular repolarization; elevated with heart attack;
depressed when insufficient oxygen.
6. Q-T INTERVAL - time for singular depolarization and repolarization of the ventricles.
Conduction problems, myocardial damage or congenital heart defects can prolong this.
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