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Cardio SDL 1
Cardiovascular Primer
58
Pharmacology
Graduate
01/20/2013

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Cards

Term
Define Cardiovascular Disease (CVD)
Definition
Diagnosis of ischemic heart disease, heart failure, peripheral vascular disease, cerebrovascular disease or dysrhythmia
Term
Define Ischemic Heart Disease (IHD)
Definition
Aka: CAD- coronary artery disease or CHD- coronary heart disease. Patients have some type of blockage in one or more of the coronary arteries
Term
Define Heart Failure
Definition
Patients who have a problem with the mechanical functioning of the pump. Not the same thing as having a blockage
Term
Define Peripheral vascular disease
Definition
Patients with blockages in ARTERIES in the arms or legs rather than the heart
Term
Define Cerebrovascular disease
Definition
Patients with or at high risk for stroke (CVA- cerebrovascular accident) or transient ischemic attack (TIA- the lay person terminology is “mini-stroke”)
Term
Define Dysrhythmia
Definition
Patients with an abnormality in the heart’s conduction system
Term
Define Deep Vein Thrombosis (DVT)
Definition
Patients with clots in the veins of their legs or arms (as opposed to the arteries). DVT and PE are not technically considered CVD, though they are vascular diseases. If a patient has just DVT or PE as a diagnosis, they would not be considered to have DVT
Term
Define Pulmonary Embolism (PE)
Definition
Condition closely related to DVT that specifically describes patients with a blood clot in the pulmonary venous system.
Term
Define Angioedema
Definition
Swelling of the facial area, which could include tongue, lips, or throat
Term
Define Angina
Definition
Chest pain
Term
Define Bradycardia
Definition
Slow HR (<60 beats per minute)
Term
Define Diaphoresis
Definition
Sweating
Term
Define Distal
Definition
Situated away from the center of the body
Term
Define Dyspnea/ Dyspnic
Definition
Difficulty breathing
Term
Define Euvolemic
Definition
Appropriate intravascular volume status
Term
Define Hematoma
Definition
Pocket of blood extravasated in tissue
Term
Define Hematuria
Definition
Blood in urine
Term
Define Hypervolemia
Definition
Volume overloaded
Term
Define Hypovolemia
Definition
Dehydrated
Term
Define Infarction
Definition
Death of tissue due to lack of blood flow
Term
Define Ischemia
Definition
A decrease in blood flow or supply
Term
Define Lateral
Definition
On the side
Term
Define Melena
Definition
Dark, tarry stools
Term
Define Orthopnea
Definition
Difficulty breathing while supine, usually definited by the degree of elevation needed to improve breathing
Term
Define Paroxysmal nocturnal dyspnea
Definition
Intermittent shortness of breath at night, usually awakens a person
Term
Define Pedal Edema
Definition
Lower extremity swelling
Term
Define Posterior
Definition
Denoting the back of a surface
Term
Define Proximal
Definition
Nearest to the trunk or the point of origin
Term
Define Tachycardia
Definition
Fast heart rate (>100 beats per minute)
Term
Does a person with hypertension or dyslipidemia have cardiovascular disease?
Definition
No, they have conditions that increase their risk for developing CVD.
Term
Describe the role of a Chest X-Ray
Definition
-variety of organ systems to be seen (cardiac, pulmonary, vascular, skeletal)
-NOT sensitive
-cannot evaluate mechanical or electrical function of the heart
-cannot diagnose heart disease
-may help lead physician to a more appropriate diagnostic test
Term
Describe the role of a Venography
Definition
-Radiopaque contrast dye injected into peripheral veins
-most definitive test to assess for thrombosis within the veins “gold standard”
-invasive
-expensive (rarely used clinically)
-several adverse effects
-provides visualization of entire lower extremity venous system
Term
Describe the role of an Ultrasonography
Definition
-non-invasive
-inexpensive
-looks for thrombosis in the deep veins of the extremities
-done at bedside
-Advantage: sensitive to detect large thrombi that occlude proximal veins
-Disadvantage: insensitive to smaller nonocclusive thrombosis and calf vein thrombosis
-1st line diagnostic test used to assess for DVT
Technique: emission of high-pitched sound waves through a transducer
Term
Describe the role of a Doppler within an ultrasonography
Definition
Determines rate of blood flow through reflections of sound waves off red blood cells
Term
Describe the role of a Real-time B-Mode within an ultrasonography
Definition
Visualization of leg veins by means of transducer that emits high frequency sound waves that reflect off soft tissue
Term
Define a Duplex within an ultrasonography
Definition
Combination of Doppler and real-time B-mode
Term
Describe the role of a Pulmonary Angiography
Definition
radiopaque contrast dye injected into the pulmonary artery
-most definitive test to assess for thromboembolism in pulmonary arteries “gold standard”
-invasive
-expensive (rarely used in clinical practice)
-several adverse effects
Term
Describe the role of a Spiral Computed Tomography (CT Scan)
Definition
-CT scanning technology with contrast dye to evaluate the pulmonary arteries
-most common method used to evaluate PEs
-noninvasive
-good at detecting the most pulmonary emboli
-option for 1st line diagnostic testing for PE
Term
Describe the role of a D-Dimer
Definition
-simple blood test to asses active clotting
-D-dimer is formed when cross linked fibrin in lysed by plasmin
-D-dimer level elevated with active thrombosis . . . also elevated by inflammation, cancer, and aging (therefore id the D-dimer is above normal it DOES NOT confirm that there is an active thrombosis
-D-dimer level is normal this excludes “rules out” active thrombosis (DVT or PE)
-adjunct to objective diagnostic testing
-D-dimer is a degradation products of fibrin
Term
Describe the role of an Electrocardiogram(EKG or ECG)
Definition
-identify myocardial infarctions and arrhythmias
-also drug effects and electrolyte abnormalities
-electronic leads placed in various locations on body to allow for picture of heart’s electrical activity
-12 leads placed to look at electrical activity from several angles
Term
Describe the role of an Echocardiogram (echo)
Definition
-ultrasound of the heart
-looks at mechanical function of the heart (how the heart is moving around and pumping)
-performed on the chest (transthoracic echocardiogram or TTE)
-probe can also be inserted into the esophagus (atria close to esophagus= clearer more sensitive) – transesophageal echocardiogram or TEE
Various functions: movement of heart walls, systolic/diastolic function, valvular function, presence of thrombus or infection
Term
Describe the role of Exercise testing
Definition
-assess hearts function under a period of stress
-aid in assessment of ischemic heart disease
Term
Describe the role of an Exercise Tolerance Test
Definition
Standard exercise regimen on a treadmill or bicycle during continuous ECG, blood pressure, and heart rate. Echo performed during the test so that both mechanical and electrical function can be assessed simultaneously during CV exertion
Term
Describe the role of a Pharmacologic Stress Test
Definition
Alternative for patients unwilling or unable to physically exercise for an Exercise Test
Common agents: dobutamine, adenosine, and/or dipyridamole
Term
Describe the role of a Cardiac Catheterization

Aka cardiac cath, cath, cardiac angiogram, angiogram
Definition
-incision made near the groin area to access the femoral vein (allows vascular access to the coronary arteries and heart chambers)
-blockages can be found and opened with procedures called angioplasty where stents can be placed to keep the artery open (Left Heart Cath)
-Right Heart Cath
-comprehensive evaluation of the cardiac anatomy
Term
Define Automaticity
Definition
The ability to generate an electrical impulse independently
Ex: if the SA nose- the primary cardiac pacemaker-dose not send an impulse, another area of the heart will “take over” and generate an impulse)
Term
Define Excitability
Definition
The ability of a cell to respond to a stimulus and conduct or initiate an action potential
Term
Define Refractoriness
Definition
The cell is in a state of recovery from previous electrical stimulus and is temporarily resistant (or “refractory”) to another stimulus
Term
Define Conduction Velocity
Definition
The speed of forward movement of an electrical impulse
Term
What happens during the P-wave, R-wave, QRS complex, and T-wave?
Definition
P-wave: atrial depolarization
R-wave: obliterates any visualization of atrial repolarization
QRS complex: depolarization of the ventricle
T-wave: represents repolarization of the ventricle
Term
Define PR interval
Definition
Depolarization of the atria and refractory period of the AV node
Term
Define QT interval
Definition
Shows the full depolarization and repolarization of the ventricle
Term
List the cardiovascular tests that are invasive
Definition
Venography
Pulmonary Angiography
Cardiac Catheterization
Term
List the cardiovascular tests that are non-invasive
Definition
Chest X-Ray
Ultrasonography
Spiral Computed Tomography (CT) scan
Aka: Helical CT scan
Electrocardiogram
Echocardiogram (could be invasive if obese)
Exercise testing
Term
What test(s) is/are most appropriate to test for a Deep Vein Thrombosis (DVT)?
Definition
Venography
Ultrasonography
D-Dimer
Term
What test(s) is/are most appropriate to test for Pulmonary Embolisms (PE)?
Definition
Pulmonary Angiography
Spiral Computed Tomography (CT) Scan
D-Dimer
Term
How can troponins be used to measure a MI?
Definition
Related in response to ventricular injury
More specific to cardiac tissue than CK-MB
-Starts to risk 3-12 hours after injury
-Peaks ~24 hours
-Returns to normal around day 5-6
Term
How can Creatine Kinase Myocardial Band(CK-MB) be used to measure a MI?
Definition
Also released in response to cardiac muscle injury
-starts to rise 3-12 hours after injury (some test can show quicker rise)
-Peaks ~24 hours, but returns to normal around day 2-3
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