Cardiology 2

plasty

repair

sten(o)

narrow

steth(o)

chest

tachy

fast

therap

treatment

thorac(o)

chest

thromb(o)

clot

ven(o)

vein

cardiomyopathy

Progressive impairment of the structure and function of the muscular wall of the heart chambers. It has multiple causes, but the most common one is ischemic heart disease

cardiomegaly

enlarged heart

CHF

Congestive Heart Failure (or simply Heart failure) is a disorder in which the heart pumps blood inadequately, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and other changes that may further weaken the heart. Heart failure can be due to ischemic heart disease or myocardial damage from a viral infection of the heart muscle.

Why is CHF important to HC Administrators?

CHF is a common reason for people to be admitted to the hospital. If the patient is sent home, returns to the hospital and gets admitted in less than 30 days, the hospital receives no money for the second admission (readmission).

Left-sided heart failure

Left ventricle unable pump blood that enters it from the lungs. Most common symptom is shortness of breath (dyspnea) due to fluid backing up into the lungs because the left ventricle not working correctly. The person will also be weak because inadequate blood flow to the rest of the body.

Right-sided heart failure

Right side of heart cannot empty all of blood received from venous circulation. The most common symptom is swelling (edema) of the body, most commonly in the lower extremities. This is due to fluid retention because the right heart cannot pump normally

BNP

B-type natriuretic peptide (BNP) is a hormone secreted by cardiomyocytes in the heart ventricles in response to stretching caused by increased ventricular blood volume. Elevated in patients with congestive heart failure.

Pericarditis

Pericarditis refers to inflammation of the pericardium, two thin layers of a sac-like tissue that surround the heart.

Peripheral Vascular Disease

Can be from arterial or venous issues. Occlusive peripheral arterial disease is blockage or narrowing of an artery in the legs (or rarely the arms), usually due to atherosclerosis and resulting in decreased blood flow.

Intermittent claudication

Intermittent claudication is the most common symptom of peripheral arterial disease, results from gradual narrowing of a leg artery. It is a painful, aching, cramping, or tired feeling in the muscles of the leg—not in the joints. It occurs regularly and predictably during physical activity but is always relieved promptly by rest.

Atrial Fibrillation and flutter

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that occurs in the top of the heart (atria) It can lead to blood clots, stroke, heart failure, and other heart-related complications. At least 2.7 million Americans are living with AFib. It is the most common heart arrhythmia.

Arrhythmia

Arrhythmia, also known as cardiac arrhythmia or heart arrhythmia, is a group of conditions in which the heartbeat is irregular, too fast, or too slow     

Ventricular fibrillation

Ventricular fibrillation is uncoordinated series of very rapid, ineffective contractions of the ventricles caused by many chaotic electrical impulses. Patient is dead unless CPR started.

Defibrillation

Delivery of a therapeutic dose of electrical energy to the affected heart. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.

CAD

Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked.

LDL

low density lipoprotein is bad cholesterol. It contributes to fatty buildups in arteries (atherosclerosis)

HDL

High density lipoprotein is the good cholesterol. Experts believe that HDL acts as a scavenger, carrying LDL (bad) cholesterol away from the arteries and back to the liver, where the LDL is broken down and passed from the body.

Statins

A class of drugs used to treat high cholesterol

Atherosclerosis

Atherosclerosis is a condition in which patchy deposits of fatty material (atheromas or atherosclerotic plaques) develop in the walls of medium-sized and large arteries, leading to reduced or blocked blood flow.

Hands-only CPR

A better way for lay-person CPR in adults. The rescuer no longer does mouth-to-mouth or checks a pulse. They simply compress the chest fast and deep. Better survival than traditional CPR.

Percentage of all out-of-hospital cardiac arrests that are in adults

98% of out-of-hospital cardiac arrests are in adults.

AED

An automated external defibrillator (AED) is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation (VF) and pulseless ventricular tachycardia and is able to treat them through defibrillation, the application of electricity which stops the arrhythmia, allowing the heart to re-establish an effective rhythm.

Angina

Angina, also called angina pectoris, is temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. Does not cause death of heart muscle.

Atypical Angina

Symptoms other than chest pain with the heart muscle is not receiving enough oxygen.

Unstable Angina

Unstable angina is chest pain (or equivalent symptom) that is different, more severe, or occurs with less activity than the patients normal chest pain.

Angioplasty

balloon-tipped catheter into a large artery (radial or femoral), and threads the catheter through the connecting arteries and the aorta to the narrowed or blocked coronary artery. Then the doctor inflates the balloon to force the atheroma against the arterial wall and thus open the artery.

PCI

Percutaneous Coronary Intervention (also called percutaneous transluminal coronary angioplasty—PTCA) refers to angioplasty with or without stenting of the coronary

Coronary artery stenting

A tube made of wire mesh (a stent) is placed over the deflated balloon at the catheter's tip and inserted with the catheter. When the catheter reaches the atheroma, the balloon is inflated, opening up the stent. Then the balloon-tipped catheter is removed, and the stent is left in place to help keep the artery

CABG

Coronary artery bypass grafting (CABG) is also called bypass surgery or coronary artery bypass surgery. In the procedure, doctors take an artery (from the chest wall) and connect it to the coronary artery just past the blockage, or they take a vein from the legs to connect the aorta (the major artery that takes blood from the heart to the rest of the body) to a coronary artery past the point of its blockage.

ACS

Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or heart attack (myocardial infarction) depending on the location and amount of blockage.

Troponin

A blood test used to diagnose heart muscle damage. Used to diagnose NSTEMI.

STEMI

ST-elevation myocardial infarction. This type of heart attack is diagnosed using an EKG. These are the heart attacks that must either immediately to the cardiac cath lab or must receive thrombolytics.

NSTEMI

Non-ST-elevation myocardial infarction. This type of heart attack is not readily apparent on the EKG. It requires blood tests to diagnose. Some of these patients may go to the cath lab immediately, but not all. They never are treated with thrombolytics.

Artificial Heart Valves

When a heart valve is damage or not functioning correctly, there can be stenosis (limiting blood flow) or regurgitation. There are three options to fix the problem: Mechanical valve replacement, bioprosthetic valve replacement (Pig or Cow), or repair of the valve. Mechanical valves require the person to be on blood thinners for life.

Pacemaker

A pacemaker (or artificial pacemaker, so as not to be confused with the heart's natural pacemaker) is a medical device that uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate.

ICD

Implantable Cardioverter Defibrillator is a small device that's placed in the chest or abdomen. Doctors use the device to help treat irregular heartbeats called arrhythmias (ah-RITH-me-ahs). An ICD uses electrical pulses or shocks to help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest

LVAD

Left Ventricular Assist Device is a mechanical pump that's used to support heart function and blood flow in people who have weakened hearts. The device takes blood from the left ventricle of the heart and pumps it to the aorta, which delivers blood to the body and vital organs

Thrombolytic

These are clot-dissolving drugs that are given to a person having a STEMI when PCI is not available within 90 minutes.

Coronary Angiogram

The coronary arteries supply the heart with oxygen-rich blood. Coronary angiography done during a catheterization of the left side of the heart. The catheter is threaded toward the heart, then into the coronary arteries. During insertion, the doctor uses fluoroscopy (a continuous x-ray procedure) to observe the progress of the catheter as it is threaded into place. After the catheter tip is in place, a radiopaque dye, which can be seen on x-rays, is injected through the catheter into the coronary arteries, and the outline of the arteries appears on a video screen and is recorded.

Left heart cath

A catheterization of the left side of the heart (arterial side), including the coronary arteries.

Right heart cath

A catheterization of the right side of the heart (venous side)

Myocardial Infarction

Heart attack (myocardial infarction) is a medical emergency in which some of the heart's blood supply is suddenly and severely reduced or cut off, causing the heart muscle (myocardium) to die because it is deprived of its oxygen supply. Please note that this is NOT called a cardiac infarction.

What is the difference between myocardial ischemia (angina) and myocardial infarction?

Myocardial ischemia is when the heart is not getting enough blood, but there is no death of heart muscle. With myocardial infarction, some of the heart muscle dies.

What are the types of ACS?

There is unstable angina, NSTEMI and STEMI

How can we treat a STEMI?

A STEMI can be treated with either PCI or with thrombolytics.

What are the advantages and disadvantages of thrombolytics for STEMI?

Thrombolytics have the advantage of being readily available and can be given through an peripheral IV by any physician. However, they can cause fatal bleeding in some patients. They are reserved for STEMIs when a cath laboratory cannot be reached within 90 minutes.

What are the advantages and disadvantages of PCI for STEMI?

PCI has the advantages of much lower risk of bleeding and it fixes the problem, but it requires a cardiologist and a cath laboratory.

aden(o)

gland

glyc(o)

glucose

pnea

breathing

pneum(ato)

air

pneumon(o)

lung

pulmon(o)

lung

larynx

voice box

diaphragm

The diaphragm is the primary muscle used in respiration, which is the process of breathing. This dome-shaped muscle is located just below the lungs and heart. During inspiration it contracts and decreases intrathoracic pressure, which causes air to rush into the lungs. When it relaxes, the lungs are crushed and pressure goes up, which causes air to rush out.

Bronchi

two branches off the trachea

Bronchiole

branches off the bronchi

Pulse Oximetry

Noninvasive measurement of oxygen concentration in the blood using a sensor clipped on a finger or an earlobe.

Capnography

Noninvasive measurement of CO2 concentration in expired air. Also called end tidal C02

Alveoli

air sacs where oxygen exchange occurs

Trachea

Windpipe

Cough

a sudden, explosive exhalation of air; the function of a cough is to clear material from the airways.

Dyspnea

shortness of breath or hard time breathing

Wheezing

Wheezing is a whistling, musical sound during breathing resulting from partially obstructed airways in the lungs.

ABG

An Arterial Blood Gas is a blood sample is taken from an artery and analyzed to determine the level of oxygen and carbon dioxide in the blood.

Cyanosis

bluish discoloration of the skin resulting from an inadequate amount of oxygen in the blood

Hemoptysis

Coughing up blood from the lungs

PFTs

Pulmonary function tests are tests that measure the lungs' capacity to hold air, to move air in and out, and to exchange oxygen and carbon dioxide.

Thoracotomy

Operation in which the chest wall is opened up to view the internal organs.

Bronchoscopy

a direct visual examination of the voice box (larynx) and airways through a flexible viewing tube (a bronchoscope). A bronchoscope has a light at the end that allows a doctor to look down through the larger airways (bronchi) into the lungs.

Bronchitis

inflammation of the large airways that branch off the trachea (bronchi), usually caused by infection but sometimes caused by irritation from inhaling gases, smoke, dust particles, or some types of pollution.

Acute Bronchitis

Bronchitis (see definition above) that last less than 90 days. It is almost always viral and should not be treated with antibiotics.

Pneumoni

Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Can be caused by bacteria, viruses and fungi. Typically treated with antibiotics due to high percentage that are bacterial.

Community-acquired Pneumonia

is when someone develops pneumonia in the community (not in a hospital)

Healthcare-associated Pneumonia

is when someone develops pneumonia during or following a stay in a healthcare facility. Healthcare facilities include hospitals, long-term care facilities, and dialysis centers.

VAP

Ventilator-associated Pneumonia is when someone gets pneumonia after being on a ventilator, a machine that supports breathing.

COPD

Chronic obstructive pulmonary disease is persistent obstruction of the airways occurring with emphysema, chronic bronchitis, or both disorders.

DVT

A thrombosis is when a blood clot (called a thrombus) blocks a blood vessel. Deep vein thrombosis (DVT) is when a blood clot forms inside a large vein. Usually the vein is deep in your leg, but a clot may form in a vein in your pelvic area or your arm.

Pulmonary Embolism

Pulmonary embolism is the sudden blocking of an artery of the lung (pulmonary artery) by an embolus—usually a blood clot (thrombus).

Pneumothorax

A pneumothorax is a pocket of air between the two layers of pleura, resulting in collapse of the lung.

Emphysema

Emphysema is irreversible enlargement of many of the 300 million air sacs (alveoli) that make up the lungs and destruction of the air sac walls.

Chronic Bronchitis

Chronic bronchitis is characterized by a cough that produces sputum for 3 months or more during 2 successive years; the cough is not due to another lung disease

Asthma

Asthma is a condition in which the airways narrow—usually reversibly—in response to certain stimuli

Tuberculosis

Tuberculosis is a contagious infection caused by an airborne bacterium, Mycobacterium tuberculosis.

Primary TB

Patient has been exposed to someone who has tuberculosis and the bacteria enter the lungs. These bacteria are quickly destroyed by the body’s macrophages, but some remain viable inside of the macrophages and can be activated sometime later in life

Latent TB

People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. Positive PPD or Quantiferon Gold test. Negative CXR.

Active TB

People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease. People with TB disease of the lungs or throat are capable of spreading germs to others. Positive PPD or Quantiferon Gold test. Positive CXR.

QuantiFERON Gold

Blood test to determine if a patient has mycobacterium tuberculosis in their body. Also called the TB Blood test.

T-Spot

Blood test to determine if a patient has mycobacterium tuberculosis in their body.

PPD

Purified Protein Derivative. Also known as the TST (Tuberculin skin test). Injected under the skin to determine in a patient has mycobacterium tuberculosis in their body.

Stethoscope

An instrument for listening to sounds within the body

Hypoxia

low oxygen level in the blood