FIX THIS Official ICVT intro. Final Exam Flashcard set

Types of acute coronary syndrome

just the names

• Unstable angina

  • non predictable

• Stable angina

  • predictable

• ST-elevation Myocardial infarction (STEMI)

  • complete occlusion (100%)

• Non ST-elevation Myocardial infarction (NSTEMI)

  • Sub-occlusive (97-99%)

counterpulsation or IABP que es

IABP Intra-aortic balloon pump

assist heart in pumping blood (reduce workload)

intracorporeal in relation to cardiac assist devices

they refer to mechanical devices implanted within body.

relation to cardiac assist these devices augment the hearts ability to pump blood

what are extracorporeal devices in relation to cardiac assist devices

mechanical systems that support heart function outside of body,

blood can be pumped outside the body and return to pt.

heart to weak to pump.

cardiogenic shock

what cardiac assist devices are intracorporeal

IABP

impella CP

PHP+

What is special about ECMO as a cardiac assist device

not only does it function to provide cardiac support but it also provides respiratory support by acting as a artificial lung

important during cardiogenic shock

what volume of blood does the IABP balloon displace

25-50 ml

what cardiac assist devices are extracorporeal

Tandem heart

VA-ECMO

Inflation during IABP does what and during when

augments diastolic pressure

^ art pressure which support hemodynamics

more importantly

displacement of blood retrograde in aorta to help perfuse coronary arteries

occurs during diastole

when does deflation of the IABP occur on an ECG

Onset of systole

peak of R wave

Tandem heart

short term extracorporeal centrifugal flow punmp

Impella

short term percutaneous catheter with a microaxial continuous non pulsatile pump

extracorporeal membranous oxygenaton ECMO

provides short-term full cardiopulmonary support for pt in sever shock

when does inflation of the IABP occur on an ECG

beginning of diastole

T wave on ECG

types of foreign body retrieval devices

Amplatz goose neck snare

EN Snare endovascular snare system

Forceps

what occurs during diastole in relation to IABP

IABP inflates helping increase hemodynamics

insertion of IABP occurs where

Left or right femoral artery

IABP location

tip of balloon resting just before aortic arch, 1-3 cm distal to left subclavian artery

bottom of balloon

just above the renal arteries

Type of gas used to pump balloon in IABP

helium

what is necessary during the consideration of IABP in a pt

a moderately functioning ventricle. The IABP only assists in hemodynamics.

deflation during IABP does what and during when

4 things

OCCURS DURING ISOVOLUMETRIC CONTRACT

lowers central aortic pressure

decreases afterload- decrease workload- dec. myocard. o2 demand. - contract greater amount of blood- augment hemod.

decreases myocardial oxygen demand

when does the IABP deflation occur

deflation occurs during isovolumetric contraction

when the heart begins to contract but the heart has not overcome the pressure which has not opened the AV valve. deflation lowers that central aortic pressure. (vacuum)

Unstable Angina

minimal exertion

usually more sever and prolonged

indicates significant risk of heart attack soon

Stable angina

predictable

pains is reproducible and felt as mild discomfort

dyspnea

nausea

sweating

lightheadedness

STEMI means

ST Elivated Myocard Infarc.

complete vessel occlusion

sever form of heart attack

muscle being deprived of oxygen

results in ST-segment elevation on an ECG & is associated with extensive heart damage

what is NSTEMI

Non-ST segment elevation Myocard. Infarction

decreased flow to part of heart muscle

leads to damage to heart muscle

indicated by ^ cardiac biomarkers but no persistent ST segment elevation

Lethal arrhythmias

• asystole

• V-fib

• V-tach (pulseless) heart beating fast/disorganized, inadequate blood circulation

Coronary arteries

Blood vessels that supply the heart muscle with oxygen and nutrients.

sterile vs non sterile

non sterile does not eliminate most pathogens therefor non sterile products are administired to regions of human body that have a high density of natural microbial flora, physical/immunological barriers to infection.

sterile- no organisms

What does Pascal’s law states that…

pressure applied to a liquid at any point is transmitted equally in all directions.

Types of temporary pacing

• Transcutaneous

• Transvenous

• Transcoronary

• Transesophageal

• Transthoracic epicardial

Pacing terminology

Capture

successful cardiac muscle depolarization triggered by cardiac pacing

Pacing terminology

Current (output)

The strength of the electrical impulse created by the pacemaker generator

Pacing terminology

Sensitivity

The ability of the generator to detect and analyze the heart’s intrinsic electrical activity

Pacing terminology

Threshold

Minimum amount of energy required to stimulate cardiac muscle depolarization

Pacing terminology

Pulse generator

the battery and control of the console of the pacemaker

Pacing terminology

Pacing rate

rate of impulses sent to stimulate the cardiac muscle

Placement of transcutaneous pacing pads

Right pec. & left lateral mid axillary

1. R. upper right torso, mid clav. line btx nip & clavicle

2. L. below left shoulder blade btx left subscapular area & left midaxillary line

What is a transducer in regards to a pressure measurement system

device used to convert one form or energy to another .convert mechanical pressure into an electrical signal to display the pressure within blood vessels.

What must be done to a transducer to get accurate readin levels.

leveling should be performed before balancing (zeroing)

leveling - same level as the tip of the IV catheter (important for right heart measurements & a carpenters leveler is rq’d, not always for left)

balancing - pressure measurement system btx trasnducer & the monitor. must be reset to local atmospheric pressure in room by stopcock near trasnducer.

transducer placement

phlebostatic axis

the 4th intercostal soace at the mid-anterior-posterior diameter of the chest wall

thrombectomy

operation where a clot (thrombi) is obstructing blood flow is removed to restore blood flow.

can occur in cerebral, coronary, peripheral lung renal, arteries ETC.

MINOR cath lab emergencies

UHBVBE

Urticaria

Hypotension

Bronchospasm

Vascular incidents

Bradycardia

Edema

Major complications in cath lab

VSSAAD

Vasospasm

Shock

Stroke

ACS

Arrythmias

Death

Moderate complications in the cath lab

HVFB

Headache

Vomiting

Facial edema

Bronchospasms mild

arrhythmias that occur during major complication

Pulseless VT

VF

Asystole

3rd degree heart block

JL4 Catheter

Angiographic catheter for coronary ostium

valves during systole

Open

• AO & PA

closed

TV & MV

valves closed during systole

TV & MV

valves opened during diastole

open

TV & MV

valves during diastole

Open

TV &MV

closed

AO & PA

JR4 Catheter

Angiographic catheter for coronary ostium

Inherent rate of ventricle

40-20

Pigtail Catheter

Angiographic catheter for coronary ostium

Swan-Ganz Catheter

Flow-directed, balloon-tipped catheter for right heart pressures

Andreas Gruentzig

Performed 1st successful percutaneous transluminal coronary angioplasty

Heart Size

Roughly the size of a clenched fist

Heart Location

Slightly behind and to the left of the sternum

Blood Flow Path

Vena cava, RA, TV, RV, PA, lungs, PV, LA, MV, LV, AorticV, Ao

Vessel representing oxygen saturation, which ones have which

Depleted: venous; Rich: arterial

Heart Layers

Fibrous pericardium, parietal layer of serous pericardium, pericardial cavity, epicardium, myocardium, endocardium

Heart Valves

Semilunar (aortic & pulmonic), Atrioventricular (mitral & tricuspid)

Arterial Layers

Endothelium, elastic tissue, circular smooth muscle, connective tissue with elastic fibers

Coronary Arteries

Families, major coronaries, and location

SA Node

Inherent rate: 60 - 100 bpm

AV Node

Inherent rate: 60 - 40 bpm

Purkinje Fibers

Inherent rate: 40 - 20 bpm

Radiography Projections

RAO/LAO/Cra/Cau with specific hints for each

Radiation Safety

ALARA principle and 3 principles of radiation safety

Contrast Media

Radiopaque, radiolucent, filtration/metabolism, and contrast reactions/allergies

LHC vs RHC

Differences in measurements and procedures

IVUS vs OCT

Comparison of intravascular imaging techniques

iFR vs FFR

Comparison of functional assessment techniques for CAD

POBA vs Stenting

Comparison of angioplasty techniques

Access Site Hemostasis

Understanding of NAVL and manual compression hand placement

Endomyocardial Biopsy

Indications and location of myocardial samples retrieval

Angina

Chest pain or discomfort caused by reduced blood flow to the heart

RCIS

Registered Cardiovascular Invasive Specialist

ALARA

As low as reasonably achievable principle in radiation safety

PTCA

Percutaneous Transluminal Coronary Angioplasty

POBA

Plain old balloon angioplasty

LAD

Left anterior descending artery

CX

Circumflex artery

RCA

Right coronary artery

RAO/LAO/Cranial/Caudal

Different radiography projections

What does a LHC test for and where does it travel through

• enters groin or wrist

  assesses

• coronary arteries

• left ventricle

RHC enters and test for

• through right side of the heart

  assess

• pressures within heart chambers

• function of right ventricle

  conditions

• pulmonary hypertension

• congenital heart disease

• certain heart failures

iFR

Instantaneous wave free ratio

FFR

fractional flow reserve

ICE

Intracardiac echocardiagram

iVUS

resolution?

intravascular ultrasound

poor

OCT

resolution?

optical coherence tomography

good

NIRS

near infrared spectroscopy

IVUS, whats it do

uses catheters with ultrasound tech,

view and analyze vessel from inside out

What is IVUS optimal for

deep tissue penetration

• vessel size

• plaque morphology

• extent of vessel narrowing

guide interventions such as stent placement

OCT uses

light waves, near infrared light

iVUS vs OCT what does what better

iVUS deeper tissue penetration

OCT superior image quality