Cardiology Fisdap Exam for EMT

A 44-year-old man reports dizziness and lightheadness. His BP is 88/26 mm Hg, his heart rate is 190 beats per minute and weak. His skin is cool clammy and pale. Why is his BP low?

decreased ventricular timing

Switching compressors during two-rescuer CPR:

should occur every two minutes throughout the arrest

Stable angina

chest pain that occurs when a person is active or under severe stress

Unstable angina

chest pain that occurs while a person is at rest and not exerting himself

What occurs during recoil of the chest inbetween compressions

a vacuum is created and blood returns to the heart

A group of symptoms caused by myocardial ischemia; includes angina and myocardial infarction

acute coronary syndrome

A heart attack; death of the heart muscle following obstruction of blood flow to it; in this context the attack is "new" or "happening right now"

acute myocardial infarction (AMI)

Transient (short-lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle; also called angina

angina pectoris

a weakness in the wall of the aorta that makes it susceptible to rupture

aortic aneurism

the one way valve that lies between the left ventricle and the aorta keeps blood from flowing back into the left ventricle after the left ventricle ejects its blood into the aorta; one of the four heart valves

aortic valve

a tracing on an ECG that is the result of interference, such as patient movement, rather than the heart's electrical activity

artifact

the complete absence of all heart electrical activity

asystole

the ability of cardiac muscle cells to contract without stimulation from the nervous system

automatically

when the heart fails to generate effective and detectable blood flow; pulses are not palpable, even if muscular and electrical activity continues in the heart

cardiac arrest

a disorder in which the hear loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs

congestive heart failure

the blood vessels that carry blood and nutrients to the heart muscle

coronary arteries

to shock the fibrillating (chaotically beating) heart with specialized electric current in an attempt to restore a normal, rhythmic beat

defibrillate

swelling in the part of the body closest to the ground, caused by the collection of fluid in the tissues; a possible sign of congestive heart failure

dependent edema

Widening of a tubular structure such as a coronary artery.

dilation

a condition in which the inner layers of an artery, such as the aorta, become seperatated, allowing blood (at high pressures) to flow between the layers

dissecting aneurysm

An irregular or abnormal rhythm of the heart

dysrhythmia

an emergency situation created by excessively high blood pressure, which can lead to serious complications such as a stroke or aneurysm

hypertensive emergency

death of body tissues, usually caused by interruption of its blood supply

infarction

the inside diameter of an artery or other hollow structure

lumen

the heart muscle

myocardium

a blockage, usually of a tubular structure such as a blood vessel

occlusion

a blood clot that has formed within a blood vessel and is floating within the bloodstream

thromboembolism

disorganized, ineffective quivering of the ventricles, resulting in no blood flow and a state of cardiac arrest

ventricular fibrillation

a rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest

ventricular tachycardia

How does nitro work?

vasodilation and increased cardiac oxygen demand

pulmonary edema

fluid in the air sacs and bronchioles of the lung; cannot breathe while lying down

Patient presents with weakness and nausea. She is conscious and alert and her skin is cool and clammy. BP is 140/88, pulse is 70 and regular, and R is 16 and unlabored. She has hypertension (high BP), diabetes, and a pacemaker. What should you suspect?

AMI (heart attack)

left ventricular assist device

Booster pump implanted in the abdomen with a tube inserted into the left ventricle. An LVAD is a "bridge to transplant" or destination therapy when heart transplantation is impossible.

patients will be normal, but you cannot read a heartrate or blood pressure

For each minute that defibrillation is delayed, a victim's chance of survival is decreased by as much as:

10 %

Dyspena

difficult or labored breathing

congestive heart failure (CHF)

the failure of the heart to pump efficiently, leading to excessive blood or fluids in the lungs, the body, or both

cardiogenic shock

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.

causes:

- low BP

- high and weak pulse

- high and labored R

-skin cool and clammy

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:

ventricular filling can occur

because of automaticity, cardiac muscle cells are able to..

contract spontaneously without a stimulus from a nerve source

Synocopal episode

Fainting, or a sudden temporary loss of consciousness.

**can cause "acute cardiac dysthymia"

Bradycardia

abnormally slow heartbeat

detrimental to a patient in cardiac arrest

interrupting CPR for more than 10 minutes

stimulates the ventricles and causes them to contract

Purkinje fibers

The middle, muscular layer of the heart is called the

A. epicardium

B. pericardium

C. myocardium

D. endocardium

C. myocardium

Apneic

Not breathing (may be temporary episodes of not breathing)

The energy setting for a biphasic AED:

• A:increases by 50 joules with each shock.

• B:must be manually set by the EMT.

• C:is manufacturer specific.

• D:is typically 360 joules.

C. is manufacturer specific

systolic blood pressure

the maximum pressure generated in the arms and legs during contraction of the left ventricle

acute aortic dissection

may appear to be abdominal pain due to lower back pain; presents as a "tearing" pain

radial pulses are DIFFERENT

Ventricular fibrillation (V-fib)

the rapid, irregular, and useless contractions of the ventricles

*require AED shock!

the vital organs of an 85-year-old patient need additional blood flow, the heart may not be able to treat the increased need because...

the reserve capacity of the heart is reduced as a person ages

After nitro, patient has an increase in heart rate caused by....

a drop in blood pressure

Freshly oxygenated blood returns to the heart via which of the following blood vessels?

A. Aorta

B. Vena cava

C. Pulmonary vein

D. Pulmonary artery

pulmonary veins (coming from the lungs to the heart)

veins

carry blood back to the heart

Arteries

carry blood away from the heart

pulmonary veins

Deliver oxygen rich blood from the lungs to the left atrium

pulmonary arteries

carry deoxygenated blood out of the right ventricle and into the lungs

while the AED is charging before an advised shock

continue chest compressions until your partner tells you to stand clear

Cardiac ischemia can result in

myocardial infarction (mini heart attack)

Cardiac ischemia can cause what alone?

Chest pain (angina)

patient took nitro, has bad headache, chest pain

ongoing cardiac ischemia

you may not want to give aspirin to patients with

stomach ulcers

sudden cardiac arrest in an adult population is most often the result of...

cardiac dysrhythmia

man has general weakness and chest pressure, but has not taken nitro

give 325mg of aspirin if not allergic

acute coronary syndrome (ACS) is most often the result of...

atherosclerosis

Atherosclerosis

a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls.

which of the following is the most detrimental effect that tachycardia (fast heart beat) can have on a patient experiencing a cardiac problem?

increased oxygen demand

acute coronary syndrome (ACS) symptoms

ashy skin

diaphoresis (sweating a lot)

anxiety