Cardiovascular System Review

Flashcards about the cardiovascular system, blood flow, heart failure, cardiac output, angina, myocardial infarction, and related treatments and education.

What is preload in the context of the cardiovascular system?

The amount of blood coming into the right side of the heart from the venous system.

Describe the normal blood flow through the heart.

Blood comes from the venous system into the right atrium, then the right ventricle, goes to the lungs for oxygenation, returns to the left atrium, then the left ventricle, and out through the aorta.

Which side of the heart is considered the 'big bad pump'?

The left side of the heart.

What is the aorta?

The first and largest artery in the body, responsible for delivering oxygenated blood.

What happens in right-sided heart failure?

Blood backs up into the venous system because it's not moving forward into the lungs.

What happens in left-sided heart failure?

Blood backs up into the lungs because it's not being pumped forward to the body.

What is the formula for cardiac output?

Cardiac output = Heart Rate x Stroke Volume

How does a weak heart affect cardiac output?

It decreases cardiac output.

List some signs and symptoms of decreased cardiac output.

Decreased LOC, chest pain, cold and clammy skin, wet lung sounds, decreased peripheral pulses, and decreased urine output.

What should you associate cardiac output with?

The left ventricle and how much blood it's pumping out to the body.

What happens to blood pressure when heart rate drops significantly?

Blood pressure initially drops, but compensatory mechanisms may bring it back up.

What is the rule regarding arrhythmias and cardiac output?

Arrhythmias are not a major concern until they affect cardiac output.

Why are V tach, V fib, and asystole considered critical arrhythmias?

Because they result in no cardiac output.

What is the first thing a doctor will want to know about a rhythm change?

The signs and symptoms of adequate cardiac output.

What is chronic stable angina?

Decreased blood flow to the myocardium, leading to ischemia and chest pain, usually caused by coronary artery disease.

What typically triggers chronic stable angina pain and what relieves it?

Pain is usually triggered by exertion or low oxygen and relieved by rest and/or nitroglycerin.

How does nitroglycerin work?

It causes venous and arterial vasodilation, decreasing preload and afterload, which decreases the workload of the heart. It also dilates coronary arteries, increasing blood flow to the myocardium.

How should nitroglycerin be administered and stored?

Sublingually, in a dark glass bottle, kept dry and cool. Remove cotton from the container.

What are common side effects and instructions related to nitroglycerin?

Headache, blood pressure drop. Renew every six months. Stay with the patient after administration to monitor blood pressure.

What is the effect of beta blockers on blood pressure, pulse, and myocardial contractility?

They decrease blood pressure, pulse, and myocardial contractility, reducing the workload of the heart.

What is the effect of calcium channel blockers on blood pressure and coronary arteries?

They decrease blood pressure and dilate coronary arteries, enhancing blood flow to the heart muscle.

List some patient education points for chronic stable angina.

Avoid isometrics and overeating, rest frequently, avoid excess caffeine or drugs that increase heart rate, wait two hours after eating to exercise, dress warmly in cold weather, take nitroglycerin prophylactically, stop smoking, and lose weight.

What is the main goal in managing chronic stable angina?

To decrease the workload on the heart.

What is the difference between chronic stable angina and acute coronary syndromes (MI/unstable angina)?

Acute coronary syndromes involve both ischemia and necrosis, and pain may occur even at rest.

What are some classic and atypical signs and symptoms of an MI?

Classic: pressure in the chest with radiation to the left side. Atypical: pain in the left jaw, back pain (especially in women), bilateral elbow pain, indigestion, or fainting.

What are initial signs observed during decreased cardiac out put?

cold and clammy skin, and a drop in blood pressure.

What changes in lab values are often associated with the inflammatory response to a heart attack

White blood cell count and temperature are increased.

What cardiac enzyme isoenzyme is the most sensitive indicator of an MI?

CKMB

Why is troponin considered a favorite cardiac test?

It has high specificity for myocardial cell injury and is always normal in non-cardiac muscle diseases, and It elevates sooner and stays elevated longer than other markers.

Which cardiac markers are most helpful when a patient delays seeking help for a suspected MI?

LDH and troponin

What is the initial treatments in the ER while diagnosing a patient presenting with chest pain??

ASpirin ( anti platelet effect)

What is the drug of choice for pain during an MI and how does it help?

Morphine IV, relieves pain and causes vasodilation, which decreases the workload on the heart.

What does 'MONA' stand for in the context of initial MI treatment?

Morphine, Oxygen, Nitroglycerin, and Aspirin.

Which arrhythmias put a patient at risk for sudden death?

V fib (most common), pulseless V tach, and asystole.

What is the immediate action for a patient in V fib?

Defibrillation (early defibrillation is crucial).

What drugs are used to treat arrhythmias that can lead to sudden death?

Lidocaine and amiodarone.

What is a sign of lidocaine toxicity?

Any neuro change.

What is an important side effect of amiodarone?

Hypotension and other arrhythmias.

Why is the head-up position important for a patient having an MI?

It decreases workload on the heart and increases cardiac output. Lying flat increases the workload by causing the heart to pump uphill.

Define PCI and name the major complication?

Percutaneous Coronary Intervention. MI, bleeding.

When is coronary artery bypass graft (CABG) indicated?

With multiple blockages or a left main occlusion.

What are key elements of cardiac rehabilitation?

Smoking cessation, stepped care plan (gradual increase in activity), diet changes (no fat, no salt, low cholesterol), and avoiding isometrics and Valsalva maneuvers.

Why is the Valsalva maneuver avoided in heart patients?

It can stimulate the vagus nerve, causing the heart rate to drop.

What should you give to avoid constipations and straining during bowel movements

Colace

When can a patient resume sexual activity post-MI?

When they can walk around the block or up a flight of stairs with no discomfort.

What is the safest time of day for sex post-MI and why?

Morning time (8-9 am), because the patient should be well-rested and not coming out of REM sleep.

What is the best exercise for an MI patient?

Walking.

List signs and symptoms of potential post MI heart failure.

Ankle edema, shortness of breath, confusion, and weight gain.