Cardiology II
Terms
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- cardiac electrical system
- controls heart rhythm abnormalities in electrical system most heart arrhythmias
- EKG ECG
- electrocardiogram most common cardiac test measures electrical activity recording currents in heart
- leads 10-12 electrodes placed
- trunk and extremities creates graph electrical impulses less than 5 min
- cardiac atherterization
- small catheter threaded through vein into heart observe chest pain need for coronary artery surg angioplasty congential heart defects valvular heart disease heart failure
- catheter inserted in
- blood vessels in groin arm or neck through blood vessels to heart
- once in heart catheter maneuvered to varioius locations ion heart
- chambers of heart measiured injecting dye through cath rapid x-ray images recorded blood flowing through cardicac chambers
- cardiac cathererization
- angiography arteriography
- cardioversion
- restores heart rate to normal shock electricity to heart
- echocardiogram
- pulsed high-frequencysound waves ultrasound heart valves aortic stenosis mitral valve oprolapse congential heart disease
- doppler
- echocardiography and color Doppler echocardiography
- transesophageal echocardiogram
- TEE image cardiac structures difficult to see echo images during heart surgery
- holter monitor
- ambulatory monitoring event recorders records heart beat prolonged time transient cardiac problems come and go transient heart arrhythmias transient cardiac ischemia
- 2 types ambulatory monitoring
- Holter monitor event recorder
- event recorders
-
30 seconjds of heart rhythm most recent 30 sec s/he presses button when symptom
transmitted by telephone to center - stess test
- evaluate heart and vascular system during exercise bike or treadmill graded every 3 min level increased pulse blood pressure ECG recorded symptoms
- maximal stress test
- gradually increased until cannot keep up any longer
- submaximal stress test
- pre-determined level attained dnown coronary artery disease
- nuclear perfusion study
-
conjunction with stress test radioactive substance thallium sestamibi Cardiolite injected into vein during exercise
collects in heart pictures of heart not receiving good blood flow blockage in coronary arteries identified - echocardiograms with stress test
- echo made at rest then with exercise changes in function of heart musscle during exercise CAD
- when cannot perform exercise
- Persantine and dobutamine used
- tilt table test
- syncope loss of consciousness strapped to table upright 20-30 min pulse bood pressure ekg blood oxygen saturation monitored
- orthostatic hypotension vasovagal syncope
- cardio adjustment to upright not function normally
- orthostatic hypotension
- blood pressure drops precipitiously
- vasovagal syncope
- normally adjust within 20-30 min sudden change in vital signs passout recover after table is back down and lying down
- MUGA scan
- multiple gated acquisition scan assess moving image of beating heart and cadiac ventricles major pumping chambers
- MUGA
- radioactive substance Technetium99 to rbc inject rbc into blood stream gamma camera detect low-level radiation image of heart beating
- Muga useful for
- localizing portion of heart muscle damage degree of damage measuring monitoring Ijection fraction of cardiac ventricles
- left ventriclular ejection fraction
- LVEF overall cardiac function proportion of blood expelled from ventricle each heart beat 60%=0.6 normal 0.5 or greater highly accurate
- EP study electrophysiology study EP
- diagnose conduction system disease serious arrhythmias cath test electrode caths inserted into heart groin arm or neck study cardiac electrical system
- EPstudy caths advanced through blood vessels to heart
- recordidng strategic locales most cardic arrhythmias confirms significant bradycardia permjanent pacemaker inserted immediately
- ablation
- supraventricular tachycardia SVT ventricular tachycardia VT found
- radiofrequency ablation
- after EP study specialized electrode cath inserted heart's electrical sys mapped
- area of heart most resposnible for arrhythmia
-
radiofrequency energy moved tip of cath
cauterizing culprit area - SVT ablation eliminates
- 95% of patient's arrhythmia
- chest x-ray
- reveal cardiac enlargement and aortic dilation
- coronary arteriography
- cineangiographic visualization of coronary arterial narrowing or occlusion after injecting radiopaque material into coronary arteries
- digital subtraction angiography
- evaluation of coronary arteries through use of x-ray images that are digitally subtracted by computer
-
common lab tests
certain chemicals in our blood and having heart attacks strokes and high blood pressure chemicals are -
cholesterol triglycerides lipoproteins
lipoproteins attached to cholesterol and/or triglycerides transport in blood - HDL's
- high density lipoproteins good cholesterol
- LDLs
- low-density lipoproteins bad cholesterol
- VLDL
- very low-density lipoproteins associated triglycerides
- Test Cholesterol CT
-
desireable <200 mg/dL
Borderline 200-239 mg/dL
high risk >239 mg/dL
cholesterolTC total amount from diet some made in liver cholesterol essential for life
in excess builkds up in blood vessel walls damage - Triglycerides
-
<150 mg/dL good
150-199 mg/dL borderline
200-499 mg/dL high risk
Triglyserides main way blood transports fat storage tissue cells to burn give energy
after eating large amounts of tris released into blood
Liver also makes triglycerides from extra carbs other calorie-containing chemicals -
HDL cholesterol
HDL-C -
> 40 mg/dL
good cholesterol attached to high-density lipoproteins involved in keeping cholesterol from being deposited in blolld vessel walls may assist in removing cholesterol - LDL Cholesterol
-
<100 mg/dL good
130-159 mg/dL borderline
160-189 mg/dL high risk
bad cholesterol fraction of total cholessterol bound to low-density lipoproteins elevated in blood assoc. fatty build up in vessel walls narrow rigid possibly clogged - VLDL cholesterol
-
<40 mg/dL
VLDL lipoproteins associated with triglycerides in blood vessel disease - TC/HDL-C Ratio
-
<4.5
ratio of TC total chol. to HDL-Chol. good predicatabiliy heart disease - hujman heartbeat controlled by
- heart's bioelectrical triggering system not working pacemaker
- Pacemaker****
-
2 parts batterey-powered generator wires connected to heart silver dollar size 7-12 life below collarbone leads WIRES**** threaded into veins leading to heart
local anesth. one hour - most common pacing device
- demand pacemaker takes control when heart rate falls below 60 beats pm
-
heart block stops beating
tacyarrhythmea overly rapid heart beat - other conditions require pacemakers
- more sophisticated pacemaker
- monitors number of physical changes in body increase or decrease in activity rate-responsive pacemakers slowly raise of lwer heartbeat appropriate level from 60-150 bps
- reprogramming implanted generator
- cadiologist changes to on-board computer electromagnetic signaling device placed above pacemaker over skin
- modern pacemakers are shielded from stray
- electromagnetic forces backup mode takes over if electromagnetic field does disrupt main circuit's programming
- Percutaneous trasluminal cronary angioplasy PTCA ******
- coronary artery balloon dilation or balloon angioplasty
- PTCA performed for
- dilation widen narrowed arteries 70-90 %involve stent
- PTCA performed by doctor
- inserting cath deflated balloon into narrowed part of artery balloon inflated compressing plaque enlarging inner diameter of blood vessel blood flows balloon deflated and cath removed
- Coronary artery bypass surgery CABG
- most common open-heart surgery bocked or narrowed arteries result atherosclerosis plaque accumulation blood supply reduced or blocked heart attack bypass surgery arteries that are blocked bypassed piece of vein or artery from another part of body sewn around blockage
- congenital heart disease blood vessel defects
-
phamacological treatment diuretics digoxin other drugs diuretics excrete water salts promoting urination
digoxin used stregthen heart
scontractions slow heart rate removes extra fluid from tissues - arterial switch*****
- corrects cond. infants great arteries stransposed aorta connected to left ventricle pumps oxygen-rich red blood to body pulmonary artery connected to right ventricle pumps venous bluish blood to lungs
- balloon atrial septostomy
- during heart cath improe body's oxygen supply inbabies great arteries trasposed enlarging atrial opeining reduce cyanosis
- balloon valvuloplasty*****
- special cath deflated balloon in narrowed heart valve balloon inflates lkvalve stretches open balloon removed
- Damus-Kaye-Stansel procedure surgical****
- repair congenital transposition of great arteries
- Fontan Porcedure or operation****
- surgical right A connected to Pulmonary artery blood bypass incomplete underdeveloped right V tricuspid atresia pulmonary atresia
- pulmonary artery banding ****
- band daround pulmonary artery narrow it reduce blood flow high pressure in lungs for ventricular septal defect atrioventricuolar canal defect and tricuspid artesia child older remove band fix with open heart surgery
-
Ross procedure
diseased or abnormal aortic valve**** - replaced patient's own pulmonary valve pulmonary autograft valve from donor placed where pulmonary valve used to be
- Shunt shunting procedure****
- forma passage between blood vessels divert blood from one part of body to another reduce cyanosis in infants with tetralogy of Fallot and tricuspid datresia or puolmonary atresia
- venous switch intra-atrial baffle ARTERIAL ****
- tunnel inside atria help correct transposition of great arteries redirects oxygen-rich red blood to right V and aorta redirect venous bluish blood to left ventricle and pulmonary artery
- HEART VALVE SURGERY
- repaining replacing one of valves of heart valve useable repair performed help valve work better
- replacement
- diseased valve removed and new valve inserted
- if valve cannot be repaird
- may be replaced with prosthetic valve
- 2 kinds prosthetic heart valves
-
mechanical manmade materials
biological tissue valves human pig cow -
mecanical valves
biological valves -
Mec valves used anticoagulation meds rest of patient's life
Biological valves do not sast as long therapy with anticoagulant meds often not necessary - congenital heart surgery
- performed to correct or treat birth defects of heart
- heart defects can occur
- inside or in large blood vessels outside heart
- may need immediate
- surgery or wait for months or years
- heart defect may be repaired in
-
single surgical procedure
may require series of procedures - some heart defect surgeries
-
PDA ligation
Coarctation of aorta repair
ASD repair atrial septal defects
VSD repair
Tetralogy of Fallot repair
Transposition of great vessels
Truncus arteriosus repair
Tricuspid atresia repair - Carotid Endarterectomy
-
carotids 2 main arteries in neck supply blood to brain
removes fatty deposits from one carotid artery prevent stroke atherosclerosis hardening of arteries fatty deposit plaque - narrowing of artery
- stenosis
-
pericardiocentesis pericardia tap
percutaneous pericardiocetesis -
process withdrawing fluid from pericadiac sac memebrane surrounds heart
evaluate fluid or remove fluid causing compression of heart - heart transplant
- final stage of heart disease diseased heart removed except for back walls of atria replaced with donor's heart restarted using electrical shock
- surgical complications rare majhor risks come
- from reject of organ by recipient occasionally infections
- correct spelling
- lotensin****
- correct
- atenolol
- not a way to count lines
- MS word counting tool ***
- MI
- heart attack****
- corrct
- amiodarone
- occlusion of artery
- blockage ****
- mri
- magnetic resonance imaging****
- sagittal plane
- median plane****
- plural wrong
- term ends in is, plural made changing the is to is's****
- clavicle
- shoulder***
- IDDM
- pancreas
- papilloma
- benign epithelial neoplasm***
- not correct
- although we loved it.
- safely use abbreviation
- if doctor dictates it and it's not in the assessment or plan and hospital approves
- postpartum
- after childbirth****
- not part of spinal cord
- ischium***