Cardiology Final
Terms
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- what are varicose veins
- Dilated, tortuous superficial veins (usually greater and lesser saphenous)due to incompetent valves
- Factors that promote DVT
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stasis, abnormal vessel wall, altered coagulation
leg trauma, prolonged bed rest,CHF, cancer, obesity, surgery, central lines, medical illnesses, venous insufficiency, OCP’s, etc - Classic signs of DVT are seen how often?
- Classic signs of pain, swelling, warmth present only 50% of the time
- what is a complication of DVT?
- Pulmonary Embolism
- Treatment of DVT
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intravenous infusion of UHF of LMWH for 5-10 days start
Coumadin before DC of heparin and given for 3 months - what is Virchow’s Triad?
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Seen in PE:
Venous-stasis
Hypercoagulability
vessel wall inflammation - The Most Common ECG abnormalities of PE
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tachycardia
nonspecific ST-T wave abnormalities - What is superior vena cava syndrome
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A partial occlusion of the superior vena cava.
75% secondary to bronchogenic carcinoma, the remainder are lymphoma generated. - what is Afterload?
- Load against which the contracting myocardium exerts its force (Aortic pressure).
- What is a WAP?
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when pacemaker site shifts back and forth between the SA node and the ectopic sites in the atria or AV junction, producing P waves of varying size, shape, and direction.
The heart rate is usually 60-100 bpm
3 different P wave morphologies - what is a MAT
- when a WAP reaches 100 bpm or greater, the rhythm is MAT
- what is a PAT
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PAT is often initiated by a PAC.
By definition 3 or more PAC’s is considered to be PAT.
PAT is a regular tachycardia with an atrial rate of 150-250 bpm - What is an SVT
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SVT occurs when a rapid atrial ectopic focus overrides the SA node and becomes the heart’s primary pacemaker.
SVT then is if the rate is >150 bpm - what is a PSVT
- PSVT is an absolutely regular rhythm, with a rate usually between 150-250 bpm
- what's the difference between LGL and WPW?
- both have a shortened PRI but LGL has NO delta waves and the QRS is NOT widened.
- Criteria for LVH
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R in V5 or V6 +
S in V1 or V2 >35mm
aVL > 13mm
LAD
Atrial enlargement
Strain Pattern - what lead is best to eval Atrial enlargement?
- V1
- EKG changes in Hyperkalemia
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Progressive pattern:
Diffuse ‘Peaked’ T waves
Prolonged PR interval with flattening of P wave
QRS widens with merging into T wave forming a ‘Sine wave’ pattern
V-Fib - EKG changes in Hypokalemia
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Progressive Pattern
1. Diffuse Flattening of the T wave (c possible diffuse ST segment depression or T wave inversion)
2. Appearance of the U wave
3. Torsades de Pontes - EKG changes in Hypocalcemia
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1. Prolonged QT interval
2. Torsades de Pontes - EKG changes in hypercalcemia
- Shortened QT interval
- Venous return is influenced
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Muscle contraction
Sympathetic activation of veins
respiratory inspiration
Valsalva and pregnancy reduce venous return - Jxn escape rhythm characteristics
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1. negative or hidden P wave in lead II
2. Short PR interval <0.10 sec
3. A normal QRS complex
4. 40-60 bpm - what causes RVH?
- caused by right ventricular overload due to pulmonary valve stenosis, tricuspid insufficiency, or pulmonary hypertension. Can also be caused by congenital abnormalities such as VSD
- calibration of EKG
- should equal 1 mV or two big boxes
- what is Einthoven's triangle
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it's made up of leads I, II, III
Right/left arms
Left foot - what determines stroke volume
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1. The volume of venous blood returned to the heart(preload)
2. Ventricular distensibility/contractility(Frank-Starling)
3. Aortic or pulmonary artery pressure (afterload) - How do you treat SVT?
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1. vagal maneuvers (valsalva (squatting/ bearing down), cough, and carotid massage),
2. Adenosine IV,
3. Ca channel blockers (cardizem)
4. procainamide
5. Beta Blockers
6. Digitalis
7. Cardioversion - when would you not cardiovert a pt?
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1. In A-fib with an onset > 48 hours
2. In a PSVT from Digitalis Toxicity - What are EKG changes with Dig Toxicity
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Dali's Mustache(assymetrical T inversion w/downsloping ST segments)
SA & AV blocks
PAC’s & PVC’s
Atrial and ventricular tachycardia (arrhythmias)
V-tach
V-fib - As a class, they are responsible for more drug-related deaths than any other medications
- TCAs
- Conditions that cause low voltage on EKG
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COPD
Pericardial effusion
There's a couple more that I can't think of right now