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Cardiology II


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cardiac electrical system
controls heart rhythm abnormalities in electrical system most heart arrhythmias
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
restores heart rate to normal shock electricity to heart
pulsed high-frequencysound waves ultrasound heart valves aortic stenosis mitral valve oprolapse congential heart disease
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
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
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
high density lipoproteins good cholesterol
low-density lipoproteins bad cholesterol
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
<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
> 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

ratio of TC total chol. to HDL-Chol. good predicatabiliy heart disease
hujman heartbeat controlled by
heart's bioelectrical triggering system not working 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
repaining replacing one of valves of heart valve useable repair performed help valve work better
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
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
not a way to count lines
MS word counting tool ***
heart attack****
occlusion of artery
blockage ****
magnetic resonance imaging****
sagittal plane
median plane****
plural wrong
term ends in is, plural made changing the is to is's****
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
after childbirth****
not part of spinal cord

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