spectrum of coronary artery disease proceses from myocardial ischemia and myocardial injury to myocardial infarction and includes the clinical entities of stable and unstable angina and acute myocardial infarction.
ACS (acute coronary syndrome
chest pain that results when the heart's o2 requirements exceed o2 supply available from blood.
physiologic Q waves measure:
pathologic Q waves measure:
phy - less than .04 sec (40 mms)
pas - greater than or equal to .04 sec
restoring blood flow to ischemic tissue
death and subsequent necrosis o fthe heeart muscle caused by inadequate blood supply; also (AMI) acute myocardial infarction
MI (myocardial infarction)
myocardial infarction that affects the full thickness of the myocardium and almost always results in a pathological Q wave in the affected leads.
more then ________ americans have some form of CVD
the single largest killer of Americans is ____ in which _____people die
communication between 2 or more vessels.
protective mechanism that provides an alternative path for blood flow in case of a blockage somewhere in the system.
law stating that blood flow through a vessel is directly proportional the the radius of teh vessel to the fourth power.
period of time from the end of one cardiac contraction to the end of the next
period of time when the myocardium is relaxed and the cardiac filling and coronary perfusion occur
the period of the cardiac cycle when the myocardium is contracting
ratio of blood pumped from the ventricle to the amount remaining at the end of diastole
amount of blood pumped out by heart in one cardiac contraction
the more the myocardium is stretched up to a certain point, the more forceful the subsequent contraction will be
resistance against which the heart must pump
the pressure within the ventricles at the end of diastole; commonly called the end-diastolic volume
the amount of blood pumped by the heart in 1 minute
formula for blood pressure
blood pressure = cardiac output x systemic vascular resistance
formula for cardiac output
cardiac output = stroke volume x heart rate
pertaining to heart rate
pertaining to cardiac contractility force
pertaining to the speed of impulse transmissions
alpha receptors located in _______ responsible for __________
beta1 located in ____ increase __ and __
beta2 located in _____
- heart increase heart rate and contractility
- lungs cause bronchodilation and peripheral vasodilation
specialiazed bands of tissue inserted between myocardial cells that increase the rate in which the action potential is spread from cell to cell.
a reversal of charges at a cell membrane so that the inside of the cell becomes positive in relation to the outside.; the opposite of the cell's resting state in which the insideof the cell is negative in relation to the outside
the normal electrical state of cardiac cells.
The heart receives blood from the ___, which originate in the ______
coronary arteries, aorta
blood is supplies to the left ventricle, interventricular septum, part of the right ventricle, and conduction system by
left coronary artery
the 2 major branches of the left coronary artery
anterior decending artery and the circumflex artery
blood is supplied to part of the right ventricle and right atrium, and part of the conduction system by
right coronary artery
the 2 major branches of the right coronary artery
posterior descending artery and marginal artery
coronary vessels receive blood during ___
communication between two or more vessels
layers of artery and vein walls
innermost - tunica intima
middle - tunica media
outermost - tunica adventitia
purpose of AV junction
slow impulse down to allow ventricles to fill
cardiac cells have these 4 characteristics
where the esophapus meets the the stomach
3 groups that may show untypical signs and symptoms of chest pain
elderly, females, diabetic
most common cause of fatalities from a heart attack
leading cause of death ACS
this results in increased back pressure into the pulmonary circulation
Left ventricular failure
this results in increased back pressure into systemic venous circlation
Right ventricular failure
pitting edema result of
pathophysiology of CHF
reduction in stroke volume causes fluid overload throughout the body's other tissues
how is hydrostatic pressure affected in CHF
drugs to treat CHF
in CHF mental status changes indicate
impending respiratory failure
primary cause for HTN emergency
noncompliance with prescribed antihypertension medications
signs/symptoms including headache, nausea vomiting, blurred vision, SOB, epistaxis, vertigo, tinnitis point to
ballooning of an arterial wall, usually the aorta, that results from a weakness or defect in the wall
aneurysm inferior to vena cava often the result of atherosclerosis
AAA - abdominal aortic aneurysm
blockage of a pulmonary artery by a blood clot or other particle.
acute pulmonary embolism
sudden occlusion of arteriol blood flow due to trauma, thrombosis, tumor, embolus, or idiopathic means
acute arteriol occlusion
inflammation of the blood vessels commonly stems from rheumatic diseases and syndromes
dialated superficial veins common with pregnancy and obesity
blood clot in vein that typically occurs in larger veins of thigh and calf - swelling, pain and tenderness, with warm red skin.
deep venous thrombosis
can be chronic often associated wth diabetes. estremities exhibit pain, coldness, numbness, and pallor
peripheral arterial atherosclerotic disease
5 P's for assesing assessment and management of vascular disorders
reeentry may cause _______ that occurs when ___. can result in rhytms such as ____
isolated premature beats
ischemia or another disease process alters 2 branches of a conduction pathway conducted retrograde back to branch's origin
- PSVT and A-fib
electrolytes most commonly associated with ecg disturbances are
potassium and calcium
condition where potassium level in blood is low
hypokalemia effect on ecg
cause prominent u wave and flatten T wave
potassium level in blood is elevated
hyperkalemia effect on eck
tall pointed T waves
- hypocalcemia can be caused by
- effects on ecg
- diuretics and certain endocrine conditions
- prolongs repolarization and causes prolonged ST segment and prolonged QT interval
-hypercalcemia can be caused by?
- effect on ecg
- adrenal insufficiency, hyperparathyroidism, kidney failure, or malignancies.
- shortens the repolarization phase thus ST segment to shorten
effects of digitalis on ecg
sagging or scooping of ST segment and can prolong pr interval
effects of hypothermia on ecg
osborn (J) wave
the ratio of blood pumped from the ventricle compared with the amount contained at the end of diastole
series of events between the end of a cardiac contraction to the end of the next
the resistance against which the heart must pump
. the phase of the cardiac cycle during which the heart contracts
the amount of blood pumped by the ventricle during one cardiac contraction
the amount of blood pumped by the ventricle during one minute
the phase of the cardiac cycle during which the heart muscle is relaxed
the end-diastolic volume in the ventricle
The parasympatholytic agent used to treat symptomatic bradycardias is
the most common presenting symptoms in cases of cardiac disease.
A blood clot in one of the pulmonary arteries is called
progressive degenerative disease of the medium-sized and large arteries.
Conduction of the electrical impulse through the heart’s conductive system in an abnormal fashion
A delay in conduction at the level of the AV node is called
first degree AV block
The five Ps of acute arterial occlusion are
pain, pallor, paresthesia, pulselessness, and paralysis
law states that the flow rate of a fluid through a tubular vessel was linked to the radius of the tube. The flow rate or pressure of blood flow through a blood vessel therefore is related to the radius or size of the vessel.
Chest pain that results when the heart’s oxygen demands exceed the blood’s supply is called
variant of angina pectoris caused by vasospasm of the coronary arteries is called
Prinzmetal’s __________ angina
and subsequent necrosis of the heart muscle caused by inadequate blood supply
A cerebral disorder of hypertension indicated by severe headache, nausea, vomiting, and altered mental status is called
The thickening, loss of elasticity, and hardening of the walls of the arteries from calcium deposits is known as
are standardized such that the paper moves across the stylus at the rate of
When properly calibrated, a deflection of ______ large box(es) is equivalent to 1 mV.
One small horizontal box on an ECG is equivalent to ___ _________, and one large box is equivalent to _____seconds________________.
0.04 and 0.20
The time-interval markings placed at the top of ECG paper are located at intervals of
Prominent U waves and a widened QRS complex are both ECG evidence of this electrolyte imbalance
inflammation and clots within a vein
relief of dyspnea on sitting upright
alternation of weak and strong pulse over time
episodes of being awakened at night by shortness of breath
paroxysmal nocturnal dyspnea
drop of more than 10 mmHg in systolic BP with inspiration
T wave inversion indicative of what on ecg
infarcted tissue or extensive transient ischemia
pathological Q wave on ecg idicative of
infarcted tissue that has formed a scar
S-T segment elevation on indicative of
S-T segment depression
infarction affects the full thickness of myocardium and almost always results in pathological Q waves in the leads associated with the region of tissue death.
transmural myocardial infarction
The most common and one of the most life-threatening complications of an acute MI
The typical window for thrombolytic therapy in the setting of acute MI is initiation of therapy within _________ of onset of symptoms
An MI is usually associated with complaints of radiating chest pain that lasts longer than 30 minutes
is the heart's reduced stroke volume causing an overload of fluid in the body's other tissues.
sudden episode of difficult breathing that occurs after lying down
paroxysmal nocturnal dyspnea
The accumulation of excess fluid inside the pericardium is called
The inability of the heart to meet the metabolic needs of the body, resulting in inadequate tissue perfusion
The absence of any ventricular contraction is called
death within one hour after the onset of symptoms.
duration from the beginning of the cardiac arrest until effective CPR is established.
Left ventricular failure causes back pressure of fluid into the pulmonary veins and into the lungs, resulting in
is the most common symptom of congestive heart failure (CHF).
problems are the most common cause of cardiac arrest in infants and children.
respiratory and shock
is a late and often sudden sign of cardiovascular decompensation in pediatric patients.
The initial dosage of fluid in a pediatric patient suffering from hypovolemia should be
20ml/kg_________ of an isotonic fluid
What is the suggested initial setting for defibrillation of pediatric patients?
- What energy is used on subsequent shocks?
What is the initial IV dose of epinephrine in pediatric cardiac arrest
passage of electrical current through the heart during a specific part of the cardiac cycle to terminate certain dysrhythmias
. synchronized cardioversion
passage of electrical current through a fibrillating heart to depolarize a critical mass of myocardium, resulting in conversion to an organized rhythm