Term
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Definition
Hypertension(HTN)
Coronary artery disease(CAD)
Congestive heart failure(CHF)
Stroke |
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Term
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Definition
1 CVD death every 37 seconds
1 coronary event every 25 seconds
1 CAD death every minute
Over 1 million myocardial infarctions (MIs) are suffered annually |
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Term
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Definition
Male ≥45 y.o Female ≥55 y.o.
Family History of: MI or Stroke 200, HDL <40 and/or LDL>160
TG>150
Diabetes Mellitus
Obesity
Sedentary Lifestyle |
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Term
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Definition
Location/Radiation
Quality
Severity
Timing(onset, duration, frequency)
Setting in which they occur
Remitting/Exacerbating factors
Associated symptoms |
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Term
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Definition
Complete cessation of smoking
Optimal blood pressure
Healthy eating
Lipid management
Regular aerobic exercise
Optimal weight
Diabetes Management
Conversion of AF to NSR or anti-coagulation if chronic AF |
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Term
| Most important symptom of cardiac disease |
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Definition
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Term
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Definition
True sx of CAD
Imbalance of coronary supply and myocardial demand |
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Term
| Typical Cardiac Chest pain |
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Definition
Retrosternal
Sudden onset
Radiating to jaw, neck, arms or upper abdomen
Pressing, squeezing, heaviness
Provoked by effort, emotion
Relieved with rest and/or nitroglycerin(NTG)
Last 1-3 minutes – up to 10 min
Associated with nausea, diaphoresis, dyspnea |
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Term
| Causes of Cardiac Chest Pain |
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Definition
CAD
MI
Angina stable & unstable
Prinzmetal Angina
Pericarditis
Valvular Heart Disease
Aortic Stenosis(AS)
Mitral valve prolapse(MVP)
Hypertrophic Cardiomyopathy |
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Term
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Definition
Unpleasant awareness of the heart beating
“fluttering”, “skipped beats”, “pounding”, “stopping” etc
Associated with arrhythmias |
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Term
| Most common cause of palpitations |
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Definition
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Term
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Definition
Tachyarrhythmias
Bradyarrhytmias
Extrasystoles
Caffeine
Smoking
Drugs
Amphetamines, Bronchodilators, Digitalis, Antidepressants
Thyrotoxicosis
Hypoglycemia
Fever
Anemia
Anxiety |
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Term
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Definition
| Definition: uncomfortable awareness of breathing that is inappropriate to a given level of exertion |
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Term
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Definition
Orthopnea
Paroxysmal nocturnal dyspnea(PND)
Dyspnea on exertion(DOE |
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Term
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Definition
Occurs when pt is lying down
Improves when pt sits up
Need for more pillows to sleep
“3 pillow orthopnea x 3 mos” |
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Term
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Definition
Sudden orthopnea that awakens pt from sleep
Usually 1-2 hrs after going to bed
Pt has to sit/stand up or go to window for air |
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Term
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Definition
Usually due to chronic congestive heart failure(CHF) or severe pulmonary disease
“1-block DOE for past 2 mos; prior to that time pt was able to walk 3 blocks without any sob” |
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Term
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Definition
Cardiac
LV failure
Mitral stenosis(MS)
Emotional
Anxiety
High-altitude exposure
Anemia
Pulmonary
COPD
Asthma
Restrictive lung disease
Pulmonary embolism(PE)
Pulmonary Arterial Hypertension(PAH) |
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Term
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Definition
Transient loss of consciousness(loc) due to inadequate cerebral perfusion
May be cardiac or non-cardiac
Important to ask activity that preceded the syncope and position of pt before the syncopal episode |
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Term
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Definition
Cardiac Syncope
Orthostatic hypotension
Vasovagal syncope
Carotid sinus syncope
Post-tussive syncope
Metabolic syncope |
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Term
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Definition
Caused by decreased CO or SV X HR
occur with arrhythmias or obstructive lesions
Ask about it with exercise- Aortic stenosis and hepertrophic obstructive cardiomyopathy |
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Term
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Definition
Form of postural syncope
Peripheral autonomic limitation
Failure of adaptive reflexes to compensate for erect posture
Sudden fall in systemic BP |
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Term
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Definition
Most common type of fainting
Occurs during time of emotional strain
Often preceded by nausea, weakness, diaphoresis, epigastric discomfort
Sudden fall in systemic vascular resistance(SVR) without a compensatory increase in CO |
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Term
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Definition
Hypersensitive carotid sinus
Occurs with constriction or turning of the neck
Increased stimulation of carotid sinus causes a sudden fall in systemic pressure |
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Term
| Syncope metabollic causes |
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Definition
Hypoglycemia
Hyperventilation
Hypoxia |
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Term
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Definition
Common sx of decreased CO
Frequent in pts with CHF or MV disease
Most common cause: anxiety and depression
Differentiate between organic and psychogenic
Other causes: anemia, chronic disease |
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Term
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Definition
Symmetrical Edema of the legs
Seen in patients with dyspnea and secondary to cardiac causes, dyspnea precedes edema |
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Term
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Definition
Pulmonary causes
Mitral stenosis
Caused by rupture of bronchial veins due to high back pressure |
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Term
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Definition
Occurs with inadequate gas exchange in lungs
Cyanosis of nails but warm hands
Diffusely involves skin & mucous membranes
Worsens w/ exercise
Cyanosis from birth is associated w/ congenital heart lesions
Frequent causes
Primary pulmonary problems
Diseases that cause mixed venous blood to bypass the lungs i.e.)intracardiac shunt |
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Term
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Definition
Cyanosis noted in LEs only
Congenital defects
Right-to-left shunt through a patent ductus arteriosus(PDA)
Coarctation of the Aorta
May be seen with pulmonary hypertension
Most often seen at birth |
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Term
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Definition
Due to increased oxygen extraction in states of low cardiac output
Limited to cyanosis of the extremities |
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Term
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Definition
Vascular
Pulmonary
Musculoskeletal
Gastrointestinal
Psychological
Neurological |
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Term
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Definition
PE
Pneumonia
Pleuritis
Pneumothorax(PTX) |
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Term
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Definition
Costochondritis
Arthritis
Muscular spasm
Bone tumor |
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Term
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Definition
Ulcer disease
Bowel disease
Hiatal hernia
Pancreatitis
Cholecystitis |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| cellular metabolic exchange |
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Term
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Definition
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Term
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Definition
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Term
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Definition
A Muscle with
Layers
Valves
Chordae tendineae
Papillary Muscles
Electrical Conduction system |
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Term
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Definition
Thin pericardial sac envelops the heart
Bottom of the sac is adhered to the diaphragm
Top is loosely attached to the upper part of the sternum |
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Term
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Definition
| Inferior and superior vena cava |
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Term
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Definition
| Aortic and pulmonary arteries |
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Term
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Definition
outermost layer of cardiac cells(epicardial cells)
insensitive to pain |
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Term
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Definition
outer sac
innervated by phrenic nerve
contains pain fibers |
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Term
| pathway of blood in heart |
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Definition
| Inferior vena cava to right atrium through tricuspid to right ventricle up through pulmonic valve to lungs back through through pulmonary veins to left atrium through bicuspid valve to left ventricle and out aortic valve to aorta |
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Term
| 7 phases of cardiac cycle |
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Definition
1- atrial contraction
2- isovolumetric contraction
3- rapid ejection
4- reduced ejection
5- isovolumetric relaxation
6- rapid filling
7- reduced filling |
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Term
| Systole valve involvement |
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Definition
Semilunar valves open
AV, PV
AV valves close
MV, TV |
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Term
| Diastole valve involvement |
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Definition
AV valves open
MV, TV
Semilunar valves close
AV, PV |
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Term
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Definition
Accounts for ~20% of ventricular filling
“a wave” in left atrial pressure(LAP)
Small increase in venous pressure
May hear S4(associated
with “stiff ventricle”) |
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Term
| Isovolumetric contraction |
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Definition
AV valves close(S1)
All valves are closed
Pressure rises in ventricles; volume remains unchanged
“c wave” in LAP |
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Term
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Definition
Semilunar valves open
Systolic ejection
Atrial filling begins |
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Term
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Definition
Semilunar valves still open
Rate of ejection falls
Atrial pressure rise slightly |
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Term
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Definition
Intraventricular pressure falls
Semilunar valves close (S2)
All valves are closed
Pressure decreases in ventricles; volume remains unchanged
Small backflow of blood into ventricles when valves close(“dicrotic notch” on pressure tracing) |
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Term
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Definition
AV valves open
“v wave” in LAP
Similar wave found in right atrium and jugular vein
May hear S3 |
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Term
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Definition
Ventricle is ~80% filled by end of this phase
Intraventricular pressure rises; pressure gradient across AV valves reduced |
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Term
| Surface Projections/Auscultation |
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Definition
Base
Proximal surface of heart at R/L 2nd interspaces close to sternum
where right ventricle (RV) narrows and meets pulmonary arteries
Apex
Tapered inferior tip of the left ventricle(LV
Apical Impulse/Point of Max Impulse(PMI)
Locates the left border of the heart
Usually in 5th intercostal space(ICS), 7-9cm lateral to midsternal line |
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Term
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Definition
Aortic
2nd right ICS @ sternal border
Pulmonic
2nd left ICS @ sternal border
Tricuspid
Left lower(3rd-5th ICS) sternal border
Mitral
Left 5th ICS in midclavicular line |
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Term
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Definition
| closing of AV valves, Mitral and Tricuspid |
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Term
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Definition
Semilunar valves close
Aortic and pulmonary |
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Term
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Definition
Location of mitral and tricuspid valves closing
Apex of heart, LLSB |
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Term
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Definition
Location of aortic and pulmonic valves closing
2nd ICS @ R and L sternal border, respectively |
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