Term
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Definition
| the first sound: closure of mitral and tricuspid valves as a result of increased ventricular pressure at the beginning of systole |
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Term
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Definition
| is slightly louder, heard when the pulmonic and aortic valves close, following systole. Sometimes it is possible to discern between the sounds made by these two valves (split S2 sound). Then the sounds can be referred to as A2 (aortic) and P2 (pulmonic) |
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Term
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Definition
norm <120/<80
pre HTN 120-139/80-89
1 140-159/90-99
2 160-179/100-109
3 180-209/110-119
4 >210/>120
dont treat if stage 3 or above 180/110 |
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Term
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Definition
Typical angina – typical referral pattern:
Substernal pain
Left shoulder
Along the inside of the left arm in the C8 and T1 distribution.
Onset: exertional, or under conditions of stress
Duration: usually longer than 1 minute but less than 10 minutes |
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Term
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Definition
Face/ jaw/ teeth
One or both shoulders
Posterior thorax
Down one or both arms
Non-exertional
Can occur at rest and often awakens a person between 2 and 5 AM. |
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Term
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Definition
| Thoracic pain that worsens with inspiration, is sharp and improves with change in position |
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Term
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Definition
| Sharp stabbing pain that occurs with a deep breath in a local area. |
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Term
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Definition
| and endocarditis (cardiac infections/inflammations). This does not necessarily cause chest pain, but chest tightness and breathlessness. These conditions may be accompanied by low-grade fever, malaise, and arthralgias |
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Term
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Definition
| gives rise to a hot throbbing sensation that increases with physical activity |
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Term
| dissecting aortic aneurysm |
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Definition
| presents as a pain of sudden onset, often located in the patient's back, with a rapid decrease in blood pressure. |
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Term
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Definition
| gives rise to burning pain, limited in area over the cutaneous distribution of a nerve, and swollen local lymph nodes. This condition is often associated with recent stress or impaired immune response |
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Term
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Definition
Increasing frequency
Earlier onset
Spreading or radiating
Higher doses of nitroglycerine needed
Longer time to relief |
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Term
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Definition
Severe, longer duration pain, not precipitated by cardiac work
Pain is almost always present at rest, even at night |
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Term
| intermittent claudication |
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Definition
calf muscle ischemia caused by peripheral vascular disease:
Calf pain with slow walking that develops into a cramp unless stopped
Older individuals
Type-2 diabetes?
Ache that may occur in the buttock, thigh, calf, or all
Disappears with rest. |
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Term
| Anterior compartment syndrome: |
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Definition
Pain + acute anterior tibial compartment swelling and cramping
Increases with activity, stops with rest
Younger individuals, usually athletes |
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Term
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Definition
Block occurs at the AV node
Often due to increased parasympathetic tone or to drug effect
Usually transient |
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Term
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Definition
Block occurs below the level of the AV node, in the bundle of His
Generally results from an organic lesion, so it can deteriorate to a third-degree block
PR interval does not lengthen before a dropped beat
May be intermittent, or the conduction ratio may vary |
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Term
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Definition
This is complete heart block between atria and ventricles
P waves occur at their own rate and rhythm and QRS complexes at a slower rate, the ventricular escape rhythm (less than 40 /min).
The rhythms have no relationship to each other
Block is usually below the AV node
There may be periods of asystole
The prognosis is poor |
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Term
| Ruling Out Cardiac Causes of Lightheadedness: |
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Definition
Take blood pressure - in orthostatic hypotension occurs only in relation to position change.
Heart rate >60/min: bradycardia is not the cause.
Respiratory rate elevated: this is a probable cause rather than cardiac problems.
ECG. Look for ventricular arrhythmias or ischemia. Both result in cardiovascular dysfunction, so there may be hypotension.
Presence of chest pain: patient must be screened for ischemia.
Blood sugar level. If low and there is diaphoresis or fatigue suspect hypoglycemia.
Motor coordination: if this is o.k. and speech not slurred the cause is probably not cerebral ischemia. |
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Term
| Suspect a cardiac cause of lightheadedness if there are: |
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Definition
Skipped beats: Check ECG for ventricular aectopic activity (VEA), paroxysmal atrial tachycardia (PAT), bradycardia, or heart block
Hypotension: check low systolic pressure and heamodynamic compromise. A low pulse pressure can also suggest cardiac problems.
Chest pain: May be present with or without ST segment depression. |
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Term
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Definition
Most frequently seen in a high anxiety, pain, or hunger. Premonitory signs or symptoms are:
Pallor
Yawning
Sighing
Hyperventilation
Epigastric discomfort
Nausea
Blurred vision. |
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Term
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Definition
Blood pressure falls from a supine to standing position, this is preceded by lightheadedness when the person is upright
Compensatory tachycardia, distinguishes this from vasovagal syncope |
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Term
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Definition
muscle jerking, breath-holding, and choking sounds
Grand mal seizures are characterized by:
Lip / tongue biting
Incontinence: bowel and bladder
Spontaneous cessation after 3 to 4 minutes
Subsequent mental confusion. |
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Term
| Physical Therapy Evaluation Of Syncope |
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Definition
Supine and standing blood pressure (orthostatic intolerance)
If prolonged consider cardiac arrest.
Check for VEA on ECG |
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Term
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Definition
Coronary artery disease
Aortic valve
Cardiomyopathy
Anemia
Hypothyroidism, though hyperthyroidism may also lead to chronic exhaustion
Depression
Conditions associated with hypoxia (respiratory failure, acute pulmonary embolus)
Cancer
Physical therapy evaluation of fatigue, related to cardiac cause:
Falling blood pressure? Think congestive heart failure. Check for basal rales and gallop over the cardiac apex
Fluid accumulation in pericardium? Look for dyspnea and weakness
Hypotension with tachycardia, bradycardia, pallor
Pulses. Get ECG in case of frequent VEA
Results of exercise tolerance tests and other tests |
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Term
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Definition
Cardiopulmonary causes:
Ventricular congestive failure, with fluid backing up in the pulmonary circulation
Coronary insufficiency
Mitral valve disease
Myocardial dysfunction
Constrictive pericarditis
Overstretched diaphragm (COPD).
Note that dyspnea on exertion (DOE), common in cardiac and pulmonary disease, may lead to progressive deconditioning.
Other forms of dyspnea
Paroxysmal nocturnal dyspnea (PAT). Frequent occurrence implies congestive heart failure, pulmonary edema, or cor pulmonale
Orthopnea (difficulty breathing with recumbency)
A stress test with gas analysis can throw a light on the etiology:
Deconditioning. Look for: early dyspnea, low VO2, and/ or low anaerobic threshold
Congestive heart failure. Look for: A nonresponsive cardiac output, (flat systolic blood pressure) and/ or a rapid rise in heart rate due to low anaerobic threshold
Peripheral circulation: Dyspnea early in the test, because of early anaerobic metabolism in ischemic muscle, low maximal VO2, and/ or local muscle pain in an area of active contraction |
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Term
| Physical Therapy Evaluation Of Dyspnea - Cardiac Causes |
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Definition
Congestive Heart Failure
Low blood pressure
High heart rate
Premature atrial contractions
High respiratory rate but normal o2 saturation
Cardiac Tamponade?
Pulsus paradoxus
Low blood pressure
Fatigue and weight loss
Mitral Valve Prolapse?
Diastolic murmur
Pulmonary Embolism?
Acute onset of dyspnea, correlating with sudden drop in O2
Chronic Perircarditis
Tachycardia with dyspnea and acute, sharp chest pain |
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Term
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Definition
Infections
Neoplasm
Allergy
Cardiovascular; left ventricular failure with pulmonary edema and pulmonary vein hypertension
Pulmonary infarction |
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Term
| depressed st wave/inverted t wave |
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Definition
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Term
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Definition
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Term
| 2) Hypoperfusion, due to drop in output: |
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Definition
● Confusion
● Weakness
● Cold and clammy extremities |
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Term
| 3) Elevated left ventricular filling pressures, measured as: |
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Definition
● Increased mean left atrial pressure
● Increased left ventricular end-diastolic pressure
● These cause pulmonary venous congestion with dyspnea on exertion and non-productive nocturnal cough. |
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Term
| 4) Elevated filling pressures of the right heart manifested by systemic venous congestion |
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Definition
● Pedal edema
● Abdominal distention
● Anorexia |
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Term
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Definition
● Chest pain
● Pericardial friction rub (select friction rub from the menu on the left hand side of the web page)
● ECG abnormalities concave upward st segment |
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Term
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Definition
Clinical presentation
● Calf tenderness
● Edema
● Calf enlargement
● Positive Homan’s sign (calf pain with forcible dorsiflexion of the foot)
● Palpable cord in inner calf
● Pain, with exercise or rest
● Confused with Baker’s cyst, sciatica
Therapeutic approach
● Hospital rest, elevation, and heat for extremity
● Heparin, Coumadin
● Goal: prevent potentially fatal embolism |
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