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Cardiac
CVP Final Exam
| Question | Answer |
|---|---|
| Cardiothoracic Ratio (CTR) | widest measurement to the right of the midline+widest measurement to the left of the midline divided by thoracic diameter (TR+TL)/TD |
| Normal Cardiothoracic Ratio is | less than or equal to 0.5 |
| Cardiothoracic ratio >0.5 indicates | cardiomegaly |
| ETT/Exercise Tolerance Testing is most commonly used for people with | CAD |
| Most commonly used ETT protocol | Bruce protocol |
| List contraindications for ETT | Acute/severe conditions, DVT, unstable angina, HTN > 220/120, recent aortic surgery |
| How do you calculate maximum predicted HR for men & women? | men=220-age; women=210-age |
| What % of maximum predicted HR should be reached? | 85% |
| What drug can be used if patient is unable to walk or bike for ETT? | dobutamine |
| Where is the J point on an EKG? | precedes the T wave |
| What is a Holter monitor? | an ambulatory EKG device worn for 24-48 hours |
| What is the purpose of an EP study? | to identify ectopic foci via electrical mapping |
| What is cardiac ablation? | the use of energy to destroy tissue (cauterize or freeze) |
| List risk factors for developing arrhythmias. | CAD, HTN, Diabetes, smoking, obesity, stress, family hx, age |
| What is sudden cardiac death? | occurs when the conduction system (electrical) malfunctions & the heart stops beating; not a heart attack |
| What is the most common cause of sudden cardiac death? | ventricular fibrillation |
| What is a pacemaker? | an implantable device that generates low voltage pulses to regulate heart rate |
| What is an ICD/Implantable Cardioverter Defibrillator? | an implantable device for high risk patients that delivers a high voltage shock to restore sinus rhythm |
| What is a CRT/Cardiac Resynchronization Therapy device? | an implantable device for patients w/CHF or BBB that improves coordination of the heart's contractions |
| What is a CRDT? | Cardiac Resynchronization Defibrillation Therapy device used for those at high risk of sudden cardiac death |
| How many leads does a CRT device have? | 3 total; one in RA, one in RV, & a third positioned in the coronary vein on the LV after passing through the coronary sinus |
| What is biventricular pacing? | both right & left ventricles are electrically stimulated to restore coordinated contractions |
| What are synonyms for Right Heart Catheterization? | Pulmonary Artery catheterization, Wedge, PA Line, or Swan Ganz Catheter |
| What is the wedge pressure? | the filling pressure of the LA |
| Swan Ganz Catheter | used for measuring right heart pressures, O2 saturation, & CO |
| Pigtail Catheter | used to obtain pressure measurements in the LV, as well as for LV & aortic angiography |
| Angiographic Catheter | used to deliver injected contrast or dye |
| Transducer Tipped Catheter | used for intracardiac imaging |
| Ablation Catheter | used to treat arrhythmias by destroying tissue |
| Export Catheter | used to remove small clots or embolisms via suction |
| Rotational Atherectomy Catheter | used to remove arterial plaque |
| What are methods of determining CO by Catheterization? | Fick, Indication Dilution, Thermodilution, & Angiography |
| Hoe does Thermodilution work? | Swan Ganz catheter w/balloon tip inserted in pulmonary artery; cold fluid is injected in RA; CO measured by the change in temp over time |
| What is the Gorlin Formula used to determine? | Valve areas |
| What is peak to peak measurement & where is it obtained? | In the cath lab, highest pressure in LV (proximal) is measured & then catheter is pulled back to measure highest pressure in aorta (distal) typically underestimates the pressure gradient compared to peak instantaneous |
| What is peak instantaneous & where is it obtained? | During US echo, the instant of highest pressure in the proximal chamber is used; typically greater & occurs earlier than peak to peak |
| In AS, which chambers are proximal & distal in systole? | LV=proximal & AO=distal |
| In MS, which chambers are proximal & distal in systole? | LA=proximal & LV=distal |
| In AI, which chambers are proximal & distal in systole? | AO=proximal & LV=distal |
| In MR, which chambers are proximal & distal in systole? | LV=proximal & LA=distal |
| How are shunts detected in the cath lab? | oximetry |
| If RA O2>IVC/SVC O2 | there is a left to right shunt (ASD) |
| If RV O2>RA O2 | there is a left to right shunt (VSD) |
| If MPA O2>RV O2 | there is a right to left shunt of greater vessel (PDA) |
| What is Coronary Arteriography used for? | to visualize the coronary vessels & branches |
| What is Angiocardiography used for? | to visualize the great vessels & chambers of the heart |
| Inotropic | drugs affecting the strength or force of myocardial contraction |
| Chronotropic | drugs affecting the heart rate via SA node |
| Dromotropic | drugs affecting the conduction speed through the AV node |
| Lusitropic | drugs affecting the rate of relaxation of the myocardium |
| Carotid Pulse tracings represent events originating from where? | LV |
| What causes hypokinetic pulse tracings? | hypovolemia, hypotension, LV failure, MS |
| What causes hyperkinetic pulse tracings? | anxiety, stress, exercise, fever, HTN, AI, PDA |
| Parvus et Tardus is commonly found in pts with | AS |
| Pulsus Bisferiens is common in pts with | HOCM or any outflow obstruction |
| Pulsus Alternans is common in pts with | LV failure |
| Pulsus Paradoxus is common in pts with | cardiac tamponade, COPD, asthma |
| How do you calculate Mean Arterial Pressure? | SBP + 2DBP/3 |
| Jugular Venous Pulse Contours represent events originating from where? | RA |
| What are normal pressures RA? | 8/2 |
| What are normal pressures LA? | 15/3 |
| What are normal pressures MPA? | 25/9 |
| What are normal pressures RV? | 25/4 |
| What are normal pressures LV? | 125/8 |
| What are normal pressures AO? | 120/75 |
| Concentric hypertrophy is caused by | pressure overload; causes LVH & increased wall thickness |
| Eccentric hypertrophy is caused by | volume overload; causes dilation of the chamber & decreased wall thickness |
| How does LVH affect wall stress? | it decreases/normalizes wall stress because the stress is distributed over a larger mass/area |
| In tissue doppler, the S wave represents | systole |
| A normal S wave in tissue doppler should be equal to or greater than | 10cm/sec |
| Myocardial density is normally | 1.05 g/ml |
| Simpson's Biplane is used o evaluate | LV function & EF |
| How do you obtain measurements for Simpson's Biplane? | trace LVEDV & LVESV area in Ap4 & Ap2 |
| What does the E wave represent in tissue doppler? | LA pressure in early diastolic filling |
| What does the A wave represent in tissue doppler? | atrial kick/late diastolic filling |
Created by:
ginaliane
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