Cardiovascular Assessment
What are the S1 and S2 heart sounds associated with?
S1 = closure of the mitral and tricuspid
S2 = Closure of the aortic and pulmonary
What is the normal range for MAP?
70-100 mmHg
What is the hallmark EKG finding in afib?
Irregular rhythm with no P waves
what are the two primary compensatory mechanisms in HF?
RAAS activation and SNS stimulation
what is the first line medication for an acute MI?
aspirin 162-325mg
What is the best position to auscultate an S3 sound?
Left lateral recumbent position
What does an elevated CVP suggest?
Fluid overload, R-sided HF, or venous congestion
What does ST elevation indicate?
STEMI
What is the first line medication for HFrEF (systolic HF)
ACE inhibitor or ARBS
What is the time frame for PCI in a STEMI?
90 mins door to balloon
What does JVD indicate?
R-sided HF or Increased CVP
what is the primary goal of vasopressors like norepinephrine in shock?
Increase SVR and improve perfusion
A patient is in vtach and has no pulse - what do you do first?
CPR and defib immediately
A patient with left sided HF has crackles, dyspnea, and pink-frothy sputum - what is the priority intervention?
Diuretics (furosemide), oxygen, and positioning (high fowlers)
MONA: morphine, oxygen, nitro, aspirin
A patient has cool, pale, and clammy skin - what does this indicate in a cardiac assessment?
Poor perfusion, possible shock or HF
What is the primary purpose of an arterial line in hemodynamic monitoring?
To provide continuous blood pressure monitoring and allow for frequent arterial blood gas (ABG) sampling without repeated needle sticks.
What electrolyte imbalance can cause prolonged QT interval and torsades de pointes?
hypomagnesemia
In a patient with heart failure, what physical assessment finding is most indicative of pulmonary congestion?
Crackles (rales) on lung auscultation
what is the goal of tPA in STEMI?
dissolve the clot and restore coronary perfusion (must be given within 30 mins if PCI is unavailable)
When assessing a patient’s peripheral pulses, what finding indicates a significant decrease in cardiac output?
A weak, thready pulse (1+ on a 0-4+ scale)
In hypovolemic shock, how do preload, afterload, and cardiac output change?
What EKG findings suggest hyperkalemia?
peaked T waves, widened QRS
Why are beta-blockers used in chronic HF patients but avoided in acute decompensated HF?
in chronic HF they can reduce mortality but in acute HF they can worsen symptoms due to negative inotropy
What lifestyle modifications help prevent CAD?
smoking cessation, DASH diet, exercise, BP/cholesterol control