Valves, Veins, and Ventricles
The valve that separates the left ventricle to the left atrium
Mitral valve or bicuspid valve
List three major cardiac risk factors
Smoking
Hypertension
Elevated total cholesterol and LDL
Decreased HDL
Diabetes Mellitus
Advanced age
What is the pathology of acute coronary syndrome?
Myocardial oxygen demand is higher than supply.
Finish this is sentence... My husband is a ______ - Dr. Z.
Cardiologist!!!
What are the four anti-hypertensive drug categories?
Angiotensin converting enzyme inhibitors
Blockers of the angiotensin receptor
Calcium channel blockers
Diuretics
Fibrous pericardium
Parietal pericardium
Pericardial cavity
Epicardium
Myocardium
Endocardium
How would you describe 2+ pitting edema?
Easily identified depression and skin rebounds in <15 seconds.
What on the EKG would indicate a patient with ischemic chest pain is having an MI?
ST-segment elevation
What are three risk factors that increase the risk of sternal infection in patients following median sternotomy?
Female gender
Diabetes Mellitus
Obesity
Internal mammary artery grafting bilateral.
Smoking
COPD
Prolonged CABG surgical time
How can symptoms of stable angina be relieved?
Rest or nitroglycerin
What is the formula for cardiac output, and what is its normal resting value (L/min)?
CO=HRxSV
At rest 4-5 L/minute
In what phase does the sound increase in intensity with a distinct tapping? (Korotkoff sounds)
Phase 3
This indicates blood flow is increasing as artery compression is decreasing
What is Beck's Triad, and what scary pathology does it indicate?
Beck's triad: Low blood pressure, Jugular venous distention, muffled heart sounds.
Cardiac Tamponade
List three sternal precautions
No lifting, pulling, pushing >10-20lbs
No use of UE for STS or keep shoulder in neutral
Counter pressure with valsalva
No driving 2-4 weeks
Avoid horizontal abduction past midline or no scapular retraction
No lifting arms > 90 if weighted
for 2-4 weeks
What are the common side effects associated with calcium channel blockers? list three.
Edema, flushing, palpitations, constipation.
What is inversely related to stroke volume? And what is its function in hemodynamics?
Afterload. Force of the left ventricle it must generate to overcome aortic pressure to open the aortic valve.
What is the classic sign of congestive heart failure?
S3 heart sound is best appreciated at the apex; it is due to decreased ventricular compliance.
How would you classify a patient with symptomatic heart failure marked limitation of physical activity; comfortable at rest, but less than ordinary activity results in fatigue, palpitations, or dyspnea?
III based off the NYHA functional class of heart failure
What are the PT implications for a denervated heart, and what intensity metric might you use?
Vagus nerve and sympathetic nerves lead to a loss of sympathetic stimulation and parasympathetic activity, requiring extended warm-up and cool down.
HR response is blunted or may be increase- use the RPE
Stroke volume and Left ventricular ejection fracture is lower than normal
List three drugs associated with the diuretics class
Hydrochlorothiazide
Furosemide (Lasix)
Spironolactone (Aldactone)
What three hormones cause vasoconstriction?
What two lab tests assess cardiac function after the presence of an acute MI?
Creatine kinase
Troponin I
Hypertrophic
What signs and symptoms indicate that the patient is rejecting the heart transplant? List 5
Low-grade fever
Myalgia and fatigue
Hypotensive with activity but hypertensive at rest
Decreased exercise tolerance and dyspnea
Arrhythmias
Weight gain due to fluid retention
Decreased urine output
Describe the mechanism of action of beta blockers and common side effects (list three).
Block beta-adrenergic receptors, reducing heart rate and cardiac output.
Side effects: fatigue, bradycardia, weight gain, depression.