CV A&P LP 3&4 - Pressure/volume and Cardiac Assessement

Cardiac Cycle

100

Name the 4 Diastolic phases of the Cardiac Cycle

Atrial Systole, Isovolumic Relaxation time, Rapid Filling, reduced Filling (diastasis)

200

All of the valves remain closed during these two phases of the Cardiac Cycle

IVCT and  ICRT

300

Only 10% of ventricular Filling takes place during this phase

Atrial Systole (Phase 1)

400

Opening of the AV valves (atrioventricular valves) marks the end of what phase in the cardiac cycle?

Isovolumic relaxation time

500

When ventricular Pressure slightly exceed that of the pressure in the aorta

systolic rapid ejection (Phase 3)

Pressure/volume loops

100

Name the term to describe the amount of blood that is in the ventricles before the heart contract 

End Diastolic Volume

200

An increase in afterload will decrease the width of the pressure/volume loop curve. What does that width represent?

Stroke Volume

300

This term is used to describe how easily a chamber of the heart or (the lumen of a blood vessel) expands when it is filled with a volume of blood. 

* will effect preload

Compliance

400

Inotropy and preload have a direct or inverse relationship with stroke volume

Direct

500

Name one thing that can increase each: Preload, Afterload, Inotropy

Preload - Decrease in inotropy, HR, inflow resistance, venous compliance or increase outflow resistance (afterload), increase atrial contraction, increase ventricular compliance, increase in venous pressure, increase venous blood volume(increase in venous return)

Afterload - valve resistance(AS), vascular resistance (hypertension), vascular impedance, blood viscosity 

Inotropy - Increase afterload, SNS activation, catecholamines, heart rate

Calculations & principles

100

EDV - ESV = ?

Stroke Volume

70-100 ml

200

CO is calculated by HR X SV?  True or False

What will then units typically be?

True

L/min

300

The greater the ventricular volume, the great the force of contraction describes what principle

Frank-Starling

400

EDV-ESV/EDV x 100 calculates what?

Ejection Fraction

Discuss how this is done on Echo...

500

Myocardial O2 consumption can be calculated by the _____ principle.

Fick

** it can also be calculated by the RPP •This index can be measured noninvasively by multiplying heart rate and systolic arterial pressure

*afterload has a greater effect on myocardial o2 consumption than preload

Hearts Sounds

100

S1 and S2 represent what?

Closure of the AV and SL valve respectively

200

This can be normal in children but is abnormal if heard in adults, representing decrease ventricular compliance and resistance to early filling

S3

300

These sounds_______ and _______ are often used to describe rigidity in a valve. ( MVP or Mitral stenosis)

Click and Snap

400

This heart sound ______ may be soft due _________ on a semilunar valve.

S2 - calcification or significant stenosis (may have reduced EF or low output).

500

This heart sound would represent a stiff LV heard in late diastole.

S4

Heart Murmurs

100

Aortic Stenosis could be represented by what murmur.

Systolic ejection

200

Most common diastolic, blowing decrescendo murmur represents what diagnosis?

Aortic regurgitation

What about MS? Why not most common?

300

A patient with significant  Aortic stenosis and regurgitation or a patient with a PDA (patent ductus arteriosis) could present with what type of murmur)

Systolic, Diastolic or Continuous (To-fro)

Continuous or To and fro

400

 In detail describe the type, location, intensity and duration of a Severe Aortic Stenosis patient

RUSP, 5/6, mid-late peaking, systolic ejection, crescendo decrescendo, radiation to the carotid, reduced carotid upstroke, possible a quiet/soft S2

500

What diagnosis would fit a mid systolic murmur that increases with Valsalva maneuver on a 22 year old patient?

Hypertrophic Obstructive Cardiomyopathy