EHR 519 weeks 1-2
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Questions and Answers

What is the function of the interventricular septum?

  • Separates the atria
  • Pumps blood through the heart
  • Separates the ventricles (correct)
  • Connects the atria and ventricles
  • The pulmonary valve is located between the right atrium and the right ventricle.

    False

    What is the name of the valve between the left atrium and the left ventricle?

    Left AV (bicuspid) valve

    The _______________________ is the muscular wall that separates the ventricles.

    <p>interventricular septum</p> Signup and view all the answers

    What is the name of the valve between the right ventricle and the pulmonary artery?

    <p>Pulmonary valve</p> Signup and view all the answers

    The heart is located in the abdominal cavity.

    <p>False</p> Signup and view all the answers

    What is the name of the system that includes the pulmonary and systemic circuits?

    <p>Cardiovascular System</p> Signup and view all the answers

    The _______________________ is the outermost layer of the heart.

    <p>Epicardium</p> Signup and view all the answers

    Match the following heart structures with their functions:

    <p>Septum = Separates chambers Valves = Regulates blood flow Papillary muscles = Supports the valves Trabeculae carneae = Muscular ridges in the ventricles</p> Signup and view all the answers

    The heart has three layers: endocardium, myocardium, and epicardium.

    <p>True</p> Signup and view all the answers

    What is the main function of the pericardium?

    <p>To allow the heart to beat without friction</p> Signup and view all the answers

    The pericardial cavity is filled with 50 mL of pericardial fluid.

    <p>False</p> Signup and view all the answers

    What is the function of the fibrous skeleton of the heart?

    <p>Provides structural support and attachment for cardiac muscle and anchor for valve tissue, and electrical insulation between atria and ventricles</p> Signup and view all the answers

    The ______________ layer of the pericardium is the outer wall of the sac.

    <p>Parietal</p> Signup and view all the answers

    Match the following structures with their descriptions:

    <p>Epicardium = Smooth inner lining of heart and blood vessels Myocardium = Layer of cardiac muscle proportional to work load Endocardium = Serous membrane covering heart Pericardium = Layer of cardiac muscle proportional to work load</p> Signup and view all the answers

    What is the main component of the myocardium?

    <p>Cardiac muscle</p> Signup and view all the answers

    The pericardial sac is anchored to the diaphragm superiorly and sternum anteriorly.

    <p>False</p> Signup and view all the answers

    What is the function of the pericardial fluid?

    <p>Provides lubrication to allow the heart to beat without friction</p> Signup and view all the answers

    The coronary blood vessels travel through the ______________ layer.

    <p>Epicardium</p> Signup and view all the answers

    Match the following structures with their functions:

    <p>Parietal pericardium = Provides structural support Visceral pericardium = Allows heart to beat without friction Pericardial cavity = Covers the valve surfaces Endocardium = Provides electrical insulation</p> Signup and view all the answers

    What is the duration of the PR interval on the diagram?

    <p>0.8 seconds</p> Signup and view all the answers

    The atria contract during the T wave

    <p>False</p> Signup and view all the answers

    What is the name of the segment between the Q wave and the S wave?

    <p>QRS interval</p> Signup and view all the answers

    The QT interval is the duration of the action potential from the start of the ______________ wave to the end of the T wave.

    <p>P</p> Signup and view all the answers

    Match the following parts of the heart with their corresponding contractions:

    <p>Atria = P wave Ventricles = T wave</p> Signup and view all the answers

    What is the unit of measurement for the amplitude of the ECG wave?

    <p>Millivolts</p> Signup and view all the answers

    What is the role of the sinoatrial node?

    <p>To regulate heartbeat</p> Signup and view all the answers

    The atrioventricular node is responsible for distributing excitation through the ventricular myocardium.

    <p>False</p> Signup and view all the answers

    What is the role of the Purkinje fibers?

    <p>Distribute excitation through the ventricular myocardium.</p> Signup and view all the answers

    Excitation spreads through the ______________ after the atrioventricular node fires.

    <p>AV bundle</p> Signup and view all the answers

    Match the following structures with their functions:

    <p>Sinoatrial node = Regulates heartbeat Atrioventricular node = Transmits electrical signal to ventricles Purkinje fibers = Distributes excitation through ventricular myocardium AV bundle = Transmits electrical signal from atrioventricular node to ventricles</p> Signup and view all the answers

    How many cusps does the Right AV valve have?

    <p>Three</p> Signup and view all the answers

    The Left AV valve has three cusps.

    <p>False</p> Signup and view all the answers

    What is the purpose of the chordae tendineae?

    <p>To prevent AV valves from flipping inside out or bulging into the atria when the ventricles contract</p> Signup and view all the answers

    The valves in the heart ensure a one-way flow of blood through the ______________.

    <p>heart</p> Signup and view all the answers

    Match the following heart valves with their descriptions:

    <p>Aortic valve = Prevents backflow from the aorta into the left ventricle Pulmonary valve = Prevents backflow from the pulmonary artery into the right ventricle Left AV valve = Prevents backflow from the left atrium into the left ventricle Right AV valve = Prevents backflow from the right atrium into the right ventricle</p> Signup and view all the answers

    What is the name of the valve that has two cusps?

    <p>Bicuspid valve</p> Signup and view all the answers

    The heart has a two-way flow of blood.

    <p>False</p> Signup and view all the answers

    What is the function of the atrioventricular (AV) valves?

    <p>To control blood flow between atria and ventricles</p> Signup and view all the answers

    What happens to monocytes after they differentiate into macrophages?

    <p>They become foam cells</p> Signup and view all the answers

    Injured endothelial cells release inflammatory mediators and TF which promotes inflammation and coagulation.

    <p>True</p> Signup and view all the answers

    What is the result of the stimulation of EC receptors by damage-associated molecular patterns?

    <p>Upregulation of adhesion molecules and monocyte adhesion.</p> Signup and view all the answers

    Chronic ______________ and immune dysregulation play a role in the development of atherosclerosis.

    <p>inflammation</p> Signup and view all the answers

    Match the following with their functions:

    <p>Inflammatory cytokines = Promotes nuclear factor-κB signalling oxLDL = Phagocytosed by macrophages to become foam cells TF = Promotes inflammation and coagulation</p> Signup and view all the answers

    What is the result of cells of injured tissue undergoing morphological and functional modifications?

    <p>Inflammation</p> Signup and view all the answers

    What is the percentage of Australians who had 1 or more conditions related to heart, stroke, or vascular disease in 2022?

    <p>5.3%</p> Signup and view all the answers

    Cardiovascular disease has a greater impact on females in Australia.

    <p>False</p> Signup and view all the answers

    What is the prevalence of heart, stroke, and vascular disease in Indigenous Australians compared to non-indigenous Australians?

    <p>2.1 times higher</p> Signup and view all the answers

    In 2022, approximately ______________ million Australians had 1 or more conditions related to heart, stroke, or vascular disease.

    <p>1.3</p> Signup and view all the answers

    Which of the following is a risk factor for cardiovascular disease?

    <p>Increased waist circumference</p> Signup and view all the answers

    Match the following demographics with their corresponding prevalence of cardiovascular disease:

    <p>Males = 5.9% Females = 4.6% Indigenous Australians = 2.1 times higher than non-indigenous Australians Socioeconomically disadvantaged = 8.2%</p> Signup and view all the answers

    Cardiovascular disease is a major health problem in Australia.

    <p>True</p> Signup and view all the answers

    What is the name of the condition that describes many different conditions affecting the heart and blood vessels?

    <p>Cardiovascular disease</p> Signup and view all the answers

    What is the primary function of the vascular endothelium?

    <p>To maintain a balance between vasodilation and vasoconstriction</p> Signup and view all the answers

    Nitric oxide (NO) is a potent vasoconstrictor.

    <p>False</p> Signup and view all the answers

    What is the name of the enzyme responsible for producing nitric oxide (NO) from L-arginine?

    <p>endothelial NO synthase (eNOS)</p> Signup and view all the answers

    What is the primary underlying mechanism for the development of endothelial dysfunction?

    <p>Oxidative stress</p> Signup and view all the answers

    Chronic exposure to cardiovascular risk factors and _______________________ stress can lead to endothelial dysfunction.

    <p>oxidative</p> Signup and view all the answers

    Endothelial dysfunction is characterized by increased anti-inflammatory effects.

    <p>False</p> Signup and view all the answers

    Match the following chemicals with their functions in vascular tone regulation:

    <p>Nitric oxide (NO) = Vasodilation Endothelin-1 (ET-1) = Vasoconstriction Angiotensin II = Vasoconstriction EDHF = Vasodilation</p> Signup and view all the answers

    What is the role of eNOS in healthy endothelium?

    <p>responsible for most of the vascular NO production</p> Signup and view all the answers

    C-reactive protein (CRP) is a protein present in the ______________________ response.

    <p>acute inflammatory</p> Signup and view all the answers

    What is the result of chronic exposure to cardiovascular risk factors and oxidative stress on the vascular endothelium?

    <p>Endothelial dysfunction</p> Signup and view all the answers

    Match the following molecules with their effects on endothelial dysfunction:

    <p>NO = anti-inflammatory effects ROS = pro-oxidant effects TNF-α = promotes leukocyte adherence and migration IL-1 = promotes macrophage transformation into foam cells</p> Signup and view all the answers

    Endothelial dysfunction is a major contributor to the progression of atherosclerotic cardiovascular disease.

    <p>True</p> Signup and view all the answers

    What is the result of overexpression of TNF-α and IL-1?

    <p>Promoted leukocyte adherence and migration</p> Signup and view all the answers

    What is the name of the monolayer of cells covering the lumen of the vessels?

    <p>vascular endothelium</p> Signup and view all the answers

    Endothelial dysfunction is characterized by increased NO bioavailability.

    <p>False</p> Signup and view all the answers

    What is the effect of oxidative stress on endothelial function?

    <p>deteriorates</p> Signup and view all the answers

    Where are atherosclerotic lesions usually generated in the entire vascular tree?

    <p>All of the above</p> Signup and view all the answers

    Low endothelial shear stress is associated with upregulation of eNOS.

    <p>False</p> Signup and view all the answers

    What is the main mechanism of the beneficial effects on the cardiovascular system during exercise?

    <p>Increases in vascular blood flow and shear rate</p> Signup and view all the answers

    C-reactive protein is a marker of ______________ levels.

    <p>inflammation</p> Signup and view all the answers

    Match the following with their descriptions:

    <p>Shear stress = Locally disturbed shear stress by pulsatile blood flow Endothelial dysfunction = Clinical implications in cardiovascular disease and therapeutic approaches C-reactive protein = A marker of inflammation levels eNOS = Upregulated by high endothelial shear stress</p> Signup and view all the answers

    Endothelial dysfunction is only associated with cardiovascular disease.

    <p>False</p> Signup and view all the answers

    Which of the following is a risk factor for endothelial dysfunction?

    <p>All of the above</p> Signup and view all the answers

    What is the name of the journal where the article 'Endothelial dysfunction: clinical implications in cardiovascular disease and therapeutic approaches' was published?

    <p>Journal of Korean medical science</p> Signup and view all the answers

    What is the primary pathway for transmitting cardiac pain?

    <p>Sympathetic nerves</p> Signup and view all the answers

    The atria and ventricles are supplied with parasympathetic sensory innervation.

    <p>False</p> Signup and view all the answers

    What is the basis for cardiac pain referred to the chest, wall, arm, and back?

    <p>Convergence-projection theory</p> Signup and view all the answers

    Sympathetic impulses from the heart converge with impulses from somatic thoracic structures onto the same ascending _______ neurons.

    <p>spinal</p> Signup and view all the answers

    Match the following components of the cardiac pain pathway:

    <p>Afferent fibers = transmit cardiac pain Sympathetic ganglia = receive afferent fibers Thoracic dorsal roots = receive sympathetic impulses</p> Signup and view all the answers

    What is the role of vagal afferent fibers in cardiac pain?

    <p>Refer pain to the jaw and neck</p> Signup and view all the answers

    Localisation of ischemic pain can predict the site of myocardial ischemia.

    <p>False</p> Signup and view all the answers

    What is the name of the theory that explains cardiac pain referred to the chest, wall, arm, and back?

    <p>Convergence-projection theory</p> Signup and view all the answers

    In addition to sympathetic afferent fibers, _______ afferent fibers also play a role in cardiac pain.

    <p>Vagal</p> Signup and view all the answers

    What is the basis for cardiac pain referred to the jaw and neck?

    <p>Vagal afferent fibers</p> Signup and view all the answers

    What is the level of discomfort or pain described as 'excruciating and unbearable pain'?

    <p>4</p> Signup and view all the answers

    Monitoring should continue for at least 10 minutes after exercise.

    <p>False</p> Signup and view all the answers

    What should be recorded during the post-exercise period?

    <p>Heart rate recovery (HRR)</p> Signup and view all the answers

    ST-segment changes that occur only during the ______________ period are currently recognized to be an important diagnostic part of the test.

    <p>post-exercise</p> Signup and view all the answers

    What is the minimum duration of monitoring after exercise?

    <p>6 minutes</p> Signup and view all the answers

    HR and BP should return to exact baseline levels before discontinuation of monitoring.

    <p>False</p> Signup and view all the answers

    What is the purpose of walking 'recovery' with a standardized speed?

    <p>To appraise changes in fitness</p> Signup and view all the answers

    Match the following with their descriptions:

    <p>Pain level 1 = Definite discomfort or pain but only of initial or modest levels Pain level 2 = Moderate discomfort or pain from which the client's attention can be diverted by a number of common stimuli Pain level 3 = Intense pain from which the client's attention cannot be diverted except by catastrophic events Pain level 4 = Excruciating and unbearable pain</p> Signup and view all the answers

    During the post-exercise period, HR and BP should return to near ______________ levels before discontinuation of monitoring.

    <p>baseline</p> Signup and view all the answers

    The heart rate recovery (HRR) is not an important prognostic marker.

    <p>False</p> Signup and view all the answers

    Study Notes

    Heart Structure

    • The heart has four chambers: Right Atrium, Right Ventricle, Left Atrium, and Left Ventricle.
    • The heart has four valves: Tricuspid valve, Mitral valve, Pulmonary valve, and Aortic valve.
    • The valves ensure a one-way flow of blood through the heart.

    Atrioventricular (AV) Valves

    • Right AV valve has three cusps → Tricuspid valve.
    • Left AV valve has two cusps → Mitral or Bicuspid valve.
    • Chordae tendineae: cords connect AV valves to papillary muscles on the floor of ventricles.
    • Prevent AV valves from flipping inside out or bulging into the atria when the ventricles contract.

    The Heart Wall

    • Pericardium: double-walled sac that encloses the heart.
    • Allows heart to beat without friction, provides room to expand, yet resists excessive expansion.
    • Anchored to diaphragm inferiorly and sternum anteriorly.

    Pericardial Cavity

    • Space inside the pericardial sac filled with 5 to 30 mL of pericardial fluid.

    Epicardium (Visceral Pericardium)

    • Serous membrane covering the heart.
    • Adipose in thick layer in some places.
    • Coronary blood vessels travel through this layer.

    Myocardium

    • Layer of cardiac muscle proportional to work load.
    • Muscle spirals around heart, producing a wringing motion.
    • Fibrous skeleton of the heart: framework of collagenous and elastic fibers.
    • Provides structural support and attachment for cardiac muscle and anchor for valve tissue.

    Endocardium

    • Smooth inner lining of the heart and blood vessels.
    • Covers the valve surfaces and is continuous with the endothelium of blood vessels.

    Blood Flow Through the Chambers

    • Deoxygenated blood from the body enters the Right Atrium through the Superior and Inferior vena cava.
    • Blood then flows through the Tricuspid valve into the Right Ventricle.
    • From the Right Ventricle, blood flows through the Pulmonary valve into the Pulmonary artery.
    • Oxygenated blood from the lungs returns to the heart through the Pulmonary veins and enters the Left Atrium.
    • From the Left Atrium, blood flows through the Mitral valve into the Left Ventricle.
    • From the Left Ventricle, blood flows through the Aortic valve into the Aorta.

    Heart Location

    • The heart is located in the thoracic cavity, superior to the diaphragm.
    • The heart is anchored to the diaphragm inferiorly and sternum anteriorly.

    Cardiovascular System

    • The cardiovascular system has two major circulatory circuits: Pulmonary and Systemic.
    • The Pulmonary circuit transports deoxygenated blood from the heart to the lungs and returns oxygenated blood from the lungs to the heart.
    • The Systemic circuit transports oxygenated blood from the heart to the rest of the body and returns deoxygenated blood from the body to the heart.

    Cardiovascular Disease

    • Cardiovascular disease (CVD) is a term that describes many different conditions affecting the heart and blood vessels.
    • Common and serious types of CVD include coronary heart disease, stroke, and heart failure.
    • Despite declining mortality and hospitalisation rates, CVD remains a major health problem in Australia.
    • CVD has a greater impact on males, the elderly, Indigenous Australians, and people living in remote and socioeconomically disadvantaged areas.

    Prevalence of Cardiovascular Disease in Australia

    • In 2022, approximately 1.3 million Australians (5.3%) had one or more conditions related to heart, stroke, or vascular disease.
    • The prevalence of CVD increases with age, with 0.6% of Australians aged 0-44 years and 27.7% of those aged 75 years and over affected.
    • Socioeconomically disadvantaged individuals are more likely to be affected, with 8.2% compared to 3.6% of those who are not disadvantaged.
    • Indigenous Australians are 2.1 times more likely to be affected than non-Indigenous Australians.

    Endothelial Dysfunction and Cardiovascular Disease

    • Endothelial dysfunction is an important factor in the progression of atherosclerotic CVD.
    • The vascular endothelium is a monolayer of cells covering the lumen of the vessels, playing a complex role in maintaining homeostasis.
    • Chronic exposure to cardiovascular risk factors and oxidative stress can overwhelm the defense mechanisms of the vascular endothelium, leading to endothelial dysfunction.

    Nitric Oxide and Endothelial Dysfunction

    • Nitric oxide (NO) is the most potent endogenous vasodilator in the body, maintaining homeostasis by inhibiting platelet aggregation, inflammation, and oxidative stress.
    • NO is produced and released from L-arginine through the activity of endothelial NO synthase (eNOS).
    • Oxidative stress can deteriorate endothelial function, and NO production is impaired in endothelial dysfunction.

    Oxidative Stress and Endothelial Dysfunction

    • Oxidative stress is the most common underlying mechanism for the development of endothelial dysfunction.
    • Up-regulation of reactive oxygen species (ROS) leads to impaired homeostasis, reduced anti-inflammatory effects, and increased vascular permeability to lipoproteins.
    • Endothelial NO synthase (eNOS) can become a potential ROS generator when in a pathological uncoupled state.

    Chronic Inflammation and Endothelial Dysfunction

    • Chronic inflammation is another common underlying mechanism for endothelial dysfunction.
    • Dysfunctional endothelium promotes ROS generation and aggravates inflammation, amplifying inflammation signaling pathways.
    • C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-α) are involved in the inflammatory response, promoting leukocyte adherence and migration.

    Shear Stress and Endothelial Dysfunction

    • Locally disturbed shear stress by pulsatile blood flow is one of the modulators of the atherogenic process.
    • Low endothelial shear stress (ESS) is associated with plaque progression and vulnerability, while high ESS is associated with upregulation of eNOS.
    • Increases in vascular blood flow and shear rate are considered the main mechanisms of the beneficial effects on the cardiovascular system during exercise.

    Meeting the Client (A)

    • Informed consent is essential before exercising, and it involves identifying individuals at risk of adverse exercise-related cardiovascular events.
    • Health screening and cardiovascular risk factor analysis are crucial in determining the appropriate objective physiological tests and devising an intervention program.
    • Ability to predict rare exercise-related events is low due to the high prevalence of cardiovascular disease risk factors among adults and the rarity of exercise-related sudden cardiac death and acute myocardial infarction.

    Interview

    • The interview process consists of two main steps:
      • General interview for subjective information
      • Assessment and evaluation for objective measures (anthropometric, BP, CV fitness, strength, mobility, etc.)
    • The interview environment should be quiet, secure, and free of distractions, with the use of lay terms and empathy to build trust.

    Reason for Referral

    • The reason for referral is usually self-explanatory (e.g., increase exercise tolerance, improve ROM, or behavioral changes)
    • It is essential to bridge the gap between the nature of the referral and the client's interpretation to establish a good working relationship

    Demographics

    • Age, sex, and ethnicity are related to the risk of cardiovascular conditions and/or comorbidities
    • Age is an independent predictor of survival in almost all cardiopulmonary conditions
    • Sex may affect exercise compliance and disease management, with CVD onset generally 10 years later in women
    • Ethnicity differences are often related to differences in SES and access to care

    History of Present Illness

    • Record and convey primary information related to the condition leading to the referral
    • Chief complaint, summary of manifestations, and information about date of onset, chronicity of symptoms, types of symptoms, exacerbating or alleviating factors, and major interventions
    • Ask specific questions about symptoms using OPQRTS and A (Onset, Provocation and palliation, Quality, Region and radiation, Severity, Timing, and Associated signs and symptoms)

    Medications and Allergies

    • Current medication list is essential, considering how they align with current and previous medical history
    • Ask about dose, administration route, frequency, and time of day taken, as well as allergy history

    Medical History

    • Concise, relevant list of past medical problems, including dates
    • All conditions, injuries, etc., as one may influence another and exercise prescription

    Family History/Social History

    • Family history should be restricted to heritable disorders in first-degree family members
    • Relevant heritable conditions include cancers, Type II diabetes, familial hypercholesterolemia, sudden death, and premature coronary artery disease
    • Social history includes information about the client's lifestyle and living patterns, including smoking, alcohol, illicit drugs, occupation, transportation, housing, routine, and leisure activities

    Goals (SMARTER)

    • Behavior: smoking, alcohol, nutrition, physical activity, and weight management
    • Biomarkers: lipids, blood pressure, fasting blood glucose concentrations
    • Medications
    • Cardiopulmonary condition and associated symptoms

    Physical Examination

    • [No specific information provided]
    • Informed consent from individuals before exercise testing is an essential ethical and legal step
    • Form must be read and signed, with an opportunity to ask questions
    • Clients under 18 years must have a parent/caregiver sign consent as well

    Symptoms of Cardiovascular Disease (CVD)

    • Orthopnoea: dyspnoea at rest in a recumbent position, quickly relieved by sitting or standing upright (Left Ventricular Dysfunction, LVD)
    • Paroxysmal nocturnal dyspnoea: occurs 2-5 hours after the onset of sleep, relieved by sitting on bedside (LVD)
    • Ankle oedema: bilateral characteristic of Heart Failure (HF) or bilateral chronic venous insufficiency; unilateral often lymphatic blockage; generalised nephrotic syndrome or hepatic cirrhosis
    • Palpitations: rapid or forceful heart, sudden tachycardia, bradycardia, ectopic beats, SV changes from valvular regurgitation (anxiety, high Q, anaemia, fever)
    • Intermittent claudication: pain in the lower limbs during exercise from a lack of blood supply (atherosclerosis); onset during ambulation, disappears 1-2 mins of rest; increased prevalence of Coronary Artery Disease (CAD)
    • Known heart murmur: some innocent but may indicate valvular disease or other CVD; rule out hypertrophic cardiomyopathy and aortic stenosis = high risk of exercise related sudden cardiac death
    • Unusual fatigue or SOB with usual activities: can be benign, may also signal the onset of, or change in CVD

    Diagnostic Clinical Exercise Testing

    • Diagnostic clinical exercise test for Ischaemic Heart Disease (IHD) needs specialist attendance
    • Also used for pulmonary diseases, pacemaker or HR response, claudication, disability, and Prognosis Assessment (PA)
    • Prognosis: ST-segment depression, magnitude, number of leads identified, time to onset and recovery from
    • Functional capacity (FC) in metabolic equivalents (METS) or VO2max (1 MET/3.5ml.kg-1.min-1 = 15% risk of CVD related mortality)

    Exercise Protocol Design

    • Consider: purpose of evaluation, specific outcomes desired, characteristics of individual being tested (age, gender, PA status, fitness, experience, orthopedics, symptomatology)
    • Most common exercise test protocols: Bruce, Ellestad, Naughton, Balke-Ware
    • Need to consider: modality, ramp vs. step, start load, load increments, stage duration, test duration, onset of “fatigue”, peak metabolism

    Tools to be Used During Exercise Testing

    • 12-lead electrocardiogram: heart rate, varying software, anomaly flagging capabilities
    • Blood pressure: sphygmomanometer and stethoscope, automatic option; consider accuracy
    • Pulse oximetry: finger or earlobe based, may be integrated into ECG software or single device
    • Scales: perceived exertion, angina, dyspnoea, intermittent claudication
    • Charts: normative data, data specific to conditions (e.g. ejection fraction and performance)
    • Senses: sight (pallor, cyanosis, ataxia) and sound (dyspnoea) very important

    Angina, Dyspnoea, and Intermittent Claudication Scales

    • Four-point dyspnoea scale: 1 = Mild, noticeable to patient but not the observer; 2 = Mild, some difficulty, noticeable to observer; 3 = Moderate difficulty, but patient can continue; 4 = Severe, difficulty, patient cannot continue
    • Four-point peripheral vascular disease scale: 1 = Definite discomfort or pain but only of initial or modest levels; 2 = Moderate discomfort or pain from which the client's attention can be diverted; 3 = Intense pain from which the client's attention cannot be diverted; 4 = Excruciating and unbearable pain

    Termination of the Test

    • Termination criteria: absolute and relative contraindications
    • Post-exercise period: monitoring should continue for at least 6 min after exercise or until ECG changes return to baseline and significant signs and symptoms resolve
    • ST-segment changes that occur only during the post-exercise period are currently recognized to be an important diagnostic part of the test
    • Heart rate recovery (HRR) from exercise is an important prognostic marker that should be recorded

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    Description

    This quiz covers the structure and components of the human heart, including its valves, arteries, and chambers. It includes identification of the aorta, pulmonary artery, and ventricles.

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