Cardiology Essentials Quiz

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Questions and Answers

What is the primary function of the right side of the heart?

  • To pump deoxygenated blood to the lungs for oxygenation (correct)
  • To supply oxygenated blood to the body
  • To receive deoxygenated blood from the body
  • To regulate blood pressure within the pulmonary circulation

Which symptom is indicated by difficulty breathing while lying flat?

  • Nocturia
  • Cyanosis
  • Dyspnea
  • Orthopnea (correct)

What could edema in the ankles and feet indicate?

  • Fluid overload due to dehydration
  • Liver failure
  • Poor circulation from arterial disease
  • Hypervolemia (correct)

Which heart valve closes during the first heart sound (S1)?

<p>Tricuspid valve (D)</p> Signup and view all the answers

What is a potential consequence of congenital heart disease?

<p>Improper septal development (C)</p> Signup and view all the answers

What condition results from inflammation of all layers of the heart, impairing contraction and valve function?

<p>Pericarditis (A)</p> Signup and view all the answers

Which lifestyle habit is NOT commonly associated with increased risk for cardiac issues?

<p>Regular exercise (C)</p> Signup and view all the answers

What is a characteristic symptom of angina pectoris?

<p>Pain on exertion relieved by rest (A)</p> Signup and view all the answers

What type of edema involves a depression that remains for 5-30 seconds after pressure is applied?

<p>Pitting edema (B)</p> Signup and view all the answers

What is the most common symptom that requires immediate assessment in a patient with chest pain?

<p>Angina pectoris (C)</p> Signup and view all the answers

What differentiates non-cardiac chest pain from cardiac-related chest pain?

<p>Type of associated symptoms (D)</p> Signup and view all the answers

Which of the following indicates that edema is related to poor cardiac function?

<p>Dependent edema in the legs (A)</p> Signup and view all the answers

What is the OLD CART acronym used for during a chest pain assessment?

<p>Assessing pain and its characteristics (B)</p> Signup and view all the answers

Which factor does NOT typically lead to myocardial infarction?

<p>Infrequent meal intake (C)</p> Signup and view all the answers

What is a common manifestation of pulmonary edema that indicates heart failure?

<p>S3 gallop heart sound (B)</p> Signup and view all the answers

Which treatment is often used for managing hypervolemia in patients with heart failure?

<p>Diuretics (A)</p> Signup and view all the answers

What symptom indicates inadequate oxygen supply to the body in heart failure?

<p>Cyanosis (A)</p> Signup and view all the answers

Which of the following is a common cause of Venous Thromboembolism (VTE)?

<p>Prolonged travel (B)</p> Signup and view all the answers

What does jugular venous distension (JVD) indicate about a patient's condition?

<p>Hypervolemia (D)</p> Signup and view all the answers

What is the primary function of the lymphatic system?

<p>Drain excess fluid from tissues (A)</p> Signup and view all the answers

How would you classify the edema caused by a deep vein thrombosis (DVT)?

<p>Usually unilateral (D)</p> Signup and view all the answers

What is the primary method for assessing jugular venous pressure (JVP)?

<p>Inspecting the right internal jugular vein at a specific angle (B)</p> Signup and view all the answers

What might a displaced point of maximal impulse (PMI) indicate?

<p>Left ventricular hypertrophy (LVH) (C)</p> Signup and view all the answers

What is a common treatment option that can lead to heparin-induced thrombocytopenia (HIT)?

<p>Low molecular weight heparin (LMWH) (D)</p> Signup and view all the answers

Flashcards

Right Heart Blood Flow

Deoxygenated blood flows from the body to the lungs via the superior/inferior vena cava, right atrium, tricuspid valve, right ventricle, pulmonic valve, and pulmonary artery.

Left Heart Blood Flow

Oxygenated blood travels from the lungs to the body via pulmonary vein, left atrium, mitral valve, left ventricle, aortic valve, and aorta.

Heart Sounds (Auscultation)

Heart sounds, like S1 and S2, are produced by valve closures and can indicate potential heart problems (e.g., murmurs).

Cardiac Symptoms

Common cardiac symptoms include chest pain, arrhythmias, dyspnea, orthopnea, edema (swelling), nocturia (frequent urination at night), fatigue, cyanosis (blue skin), and pallor (pale skin).

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Heart Murmurs

Abnormal heart sounds indicating blood flow issues within the heart, possibly due to defects in the valves or structure.

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Cardiac Inflammation

Inflammation affecting all layers of the heart, impacting its ability to pump blood and regulate valve function.

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Lifestyle and Heart Health

Factors like diet, smoking, alcohol consumption, exercise, and drug use can significantly impact heart health.

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Family History and Heart Risk

Having a family history of heart conditions like hypertension, heart attacks, high cholesterol, or diabetes increases your risk.

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Chest Pain - The Symptom

Chest pain is a major symptom that needs immediate attention. It can be a sign of a heart attack, angina, or other serious conditions.

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Angina Pectoris

Chest pain caused by reduced blood flow to the heart during exertion, which is relieved by rest.

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Non-Cardiac Chest Pain

Chest pain can be caused by conditions other than heart problems, like inflammation of the lungs, acid reflux, muscle pain, or anxiety.

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OLD CART Chest Pain Assessment

A mnemonic used to assess chest pain. It stands for Onset, Location, Duration, Characteristic, Aggravating factors, Relieving factors, Treatment.

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Edema: Fluid Accumulation

Edema is swelling due to excessive fluid in the body's tissues.

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Pitting Edema

Edema where the skin retains an indentation after pressure is applied.

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S3 Gallop

An extra heart sound heard during heart failure, often described as a "lub-dub-dee" rhythm. It indicates the heart is struggling to fill effectively.

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JVD (Jugular Venous Distension)

The swelling of the jugular vein in the neck, often a sign of heart failure or other conditions where the blood is backing up in the veins.

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Orthopnea

Difficulty breathing when lying flat, a symptom often associated with heart failure or fluid buildup in the lungs.

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Crackles in Lower Lungs

Rattling sounds heard during breathing, indicating fluid in the lungs, often associated with heart failure.

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Peripheral Edema

Swelling in the extremities, especially the ankles and feet, often a sign of fluid buildup due to heart failure or other circulatory problems.

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VTE Prophylaxis

Measures taken to prevent blood clots (deep vein thrombosis - DVT and pulmonary embolism - PE) in high-risk individuals.

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Compression Stockings

Special stockings worn to help prevent blood clots by applying pressure to the legs, often used for patients at risk for DVT.

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LMWH (Low Molecular Weight Heparin)

A type of blood thinner injected under the skin to help prevent blood clots.

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Edema due to DVT

Swelling caused by a blood clot in a deep vein, typically affecting one leg.

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Lymphatic System

A network of vessels and nodes that collect excess fluid and waste products from the body and return them to the bloodstream. Think of the lymphatic system as the 'drainage' system of your body.

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Study Notes

Heart Blood Flow

  • Right Side (Deoxygenated): Blood travels from the heart to the lungs

    • Superior Vena Cava (SVC) / Inferior Vena Cava (IVC)
    • Right Atrium
    • Tricuspid Valve
    • Right Ventricle
    • Pulmonic Valve
    • Pulmonary Artery

  • Left Side (Oxygenated): Blood travels from the heart to the body

    • Pulmonary Vein
    • Left Atrium
    • Bicuspid (Mitral) Valve
    • Left Ventricle
    • Aortic Valve
    • Aorta

Heart Sounds

  • Aortic: Aortic Valve
  • Pulmonic: Pulmonic Valve (S2)
  • Tricuspid: Tricuspid Valve (S1)
  • Mitral: Mitral Valve (apex)

Cardiac History

  • Chest Pain: Differentiate cardiac, respiratory, GI, musculoskeletal causes. Priority symptom.
  • Arrhythmias: Irregular heartbeats (skipped beats, palpitations)
  • Dyspnea: Shortness of breath; not just a lung problem.
  • Orthopnea: Trouble breathing lying down
  • Cough: Could indicate left-sided heart failure
  • Edema: Swelling in ankles/feet; hypervolemia.
  • Nocturia: Frequent urination at night.
  • Fatigue: Exhaustion.
  • Cyanosis/Pallor: Blue/pale skin; poor oxygenation.
  • Murmurs: Heart defects impacting pumping (reduced O2 supply).
  • Congenital Heart Defects
  • Rheumatic Fever: Heart valve damage from strep infection. Inflammation of all heart layers.
  • Hypertension
  • Hypercholesteremia: High cholesterol
  • Diabetes

Lifestyle and Habits

  • Diet (Obesity)
  • Smoking
  • Alcohol
  • Exercise
  • Drug Use

Family History

  • Hypertension
  • Myocardial Infarction (MI): Heart attack; impaired blood flow (ischemia).
  • Coronary Artery Disease (CAD)
  • Hyperlipidemia
  • Diabetes Mellitus

Chest Pain Etiology

  • Cardiac
  • Respiratory
  • Gastrointestinal (GI)
  • Musculoskeletal

Chest Pain - Detailed Inquiry (OLD CART)

  • Onset: When did it start? Recurring? Nighttime?
  • Location: Exact description; does it radiate?
  • Duration: How long does it last?
  • Characteristic: Intensity (0-10), description (stabbing, pressure).
  • Aggravating Factors: Associated symptoms (nausea, sweating, lightheadedness)
  • Relieving Factors: Does rest relieve it? Medications?
  • Treatment: What has the patient taken?

Edema

  • Assessment Questions: (Shoes, rings, eyelids)
  • Timing & location of swelling
  • Dependent Edema: Swelling in lower body parts (feet, legs, sacrum)
  • Causes: Cardiac failure, peripheral vascular disease (PVD), nutritional (low albumin), positional.
  • Pitting Edema Grading: Depth of indentation (1+ to 4+)

Fluid Balance

  • Homeostasis: Intake = Output
  • Maintaining fluid balance (volume & composition) is crucial.

Fluid Volume Excess (Hypervolemia)

  • Poor heart function; body can't handle excess fluid.
  • Possible causes: Heart failure, pulmonary edema.
  • Impacts lab values (hematocrit, electrolytes).
  • Signs: S3 gallop (ventricular gallop), crackles in lungs, distended neck veins (JVD), dyspnea, orthopnea, increased respiratory rate, blood pressure
  • Treatment: Diuretics (loop, potassium-sparing, thiazide)

Other Associated Symptoms of Hypervolemia

  • Fatigue
  • Cyanosis/Pallor
  • Nausea & Vomiting
  • Syncope
  • Diaphoresis

Peripheral Vascular System

  • Veins: Carry deoxygenated, nutrient-depleted blood back to the heart
  • VTE (Venous Thromboembolism): Includes DVT (deep vein thrombosis) and PE (pulmonary embolism). Preventable in hospitalized patients.
    • Risk factors: Post-op, obesity, prolonged travel, surgery, trauma, pregnancy, medications, heparin.
  • VTE Prophylaxis: Compression stockings, early ambulation, vena cava filters, SCD's, anticoagulants
  • Edema due to DVT: Unilateral swelling of calf/ankle.
  • Lymphatic System: Drains excess fluid from tissues to venous system
  • Edema Prevention: Lymphatic system helps prevent fluid buildup.

Cardiovascular (Physical Assessment)

  • Active Learning: Students interview/perform cardiac exams on partners.
  • Components: Face, neck vessels, precordium, heart sounds, peripheral edema, vital signs, pulse (6).
  • Jugular Venous Distension (JVD): Assesses volume status; reflects pressure in right atrium (or central venous pressure). The higher the distension, the greater the volume problem.
  • Position (supine, 30-45 degrees), locate internal jugular vein.
  • Causes of Increased JVD: Heart failure, pulmonary hypertension, tricuspid stenosis, pericardial tamponade.

Cardiovascular Exam - Inspection

  • Skin color, lips, mouth, conjunctiva
  • Eyes: Xanthelasma, orbital edema
  • Capillary refill
  • Clubbing of fingertips (low blood oxygen)
  • Neck veins (distention/pulsations)
  • Precordium (visible pulsations)
  • Apical Impulse Inspection

Cardiovascular Exam - Palpation

  • Arterial Pulses: (bounding +4, strong 3+, normal +2, weak +1, thready +1)
  • PMI (Point of Maximal Impulse) Location: Left ventricular contraction
  • Displacement of the PMI suggests Left Ventricular Hypertrophy (LVH)
  • Heart rate and rhythm
    • Sinus tachycardia (100-180 bpm)
    • Normal sinus rhythm (60-100 bpm)
    • Sinus bradycardia

Cardiovascular Exam - Capillary Refill

  • Rapid refill (2 second or less) – normal; a slow refill suggests a compromised circulation in some location or cardiac/Respiratory diseases caused by hypoxia

Cardiovascular Exam - Pulses

  • Radial
  • Brachial
  • Popliteal
  • Femoral
  • Dorsalis pedis
  • Posterior tibial

Cardiovascular Exam - Neck

  • Palpate for thrills (buzzing)

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