Term
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Definition
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Term
| Normal heart axis should lie between ___ degrees and ___ degrees |
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Definition
| Betwee -30 degrees and +110 degrees. (AvL - AvF) |
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Term
| pulmonary htn results in what kind of shift? Why |
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Definition
| Pulmonary htn results in a right shift due to hypertrophy of RV. |
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Term
| COPD results in what kind of shift |
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Definition
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Term
| What leads are used for axis evaluation? What should they be |
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Definition
| Lead I and AvF are used to diagnose Axis. The majority of the deflection in both should be positive. |
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Term
| what is the difference in junctions between myocytes and electrical cells of the heart |
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Definition
| myocyctes have gap junctions which are slower than electrical heart cells which have tight junctions |
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Term
| Which leads are good diagnostic leads for bundle branch blocks |
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Definition
| V1 and V2 since they sit over the septum. |
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Term
| A pulmonary artery catheter causes what kind of bundle branch |
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Definition
| Right bundle branch. 2-5% of the time. |
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Term
| the left bundle branch can be further divided into what? |
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Definition
| the posterior fascicle and anterior fascicle |
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Term
| How do you identify right ventricular hypertrophy |
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Definition
| Huge R wave in V1 which needs to be equal or greater > than S wave |
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Term
| The normal amplitude of QRS is never bigger than |
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Definition
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Term
| Left ventricular hypertrophy can be identified with an EKG how? |
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Definition
| measure the largest R wave (in mm) either from V5 or V6 and add to S wave in V1. If total is = or > than 35 = LVH |
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Term
| there can be two different types of ST elevation |
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Definition
1. non-concave (convex)
2. concave |
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Term
| The most common ST elevation for MI's is? |
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Definition
| Convex ST elevation which is one large curve. |
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Term
| MI with a concave design can also be confused with what other pathology |
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Definition
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Term
| ST elevation indicates there has been an MI in the last ___ hours |
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Definition
| <48 hours sensitive for an MI |
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Term
| A significant Q wave is dimensional as follows |
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Definition
1. 0.04 seconds wide OR
2. 1/3 the size of the r wave |
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Term
| Age indeterminant MI criteria |
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Definition
| 1. significant Q waves, inverted T waves, near baseline ST segment. Indicates an event in days to a year. |
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Term
| what are some contraindications for a stress test |
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Definition
1. MI <48 hours
2. Uncontrolled symptomatic HF
3. unstable angina
4. uncontrolled cardiac arrhythmias with sx
5. severe AS or w/sx
6. dissecting aneurysm
7. Acute phase of a PE |
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Term
| If a patient is healthy what will you see on a stress test |
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Definition
1. tall P waves from increased lung capacity
2. increase in BP due to increase CO
3. Increase RR
4. sweating
5. fatigue
6. J-point depression (TRANSIENT! <0.08 seconds in actual length) |
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Term
| A positive stress test (PT WAS COMPROMISED) will show with what results |
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Definition
1. ST segment dperession that continues after test. (1-1.5 mm depressed) and lasts longer than 0.08 seconds).
2. Any ST elevation = FAIL |
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Term
| What are on the PET scan or nuclear scan for a stress test would indicate a person has failed |
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Definition
| DArk areas indicate lack of flow or effective flow of blood due to constriction of coronaries that can't keep up with increase demand. |
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Term
| what type of an echo is good for posterior views of the heart |
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Definition
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Term
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Definition
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Term
| an EF of ___ % is compatible with life |
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Definition
| EF of 5% can support life |
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Term
| What waves are on the ECHO machine when assessing flow across a valve? What do they represen/ t |
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Definition
E then A waves.
E wave: Passive filling. It is larger than A wave.
A wave: represents contraction of |
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Term
| If the ECHO has a A wave that is larger than the E wave..this indicates? |
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Definition
A>E indicates abnormal diastolic function
From:
1. LVH
2. HTN
3. Age
4. LEss compliant |
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Term
| If E wave in an ECHO is exagerated may indicate |
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Definition
| Restrictive cardiomyopathy or constrictive pericarditis |
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Term
| the most sensitive indicator of left ventricular wall ischemia intra op is determined by use of? What will be off? |
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Definition
| Wall motion abnormality intra-op through use of an echo device will give you the best chances of early diagnosis of ischemia. |
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Term
| What are the two types of wall motion abnormality |
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Definition
1. hypo-kinetic movement
2 akinetic movement. |
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Term
| A normal mean gradient of the aorta is? If its > ___ then there is severe aortic stenosis |
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Definition
| normal aortic gradient = <10. If severe AS then gradient >45 mm Hg |
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Term
| Normal mitral mean gradient is? Severe mitral stenosis is? |
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Definition
normal mitral gradient < 5 mm Hg
Severe Mitral Stenosis > 10 mm Hg |
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Term
| the prevalence of mitral valve prolapse is |
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Definition
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Term
| MVP is a high risk for other things such as |
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Definition
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Term
| The average O2 consumption per min for an average person at 1 MET is? |
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Definition
| 1 MET = 250 mL of O2 / min / 70Kg person |
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Term
| what patients must get an ECHO prior to surgery |
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Definition
| pts with clinically moderate or greater stenosis need an ECHO within one year of surgery as long as no major changes since that last one |
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Term
| Can patients have surgery with severe valvular disease? |
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Definition
| YES. AS LONG AS THEY ARE NOT SYMPTOMATIC |
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Term
| patients with ischemic heart disease will often present with what findings on ECG |
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Definition
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Term
| what patients should get a pre-op ECG |
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Definition
1. CVA hx
2. PVD
3. Structural disease present of heart |
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Term
| pts with a MET score of ___ need to get a stress test |
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Definition
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Term
| patients with three or more risk factors (cardiac) need to be placed on what kind of drug?? How long prior to surgery to get a benefit |
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Definition
| NEED TO BE on a beta blocker and start that beta blocker 2-7 days prior. No benefit if starting beta blocker day of. |
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Term
| is there a difference in cardiac risks for patients undergoing TIVA compared to Volatile? |
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Definition
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