and CORRECT Answers
S1 - CORRECT ANSWER - Denoted AV Valve Closure
S2 - CORRECT ANSWER - denotes semilunar valve closure
S3 - CORRECT ANSWER - abnormal sound caused by high ventricular pressure; Normal
but could be alarming in the older population (early CHF) -*Tennessee*
S4 - CORRECT ANSWER - abnormal sound caused by poor ventricular compliance or
hypertension; blood is packing into an already full ventricle - *Kentucky*
Murmur - CORRECT ANSWER - Caused by turbulent blood flow; Graded 1-4
Semilunar Valves - CORRECT ANSWER - Aortic Valve
Pulmonic Valve
Atrioventricular Valves - CORRECT ANSWER - Mitral Valve
Tricuspid Valve
Cardiac Output - CORRECT ANSWER - CO= HR x SV
Normal 4-8 liters per minute
Left Coronary Artery (LCA) - CORRECT ANSWER - -bifurcates to the LAD and LCX
Left Anterior Descending (LAD) - CORRECT ANSWER - -go down/inferior
-supplies the anterior side of left ventricle
,-front of heart
Left Circumflex (LCX) - CORRECT ANSWER - -wraps around the left towards the back
-supplies the left wall of left ventricle
-in half of population this supplies the posterior portion of the heart
Right Coronary Artery (RCA) - CORRECT ANSWER - -splits to the RM and PD
-supplies blood to SA node
Right Marginal (RM) - CORRECT ANSWER - -supplies the inferior surface of the left
ventricle
Posterior Descending (PD) - CORRECT ANSWER - -wraps around the bottom and back
of the heart
-in half of population this supplies the posterior portion of the heart
Coronary Perfusion Pressure - CORRECT ANSWER - CPP= DBP-LVEDP
Pressure that must be maintained to perfuse the heart
Left Ventricular End Diastolic Pressure (LVEDP) - CORRECT ANSWER - -Pressure in
the left ventricle during diastole
-Sometimes referred to as LV Wedge Pressure
-normal value is 50
Transmural Infarction - CORRECT ANSWER - -damage extends through the full
thickness of the myocardium
-entire blood vessel is occluded
-ST elevation with reciprocal changes
,Subendocardial Infarction - CORRECT ANSWER - -necrosis is limited to the
subendocardial tissue and not the full wall of the heart
-presents with ST depression due to the inside portion of the tissue infarcting but the outside still
perfusing
Unstable Angina - CORRECT ANSWER - -ST changes may not show up on 12 lead
-affects a very small spot of the heart
-Negative cardiac markers
Non-STEMI - CORRECT ANSWER - -ST depression or dynamic T wave changes in 2
contiguous leads
-Positive cardiac markers
STEMI - CORRECT ANSWER - -ST segment elevation in 2 or more contiguous leads
-New onset LBBB
-Positive cardiac markers
Stable Angina - CORRECT ANSWER - -Chest pain that occurs with work (predictable)
-Patient runs for 10 min, gets CP, takes Nitro, pain relieved
-When plaque ruptured and platelets form causing a block, this is now unstable
Myoglobin - CORRECT ANSWER - -Rises the quickest, usually in 1 hour
-Same as hemoglobin except its in muscles
-Not specific to cardiac
CK-MB - CORRECT ANSWER - -CK-MB is released into the bloodstream once heart
tissue ruptures from lack of oxygen
-Specific to cardiac
-Rises in 4-8 hours
, Troponin - CORRECT ANSWER - -Same as CK-MB
-Very sensitive to the heart
-Rises with a very small lack of oxygen in heart tissue
-Rises in 4-6 hours, last the longest
Anterior-Septal MI - CORRECT ANSWER - -Occlusion of the LAD
-V1-V4
-Watch for acute CHF due to valves not closing properly
Lateral MI - CORRECT ANSWER - -Occlusion of the LCX
Inferior MI - CORRECT ANSWER - -Occlusion of the RCA
-Work backwards and find how far back the RCA is occluded
-Assess for posterior MI
Q-Waves - CORRECT ANSWER - Pathologic- wider than 1 box, deeper than 1/3 R wave
-Damage has been done previously to this portion of the heart
Physiologic-means nothing
Central Venous Pressure (CVP) - CORRECT ANSWER - Normally 2-6mmHg
-Measured in the great veins/right atria
-Think like plumbing, obstruction down the line causes higher pressure before obstruction
Central Venous Waveform - CORRECT ANSWER - Waveform is low amplitude, similar
to V-Fib
Systemic Vascular Resistance (SVR) - CORRECT ANSWER - 800-1200 dines