CMSRN - Cardiac Exam Questions And Accurate Answers
Heart valves on the right side of the heart ANSWER Tricuspid Valve, Pulmonary Valve
How does blood flow through the tricuspid valve? ANSWER Blood flows from the right
atrium, to the right ventricle
How does blood flow through the pulmonary valve? ANSWER Blood flows from the right
ventricle, to the pulmonary arteries
Heart valves on the left side of the heart ANSWER Aortic valve, mitral valve
How does blood flow through the mitral valve? - ANSWER Blood flows from the left
atrium into the left ventricle
How does blood flow through the aortic valve? - ANSWER Blood flows from the left
ventricle into the aortic arch
What does S1 sound like? What is happening in heart? -ANSWER S1 is the first heart
sound heard-the "lub" in "lub-dub". The sound is caused by the closure of the mitral and
triscupid valves at the start of systole
What does S2 sound like? What is happening in the heart? - ANSWER S2 is the second
heart sound heard (the "dub" in "lub-dub"). The sound is caused by the closure of the
aortic and pulmonic valves - representing the end of systole
What is the name of this sound of S3? What is happening to the heart? - ANSWER The S3
is an extra heart sound, also known as a gallop. It can be heard directly after S2 and can
indicate atrial or mitral regurgitation, left ventricular heart failure, or volume overload.
,What does S4 sound like? What is happening in the heart? -ANSWER S4 is an extra heart
sound, called a gallop. It occurs before S1 and signifies HTN, acute MI, aortic stenosis,
pulmonary stenosis, pulmonary HTN
What are types of coronary ischemia? - ANSWER Stable angina, unstable angina and
AMI
What interventions are needed for coronary ischemia? - ANSWER Stress echo, nuclear
perfusion imaging or cardiac catheterization
What is stable angina? - ANS Exercise-induced chest pain relieved by rest or
nitroglycerin
What is unstable angina? - ANS Angina that is either new in onset or differs from a
patient's typical stable angina pattern. Pain at rest does not respond to nitroglycerin.
Precursor to MI.
What causes unstable angina? - ANS Rupture of plaque with w/thrombus and incomplete
occlusion of coronary artery
What EKG changes are seen with unstable angina? - ANWER T-wave inversion, or ST
depression, occasionally ST elevation.
What are AHA core measures for chest pain? - ANWER EKG within 10 minutes,
thrombolytic within 30 minutes, cath-lab within 90 minutes
Classic signs/symptoms of MI - ANWER Chest pressure/pain, radiates to jaw/left arm,
not relieved by sublingual nitro, SOB, diaphoretic, pallor, anxiety, nausea/vomiting
Atypical MI symptoms- ANSWER Fatigue, palpitations, dizziness, acute CHF, pulmonary
edema, silent myocardial ischemia, sudden cardiac arrest
, Who is at risk for atypical MI presentation?- ANSWER Women, eldery, diabetics
What does t-wave inversion indicate?- ANSWER Ischemia
Pathologic q-wave- ANSWER is wider than 0.04 seconds and indicates that a myocardial
infarction occurred in the past, and/or necrosis
Lab work for chest pain - ANSWER CBC, PT/PTT, Chemistry panel, Troponin I, CK total
and CK-MB
CK-MB - ANSWER Creatine Kinase-Muscle Breakdown
Elevated troponin - ANSWER Indicative of any myocardial damage as enzymes are
released. (MI, renal failure, pericarditis, myocarditis, tachycardia, heart failure, dilated
or hypertrophic cardiomyopathy). >0.40 is positive.
Inferior wall (posterior) MI - ANSWER Involves Right Coronary Artery. (Leads II, III and
aVF)
Septal wall MI - ANSWER Involves LAD-Leads V1 and V2
Anterior wall MI - ANSWER Involves LAD-Leads V2, V3, and V4
Lateral Wall MI - ANSWER Involves Circumflex Artery-Leads I and aVL, V5 and V6.
STEMI standard therapies - ANSWER M- Morphine
O- Oxygen
N- Nitrates
A- Aspirin
Heart valves on the right side of the heart ANSWER Tricuspid Valve, Pulmonary Valve
How does blood flow through the tricuspid valve? ANSWER Blood flows from the right
atrium, to the right ventricle
How does blood flow through the pulmonary valve? ANSWER Blood flows from the right
ventricle, to the pulmonary arteries
Heart valves on the left side of the heart ANSWER Aortic valve, mitral valve
How does blood flow through the mitral valve? - ANSWER Blood flows from the left
atrium into the left ventricle
How does blood flow through the aortic valve? - ANSWER Blood flows from the left
ventricle into the aortic arch
What does S1 sound like? What is happening in heart? -ANSWER S1 is the first heart
sound heard-the "lub" in "lub-dub". The sound is caused by the closure of the mitral and
triscupid valves at the start of systole
What does S2 sound like? What is happening in the heart? - ANSWER S2 is the second
heart sound heard (the "dub" in "lub-dub"). The sound is caused by the closure of the
aortic and pulmonic valves - representing the end of systole
What is the name of this sound of S3? What is happening to the heart? - ANSWER The S3
is an extra heart sound, also known as a gallop. It can be heard directly after S2 and can
indicate atrial or mitral regurgitation, left ventricular heart failure, or volume overload.
,What does S4 sound like? What is happening in the heart? -ANSWER S4 is an extra heart
sound, called a gallop. It occurs before S1 and signifies HTN, acute MI, aortic stenosis,
pulmonary stenosis, pulmonary HTN
What are types of coronary ischemia? - ANSWER Stable angina, unstable angina and
AMI
What interventions are needed for coronary ischemia? - ANSWER Stress echo, nuclear
perfusion imaging or cardiac catheterization
What is stable angina? - ANS Exercise-induced chest pain relieved by rest or
nitroglycerin
What is unstable angina? - ANS Angina that is either new in onset or differs from a
patient's typical stable angina pattern. Pain at rest does not respond to nitroglycerin.
Precursor to MI.
What causes unstable angina? - ANS Rupture of plaque with w/thrombus and incomplete
occlusion of coronary artery
What EKG changes are seen with unstable angina? - ANWER T-wave inversion, or ST
depression, occasionally ST elevation.
What are AHA core measures for chest pain? - ANWER EKG within 10 minutes,
thrombolytic within 30 minutes, cath-lab within 90 minutes
Classic signs/symptoms of MI - ANWER Chest pressure/pain, radiates to jaw/left arm,
not relieved by sublingual nitro, SOB, diaphoretic, pallor, anxiety, nausea/vomiting
Atypical MI symptoms- ANSWER Fatigue, palpitations, dizziness, acute CHF, pulmonary
edema, silent myocardial ischemia, sudden cardiac arrest
, Who is at risk for atypical MI presentation?- ANSWER Women, eldery, diabetics
What does t-wave inversion indicate?- ANSWER Ischemia
Pathologic q-wave- ANSWER is wider than 0.04 seconds and indicates that a myocardial
infarction occurred in the past, and/or necrosis
Lab work for chest pain - ANSWER CBC, PT/PTT, Chemistry panel, Troponin I, CK total
and CK-MB
CK-MB - ANSWER Creatine Kinase-Muscle Breakdown
Elevated troponin - ANSWER Indicative of any myocardial damage as enzymes are
released. (MI, renal failure, pericarditis, myocarditis, tachycardia, heart failure, dilated
or hypertrophic cardiomyopathy). >0.40 is positive.
Inferior wall (posterior) MI - ANSWER Involves Right Coronary Artery. (Leads II, III and
aVF)
Septal wall MI - ANSWER Involves LAD-Leads V1 and V2
Anterior wall MI - ANSWER Involves LAD-Leads V2, V3, and V4
Lateral Wall MI - ANSWER Involves Circumflex Artery-Leads I and aVL, V5 and V6.
STEMI standard therapies - ANSWER M- Morphine
O- Oxygen
N- Nitrates
A- Aspirin
