CV-BC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

S1 heart sound

Produced by closure of the mitral and tricuspid valves at the onset of ventricular systole; best heard at the apex with the diaphragm during the blood pressure assessment sequence.

Paradoxical split S2

A split that widens on expiration and narrows on inspiration, reflecting delayed right ventricular emptying as seen in right bundle branch block or pulmonary stenosis.

JVP assessment technique

With the head of bed at 30-45 degrees, observe the internal jugular pulsation; a column more than 3 cm above the sternal angle indicates elevated right atrial pressure.

Troponin release timeline

Rises within 3-6 hours of myocardial injury, peaks around 12-24 hours, and remains elevated 7-14 days, so it cannot reliably identify early reinfarction.

Ankle-brachial index interpretation

Ankle systolic pressure divided by the highest brachial systolic pressure; 0.90 or less indicates peripheral artery disease and over 1.30 suggests noncompressible calcified vessels.

Normal PR interval

Measured from the start of the P wave to the start of the QRS complex and normally 0.12-0.20 seconds; prolongation beyond this indicates first-degree AV block.

STEMI ECG criteria

ST elevation of at least 1 mm in two contiguous limb leads or at least 2 mm in V2-V3 (adjusted for age and sex), or a new left bundle branch block.

Aortic stenosis classic triad

Angina, syncope, and exertional dyspnea; the onset of any of these symptoms in severe stenosis signals the need for aortic valve replacement.

HFrEF ejection fraction

Left ventricular ejection fraction of 40% or less; guideline-directed quadruple therapy with ARNI, beta-blocker, MRA, and SGLT2 inhibitor reduces mortality.

Pericarditis pain pattern

Sharp, pleuritic chest pain that worsens when supine and improves when leaning forward, accompanied by diffuse ST elevation and PR depression on ECG.

Paroxysmal nocturnal dyspnea

Sudden breathlessness that wakes the patient one to two hours after lying down, reflecting pulmonary congestion from left-sided heart failure.

CHA2DS2-VASc purpose

Estimates stroke risk in atrial fibrillation; scores of 2 or more in men and 3 or more in women generally warrant long-term oral anticoagulation.

Virchow triad

The three contributors to thrombosis: venous stasis, endothelial injury, and hypercoagulability, used to identify risk for deep vein thrombosis and pulmonary embolism.

Intermittent claudication characteristics

Reproducible muscle pain provoked by exercise and relieved by rest within 2-5 minutes, occurring at a consistent walking distance in peripheral artery disease.

Aortic dissection blood pressure clue

An interarm systolic difference greater than 20 mm Hg accompanying abrupt tearing chest or back pain and pulse deficits suggests aortic dissection.

AAA repair threshold

Abdominal aortic aneurysm repair is considered when diameter exceeds 5.5 cm in men or 5.0 cm in women, or grows more than 0.5 cm in 6 months.

Venous stasis ulcer features

Shallow, moist, irregular ulcer near the medial malleolus with surrounding edema, hemosiderin staining, and palpable pulses, caused by chronic venous hypertension.

Sacubitril-valsartan washout period

Thirty-six hours must separate the last ACE inhibitor dose from starting sacubitril/valsartan to avoid angioedema from additive bradykinin accumulation.

Digoxin toxicity signs

Nausea, anorexia, confusion, bradycardia, and yellow-green visual halos; hypokalemia and renal impairment increase risk, and digoxin immune Fab is the antidote.

Amiodarone monitoring parameters

Baseline and periodic thyroid, hepatic, pulmonary, and ophthalmologic testing; pulmonary toxicity and thyroid dysfunction are key adverse effects given its long half-life.

Heparin-induced thrombocytopenia

A platelet drop greater than 50%, typically 5-10 days after heparin exposure; stop all heparin, avoid platelet transfusions, and give a non-heparin anticoagulant such as argatroban.

Nitrate PDE-5 contraindication

Nitroglycerin must not be given within 24 hours of sildenafil or 48 hours of tadalafil because the combination causes life-threatening hypotension.

High-intensity statin dosing

Atorvastatin 40-80 mg or rosuvastatin 20-40 mg daily, used to achieve an LDL cholesterol below 70 mg/dL in very high-risk atherosclerotic disease.

Daily weight heart failure teaching

Weigh each morning after voiding on the same scale with similar clothing; report a gain of 2-3 lb in a day or 5 lb in a week.

Teach-back method

Asking the patient to restate instructions in their own words, which confirms actual comprehension rather than simple agreement when asked if they understand.

Cardiac rehabilitation components

Supervised exercise plus risk-factor education, typically 36 sessions over 12 weeks, which lowers mortality and rehospitalization after a cardiac event.

Resuming sex after MI

Generally safe once the patient can climb two flights of stairs or walk briskly without symptoms, often about one week after an uncomplicated myocardial infarction.

5 A's of smoking cessation

Ask, Advise, Assess, Assist, Arrange: a brief structured intervention delivered at every encounter to support tobacco cessation.

SBAR handoff

Situation, Background, Assessment, Recommendation: a structured format used for handoffs and for escalating concerns about a deteriorating patient.

Door-to-balloon time

The interval from hospital arrival to primary PCI, targeted at 90 minutes or less, or 120 minutes or less when the patient requires transfer.

Delegation limits for RN

Assessment, patient teaching, evaluation, and clinical judgment cannot be delegated to unlicensed assistive personnel; only tasks with predictable outcomes may be assigned.

Root cause analysis

A structured review after a sentinel event that identifies system failures and redesigns processes, focusing on systems rather than assigning individual blame.