Professional Documents
Culture Documents
Assessment of
Cardiovascular Function
Atrioventricular valves:
tricuspid and mitral
Coronary arteries
Cardiac hemodynamics
Figure 25-1
Copyright 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
(40-60)
(30-40)
(30-40)
Figure 25-3
Copyright 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Which of the following is the primary pacemaker for the
myocardium?
A. Atrioventricular junction
B. Bundle of His
C. Purkinje fibers
D. Sinoatrial node
Answer
D. Sinoatrial node
Rationale: The sinoatrial node is the primary pacemaker
for the myocardium.
Cardiac Hemodynamics
Stroke volume(SV): amount of blood ejected with each
heartbeat
Preload: degree of stretch of cardiac muscle fibers at
end of diastole
Afterload: resistance to ejection of blood from
ventricle
Contractility: ability of cardiac muscle to shorten in
response to electrical impulse
Question
Which of the following best defines stroke volume?
A.The amount of blood ejected with each heartbeat
B.Amount of blood pumped by the ventricle in liters per
minute
C.Degree of stretch of the cardiac muscle fibers at the end
of diastole
D.Ability of the cardiac muscle to shorten in response to an
electrical impulse
Answer
A. The amount of blood ejected with each heartbeat
Rationale: Stroke volume is the amount of blood ejected
with each heartbeat. Cardiac output is the amount of
blood pumped by the ventricle in liters per minute.
Preload is the degree of stretch of the cardiac muscle
fibers at the end of diastole. Contractility is the ability of
the cardiac muscle to shorten in response to an electrical
impulse.
Health History
Demographic information
Family/genetic history
Cultural/social factors
Risk factors
Modifiable
Non-modifiable
Assessment
Physical examination
Palpation, percussion, auscultation
Medications
Nutrition
Elimination
Activity, exercise
Sleep, rest
Assessment (contd)
Vital signs
Self-perception, self-concept
Roles, relationships
Sexuality, reproduction
Coping, stress tolerance
Prevention strategies
Family history
Laboratory Tests
Cardiac biomarkers
CK, CK-MB
C-reactive protein
Myoglobin
Troponin T and I
Lipid profile
Electrocardiography
12-lead ECG
Continuous monitoring: hardwire, telemetry
Signal-averaged ECG
Continuous ambulatory monitoring
Transtelephonic monitoring
Wireless mobile monitoring
Electrocardiography (contd)
Cardiac stress testing
Exercise stress testing
Pharmacologic stress testing
Echocardiography
Transthoracic
Transesophageal
Diagnostic Tests
Radionuclide imaging
Myocardial perfusion imaging
Test of ventricular function, wall motion
Computed tomography
Positron emission tomography
Magnetic resonance angiography
Cardiac Catherization
Invasive procedure study used to measure cardiac
chamber pressures, assess patency of coronary arteries
Requires ECG, hemodynamic monitoring; emergency
equipment must be available
Assessment prior to test; allergies, blood work
Hemodynamic Monitoring
CVP (2-6mmHG is normal. Elevated=hypervolemia;
decreased=hypovolemia)
Pulmonary artery pressure measures left ventricular
function
Intra-arterial BP monitoring is used to obtain direct and
continuous BP measurements
Phlebostatic Level
Figure 25-10
Figure 25-12
Copyright 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins