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abnormal heartbeat
arrhythmia
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slow heart rate, usually under 60 beats per minute
bradycardia
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intentional stopping of the heart during cardiac surgery
cardioplegia
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congenital narrowing or stricture in the descending thoracic aorta
coarctation
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phase of cardiac cycle when ventricles contract
diastole
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uncoordinated muscular activity in heart muscle which results in "quivering" rather than pumping action - results in pooling of blood
fibrillation
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type of aneurysm that involves entire circumference of a blood vessel
fusiform aneurysm
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necrosis and death of tissue related to obstruction of blood flow
infarction
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reduced blood supply to tissue
ischemia
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enclosed cavity in the chest that contains the heart, large vessels, trachea, esophagus and lymph nodes
mediastinum
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type of aneurysm in which a saclike formation with narrow neck projects from side of the artery
saccular aneurysm
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narrowing of hollow structure such as blood vessel or duct
stenosis
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incision made into the sternum
sternotomy
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relaxation phase of the cardiac cycle when ventricles are filling with blood
systole
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fast heart rate, usually over 120 beats per minute
tachycardia
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incision made into thoracic cavity
thoracotomy
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2 upper chambers of the heart
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2 lower chambers of heart
- right ventricle
- left ventricle
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cavity that contains the heart and its great vessels, lungs and associated respiratory structures, mediastinum, and portion of esophagus
thoracic
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closed cavity containing the heart
mediastinum
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double-layered membrane that encloses the heart
pericardium
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outer pericardium
parietal pericardium
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inner pericardium
visceral pericardium
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3 layers of wall of heart
- epicardium (outer layer)
- myocardium (middle layer)
- endocardium (inner layer)
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specialized muscle tissue capable of generating electrical impulses, which cause the heart to contract
myocardium
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valve that lies on the right side of the heart
tricuspid
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valve that lies on the left side of the heart
bicuspid (mitral)
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connective tissue that attaches AV valve leaflets to the papillary muscle of the ventricles
chordae tendineae
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initiates cardiac cycle and is sometimes called the heart's pacemaker
sinoatrial (SA) node
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interventional radiology procedure that involves insertion of a cardiac catheter into the heart chambers and large vessels
cardiac catheterization
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test that demonstrates movement of blood through the valves and can be used to measure the ejection fraction, etc.
ventricular angiography
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short length of rubber tubing either commercially prepared or cut from a straight urinary cath
Rumel tourniquet
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method of preparing graft to prevent leakage
preclotting
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how much blood is withdrawn from patient for preclotting?
30 to 50 mL
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2 commonly used prosthetic valves
- St. Jude Medical (mechanical)
- Hancock porcine (biological)
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what does a pacemaker do?
produces electrical impulses that stimulate the heart muscle
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where are temporary electrodes placed?
implanted on the surface of the heart
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2 types of permanent electrodes
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what does a defibrillator do?
electricity from the defibrillator shocks heart cells, converting the rhythm back to normal
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cannula that is straight ended and has multiple holes in the distal tip - used to shunt blood from the heart
venous cannula
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cannula that may have straight or angled tip to direct blood toward descending thoracic aorta - carries oxygenated blood
aortic cannula
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cannula that carries oxygenated blood, tapered to match size of artery, and has beveled end to allow easier insertion
femoral arterial cannula
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cannula that has a cuff near its tip to prevent from being inserted too far into coronary arteries - used to infuse cardioplegic solution directly into the heart
coronary antegrade perfusion cannula
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drains air and blood within the heart and prevents accumulation of blood
left ventricular sump (vent) catheter
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used to decompress left ventricle and remove intracardiac air
right superior pulmonary vent catheter
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anticoagulant that prevents conversion of fibrinogen to fibrin
heparin sodium
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drug administered to reverse effects of heparin
protamine sulfate
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drug commonly used in treatment of ventricular arrhythmia
lidocaine
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drug used for cardiac stimulation - cannot start heart that has stopped beating, but can stimulate adrenergic receptors
epinephrine
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mixture of potassium chloride, lidocaine, dextrose, insulin, albumin, tromethamine, and Plasmanate
cardioplegic solution
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2 methods of administering cardioplegic solution
- antegrade cardioplegic infusion
- retrograde cardioplegic infusion
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midline incision of sternum used for surgical procedures of the heart and great vessels
median sternotomy
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sutures used for closing the sternum
six to eight #5 wire sutures
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what does cardioplegic solution do?
stops the heart, reducing energy required by cardiac muscle
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why is cardioplegic solution used?
to protect the cardiac muscle from damage while the aorta is occluded and blood supply is interrupted
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why is CABG done?
to improve circulation to the heart
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what is usually used as the bypass graft in CABG?
autograft
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why are metal rings or radiopaque materials sometimes placed around each vein graft on the aorta?
they mark the veins in the even cardiac cath is performed in the postop period
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procedure in which a series of small-bore, transmural channels are created with laser to perfuse the myocardium
transmyocardial revascularization (TMR)
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goal of TMR
to increase blood flow to the heart in patients in whom bypass surgery or medical management is not feasible
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what does the aortic valve do?
maintains one-way blood flow from left ventricle to aorta
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what type of incision is made to open aorta in aortic valve replacement?
- transverse
- occasionally vertical
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what causes mitral valve disease?
- rheumatic heart disease
- dilation of the annulus
- ischemic heart disease
- trauma
- changes in the tissue that produces regurgitation
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heart rate of 240 to 450 beats per minute
atrial flutter
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chaotic, disorganized stimulation of one or both ventricles that does not pump the blood
ventricular fibrillation
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ICDs are used for what types of patients?
patients susceptible to ventricular fibrillation or ventricular tachycardia
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incisions used for ICDs
- thoracotomy
- subxyphoid
- median sternotomy
- transvenous
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ICD incision most used
transvenously
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selective destruction of diseased conductive tissue to correct atrial fibrillation
cardiac ablation
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goal of pericardial window
removal of accumulated blood or fluid in the pericardium which can compress the heart and impede filling of ventricles
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where is incision made for pericardial window?
in fourth or fifth intercostal space
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why can constrictive pericarditis develop?
- viral infection
- tuberculosis
- chronic pericarditis
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what does intraaortic balloon catheter do?
reduces workload of heart after MI or in patients who cannot be taken off bypass
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why is VAD used?
- to wean patients from cardiopulmonary bypass when other means are ineffective
- patients awaiting heart transplantation
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patients suitable for heart transplant are those with?
- coronary artery disease
- congenital heart disease
- valve disease
- rejection of previously transplanted heart
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