The Language Of Medicine th 11 edition DaviEllen

The Language Of Medicine th 11 edition Davi-Ellen Chabner Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 1

Chapter 11 Cardiovascular System Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 2

Chapter Goals • Name the parts of the heart and associated blood vessels and their functions in the circulation of blood. • Trace the pathway of blood through the heart. • Identify and describe major pathologic conditions affecting the heart and blood vessels. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 3

Chapter Goals (cont’d) • Define combining forms that relate to the cardiovascular system. • Describe important laboratory tests and clinical procedures pertaining to the cardiovascular system, and recognize relevant abbreviations. • Apply your new knowledge to understand medical terms in their proper context, such as in medical reports and records. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 4

Chapter 11 Lesson 11. 1 Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 5

Introduction • Cardiovascular system: delivers oxygen and nutrients to cells of body tissue ØHeart (muscular pump) ØBlood vessels (fuel line and transportation network) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 6

Blood Vessels and the Circulation of Blood • Arteries are the vessels that lead away from the heart. • Veins have thinner walls than arteries and move deoxygenated blood toward the heart from the tissues. • Capillaries are the smallest vessels. They form the point of exchange for oxygen and nutrients into body cells and waste products coming from body cells. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 7

Blood Vessels Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 8

Blood Circulation/Systemic Circulation Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 9

The Aorta and Arteries Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 10

Anatomy of the Heart Structure of the heart. Blue arrows indicate oxygen-poor blood flow. Red arrows show oxygenated blood flow. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 11

Anatomy of the Heart Superior vena cava Aorta Pulmonary valve Pulmonary artery Pulmonary veins Left atrium Right atrium Mitral valve Left ventricle Tricuspid valve Inferior vena cava Right ventricle Aortic valve Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 12

Major Valves of the Heart • Tricuspid valve (cusps are flaps of the valves): between the right atrium and right ventricle • Pulmonary valve: between the right ventricle and pulmonary artery • Mitral valve: between the left atrium and left ventricle • Aortic valve: between the left atrium and aorta Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 13

Pathway of Blood through the Heart Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 14

Heartbeat and Heart Sounds Two phases of the heartbeat: • Diastole: relaxation • Systole: contraction ØThe diastole-systole cardiac cycle occurs between 70 to 80 times per minute (100, 000 times per day). ØThe heart pumps 3 ounces of blood with each contraction. This means that about 5 quarts are pumped per minute (75 gallons an hour and about 2000 gallons a day). Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 15

Heart Sounds Closure of valves associated with sounds “lubbdubb, lubb-dubb” • lubb: closure of the tricuspid and mitral valves at the beginning of systole • dubb: closure of the aortic and pulmonary valves at the end of systole • murmur: an abnormal heart sound caused by improper valve closure Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 16

Phases of the Heartbeat Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 17

Phases of the Heartbeat Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 18

Conduction System of the Heart Sinoatrial node (SA node): the pacemaker of the heart Pacemaker: origin of electrical impulse causing walls of the atria to contract and force blood into the ventricles (ending diastole) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 19

Conduction System of the Heart (cont’d) • Atrioventricular node (AV node): This sends the excitation wave to a bundle of specialized fibers called the atrioventricular bundle or Bundle of His. • Bundle of His (pronounced “hiss”): Helps form conduction myofibers that extend to ventricle walls and stimulate them to contract, beginning systole. A short rest period follows. • The pacemaker begins wave of excitation again. • ECG or EKG (electrocardiogram): The record used to detect electrical changes in heart muscle as the heart beats. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 20

Conduction System of the Heart Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 21

Conduction System of the Heart (cont’d) Atrioventricular bundle Sinoatrial node Atrioventricular node Right bundle branch Left bundle branch Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 22

Electrocardiogram • P wave = spread of excitation wave over the atria just before contraction; QRS wave = spread of excitation wave over the ventricles as the ventricles contract; T wave = electrical recovery and relaxation of ventricles. A heart attack (myocardial infarction or MI) can be recognized by an elevation in the S-T segment of the ECG. Thus, one type of MI is an S-T elevation MI or STEMI. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 23

Electrocardiogram (cont’d) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 24

Electrocardiogram (cont’d) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 25

Blood Pressure • Blood pressure: The force that blood exerts on arterial walls • Measured using a sphygmomanometer • Expressed as a fraction: systolic pressure/ diastolic pressure Ø Example: 120/80 mm Hg • Hypertension (high blood pressure): when BP > 140/90 mm Hg • New guidelines for patients over 60 treatment only if BP exceeds 150/90. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 26

Vocabulary • aorta • apex of the heart • arteriole • artery Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 27

Vocabulary (cont’d) • aorta The largest artery in the body • apex of the heart The lower tip of the heart • arteriole A small artery • artery The largest type of blood vessel; carries blood away from the heart to all parts of the body Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 28

Vocabulary (cont’d) • atrioventricular bundle (bundle of His) • atrioventricular node (AV node) • atrium (plural: atria) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 29

Vocabulary (cont’d) • atrioventricular bundle (bundle of His) Specialized muscle fibers connecting the atria with the ventricles and transmitting electrical impulses between them • atrioventricular node (AV node) Specialized tissue in the wall between atria; electrical impulses pass from pacemaker through AV node and bundle of His toward ventricles • atrium (plural: atria) One of two upper chambers of the heart Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 30

Vocabulary (cont’d) • capillary • carbon dioxide (CO 2) • coronary arteries • deoxygenated blood Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 31

Vocabulary (cont’d) • capillary The smallest blood vessel • carbon dioxide (CO 2) Waste gas released by body cells, transported via veins to the heart, and then to lungs for exhalation • coronary arteries Blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle • deoxygenated blood Oxygen-poor blood Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 32

Vocabulary (cont’d) • diastole • electrocardiogram • endocardium • endothelium Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 33

Vocabulary (cont’d) • diastole Relaxation phase of the heartbeat • electrocardiogram Record of the electricity flowing through the heart • endocardium Inner lining of the heart • endothelium Innermost lining of blood vessels Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 34

Vocabulary (cont’d) • mitral valve • murmur • myocardium • normal sinus rhythm Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 35

Vocabulary (cont’d) • mitral valve Valve between the left atrium and left ventricle; bicuspid valve • murmur Abnormal swishing sound caused by improper closure of heart valves • myocardium Muscular, middle layer of the heart • normal sinus rhythm Heart rhythm originating in sinoatrial node with resting rate of 60 -100 beats/min Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 36

Vocabulary (cont’d) • oxygen • pacemaker (sinoatrial node) • pericardium • pulmonary artery Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 37

Vocabulary (cont’d) • oxygen Gas carried by the blood from the lungs to the heart to be pumped via arteries to all body cells • pacemaker (sinoatrial node) Specialized nervous tissue in the right atrium that begins the heartbeat • pericardium Double-layered membrane surrounding the heart • pulmonary artery Artery carrying oxygen-poor blood from the heart to the lungs Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 38

Vocabulary (cont’d) • pulmonary circulation • pulmonary valve • pulmonary vein Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 39

Vocabulary (cont’d) • pulmonary circulation Flow of blood from the heart to the lungs and back to the heart • pulmonary valve Valve positioned between the right ventricle and the pulmonary artery • pulmonary vein Carries oxygenated blood from the lungs to the left atrium of the heart Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 40

Vocabulary (cont’d) • pulse • septum (plural: septa) • sinoatrial node (SA node) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 41

Vocabulary (cont’d) • pulse The beat of the heart as felt through the walls of the arteries • septum (plural: septa) A partition or wall dividing a cavity, such as that between the right and left atria and right and left ventricles • sinoatrial node (SA node) The pacemaker of the heart Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 42

Vocabulary (cont’d) • sphygmomanometer • systemic circulation • systole • tricuspid valve Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 43

Vocabulary (cont’d) • sphygmomanometer An instrument to measure blood pressure • systemic circulation Flow of blood from body tissue to the heart and back • systole The contraction phase of the heartbeat • tricuspid valve Located between the right atrium and right ventricle; has three leaflets or cusps Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 44

Vocabulary (cont’d) • valve • vein Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 45

Vocabulary (cont’d) • valve A structure in veins or in the heart that temporarily closes an opening so blood flows in only one direction • vein A thin-walled vessel that carries blood from body tissues and lungs back to the heart; contains valves to prevent the backflow of blood Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 46

Vocabulary (cont’d) • vena cava (plural: venae cavae) • ventricle • venule Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 47

Vocabulary (cont’d) • vena cava (plural: The largest vein in the body; superior and venae cavae) inferior venae cavae return blood to the right atrium of heart • ventricle One of two lower chambers of the heart • venule A small vein Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 48

Combining Forms and Terminology Combining Form. Meaning • • • angi/o aort/o arteri/o ather/o atri/o vessel aorta artery yellowish plaque atrium Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 49

Combining Forms and Terminology (cont’d) Combining Form • • • brachi/o cardi/o cholesterol/o coron/o cyan/o myx/o Meaning arm heart cholesterol heart blue mucus Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 50

Combining Forms and Terminology (cont’d) Combining Form • • • ox/o pericardi/o phleb/o sphygm/o steth/o thromb/o Meaning oxygen pericardium vein pulse chest clot Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 51

Combining Forms and Terminology (cont’d) Combining Form • • • valvul/o valv/o vascul/o ven/o, ven/i ventricul/o Meaning valve vessel vein ventricle Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 52

QUICK QUIZ: 1. The double-layered membrane surrounding the heart is the: A. pericardium B. arteriole C. endocardium D. endothelium Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 53

QUICK QUIZ: (cont’d) 2. The contraction phase of the heartbeat is called: A. diastole B. vena cava C. systole D. septum Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 54

Chapter 11 Cardiovascular System Lesson 11. 2 Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 55

Pathology: the Heart and Blood Vessels Heart ØArrhythmias • Heart block (atrioventricular block) • Flutter • Fibrillation Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 56

Pathology: the Heart and Blood Vessels (cont’d) Heart ØCongenital heart disease • Coarctation of the aorta (Co. A) • Patent ductus arteriosus (PDA) • Septal defects (ASD and VSD) • Tetralogy of Fallot Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 57

Pathology: the Heart and Blood Vessels (cont’d) Heart ØCongestive heart disease (CHF): The heart is unable to pump the required amount of blood. • In the U. S. , primarily the result of high blood pressure and coronary artery disease (see next slide) • Results in pulmonary edema • Fatal if untreated Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 58

Pathology: the Heart and Blood Vessels (cont’d) Heart ØCoronary artery disease (CAD) • Atherosclerosis Thrombotic occlusion (occlusive/mural) Ischemia Necrosis Infarction • Acute Coronary Syndromes (ACS) Unstable angina Myocardial infarction (MI) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 59

Pathology: the Heart and Blood Vessels (cont’d) Heart ØCoronary artery disease (CAD) • Drug therapies for CAD Nitrates (nitroglycerin) Aspirin Beta-blockers ACE inhibitors Calcium channel blockers Statins Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 60

Pathology: the Heart and Blood Vessels (cont’d) Heart ØCoronary artery disease (CAD) • Surgical therapies for CAD Coronary artery bypass grafting (CABG) Percutaneous coronary intervention (PCI) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 61

Pathology: the Heart and Blood Vessels (cont’d) Heart ØOther pathologic conditions • • • Endocarditis (vegetations) Hypertensive heart disease Mitral valve prolapse (MVP) Murmur Pericarditis Rheumatic heart disease Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 62

Pathology: the Heart and Blood Vessels (cont’d) Blood vessels ØAneurysm ØDeep vein thrombosis (DVT) ØHypertension (HTN) ØPeripheral vascular disease (PVD) ØRaynaud’s disease ØVaricose veins Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 63

QUICK QUIZ: 3. Which arrhythmia refers to rapid, random, inefficient, and irregular contractions of the atria and ventricles (350 beats or more per minute)? A. Fibrillation B. Flutter C. Bradycardia Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 64

Chapter 11 Lesson 11. 3 Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc.

Laboratory Tests • • BNP test Cardia biomarkers Lipid test profile Lipoprotein electrophoresis Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 66

Clinical Procedures: Diagnostic X-ray Ø Ø Angiography and arteriography Computerized tomography angiography Digital subtraction angiography (DSA) Electron beam computed tomography (EBCT or EBT) Ultrasound tests Ø Doppler ultrasound Ø Echocardiography (ECHO) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 67

Clinical Procedures: Diagnostic (cont’d) Nuclear cardiology Ø Positron emission tomography (PET) scan Ø Technetium TC 99 m scan Ø Thallium-201 scan Magnetic resonance imaging (MRI) Ø Cardiac MRI Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 68

Clinical Procedures: Diagnostic (cont’d) Other diagnostic procedures Ø Ø Cardiac catheterization Electrocardiography (ECG, EKG) Holter monitoring Stress test Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 69

Clinical Procedures: Diagnostic (cont’d) • Identify the normal sinus rhythm and arrhythmias Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 70

Clinical Procedures: Treatment • • • Cardioversion (defibrillation) Endarterectomy Extracorporeal circulation Heart transplantation Thrombolytic therapy Transcatheter aortic valve replacement (TAVR) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 71

Clinical Procedures: Treatment Coronary artery bypass graft (CABG) surgery A, A section of a vein is removed from the leg and anastomosed to a coronary artery to bypass an area of arteriosclerotic blockage. B, An internal mammary artery is grafted to a coronary artery to bypass blockage. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 72

Clinical Procedures: Diagnostic (cont’d) A, Normal sinus rhythm. Notice the regularity of the P, QRS, and T waves. B, Atrial flutter. Notice the rapid atrial rate (P wave) compared to the slower ventricular rate (ARS). C, Atrial fibrillation. P waves are replaced by irregular and rapid fluctuations. There are no effective atrial contractions. D, Ventricular tachycardia. Ventricular rate may be as high as 250 beats per minute. The rhythm is regular, but the atria are not contributing to ventricular filling and blood output is poor. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 73

Treatment Procedures • Percutaneous coronary intervention (PCI) Ø Includes: percutaneous transluminal coronary angioplasty (PTCA), stent placement, laser angioplasty, and atherectomy Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 74

Abbreviations • • • • AAA ACE inhibitor ACLS ACS ADP AED AF, a-fib AICD AMI ARVD ARB AS ASD Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 75

Abbreviations • • • • AAA ACE inhibitor ACLS ACS ADP AED AF, a-fib AICD AMI ARVD ARB AS ASD Abdominal aortic aneurysm Angiotensin-converting enzyme inhibitor Advanced cardiac life support Acute coronary syndrome Adenosine diphosphate Automatic external defibrillator Atrial fibrillation Automatic implantable cardioverter-defibrillator Acute myocardial infarction Arrhythmogenic right ventricular displasia angiotension II receptor blocker Aortic stenosis Atrial septal defect Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 76

Abbreviations (cont’d) • • • AV, A-V AVR BBB BNP BP CABG CAD CCU Cath CHF CK Co. A Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 77

Abbreviations (cont’d) • • • AV, A-V AVR BBB BNP BP CABG CAD CCU Cath CHF CK Co. A Atrioventricular Aortic valve replacement Bundle branch block Brain natriuretic peptide Blood pressure Coronary artery bypass grafting Coronary artery disease Coronary care unit Catheterization Congestive heart failure Creatine kinase Coarctation of the aorta Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 78

Abbreviations (cont’d) • CPR • CRT • CTNI or c. Tn. I; CTNT or c. Tn. T • DES • DSA • DVT • ECMO • ECG; also EKG • ECHO • EF • EPS Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 79

Abbreviations (cont’d) • CPR • CRT • CTNI or c. Tn. I; CTNT or c. Tn. T • DES • DSA • DVT • ECMO • ECG; also EKG • ECHO • EF • EPS Cardiopulmonary resuscitation Cardiac resynchronization therapy Cardiac troponin-I and cardiac troponin-T Drug-eluting stent Digital subtraction angiography Deep vein thrombosis Extracorporeal membrane oxygenation Electrocardiography Echocardiography Ejection fraction Electrophysiology study Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 80

Abbreviations (cont’d) • • ETT-MIBI EVAR FFR HDL hs. CRP HTN IABP Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 81

Abbreviations (cont’d) • ETT-MIBI • • • EVAR FFR HDL hs. CRP HTN IABP Exercise tolerance test combined with a radioactive tracer (sestamibi) scan Endovascular aneurysm repair Fractional flow reserve High-density lipoprotein High sensitivity C-reactive protein Hypertension (high blood pressure) Intra-aortic balloon pump Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 82

Abbreviations (cont’d) • • ICD IVUS LAD LDL LMWH LV LVAD Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 83

Abbreviations (cont’d) • • ICD IVUS LAD LDL LMWH LV LVAD Implantable cardioverter-defibrillator Intravascular ultrasound Left anterior descending (coronary artery) Low-density lipoprotein Low-molecular-weight heparin Left ventricle Left ventricular assist device Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 84

Abbreviations (cont’d) • • LVH MI MUGA MVP NOAC NSR NSTEMI Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 85

Abbreviations (cont’d) • • LVH MI MUGA MVP NOAC NSR NSTEMI Left ventricular hypertrophy Myocardial infarction Multiple-gated acquisition scan Mitral valve prolapse Novel anticoagulant drug Normal sinus rhythm Non-ST elevation myocardial infarction Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 86

Abbreviations (cont’d) • • NT-pro. BNP PAC PCI PDA PE PVC SA, S-A node Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 87

Abbreviations (cont’d) • • NT-pro. BNP PAC PCI PDA PE PVC SA, S-A node N-terminal pro-peptide of BNP Premature atrial contraction Percutaneous coronary intervention Patent ductus arteriosus; posterior descending artery Pulmonary embolus Premature ventricular contraction Sinoatrial node Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 88

Abbreviations (cont’d) • • SCD SOB SPECT STEMI SVT TAVR TEE TEVAR Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 89

Abbreviations (cont’d) • • SCD SOB SPECT STEMI SVT TAVR TEE TEVAR Sudden cardiac death Shortness of breath Single photon emission computed tomography ST elevation myocardial infarction Supraventricular tachycardia Transcatheter aortic valve replacement Transesophageal echocardiography Thoracic endovascular aneurysm repair Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 90

Abbreviations (cont’d) • • TGA t. PA UA VF VSD VT WPW Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 91

Abbreviations (cont’d) • • TGA t. PA UA VF VSD VT WPW Transposition of the great arteries Tissue-type plasminogen activator Unstable angina Ventricular fibrillation Ventricular septal defect Ventricular tachycardia Wolff-Parkinson-White syndrome Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 92

QUICK QUIZ: 4. Which procedure involves insertion of a balloon-tipped catheter into a coronary artery? A. Thrombolytic therapy B. Coronary artery bypass grafting C. Percutaneous coronary intervention D. Endarterectomy Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 93

Review Sheet COMBINING FORMS Combining Form • • aneurysm/o angi/o aort/o arteri/o ather/o atri/o Meaning ______________ ______________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 94

Review Sheet (cont’d) COMBINING FORMS Combining Form • • aneurysm/o angi/o aort/o arteri/o ather/o atri/o Meaning aneurysm vessel aorta artery yellowish plaque atrium Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 95

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • axill/o brachi/o cardi/o cholesterol/o coron/o cyan/o isch/o myx/o Meaning ______________ ______________ _______ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 96

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • axill/o brachi/o cardi/o cholesterol/o coron/o cyan/o isch/o myx/o Meaning armpit arm heart cholesterol heart blue to hold back muscle mucus Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 97

Review Sheet (cont’d) COMBINING FORMS Combining Form • • ox/o pericardi/o phleb/o pulmon/o rrhythm/o sphygm/o steth/o thromb/o Meaning ______________ ______________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 98

Review Sheet (cont’d) COMBINING FORMS Combining Form • • ox/o pericardi/o phleb/o pulmon/o rrhythm/o sphygm/o steth/o thromb/o Meaning oxygen pericardium vein long rhythm pulse chest clot Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 99

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • valvul/o valv/o vascul/o ven/o, ven/i ventricul/o Meaning ______________ ______________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 100

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • valvul/o valv/o vascul/o ven/o, ven/i ventricul/o Meaning valve vessel vein ventricle Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 101

Review Sheet (cont’d) SUFFIXES Suffix • • • Meaning -constriction -dilation -emia -graphy -lysis -megaly ______________ ______________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 102

Review Sheet (cont’d) SUFFIXES Suffix • • • Meaning -constriction -dilation -emia -graphy -lysis • -megaly narrowing widening; stretching; expanding blood condition process of recording breakdown; separation; destruction; loosening enlargement Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 103

Review Sheet (cont’d) SUFFIXES Suffix • • Meaning -meter _______ -oma -osis -plasty -sclerosis -stenosis -tomy ______________ ______________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 104

Review Sheet (cont’d) SUFFIXES Suffix • • Meaning -meter measure -oma -osis -plasty -sclerosis -stenosis -tomy tumor; mass; fluid collection condition; usually abnormal surgical repair hardening tightening; structure process of cutting Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 105

Review Sheet (cont’d) PREFIXES Prefix Meaning • a-, an _______ • brady- _______ • de- _______ • dys- _______ • endo- _______ • hyper- _______ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 106

Review Sheet (cont’d) PREFIXES Prefix Meaning • a-, an no; not; without • brady- slow • de- lack of; down; less; removal of • dys- bad; painful; difficult; abnormal • endo- in; within • hyper- above; excessive Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 107

Review Sheet (cont’d) PREFIXES Prefix Meaning • hypo- _______ • inter- _______ • peri- _______ • tachy- _______ • tetra- _______ • tri- _______ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 108

Review Sheet (cont’d) PREFIXES Prefix Meaning • hypo- deficient; below; under; less than normal • inter- between • peri- surrounding • tachy- fast • tetra- four • tri- three Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 109