Cardiology Chapter 5 239 Word or Phrase hyperlipidemia (continuedt Word Part and Definition Description hypercholesterolemia (Hv-per-koh-LES-ter-awl-EEmee-afi) hyper- above;more than normal chofesterol/o- cholestero I -emia conditionof the blood, substancein the blood hypertriglyceridemia (HY-pertry-G LIS-er-i h-DEEmee-an) hyper- above,more than normal trigf ycerid/o- triglyceride -emia conditionof the blood; substancein the blood hypertension (HTN) hypertension(Hv-per-TEN-sh un) hyper- above;more than normal tens/o- pressure,tension -ion action; condition prehypertension / n r a a - l - . l V - n a r - T F N l - < hr rn \ \ F ' ! ! ' ' pre- before; in front of hyper- above;more than normal tens/o- pressure,tension -ion action; condition Elevated Normalbloodpressure readings in an adultare bloodpressure. lessthan 120/80mm Hg.Thosebetween120/80mm Hg and 140/90 mm Hg arecategorized above as prehypertension.Bloodpressures 140/90mm Hg arecategorized as hypertension, and the patientis said to be hypertensive.Several readings, not just one,are bloodpressure neededto makea diagnosis. Essential hypertension, the mostcommon is one in whichthe exactcauseis not known. typeof hypertension, Secondary hypertension hasa knowncause,likekidneydisease, Treatment: exercise, Lifestyle changes(decreased saltintake,increased weightloss)followedby antihypertensive drugs. just readings bloodpressure i Somepeoplehaveincreased Thisis ' because they are nervous from being in a doctor's office. hypertensive(Hv-per-TEN-siv) known hypertension. This is not true hypertenas white-coat a hyper- above;more than sionbecause assoonastheyleavethe doctor'soffice,their normal pressure returnsto normal. blood tens/o- pressure,tension -ive pertaining to hypotension hypotension(ttv-poh-TEN-shu n) hypo- below, deficient tens/o- pressure,tension -ion action; condition Bloodpressure lowerthan 90/60mm Hg, usuallybecause of a lossof is saidto be hypotensive. bloodvolume.A patientwith hypotension but self-correcting Orthostatichypotensionis the sudden,temporary, decrease in systolic bloodpressure that occurswhen the patientchanges position f r o m a l y i n gt o a s t a n d i n g a n de x p e r i e n c lei g s htheadedness. hypotensive(ttv-poh-TEN-siv) Treatment: cause. Correctthe underlvino hypo- below; deficient tens/o- pressure, tension -ive pertaining to orthostatic(oR-thoh-STAT-ik) orth/o- straight stat/o- standingstill,staying in one place -ic pertaining to Orthostaticrefersto standing up straight. 240 ; Chapter 5 i Cardiology peripheralartery disease(PAD) peripheral(peh-RlF-eh-ral) peripher/o- outer aspects -al pertaining to perfusion (per-FYOO-zhun) per- through, throughout fuslo- pouring -ion action; condition Arteriosclerosis of the arteriesof the legs.Bloodflow (perfusion)to is the extremities poo; and there is ischemiaof the tissues.While walkpainin the calf(intermittent claudication). ing,the patientexperiences and may feet and toes remain cool and cyanotic In severePAD,the drugs. the tissues die. Treatment: Lipid-lowering becomenecrotic as 5urgery:Angioplasty. claudication (rLaw-dih-KAY-shun) cfaudicat/o- limping pain -ion action; condition necrotic (neh-KRAWI-| k) necrlo- death -tic pertaining to p"ripf,"r"f 1p.f,-nf f -.f,-rat1 peripher/o-outeraspects peripheral lt includes Anydisease of theextremities. of thearteries disease. arterydisease aswellasRaynaud's -al pertaining to phlebitis phleb/o- vern -itis inflammation of thrombophlebitis (rHnnwv-boh-fIeh-BY-tis) thromb/o- thrombusblood clot) phleb/o- vern -itis meansinflammation of Raynaud's disease Thearea accompanied byinfection. Inflammation of a vein,usually that andtheskinmayshowa redstreak aroundtheveinispainful, inflammation canpartially followsthe courseof thevein.A severe is occlude the veinandslowtheflow of blood.Thrombophlebitis (bloodclot).Treatment: phlebitis with theformationof a thrombus drugsfor inflammation. Analgesic drugsfor pain,anti-inflammatory a clot, Thrombolytic drugsto dissolve Antibiotic drugs,if needed. Raynaud(ray-NO) Raynaudt disease wasnamed (1834by Maurice Raynaud physician.This 1881), a French isan example of an eponym: a person fromwhomsomething takesits name. in the ilJ;;, se * andspasmof thearterioles ".t"."rr,r'ction by coldor emotional upset.They fingersandtoes, oftentriggered or hoursuntilthe become whiteor cyanotic andnumbfor minutes Treatment: Vasodilator drugs. attackpasses. Canleadto necrosis. varicose (VAR-ih-kohs) varic/o- varix;varicosevein -ose fullof valves in a veinthatletbloodflowbackward Damaged or incompetent theveinbecomes in thepreceding section of vein.Eventually andcollect of theskin andbulgingunderthesurface engorged with blood,twisting (seeFigures injury veinscanbe caused by phlebitis, 5-241).Varicose require periods that with the legs crossed, or occupations long of sitting pressure fromtheenlarging Also,duringpregnancy, constant standing. andcauses the uterusrestricts theflow of bloodin the lowerextremities varicose veins. to develop legveinsto dilate.Thereisa familytendency painandaching; andleaden. the legsfeelheavy include Symptoms Cardiology Chapter5 241 Word Part and Definition Word or Phrase Description Treatment: Destruction of theveinby injecting or a sclerosing solution foamto harden it. Laser andocclude or radiowaves to destroy thevein. Figure 5-24 J Severe varicose veins in the leg. Superficial varicose veinsareunsightly andeasily injured because they orotrude. Patients oftenhavevaricose veinstreatedto achieve an improved cosmetic appearance, buttreatment alsohelosdecrease thechance of injuryandthrombophlebitis (Chapter3). Varicose Gastroenterology veinsof the esophagusand stomachareknownasesophageal and gastricvarices. Varicose veinsof the rectumareknownas hemorrhoids. i* il-r11 r;5ct,cl5 ir ,: Word or Phrase cardiacenzymes C-reactiveprotein ,CRP) Word Part and Definition Desciption enzyme (EN-zime) Thesuffix-aseindicates an enzyme. Bloodtestto measure that are released into the the levelsof enzymes bloodwhen myocardial cellsdie.Creatinekinase(CK)is found in s k e l e t aml u s c l e c e l l sb, u t a s p e c i f ifco r m o f i t ( C K - M Bi)sf o u n d e x c l u s i v ei n l ym y o c a r d icael l l sT, h eC K - M Bl e v ebl e g i n st o r i s e2 - 6 h o u r s creatinephosphokinase aftera myocardial infarction. Alsoknownas creatinephosphokinase (KREE-ah-teen (CPK).Lactatedehydrogenase(LDH)is found in manydifferentcells, rnws-foh-KY-nays) i n c l u d i ntgh e h e a r t T . h eL D Hl e v e bl e g i n st o r i s e1 2 h o u r sa f t e ra myocardial infarction. An elevatedLDHcan supportthe CK-MBresults lactatedehydrogenase butcannob t e t h e s o l eb a s i so f d i a g n o s i nagm y o c a r d i ianl f a r c t i o n . (LAK-taytdee-HY-d days. roh-jen-ase) Cardiacenzymes are measured everyfew hoursfor several Bloodtestto measure in the body. the levelof inflammation (like I n f l a m m a t i of rno ms i t e so t h e rt h a nt h e c a r d i o v a s c usl a y sr t e m i n f l a m m a t i oonf t h e g u m so r c h r o n i cu r i n a r yt r a c ti n f e c t i o n cs a ) np r o d u c ei n f l a m m a t i oonf t h e w a l l so f t h e b l o o dv e s s e lT s .h i sc a nl e a dt o b l o o dc l o tf o r m a t i o na n d a m y o c a r d i ianl f a r c t i o n . 242 Chapter 5 Cardiology Word Part Word or Phrase and Definition Description lipid profile lipid(LlP-id) lip/o- lipid (fat) -id resembling Bloodtestthat provides u .orpr"t''t"nrivepictureof the levelsof cholesterol and triglycerides and their lipoprotein carriers in the blood: HDL,LDL,and VLDL. troponin troponin (troh-POH-n in) Bloodtestto measure the levelof two proteinsthat are reieased into the bloodwhen myocardial cellsdie.TroponinI and troponinT areonly found in the myocardium. Thetroponinlevelsbeginto rise4-6 hours aftera myocardial infarction. More importantly, they remainelevated for up to 10 days,so theycan be usedto diagnose a myocardial infarction manydaysafterit occurred. Troponinlevelsaredonein conjunction with C K - M Ba n d L D Hl e v e l s . cardiac catheterization catheterization : Diagnostic procedure performedto evaluatethe rightor left sideof the (KATH-e h-ter-ih-ZAY-sh un) i heart.Fora right heartcatheterization, a catheteris insertedinto the ' catheter/o- catheter femoralor brachialveinand threadedto the rightatrrum.Thecatheter -ization process of making, is usedto recordrightheartpressures. Thena radiopaque contrastdye creating, or inserting is injectedthroughthe catheterto outlinethe chambers of the heart.A Catheteris derivedfrom a Greek right heartcatheterization is usedto diagnose congenital heartdefects. word meaninqto senddown. Fora left heartcatheterization, a catheteris insertedinto the femoralor brachialarteryand threadedto the left atrium.Thenradiopaque contrastdye is injectedto outlinethe coronaryarteries and show narrowor blockedareas.lf blockages of the coronaryarteries are present,an angioplasty may be performedat that time. electrocardiography (ECG, EKG) electrocardiography (ee-LEK-troh-KAR-deeAWG-rah-fee) efectr/o- electricity cardilo- heart -graphy processof recording procedure Diagnostic that recordsthe electrical activityof the heart duringcontractions and rest(seeFigure5-25I). Electrodes (metalpieces in adhesive patches) areplacedon the limbs(botharmsand one leg)to recordthe electrical impulses of the heartto the EKGmachine.These arethe threelimb leads(leadsI throughlll).Electrodes placedon the chestare knownas the precordial leads(V1throughVJ. A 12-leadEKG records12 differentleadsthat showthe electrical activitybetween electrocardiogram differentcombinations of electrodes pictureof the to givean electrical (ee-Le<-troh-KAR-dee-oh-gram) heartfrom 12 differentangles.Samples of eachof thesel2 tracrngs are efectr/o- electricity mountedon a backing.A longersampleof just the leadll tracingis cardilo- heart knownas a rhvthmstrip. -gram a record or picture (continued) Figure5-251 Electrocardiography. patches Electrode attached to wire leads areplaced onthebodyto pick uptheelectrical impulses ofthe heartfrommanydifferent angles. Interpretation of anEKG involves determining theheartrate,theheart rhythm, andidentifying abnormalities intheshape pattern. of theelectrical Cardiology Chapter 5 243 Word or Phrase Word Part and Definition Description electrocardiography l rnnfinnor{t Theelectrical imagegenerated by the contraction and relaxation pattern(seeFigure5-26f). The of the hearthasa characteristic Pwavecorresponds to depolarization of the SA nodeand both atria.TheQRScomplexcorresponds to depolarization of the TheT wavecorresponds septumand bothventricles. to repolarizationof the ventricles. Therepolarization of the atriais hidden by the QRScomplex. Septal Ventricular depolarization o wave\ QRS comprex S-T segmenr Figure 5-25 f An EKGtracing. Pwave, andT Each heartcontraction hasa characteristic complex, QRS WAVE. TheK in the abbreviation EKGcomesfromthe Greekword kardia heart\. 2rt4, Chapter5, Cardiology I Word Part I Word or Phraie ii and'Definition electrophysiologic study (EPS) electrophysiologic (ee-LE K-troh-Frz-ee-oh-LAW-j ik) efectr/o- electricity physi/o- physicalfunction loglo- the study of -ic pertaining to Holtermonitor telemetry Description procedure Diagnostic to mapthe heart'sconduction systemin patients with arrhythmias. Whilean EKGis performed, catheters are insertedinto the femoralveinand the subclavian vein.X-raysare usedto guidethe cathetersto the heart.The catheterssendout electricalimoulsesto stimulatethe heartand try to inducean arrhythmia to pinpointwhere the arrhythmias areoriginating from in the heart. procedure Diagnostic Orring;hi.f' tfre patientSheartrateand rhythm arecontinuously monitoredas an outpatienllor24 hours.The patient wearselectrodes attachedto a small,portableEKGmonitor(carriedin a vestor placedin a pocket).The patientalso keepsa diaryof activities. meals,and symptoms. Thisprocedure is usedto documentinfrequently occurringarrhythmias and to linkthem to activities or symptomssuchas chesp t ain. telemetry(teh-LEM-eh-tree) tefe/o- distance -metry the process of measuring cardiacexercise stresstest pharmacologic -ik) (rnn-mah-koh-LAWJ pharmac/o-medicine, drug loglo- word;thestudyof -ic pertainingto Diagnosticprocedureto monitora patientbheartrate and rhythmin the hospital. The patientwearselectrodes that continuously transmitthe EKGtracingto a centralmonitoringstation,usuallyin the coronarycare careunit, .u!!lgr intensive procedure performed Diagnostic to evaluate theheart's response to exercise in patientswith chestpain,palpitations, or arrhythmias. The patientwalkson a motorizedtreadmill(treadmill exercisestresstest) or ridesa stationarybicyclewhile an EKGis performed.The speedof the treadmilland the steepness of its incline(or the resistance of the bicycle) aregradually increased whilethe patient'sheartrate,bloodpressure, and EKGare monitored.The procedureis stoppedif the patientcomplainsof angina,palpitations, shortness of breath,or tiredness, or if the v EKGpatternbecomesabnormal.The patient'srestingheartrateand maximumheartratearecomparedto standards for otherpeopleof the sameageand sex.Any abnormalities in the EKGpatternareanalyzed. A pharmacologicstresstest is performedin patientswho cannotexercisevigorously. A vasodilator drug likeadenosine or dipyridamole (Persantine) is givento causenormalcoronaryarteriesto dilate. Occludedarteriescannotdilate,and thisstresses the heartin a way that is similarto exercise and provokes angina. Cardiology i Chapter 5 i 245 angiography angiography (AN-jee-AWG-rah-fee) angi/o- bloodvessel; lymph vessel -graphy processof recording procedure Radiologic in whichradiopaque contrastdye is injectedinto a bloodvessel fill it. In to and outline arteriography,it is injectedinto (seeFigure an arteryand showsblockage, narrowedareas,or aneurysms 5-21).ln venography,it is injectedinto a veinand showsweakened valvesand dilatedwalls.Thex-rayimageis knownas an angiogram,or specifically as an arteriogramor venogram. arteriography In coronaryangiography, a catheteris insertedinto the femoral (ar-TEE R-ee-AWG-ra h-fee) arteryand threadedto the aorta.The radiopaque contrastdye outlines arterilo- artery the coronaryarteries and showsnarrowing,stenosis, or blockage. The -graphy processof recording x-rayis knownas a coronaryangiogram. In rotationalangiography, multiplex-raysaretakenas the x-rayarm venography(vee-NAWG-rah-fee) movesaroundthe patient.Thistechniqueis particularly helpfulin venlo- vein documenting tortuousbloodvessels in threedimensions. -graphy processof recording (DSA)combines Digitalsubtraction angiography two x-rayimages. Thefirstis takenwithout radiopaque The contrastdye. secondimageis angiogram(AN-jee-oh-gram) takenafterradiopaque contrastdye hasbeeninjectedto outlinethe angi/o- bloodvessel; lymph bloodvessel. A computerthen compares the imagesand digitally yesse/ "subtracts"or removes the soft tissues, bones,and muscles, leavingjust -gram a recordor picture the imaqeof the arteries, arteriogram (ar-TEER-ee-oh-gram) arlerilo- artery -gram a recordor picture venogram(VEE-noh-gram) venlo- vein -gram a recordor picture aortography aortography (ea-or-TAWG-rah-fee) aortlo- aorta -graphy process of recording aortogram(aa-OR-toh-gram) aortlo- aorta -gram a recordor picture procedure Radiologic in whichan radiopaque contrast dyeisusedto outlinetheaortato lookfor stenosis or an aorticaneurysm. Thex-rav imageisknownasan aortogram, 246 Chapter 5 Cardiology i word P;i Word or Phrase myocardial perfusionscan and Definition Description perfusion(per-FYOO-zhun) per- through fuslo- pouring -ion action; condition Nuclearmedicineorocedure that combinesa cardiacexercise stresstest with intravenous injections of a radioactive tracer.In a thallium stress test, thallium-201 is usedasthe radioactive traceror thallium-20'1 and technetium-99m can be used.Technetium-99m isjoinedto a synthetic molecule(sestamibi). Thecombination of technetium-99m with sestamibi is knownas Cardiolite, so thistest is alsoknownas a Cardiolite stresstest.The radioactive tracerscollectin thosepartsof the myocardium that havethe bestperfusion(bloodflow).A gamma camerarecordsgammaraysemittedby the radioactive tracersand createsa two-dimensional imageof the heart.Areasof decreased uptake("coldspots")on the imageindicatepoorperfusion from a blockedcoronaryartery.Thearterymustbe about70% blockedbefore anyabnormality is evidenton the image.Areasof no uptakeindicate deadtissuefrom a previousmyocardial infarction. thallium (THAL-ee-um) multiple-gated acquisition (MUGA) scan Nuclearmedicineprocedure that usesthe radioactive tracertechnetium99m. Firstpyrophosphate is injectedintravenously to preparethe patient'sred bloodcellsto bindwith technetium-99m. Thentechnetium99m is injected. A gammacamerarecordsgammaraysemittedby a radioactive tracerthat is boundto red bloodcells.Thecamerais coordinated(gated)with the patientsEKGso that imagesof the heartchambersaretakenat varioustimesduringthe cardiaccycle.A MUGAscan alsocalculates the ejectionfraction(how muchbloodthe ventriclecan Theejectionfractionis the mostaccurate e1ectwith one contraction). indicatorof overallheartfunction.Thisorocedure is alsoknownas a radionuclideveniriculography(RNV)or gated blood pool ventriculography scan, (ven-TRIK-yoo-LAWG-rah-fee) ventricul/o- ventricle -graphy processof recording single-photon emission computed tomography (SPECT) scan tomography (toh-MAWG-rah-fee) tom/o- a cut, slice,or layer -graphy processof recording A photonis anothernamefor a gammaray. radionuclide (RAY-dee-oh-NOO-klide) radi/o- radius(forearmbone); x-rays, radiation nucfe/o- nucleus(of an atom) -ide chemicallymodified A radionuclide is a substance whosenucleushasbeen c h e m i c a lm l yo d i f i e dt o m a k ei t radioactive. D u r i n ga m y o c a r d i p ae l r f u s i osnc a no r a M U G As c a nt,h e g a m m a positionabovethe patientS camerais normallykept in a stationary chest.However, if the gammacamerais movedin a circlearoundthe patient,then this becomes a SPECT scan.Thecomputercreatesmany ) dc o m p i l etsh e m i n t oa i n d i v i d u ai m l ageo s r " s l i c e s("t o m o g r a p hay n three-dimensional imageof the heart. Cardiolocrv Chapter 5 247 woiJ p"rt Word or Phrase a n d D e f i n i t i o n echocardiography echocardiography (EK-oh-KAR-dee-AWG-ra h-fee) ech/o- echo (soundwave) cardilo- heart -graphy processof recording Description procedure Radiologic that usesa transducer to produceultrahighfrequency soundwaves(ultrasound) that are bouncedoff the heartto createan image.Two-dimensionalechocardiography(2-Decho) createsa real-timepictureof the heartand its chambers and valvesas it contracts Theimageis knownas an echocardiogram(see and relaxes. F i q u r e5 - 2 7 1 ) . echocardiogram (EK-oh-KAR-dee-oh-gra m) ech/o- echo (soundwave) cardilo- heart -gram a recordor picture Figure 5-27 a An echocardiogram. Thisphotowastakenasa two-dimensional produced echocardiography real-time, movingimages of the hearton thedisplayscreen. An echocardiogram usessoundwavesto createimaoes. transesophageal (TRANS-ee-SAWr-ahl EE-al) trans- acrost through esophag/o- esophagus -eal pertaining to ultrasonography (ur-trah-soh-NAWG-rah-fee) ultra- beyond; higher son/o- sound -graphy processof recording duplex (DOO-pleks) Doppler (DAWP-ler) A transesophagealechocardiogram(TEE)maybe orderedwhen a r o d u c eas p o o rq u a l i t yi m a g eF s t a n d a redc h o c a r d i o g r apm . o ra T E Et,h e p a t i e nst w a l l o was n e n d o s c o ptiuc b et h a t c o n t a i nas t i n ys o u n d - e m i t t i n g t r a n s d u c eTrh. i si s p o s i t i o n eidn t h e e s o p h a g udsi r e c t l b y e h i n dt h e h e a r t . Color flow duplex ultrasonographycombines a two-dimensional u l t r a s o u nidm a g ew i t h a n o t h e irm a g eg e n e r a t ebdy D o p p l eur l t r a sonography that color-codes imagesaccording to theirvelocityand d i r e c t i o nT.h ei m a g es h o w st u r b u l e n caen dv a r i a t i oinn v e l o c i t by y d i f f e r e n t d e g r e eosf b r i g h t n e sTs h . i st e s ti st h e " g o l ds t a n d a r df"o r e v a l u a t i n g tortuousvaricose veins. Doppler ultrasonographyimagesthe flow of bloodin the arteries. The reflected soundwavesvarydependingon how fastthe bloodis t r a v e l i n ign a n a r t e r yo r v e i n .T h ei m a g ec a na l s os h o wb l o c k a g eosr clotsin the vessel. Dopplertechnologyis alsousedin automaticblood pressure machines, in hand-helddevices that givethe heartrateif placedon the skinoveran artery,and in fetal monitorsthat,when placedon the mother'sabdomen,givethe heartrateof the fetus. 248 Chapter 5 Cardiology lVtredical andSursical Procedures Word Part Word or Phrase and Definition Description auscultation auscultation(nws-kul-TAY-sh un) Medicalprocedurethat usesa stethoscopeto listento the heartsounds auscult/olistening and detectmurmursand otherabnormalsounds. -ation a process;being or having stethoscope(STETH-oh-skohp) steth/o- chest -scope instrumentused to examlne cardioversion cardioversion (KAR-dee-oh-VER-zh un) cardilo- heart vers/o- to turn; to travel -ion action; condition (ventricular Medicalprocedure to treata life-threatening arrhythmia fibrillation) and restorethe heartto normalsinusrhythm.A (seeFigure5-28I). defibrillator is the deviceusedfor the procedure Two large,handheldpaddlesareplacedon eithersideof the patient's generates chestwhilethe defibrillator an electrical shockto overridethe arrhythmia or to stimulatea nonbeatingheartaftera cardiacarrest. (AICD)is a small defibrillator (dee-FlB-rih-lay-ter) An automaticimplantable cardioverter/defibrillator de- reversalof; without devicethat is implantedin a patientwho is at highriskfor developing a fibrif f/o- musclefiber,nerve seriousarrhythmia. TheAICDis implantedunderthe skinof the chest.lt fiber hasleads(wires)that go to the heart,senseits rhythm,and deliveran -ator person or thing that (AED)is a electrical shock,if needed.An automaticexternaldefibrillator portablecomputerized does or produces devrcerepr on emergency response vehicles and in publicplaceslikeairports.lt analyzes the patientsheartrhythm and delivers an electrical shockto stimulatea heartin cardiacarrest.An persons. AEDis designed to be usedby nonmedical Figure 5-28 f Cardioversion. paddles Ihisphysician isaboutto applydefibrillator to thepatient's chest to convert a life-threatening anhythmia. Emergency departmentl operating rooml andintensive careunitsareallequipped with defibrillators thatcanbebrought to thepatient's bedside. Cardiology Chapter5 249 W;o P;ft Word or Phrase and Definition radiofrequency catheterablation Description ablation (ah-BLAY-shun) ablat/o- take away; destroy -ion action; condition Medicalprocedure to destroyectopicareasin the heartthat areemitting electrical impulses and producingarrhythmias. A catheteris insertedinto the heart.Electromagnetic energyproducedby a generatorproduces enoughheatat the siteto killthe cellscausingthe arrhythmia. Radiofrequencycatheter occlusion usesheatto collapseand seal veins. largevaricose occlusion(oh-KLOO-zhun) occfus/o- closeagainst -ion action,'condition sclerotherapy sclerotherapy (SKLER-oh-THAIR-ah-pee) scfer/o- hard; sclera(whiteof the eye) -therapy treatment vital signs Medicalprocedure in whicha sclerosing drug (liquidor foam)is injected i n t oa v a r i c o svee i n .T h ed r u gc a u s eisr r i t a t i oann d i n f l a m m a t i ot h nat laterhardensas fibrosisthat occludes the vein. Medicalprocedure duringa physical examination to measure the (TPR) pulse,and respirations temperature, aswell as the bloodpressure. The heartrateis measured by countingthe pulse.The pulsecan be felt in several differentpartsof the body(seeFigure5-29I). Pulse pointsincludethe carotidpulsein the neck,apicalpulseon the anteriorchest,axillarypulsein the armpit,brachialpulseat the inner elbow,radialpulseat the wrist,femoralpulsein the inguinalarea (groin),poplitealpulseat the backof the knee,the posterior tibialpulse a t t h e b a c ko f t h e l o w e rl e g ,a n dt h e d o r s a l ipse d i sp u l s eo n t h e d o r s u m of the foot. The radial pulse in the wristis the mostcommonlyused site.In an emergency, the carotidpulsecan be felt (seeFigure5-30I), particularly if the patientis in shockand littlebloodis flowingto the (continued Carotidoulse Axillarypulse Apicalpulse Brachialpulse Femoralpulse Radialpulse Poplitealpulse Posteriortibial pulse Dorsalispedis pulse Figure 5-29 f Pulse points. pointiswhere A pulse a pulse canbefeltonthesurface ofthebodywhentheheartcontracts andsends blood points through Pulse arefeltto determine the theartery. heartrate. 250 Chapter 5 Cardiology Word Part Word or Phrase and Definition Description vital signs (continued) Figure 5-30 f The carotid pulse. Thepulseof thecarotidarterycanbeeasilyfelt in the neck.Emergency medical technicians usethissiteto quicklyassess a patient's heartbeat. extremities. Theapical pulse (at the apexof the heart)can be heard with a stethoscooe and is alsousedto evaluate the heartsounds.The presence vascular disease can be determined by comparof peripheral ing the strengthof the pulsein the rightlegto the samepulseon the left. is measured with a sphygmomanometerand a sphygmomanometer Thebloodpressure (SrtG-moh-mah-NAWM-eh-ter)stethoscope. Thesphygmomanometer consists of a thin, inflatable cuff sphygm/o- pulse that wrapsaroundthe arm (or leg),a handbulbthat is pumpedto manlo- thin increase in the cuff, a regulating valvethat is openedto the pressure -meter instrumentusedto gaugethat is release from the cuff,and a calibrated the pressure (see measure cuffscome usedto readthe pressure Figure5-311). Bloodpressure Add wordsto makea correct in several verythin to verylargearms. differentsizesto accommodate Thereareevenbloodpressure and completedefinitionof cuffsfor newbornand prematureinfants. phyg pressure momanom eter: in strument Thecorrectsizeblood s cuff mustbe usedor the bloodpressure pressure is placedat used to measure[the readingwill be eithertoo highor too low.Thestethoscope pulse in the of thel the innerelbowoverthe brachialoulse.As oressure increases [by using a] thin When is decreased. cuff, it cutsoff the flow of blood.Thecuff pressure Iinflatablecuff]. the cuff pressure is lowerthanthe pressure in the artery,the blood spurtsthroughand creates the firstsound.Thisis the systolicpressure, (continued) Calibrated pressure gauge Inflatablecuff Brachialartery Stethoscooe Regulating valve Hand bulb Figure 5-31 I Measuring the blood pressure. A sphygmomanometer anda the stethoscooe areusedto measure bloodpressure. Cardiology Chapter5 251 Word Part Word or Phrase and Definition rital signs (continued) Description the top numberin a bloodpressure reading.Whencuff pressure reaches the restingpressure in the artery,this is the diastolicpressure.A blood pressure measurement pressure is recorded as two numbers.the systolic overthe diastolicpressure. Bloodpressure is measured in millimeters of mercury(mm Hg). aneurysmectomy aneurysmectomy (aru-yoo-riz-M EK-toh-mee) aneurysm/o- aneurysm (dilatation) -ectomy surgicalexcision procedure Surgical to removean aneurysm and repairthe defectin the arterywall.lf a dissecting aneurysm rnvolves a largesegmentof artery,a flexible,tubularsynthetic araft is usedto replacethat segment. cardiopulmonary bypass cardiopulmonary (KAR-dee-oh-PU L-moh-na ir-ee) cardilo- heart pulmon/o- /ung -ary pertaining to Technique usedduringopen-heart surgeryin whichthe patient'sbloodis r e r o u t e tdh r o u g ha c a n n u l ai n t h e f e m o r avl e i nt o a h e a r t - l u nm g achine. There,the bloodis oxygenated, carbondioxideand wasteproductsare removed,and the bloodis pumpedbackinto the bodyviaa cannulain the femoralartery.Cardiopulmonary bypasstakesoverthe functionsof the heartand lungsduringthe surgery. carotid endarterectomy endarterectomy (END-a rter-EK-toh-mee) endo- innermost,within arterlo- artery -ectomy surgicalexcision procedure Surgical to removeplaquefrom an occludedcarotidartery. Usedto treatcarotidstenosis due to atherosclerosis. _ )ronaryartery bypassgraft (cABG) anastomosis (ah-NAS-toh-MoH-sis) anastom/o- unite two tubular structures -osis condition; abnormal condition;process procedure Surgical to bypass an occludedcoronaryarteryand restore bloodflow to the myocardium. A bloodvessel(eitherthe saphenous veinfrom the leg or the internalmammaryarteryfrom the chest)ls used as the bypassgraft.lf the saphenous veinis used,it mustbe placedin a positionso that itsvalveswill not obstructthe flow of blood. reversed Thesuturingof one bloodvessel to anotheris knownas an anastomosis.Oxygenated bloodflowsthroughthe graft,pastthe blockage, and backinto the coronaryartery.Theabbreviation CABGis p r o n o u n c e"dc a b b a g e . " transplantation (rnnru s-plan-TAY-sh un) transplant/o- move somethingto another place -ation a process; being or having procedure Surgical to removea severely damagedheartfrom a patient with end-stage heartfailureand inserta new heartfrom a donor (a patientwho hasrecentlydied).The patientis matchedby bloodtype and tissuetypeto the donor.Hearttransplantpatientsmusttake immunosuppressant drugsfor the restof theirlivesto keeptheirbodies from rejecting the foreigntissueof their new heart.Somepatients receive an artificialheartmadeof plastic,metal,and othersynthetic materials. Whileawaitinga donorheart,the patientmayhavea leftventricular assistdevice(LVAD) temporarily implanted. Thisbattery-or pneumaticpoweredpump is placedin the abdomenand connected viatubesto the left ventricleand the aorta.In somepatients,it becomes a perman e n ts o l u t i o n . heart transplantation donor (DOH-nor) Donor is derivedfrom a Latin word meaningone who gives. 252 Chapter 5 Cardiology Word Part Word or Phrase and Definition pacemaker insertion Description procedure in whichan automateddeviceis implantedto control Surgical the heartrateand rhythm(seeFigure5-321). Pacemakers usetwo or on the heartto coordinate threewires(or leads)positioned the heartim b e a tw i t h a n e l e c t r i c a l pulse. Figure 5-32 I A pacemaker. pacemaker ThisMedtronic is placedundertheskinof theanteriorchest,anditswiresarepositioned on the heart. percutaneous transluminal coronary angioplasty (PTCA) percutaneous (PER-kyoo-TAYnee-us) per- through cutane/o- skrn -ous pertaining to procedure Surgical to reconstruct an arterythat is narrowedbecause of atheriosclerosis. A catheteris insertedinto the femoralarteryand In a balloon angioplasty,a balloon threadedto the siteof the stenosis. plaque withinthe catheteris inflated,compressing the atheromatous a n dw i d e n i n gt h e l u m e no f t h e a r t e r yT. h ec a t h e t ear n d b a l l o o na r et h e n removed(seeFigure5-33t). t r a n s l u m i n a(l t r a n s - L O O - m i h - n a l ) Artery trans- acrosl through fumin/o- lumen (opening) -al pertaining to Atheromatous angioplasty(AN-jee-oh-nlAS-tee) angi/o- blood vessel;lymph vesse/ -pfasty processof reshaping by surgery praque Balloon inserted via cathet W Figure 5-33I Balloon angioplasty. Theinflated balloon comoresses plaque atheromatous inthearteryopening thelumen, andreestablishing bloodflow. Cardiologyi Chapter5, 253 ,t{grd Pa* and Definition Word or Phrase -percutaneous transluminal coronary angioplasty(PTCA) (continued) Description Alternatively, an intravascular stainless steelmeshstent can be inserted on the catheter(seeFigure5-34I). Thecatheteris removed,but the expandedstent remainsin the arterv. Sheath removed from stent Figure 5-34I A stent. A stentisexpanded inside theartery to compress theatheromatous plaque andincrease theblood flow lt provides continuing support to keepthe lumen of theartery open. pericardiocentesis (PAIR-i h-KAR-dee-oh-sen-TE E-sis) peri- around cardilo- heart -centesis procedureto puncture lericardiocentesis valvoplasty procedure Surgical thatuses, .."01. ,o Orn.,rr"thepericardium and withdrawinflammatory fluidaccumulated in thepericardial sac.Usedto treatpericarditis andcardiac tamponade. valvoplasty (VAL-voh-plas-tee) Surgical procedure to reconstruct a heartvalveto correctstenosis or valvlo- valve prolapse. A valvulotomeis usedto cutthe valve.Thisprocedure isalso -pfasty processof reshaping knownasa valvuloplasty. by surgery valvulotome (VAL-vyoo-loh-tohm) valvullo- valve -tome instrument used to cut; an area with distinct edap< i I ,!"... valvuloplasty (val-vyoo-loh-PLAS-tee) valvul/o- yalye -pfasty processof reshaping by surgery 254, Chapter5 Cardiology t Word or Phrase and Definition valve replacement i i : i prosthetic(praws-THET-ik) prosthet/o- artificialpart -ic pertaining to Prosthesis is a Greekword meaningan additionto; a putfing on. Description j Surgical procedure heart to replacea severely damagedor prolapsed heartvalves i valve.Thereare severaltypesof prosthetic (replacement) valvecomesfrom an animal,it is i that can be used.lf the replacement xenograft. known as a ; !, i i i i xenograft (ZEN-oh-graft) xen/o- foreign -graft trssuefor implant or transplant i 1 1 DrugCategories Severaldifferent categoriesof drugs are usedto treat the symptoms,signs,and drseasesof the cardiovascularsystem.The most commondrugsin eachcategoryare listed. Category Word Partand Definition Description Example ACE (angiotensinconverting enzyme)inhibitor drugs Capoten,Prinivil, Vasotec, angiotensin(AN-jee-oh-TEN-sin) Treatcongestive heartfailureand hyperrateafter Zestril angi/o- blood vessel; tension.Alsoincrease the survival lymphatic vessel myocardial infarction. ACEinhibitordrugs producevasodilation tens/o- pressure,tension and decrease the blood -in a substance pressure by blockingan enzymethat convertsangiotensin I to angiotensin ll (a vasoconstrictor). antiarrhythmic drugs antiarrhythmic (AN-tee-aa-RITH-mik) anti- agarnst a- away from, without rrhythm/o- rhythm -ic pertaining to Treatarrhythmias. antibiotic drugs antibiotic (ANree-by-Awf-i k) (AN-tih-by-Awf-ik) anti- against bilo- life; living organisms; living tissue -tic pertaining to Antibioticdrugs Treatbacterial endocarditis. are not effectiveaoainstviralinfections. antihypertensive drugs antihypertensive (AN-tee-HY-per-TE N-siv) anti- agarnst hyper- above;more than normal Treathypertension. aspirin i ; tens/o- pressure, tension -ive pertainingto i ! : atropine(onlyfor (only Xylocaine bradycardia). for ventricular arrhythmia). and Seebetablockers calciumchannelblockers. ! Prevents heartattacks.Prevents blood clots i Bayeraspirin,St.Joseph i' from from formingby keepingplatelets i asprrn t I stickingtogether. Cardiology Chapter5 255 €ategory Word Partand Definition Description Example eta-blocker drugs Treatanginapectorisand hypertension. Beta Corgard, Inderal, Lopressor blockersdecrease the heartrateand dilate the arteriesby blockingbetareceptors in cellsin the heartand arteries. c a l c i u mc h a n n e l blockerdrugs Treatanginapectoris, heart A d a l a tC . a l a nP congestive . rocardia f a i l u r ea, n d h y p e r t e n s i oCna. l c i u m channel blockersblockthe movementof calciumions into myocardial cellsand smoothmusclecells of the arterywalls,causingthe heartrate and bloodpressure to decrease. d i g i t a l i sd r u g s digitalis(DU-i h-TAL-is) Treatcongestive heartfailure.Digitalis decreases the heartrateand strenothens the heartscontraction. d i g o x i n( L a n o x i n ) Digitalisdrugsarederivedfrom Digitalis(foxgloveplant).lts projections flowerswerethoughtto resemble fingerlike or digits. Figure 5-35I The Starry Night "TheStarry Vincent vanGogh's Night"(1889) isbelieved by inthe somephysicians to showevidence of digitalis toxicity painter waytheDutch depicted theyellow-green halos around frommania thestars.Van Gogh(1853-1890) suffered and epilepsy andmayhavebeengivendigitalis forlackof a more specific drugtherapy available at thattime.Digitalis caneasily reach toxiclevels intheblood. Symptoms of toxicity include nausea andvomiting, decreased heartrate,andsometimes visual halos. VanGoghmaysimply havepainted whathe actually sawbecause of digitalis toxicity. Cardiology Chapter 5 257 Abbreviations : AUAA abdominalaorticaneurysm MVP mitralvalveprolapse ACE angiotensin-converting enzyme(inhibitor) NSR n o r m asl i n u sr h y t h m ACS acutecoronarysyndrome P purse AED automaticexternaldefibrillator PAC A fib a t r i afl i b r i l l a t i o n PAD premature atrialcontractron peripheral arterydisease aorticinsufficiency PDA patentductusartenosus automaticimplantable cardioverter-def ibrillator PMI p o i n to f m a x i m u mi m p u l s e AMI acutemyocardial infarction PTCA p e r c u t a n e otur sa n s l u m i ncaol r o n a rayn g i o p l a s t y AS aoftrcStenosrs PVC premature ventricu lar contraction ASCVD cardiovascular arteriosclerotic disease PVD peripheral vascular disease ASD atrialseptaldefect RA r i g h ta t r i u m ASHD arteriosclerotic heartd isease RBBB rightbundlebranchblock AV lar atrioventricu RFA radiofrequency catheterablation BP hlnnd RNV r a d i o n u c l i dv e n t r i c u l o g r a p h y BPM, bpm hoetq nor minrta CABG ,Al AICD nro<<r rra RV rightventricle sl first heartsound coronaryarterybypassgraft s2 secondheartsound CAD coronaryarterydisease s3 third heartsound cath (cardiac) catheterization 54 fourth heartsound coronarycareunrt SA sinoatrial CHF heartfailure congestive SBE subacutebacterial endocarditis CK-MB creatinekinase-Mband SPECT s i n g l ep h o t o ne m i s s i ocno m p u t e r i z et odm o g r a p h y CPK.MB creatinephosphokinase-M band SVT tachyca rdia supraventricular CPR cardiopul monaryresuscitation TEE echocardiogram transesophageal CRP C -raeelirro TPR pulse,and respiratron temperature, CV lar cardiovascu v fib f irb r i l l a t i o n ventricula verylow-density lipoprotein . ccu nr^+ain DSA digitalsubtraction angiography VLDL ECG electrocardiography VSD ventricular septaldefect echo ^ -LAr ^ ^"At ^^-^* q r9lor ur99ror V tach lartachycard ia ventricu EKG electrocardiography HDL h i g h - d e n s iltiyp o p r o t e i n HTN JVD hypertension jugularvenousdistention LA left atrium LBBB left bundlebranchblock LDH lacticdehydrogenase LDL low-density Iipoprotein LV left ventricle LVAD left ventricular assistdevice || LVH left ventricular hypertrophy MI myocardial infarction nm Hg -MR MUGA millimeters of mercury mitralregurgitation (scan) multiple-gated acquisition ABBREVIATIONS Abbreviatrons arecommonlyusedin alltypesof however,thevcan mean medicaldocumentation; differentthingsto differentpeopleandtheirmeaning Alwaysverifythe meaningof an canbe misinterpreted. abbreviation. RA standsfor right atrium, but it can alsostandfor rheumatoidarthritis or room air. 5/ standsfor firstheartsound,but it can alsostandfor first sacralvertebra. CPR(cardiopulmonary Do not confusethe abbreviation (C-reactive protein). with CRP resuscrta tion) I 258 Chapter 5 Cardioiogy Meet Laurie, a cardiac stress test technologist in a hospital. all during terminology "Cardiology I usemedical department. isa veryimportant Wanting to know wasbornwitha heartdefect. of myjob.Mydaughter aspects here, to takea class to her,I started aboutwhatwashappening moreinformation program. Themostrewarding there, andthenjustwoundupina certificate a class thetestandat theendof thetest through partof myjobisif I cangeta patient forme."' thatsomucheasier made theysay,'You Cardiacstresstest technologistsarealliedhealthprofessionals testsin a stress who oerformECGs,Holtermonitortests,and cardiac office. hospitalsettingor a cardiologistl in the medicalspewho practice Cardiologistsarephysicians of with diseases and treatpatients Theydiagnose cialtyof cardiology. performsurgery, Whencardiologists system. the heartand circulatory or cardiosurgeons, cardiothoracic theyareknownas heartsurgeons, trainingand cantakeadditional Physicians vascular surgeons. cardiology. of pediatric becomeboardcertifiedin the subspecialty aretreatedmedically tumorsof the heartor bloodvessels Cancerous or cardiovascular by a cardiothoracic or surgically by an oncologist sur9eon. technologist (tek-NAWL-oh-Jrst) techn/o- technicalskill fog/o- the studyof -ist one who specializesin ist) cardiologist(KAR-dee-AWL-oh-j cardilo- heart loglo- the studyof -ist one who specializesin forms forms?Combining wordshavetwo differentcombining Didyou noticethat somecardiovascular today. language part of medical a remain languages from both Greekand Latin EnglishWord Greek Latin Exampleof MedicalWord bloodvessel angi/o- vas/ovascul/o- lator vasodi angiogram,vasoconstriction, angiography, vasculature vascular. heart cardi/o- cor cor puImonale monary,cardiothoracic, cardiopul cardiac,cardiology, vetn phleb/o- venio- venogram phlebitis, venous,venography, thrombophlebitis, Cardiology : Chapter 5'259 -Review all the materialin this chapterby completing the review exercresin this section.lJsethe Answer Keyat the end of the book to checkyour answers. Anatomy andPhysiology MatchingExercise Match each numbered word or phraseto its description. mediastinum _ Anothernamefor themitralvalve pericardium _ Network of bloodvessels related organ to a particular myocardium _ Dividing wallbetween theatriaandventricles ventricle _ Double-layered membrane around the heart valve tricuspid _ Bottomchamber of the heart septum _ Areabetween the lungsthatcontains theheart aorticvalve _ Valvebetweenthe rightatriumandrightventricle vasculature _ Heartmuscle bicuspid valve - Valvethat bloodflowsthroughasit leaves the leftventricle chordae tendineae - Ropelike strands thatstrengthen thetricuspid andmitralvalves -' iue or False lndicatewhethereachstatement is trueor falseby writingT or F on the line. 1. _ Theaortaisthe largest veinin thebody. 8. _ Allarteries carrybloodawayfromtheheart. 2. -Thesympatheticnervoussystemreleasesepinephrine, 9. -Thesubclavianarterycarriesbloodtotheleg. whichincreases the heartrateandbloodpressure' aspect bloodto the laterar 10. Theperonear arterycarries Thebloodflowsfromthe inferior 3. _ venacavato the of the lowerleg. rightatriumto therightventricle to thepulmonary colorbecause 11. _ Thebloodin veinsisa darkred-purple veinandto the lungs highlevels of carbon dioxide. it iscarrying periodis the time duringwhichthe 4. _ The refractory Thesystemic circulation carries bloodto thewhole 12. _ ventriclescontract. of the lungs. bodywith the exception 5. - Littleveinsare knownas capillaries. 6. - The interventricular septumis within the ventricle. 7. _ Theendocardium is a serousmembrane that lieson the surfaceof the heart. 13. _ 14. _ Intracellular fluidsarewithinthecell. isthe opposite of vasoconstriction. Vasodilation CircleExercise Circlethe correctword from the choicesgiven. 1. Thegreatvessels include thesuperior andinferior venacavae andthe(aorta,artery,mediastinum). ' 2. (arteries,capillaries, valves,veins). Thevascular structures of the bodyincludeall of the followingEXCEPT 3. Listening heartsounds with a stethoscope is knownas(auscultation, diastole,repolarization). to a patient's Thisisa uniquestructure foundonlyin thefetalheart:(apex,foramenovale,vasculature). 4. --/ 5. Thisveinbringsbloodfromthe headto thesuperior venacava:fiugular,portal,saphenous). 6. The(AVnode,Purkinjefiber,SA node)isthe pacemaker of the heart. 250 Chapter5, Cardiology Medical Language WordParts NameThat Word Part ldentify each of the word parts given hereby writing in the correct tetter(E C, or 5) on the line besideit. Thenwrite the definition of the word part on the blank line. The first one has beendone for vou. Prefix = P Combining Form = C Word Part 1. -al a. Suffix = S Definition perLaininaNo Word Part Definition 35. cholesterol/o- o- 36. circulaVo- 3. ablaVo- 5t. claudicaVo- A +- - d^L- 38. clav/o- 5. anastom/o- 39. coarcvo- 6. aneurysm/o- 40. compens/o- 7, angilo- 4 1 . conducVo- 8. anti- 4t. congesVo- 9. aorVo- 43. constricVo- 10. apic/o- 44. contracVo- 1 1. -ar 12. arteri/o- 46. cusp/o- 13. arteriol/o- 47. cutane/o- 14. arter/o- 48. oe- 49. diastol/odilaVo- 15. -ary coron/o- 16. -ated 50. 17. ather/o- 5 1 . distenVo- 18. atheromaVo- 52. dys- 19. -ation 53. -eal 20. 54. ech/o- 2 1. atri/o-ature 55. -ectomy 22. ausculVo- 56. ectop/o- 23. axill/o- 57. electr/o- 24. ot- 58. -emia 25. Dt/o- 59. emiss/o- 26. brachi/o- 60. endo- 27. brady- ot. -enI 28. capill/o- 62. ani- 29. card/i- 63. esophag/o- 30. cardi/o- 64. exlra- 31. caroVo- 65. femor/o- 32. cav/o- 66. fibrill/o- 33. cellul/o- 67. fractlo- 34. -centesis 68. fus/o- Cardiology, Chapter 5 261 Word Part Word Part Definition 69. gemin/o- 110. -ory /u. -gram 111 . 71. -graphy 112. -osis 72. hyper- 113 . 73. hypo- 74. -ia 114. palpiVo115. -pathy t 5. -tan 116. paVo- 76. -ic 117. per- 77. -id 11 8 . 78. -ide 11 9 . peripher/o- 79. ili/o- 120. perone/o- 80. -in 1 2 1 . pharmado- 81. -ine 122. phleb/o- 82. infarcVo- 83. inter- 123. physi/o124. -plasty 84. 65. intra-ton 126. 86. isch/o- 1 2 7 . porVo- 87. -itis 128. pre- -ity I zY. prostheVo- -ive 13 0 . pulmon/o- 90. -ization . radi/o131 91. jugul/o- | 52. 92. lipid/o- 13 3 . regurgitaVo- 93. lip/o- 134. ren/o- 94. log/o- 'l 35. rheumaVo- 95. -logy 136. rotaVo- 96. lumin/o- 137. rrhythm/o- 97. ly/o- 138. saphen/o- 98. man/o- 139. scler/o- 99. -megaly 140. -scope - 88. -- 89. -ose -ous pefl- 125, polar/opoplite/o- re- 100. -meter 141. sepVo- 101. -metry 142. sin/o- 102. mitr/o- 143. son/o- 103. my/o- 144. sphygm/o- 1O4. necr/o- 145. staVo- 105. nephr/o- 146. sten/o- 106. nucle/o^ '' 07. -ole 147. steth/o- -208. -oma 109. orth/o- 148. sub149. supra150. system/o- Definition 262 Chapter 5 : Cardiology Word Part Definition 151. systol/o- Word Part Definition 152. tachy- 167. triglycerid/o168. -trophy 153. tele/o- 169. -ule 154. tens/o- 170. uln/o- 155. tetr/a- 171. ultra- 156. theli/o- 172. -um 157. -therapy 173. valv/o- 158. tibi/o- 174. 159. thorac/o- 175. varic/o- i 60. thromb/o- 176. valvul/o- vascul/o- 161. -tic 177. vaVo- 162. -tome 178. 163. tom/o- 179. ven/o- 164. trans- 180. ventricul/o- 165. transplanUo- 181. verVo- vegetaVo- 166. tri- Word-BuildingExercise Use the combining forms, prefixes, and suffixes given here to build medical words that match the definitions given. Write the word that you build on the blank line. Someword partsmay be usedmore than once. The first one has beendone for you. i i ; ' , , -al (pertaining to) aorUo-(aorta) -ar (pertaining to) -ary(pertaining to) (atrium) atri/o- -ature(systemcomposedof) cardi/o-(heart) -ic (pertaining to) inter-(between) my/o-(muscle) -ous(pertainingto) peri-(around) pulmon/o-(lung) sin/o-(hollowcavity;channel) (the bodyasa whole) system/o- 1. Pertaining to a vein (Youthinkven/o-+ -ous).Youwrite venou6 2. Pertaining to aroundthe heart 3. Systemcomposedof blood vessels 4. Heartmuscle 5. Pertaining to theheartandthe lungs 6. The nodethat originates the heartbeat Pertaining to the bodyas a whole 8. Smallvein 9. Pertaininoto the aorta 1 0 . Pertaininq to betweenthe ventricles - u l e( s m a l l t h i n g ) -um (a structure) vascul/o-(bloodvessel) ven/o-(vein) ventricul/o- (ventricle) Cardiology' Chapter5 263 Symptomq Sighs, andDiseases MatchingExercise Match each numbered word or phraseto its description 1. arrhythmia Normalcontraction followedby a premature contraction 2. cardiacarrest Fattydeposit ? ovtr:<V<tnla Dysrrhythmia 4. bigeminy Any kind of premature contraction 5 r:rdinmon:lrr Chestsensation duringpremature contraction 6. thrombus C e l ld e a t h 7. palpitation Asystole 8. coarctation Bloodclot 9. necrosis Enlarged heart 10. atheroma Abnormalnarrowing 1 1 . t e t r a l o goy f F a l l o t Congenital heartdefect CircleExercise Circlethe correct word from the choicesgiven. 1. (Asystole,Bradycardia,Fibrillation)is an abnormally slow heartrate. 2. Narrowingof an arteryis knownas (arteriosclerosis, endocarditis,stenosis). 3. A weakness in the wall of an arteryis knownas a/an(aneurysm,varicosevein, ecchymosis). 4. (Patentforamen ovale, Heart block,Aneurysm)is a congenital heartdefect. Trueor False lndicatewhether each statementis true or falsebv writinq T or F on the line. 1. _ Anginapectorisis chestpainthat meansthe myocard i a lc e l l sh a v ed i e d . 6. _ To checkfor arteriosclerosis in the arteries of the legs, you wouldfeelthe pulsein the radialartery. 2. _ Prolapse of a valveis when the cuspshangdown and do not closecompletely. 7. _ Auscultation is usinga stethoscope to listento the heartsounds. 3. _ Raynaud's disease is severevasocontriction of the extremities tnggeredby coldor emotionalstress. 8. _ S 1a n d S , a r ea b n o r m ahl e a r ts o u n d s . 9. _ 4. _ Hyperlipidemia can meaneitherhypercholesterolemia or hypertriglyceridemia. ln patientswith right-sided congestive heartfailure, the neckmayshowsignsof pittingedema. 10. _ 5. _ Regurgitation is an infectionof the heartcausedbV bacteria. A sphygmomanometer measures the bloodpressure i n m i l l i m e t eo r sf m e r c u r (ym m H g ) . 264 Chapter 5 Cardiology Laboratory, Radiology, Surgery, andDrugs LaboratoryTestExercise Reviewthis form for ordering laboratorytests(seeFigure5-37). checkmarkin the box next to it. c a r d i oC R P c a r d i oC R Pw / l i p i d p r o f i l e cholesterol Find each of the following testsrelated to cardiologyand put a PANELS AND PROFILES ?687 inirl Panol 15F 102s6F :lectrolvtePanel lepatic FunctionPanel 10165F 10231A 10306F lasic Metabolic Panel 182Aaa ObstetricPanel Chem-ScreenPanel(Basic) [/otahnlin Panol leoatitis Panel. Acute 187 5547 7971A Chem-Screen Panel (Basic with HDL) C h e m - S c r e e nP a n e l ( B a s i c w i t h H D t T I B C I TESTS )o/ 387r 3563444R 15214R 30502E 7773E 19685Fl 30494R 2 6 0 13 E 15586R 30237W 242338 '19208W 30163E 22764R 20008w 54 /261 '1839W 4304 28399W 30262E 2U2E9W '156F 30940E 17417W 28423E 19687W 265F 5 18 7 0 R 1012F 23242E 28852E 14lA 2 11 0 5 R 10321A 8 0 18 5 TESTS Bilirubin(Direct) HBSAq HB Core Antibodv C a r d i oC R P GGT Protein.Total CBC Hemoqram hCG. Qualilative.Serum ANA CardioCRP with LioidProfile 26F PT with INB Lead, Blood qnltooov Screen 232Aaa 424 UA, Dipstick l r o n ,T I B C Cholesterol UricAcid RubellaAntibodv rhosphate 20867W | JE 7824 1556F 20933E 3084111E 53348W 71E 2 111 6 0 0 E 29868W 9704F 19752E 30536Rrr lipidpanel triglycerides digoxin H D Lc h o l e s t e r o l Jt tozE CBC with Diff HDL Cholesterol PTT 34F JA. Diostick and Microscopic lreatinine Iestosterone.Total lreatinineClearance Silirubin(Total) 203968 45443E 2A571E 66902E 20750E 7187W Hematocrit PSA,Total WBC count Chloride f3, Total 4259r rrotein Eleclroohoresis Diqoxin Glucose.2-HourPostorandial T3, Uptake PlateletCount Dilantin(phenytoin) Triolycerides 45484R 67868R 112680E Maonesium \A27W Glucose,Fastino T4, Free Potassium AST ,1,99i2F 249E4H 24512E 17426R Hemoglobin HIV-l Antibodv H e m o q l o b iA n1 c Alk Phosohatase tron Sodrum ALT tilcRoBtoLoGY i007w 2692E 26497 \124 ISH Ferritin Jalcrum Jccult Bood, stool )zolE i304R ;02868 aAV AnI|OOOV, tOIal 1643E Groun A Beta Streo Culture- Throal Grorrn B Beta Slren Cullrrre Genil ChlemvdiA Fn.loceruix/l ll Culture.Blood Sulture.Genitals 3 u l t u r eH . SV irrltrrre Sr 3ulture.Throat S u l t u r eU . rine 3onococcus.Endocervix./U rethra 3ram Stain STOOL PATHOGENS flood Grouoand Bh TvDe rroqesterone 10045F lrltrrre T4, Total JarbonDroxrde 4475F 10 0 18 T lulture. CamDVlobacter C u l t u r e .S a l m o n e l l a iPR 86 t 40A 10997 C)va and Parasites 63180 VeniDUncture Jrea Nitrogen {lbumin 'rolacln ,.\-a-'\-/ Figure 5-37 I \,/ r+ ,z\- Slool ^^li T Cardiology, Chapter 5 265 Word-Bui lding Exercise 'Ise the combining forms, prefixes,and suffixes hereto build medicalwords that match the definitionsgiven. Write the word that you (aneurysm) aneurysm/o- -gram(a recordor picture) -therapy(treatment) angi/o- (blood vessel;lymphaticvessel) -graphy (processof recording) -tome (instrumentusedto cut) -tomy (processof cutting or making an incision) phleb/o-(vein) cardi/o- (heart) -ectomy(surgicalexcision) scler/o-(hard;white of the eye) ultra- (beyond;higher) electr/o- (electricity) son/o-(sound) valvul/o- (valve) 1. Therapyusedto hardena varicosevein (Youthink sclerlo-+ -therapy)You write eclerobhera?y 2. Radiology testthat outlinesthe bloodvesselby usingcontrastmaterial 3. A written recordof the electricalactivitvof the heart 4. Testthatusesultrahigh-frequency soundwavesto outlinetheheart 5. Surgery to remove ananeurysm 6. Instrument usedto cut diseased valves Trueor False lndicatewhether each statementis true or falseby writing T or F on the line. 1. - Antiarrhythmic drugsare usedto treathypertension. 4. _ A stentis insertedduringa MUGAscan. 2. - Thrombolytic drugsbreakapartbloodclots. 5. _ 3. - An artificial valveis alsoknownas a prosthesir. (hardenSclerotherapy is usedto treatarteriosclerosis ing of the arteries) 255 : Chapter5 Cardiology Abbreviations MatchingExercise Match each abbreviation to its descriDtion. 1. LVAD _ "Goodcholesterol," a high-density lipoprotein 2. AAA _ Highbloodpressure 3. SBE _ Bacterial infectioninsidethe heart 4. CRP _ The heartrate set by the SA node 5. mm Hg _ Testto detectinflammationin the heart 6. HTN _ A holein the septumbetweenthe ventricles 7. NSR _ Can be dissecting-type of aneurysm 8. TPR _ Vitalsigns 9. TEE _ Measurement of bloodpressure 10. VSD _ Hearttestthat goesinto the esophagus 11. HDL _ May be usedinsteadof hearttransplantation AppliedSkills PluralNounand AdjectiveSpelling Fillin the blankswith thecorrectword form.Be sureto checkyourspelling.Thefirstone hasbeendonefor you. SingularNoun Plural Noun Adjective endoNhelial SingularNoun 7. valve 1. endothelium 2. pericardium 8. aorta 3. atrium 9. vein 4. ventricle 10. heart 5. septum 11. artery 6. myocardium Plural Noun Adjective Cardiology Chapter 5 267 Analysisof a MedicalReport -his exercisecontainsa hospitalAdmissionHistory and PhysicalExaminationreport. Readthe report and answer the questions.Use the , nswer Key at the end of the book to checkyour answers. ADMISSIONHISTORYAND PHYSICALEXAMINATION PATIENT NAME: COVINGTON, Victoria HOSPITAL NUMBER: 62-700245 DATEOF ADMISSION: January21,20xx HISTORYOF PRESENTILLNESS The patientis a 76-year-oldwhite femalewho was transferredemergentlyfrom home via ambulanceto this emergencydepartment. Apparently, the patienthad just finishedeatingbreakfastwhen her familynoticedthat she was standingin the middleof the hallwaywith her walker,seeminglydazed.She was assistedto her bed, but rest did not improveher mentalstatus.The familystatedthat she continuedto be confused,incoherent, and unableto answersimplequestions. At that point,the familycalled911. PAST MEDICAL HISTORY The past medicalhistorywas obtainedfrom the patient'sdaughter-in-law. The patienthas a historyof CHF, which has been slowlyworseningover about the past 8 years.She also has a historyof hypertension. The patienthas been diagnosedwith type 2 diabetesmellitus. The daughter-in-law remembersthat the patient's last fastingblood sugar in the doctor'soffice last month was over 250. She is usuallynoncompliantwith her diet,eatingfoodsthat are high in fat and calories.The patientdoes not take a pill or insulinfor her diabetes.In the past week, the patienthas had no appetite,has eaten little,but reportedlygained2 poundsanyway.The daughter-in-lawdoes not know the names of all of the patient'smedications,exceptfor Lasix.The patient smokes 1 pack of cigarettesper day and has done so for the past 40+ years.The patienthas no known allergies. PHYSICALEXAMINATION The patientis an obesefemale,lyingin bed.She is stuporous,openingher eyesto commandsbut she is unableto answerquestions.Heart:Regularrateand rhythm.The PMI is displacedto the left.The neckveins are slightlydistended.The breathsounds revealrales in both bases bilaterally. The abdomenis soft with hypoactivebowelsounds.Physicalexaminationof the lower extremitiesshows pittingedema in both feet with 2+ pretibialedemain the legs. COURSEIN THE EMERGENCYDEPARTMENT The patientwas placedon a cardiac monitorand given a stat dose of intravenousLasix.Labs were sent for CBC withWBC differential, electrolytes, CK-MB,troponin,and glucose.An arterialbloodgas was drawn. Portablechest x-ray in the emergencydepartmentshowedcardiomegalywith an LVHconfiguration. There was significantpulmonaryvascularcongestion. Whileawaitingthe resultsof the bloodchemistries, the patientsuddenlywent into cardiacarrest.CPR was initiated.She respondedto aggressivedrug intervention and defibrillation,and we were able to establisha normalsinus rhythm.The patientwas then transferredto the intensive care unit in criticalcondition.intubated.and on the ventilator. AE/rrlD f4tl;r^i, t'l.D. AlfredP.Molina,M.D. APM:mtt D'.01121|xx T:01l21lxx 268 : Chapter5 : Cardiology WORDANALYSIS QUESTIONS 1. for hvpertension? What is the medicalabbreviation 2. you would say,"The patient lf you wantedto usethe adjectiveform of hypertension, The patienthas hypertension. it) 3. 4. " What do theseabbreviations standfor? a. CHF b. CK-MB c. CPR d. LVH e. PMI Dividedefibrillationinto its threeword partsand defineeachword part. Word Part 5. Dividevascularinto its two word partsand defineeachword part. Word Part 6. Definition inlo its two word partsand defineeachword part. Dividecardiomegaly Word Part 7. Definition Definition Dictionary Skills this in orderto understand These medical wordswerenotcovered in thischapter, butyouneedto knowtheirmeanings or English dictionary amdwritetheirdefinitions. medical report.Lookup thesewordsin a medical Word incoherent sruporous emergently Definition - Cardiology Chapter 5 269 FACTFINDINGQUESTIONS ' 1. what is the rangeof beatsper minutefor normalsinusrhythmin an adult? 2. Name3 cardiacriskfactorsthat this patienthas. a. b. c. 3. Defibrillation was usedto treatwhat condition?(Circleone) cardiomegaly 4' hypertension cardiacarrest diabetes mellitus The PMIwas displaced to the left What diagnostic testwas donein the emergency roomthat confirmedthisfindingfrom the physical (Circleone) examination? troponin portabre chest x-ray blood grucose intubation cRtTtcALTHtNKtNG QUESTTONS 1' Thepittingedemaand the pretibialedemain the patient's extremities reflected congestion and backupof blooddue to failure of whichsideof the heart? 2. The pulmonary vascular congestion seenon chestx-rayreflected failureof whichsideof the heart? 3' Lasix isa diuretic drugthatremoves fluidfromthebodybyexcreting it in theurine.Forwhichof thepatient,s medical conditionswasthisdrugprescribed? (Circle one) congestiveheartfailure lackof appetite obesity 4. lf thepatientatelittlefoodin thepastweek,whydidshegaintwo pounds? 270 Chapter 5 Cardiology Pronunciation Checklist Readeach word and itspronunciation. Practicepronouncingeach word. Verifyyour pronunciationby listeningto the PronunciationListon the CD-ROM.Checkthe box next to the word after vou have mastereditspronunciation. (ns-eh-til-KOH-leen) tr acetylcholine tr axiIlaryartery(nr-zih-LAIR-ee AR-ter-ee) E (ah-NAS-toh-MOH-sis) tr bicuspidvalve(by-KUS-pid tr anastomosis VALV) tr aneurysm(AN-yoo-rizm) tr b i g e m i n ar hl y t h m( b y - J E M - i h - n a l E tr aneurysmal(nru-yoo-RlZ-mal) RITH-um) tr aneurysmectomy E bigeminy(byJEM-ih-nee) (nn-yoo-riz-M EK-toh-mee) E brachialartery(BRAY-kee-al AR-ter-ee) E tr angina(AN-jih-nah)(anJY-nah) (BRAD-ee-KAR-ee-ah) E E bradycardia tr anginal(AN-jih-nal)(an-JY-nal) (snno-ee-KAR-dik) E bradycardic tr a n g i n ap e c t o r i s E bruit(BROO-ee) E (AN-jih-nah PEK-toh-ris) tr angiogram(AN-jee-oh-gram) tr angiography(AN-jee-AWG-rah-fee) tr angioplasty(AN-jee-oh-eLRs-tee) tr angiotensin (AN-jee-oh-TEN-sin) tr antiarrhythmicdrug (AN-tee-aa-RITH-mik DRUHG) E antibioticdrug (nru-tee-by-AWf-ik (AN-tih-by-A\Aff-ik) DRUHG) fl antihypertensive drug (AN-tee-HY-per-TEN-siv DRUHG) E aorta(aa-oR-tah) E aorticvalve(aa-OR-tikVALV) E aortogram(aa-OR-toh-gram) D aortography(nn-or-TAWG-rah-fee) I apex(AA-peks) E a p i c a(l A P - i h - k a l ) (aa-RITH-mee-ah) fl arrhythmia E arterial(ar-TEER-ee-al) (ar-TEER-ee-oh-gram) E arteriogram E arteriography -rah-fee) (ar-TE ER-ee-AWG -lar) arteriolar (ar-rrr R-ee-OH (a arteriole r-TEER-ee-ohl) arteriosclerosis (ar-tErR-ee-oh-skleh-ROH-sis) arteriosclerotic (ar-tEEn-ee-oh-sklehRAW+ik) artery(AR-ter-ee) (aa-SlS-toh-lee) asystole atheroma(ATH-eh-ROH-mah) (ATH-eh-ROH-ma D atheromatous h-tus) atherosclerosis (ntH-eh-roh-skleh-ROH-sis) atria(AA-tree-ah) atrial(AA-tree-al) D atrioventricu lar (nn-tree-oh-ven-TRl K-yoo-la r) atrium(AA-tree-um) auscultation(AWS-ku l-TAY-sh un) tr tr tr tr tr tr tr tr tr tr tr tr E b u n d l eo f H i s( B U N - dol f H t 5 5 ) (KAP-ih-lair-ee) E capillary E cardiac(KAR-dee-ak) (KAR-dee-ak E cardiaccatheterization rnrH-eh-ter-ih-ZAY-sh un) (KAR-dee-ak fl cardiacenzymes EN-zimez) E cardiologist(KAR-dee-AWL-oh-jist) (KAR-dee-AWL-oh-jee) E cardiology E cardiomegaly (KAR-dee-oh-MEG-a h-lee) D cardiomyopathy (rnn-dee-oh-my-AWP-ah-thee) E cardiopulmonary (KAR-dee-oh-PU L-moh-nair-ee) E cardiopulmonary resuscitation (KAR-dee-oh-PU L-moh-nai r-ee ree-SU5-ih-TAY-sh un) E cardiothoracic (KAR-dee-oh-thoh-RAS-ik) fl cardiovascular system (KAR-dee-oh-VA5-kyoo-lar SIS-tem) E cardioversion (KAR-dee-oh-VER-zh un) E carotidartery(kah-ROT-id AR-ter-ee) E cavity(KAV-ih-tee) E chordaetendineae (KOHR-dee TEN-dih-nee-ee) (Sen-kyoo-LAY-shun) E circulation (SER-kyoo-lah-toH-ree) E circulatory (KLAW-dih-KAY-shun) E claudication (roH-ark-TAY-shun) E coarctation E compensated heartfailure (KAWM-pen-sAy-ted HARTFAyL-yer) E conduction(con-DUK-shun) E congestive(con-JES-tiv) (con-TRAK-shun) E contraction fl cor pulmonale(KORpul-moh-NAl-ee) E coronaryartery(KOR-oh-nair-ee AR-ter-ee) fl E E E fl E E E E I E fJ E fl E E E fl E E E E E I E E E E creatinephosphokinase (KREE-ah{een FAWS-foh-KY-nays) decompensated heartfailure (dee-KAWM-pen-sAY-ted HART FAYL-yer) (dee-FtB-rih-lay-ter) defibrillator depolarization (dee-eoHL-ar-ih-ZAY-sh un) diastole(dy-AStoh-lee) diastolic(DY-ah-STAWL-ik) digitalis(DU-ih-TAL-is) (dy-SEK-ting dissecting aneurysm AN-yoo-rizm) distention(dis-TEN-snunt (DAWP-ler Oopplerultrasonography uL-trah-soh-NAWG-rah-fee) pedis(dohr-SAH-lis dorsalis PEE-dis) ductusarteriosus (DUK-tusar-TEER-ee-OH-sus) (DOO-pleks duplexultrasonography UL-trah-soh-NAWG-rah-fee) (dis-RITH-mee-ah) dysrrhythmia echocardiogram (EK-oh-KAR-dee-oh-gram) echocardiography (rr-oh-rRn-dee-AWG-rah-fee) ectopic(ek-TOP-ik) e d e m a( e h - D E E - m a h ) electrocardiogram (ee-LEK-troh-KAR-dee-oh-gram) electrocardiographic technician (ee-LEK-troh-Knn-dee-oh-G RAF-ik tek-NISH-un) electrocardiography - rah-fee) (ee-Le r-troh-ran-dee-AWG electrophysiologic (ee-LE K-troh-Ftz-ee-oh-LAW-j ik) endarterectomy (END-ar-ter-EK-toh-mee) (eru-doh-KAR-dee-al) endocardial (EN-doh-kar-DY-tis) endocarditis (eru-doh-KAR-dee-um) endocardium (EN-doh-THEE-lee-al) endothelial (EN-doh-THEE-lee-um) endothelium (EP-ih-KAR-dee-al) epicardial (EP-ih-KAR-dee-um) epicardium (Ep-ih-NEF-rin) epinephrine (EKs-trah-SEL-yoo-lar) extracellular (EKS-trah-5lS-toh-lee) extrasystole Cardiology Chapter5 ,271 tr I 'J tr tr tr femoralartery(FEM-oh-ral AR-ter-ee) f ibrillation(ns-rih-LAY-sh un) foramenovale (foh-RAY-men oh-VAH-lee) heartdonor(HARTDOH-nor) (HART hearttransplantation rnnrus-plan-TAY-shun) hypercholesterolemia (Hv-per-koh-Lr5-ter-awl-EE-mee-a h) U E E E E E E fl E (neh-KROH-sis) necrosis E (neh-KRA\AIf-i necrotic k) nitratedrug(NY-trayt DRUHG) E (NY-trayts) nitrates node(NOHD) (oh-KLOO-zhun) occlusion orthostatic hypotension (oR-rhoh-sTAT-ik Hy-poh-TEN-shun) palpitation (pAl-pih-TAY-sh un) paroxysmal tachycardia (pArR-awk-5tZ-mal TAK-ih-KAR-dee-ah) patent(PAY-tent) percutaneous transluminal angioplasty (PER-kyoo-TAY-nee-us trans-LOO-mih-nal AN-jee-oh-ens-tee) perfusion (per-FYOO-shun) pericardial sac(parn-ih-KAR-dee-al sAK) pericardiocentesis E (pArR-i h-KAR-dee-oh-sen-TEE-sis) U hyperlipidemia (uv-per-t-t R-ih-DEE-mee-a h) E (Hv-per-TEN-shun) E E hypertension (Hv-per-TEN-siv) E hypertensive fl hypertriglyceridemia (HY-per-try-G LtS-er-i h-DEE-mee-a h) (uv-per-TRoH-fik) E hypertrophic E (hy-PER-troh-fee) E hypertrophy fl (uv-poh-TEN-shun) fl hypotension (Hv-poh-TEN-siv) fl hypotensive fl (tD-ee-oh-PATH-ik) E idiopathic fl iliacartery(tL-ee-ak AR-ter-ee) pericarditis (pAtR-ee-kar-DY-tis) (in-FARK-shun) E infarction pericardium (pAtR-ih-KAR-dee-um) fl interatrial septum(tN-ter-AA-tree-al peripheral (peh-RlF-eh-ral) 5EP-tum) peronealartery(PAIR-oh-NEE-al E interventricular seotum AR-ter-ee) (tn-ter-ven-TR|K-yoo-lar SEp-tum) phlebitis(fleh-BY-tis) rl intima(tN-tih-mah) plaque(PLAHK) (ttrt-trah-AA-tree-al) poplitealartery(pop-LlT-ee-al , .l intra-atrial (rrrt-trah-SEL-yoo-lar) U intracellular (pop-lih-TE AR-ter-ee) E-al) E intraventricular E portalvein(POR-tal VAYN) (tN-tra h-ven-TRl K-yoo-lar) fl prehypertension E ion(EYE-on) (pree-Hv-per-TEN-sh un) (is-KEE-mee-ah) E ischemia E prostheticvalve(praws-THET-ik E jugularvein(JUG-yoo-lar VAyN) VALV) fl lactatedehydrogenase E pulmonaryartery(pUL-moh-nair-ee (LAK{aytdee-HY-droh-jeh-nays) AR-ter-ee) E tipio(Lrp-io) U pulmonary valve(PUL-moh-nair-ee (Ltp-oh-pROH-teen) fl lipoprotein VALV) E lumen(LOO-men) I pulmonary vein(PUl-moh-nair-ee (vrr-dee-as-Ty-nal) I mediastinal VAYN) (vEE-dee-as-W-num) E pulse(PUHLS) E mediastinum (MY-tral E mitralvalve VALV) E eurkinjefiber(per-KlN-jee FY-ber) (My-tral E mitralregurgitation E radialartery(RAY-dee-al AR-ter-ee) ree-G ER-jih-TAY-sh un) E radiofrequency catheterablation E murmur(MER-mer) (RAY-dee-oh-FRE E-kwen-see (My-oh-KAR-dee-al) E myocardial KATH-eh-terah-BLAY-shun) E myocardial infarction E radionuclide ventriculography (My-oh-KAR-dee-al (RAY-dee-oh-NOO-kl in-FARK-shun) ioe perfusion E myocardial scan ven-TRt K-yoo-LAWG-ra h-fee (MY-oh-KAR-dee-al (ray-NOZ Raynaud's disease dih-ZEEZ) per-FYOO-zhun SK,AN) refractory(ree-FRAK-tor-ee) (vy-oh-KAR-dee-um) E myocardium renalartery(REE-nal AR-ter-ee) tr tr tr tr tr tr tr tr tr tr repolarization (ree-PO H-lar-ih-ZAY-sh un) (roo-MAT-ik rheumatic heartdisease HARTdih-ZEEZ) tr saphenousvein(sah-FEE-nus VAYN) tr sclerotherapy (sKLAtR-oh-THAIR-ah-pee) tr septal(SEP-tal) tr septum(SEP-tum) tr sinoatrialnode(sv-noh-AA-tree-al NOHD) tr sinusrhythm(SY-nusRITH-um) tr spnygmomanometer (SFrG-moh-mah-NAWM-eh-ter) tr stenosis(steh-NOH-sis) tr stethoscope(STETH-oh-skohp) tr subacute(sub-ah-KYOOT) tr subclavianartery(sub-KLAY-vee-an E E E I E E E I E E E E fl E E E E E I E E E AR-ter-ee) supraventricular tachycardia (soo-prah-ven-TRl K-yoo-lar TAK-ih-KAR-dee-ah) (sis-TEM-ik) systemic systole(Sl5-toh-lee) systolic(sis-TAWL-ik) (TAK-|h-KAR-dee-ah) tachycardia (TAK-|h-KAR-dik) tachycardic tamponade(tam-poh-NAYD) telemetry(teh-LEM-eh-tree) tetralogyof Fallot (tet-RAL-oh-jee of feh-LOW) thalliumstresstest(THAL-ee-um STRES TEST) thoraciccavity(thoh-RAS-ik KAV-ih-tee) thrombolytic drug (THRAWM-boh-LtT-ik DRUHG) thrombophlebitis (ru nawv- boh-f Ieh- By-tis) tibial arteryfitB-ee-alAR-ter-ee) tomography(toh-MAWG-rah-fee) transesophageal echocardiogram (TRANS-ee-SAWF-ah' EE-al EK-oh-KAR-dee-oh-gram) tricuspidvalve(try-KUS-pid VALV) trigeminalrhythm(trytEM-ih-nal RITH-um) trigeminy(tryJEM-ih-nee) troponin(troh-POH-nin) ulnarartery(UL-narAR-ter-ee) ultrasonography -rah-fee) (uL-trah-soh-NAWG valve(VALV) 272 Chapter 5 Cardiology E E E fJ f, E E I (VALVPROH-laps) valveprolapse E (VAl-voh-plas-tee) valvoplasty (VAL-vyoo-lar) valvular f, (vAL-vyoo-loh-PLAS-tee) valvuloplasty E (VAL-vyoo-loh-tohm) fl valvulotome varicose vein(VAR-ih-kohs VAYN) fl (VAS-kyoo-lar) vascular tr (VAS-kyoo-lah-chur) E vasculature vasoconstriction E (vAY-soh-con-5TRlK-shun) E (vnv-soh-dy-LAY-shun)E vasodilation (vt-eh-TAY-shun) vegetation E vein(VAYN) venacava(VEE-nah KAY-vah) E (VEE-noh-gram) venogram tr (vee-NAWG-rah-fee) venography (VEE-nus) venous (VENtrih-kl) ventricle (ven-TR|K-yoo-lar) ventricular ventriculography (ven-TRtK-yoo-LAWG-rah-fee) (VEN-yool) venule (ZEN-oh-graft) xenograft Cardiology, Chapter5 273 Experience Multimedia @ CD-ROMLearningActivitiesChecklist Checkoff the box as you completeeach learningactivity. E CO-nOU Learning Activity 5.1: ANATOMY WORD PARTS FLASHCARDS Useflashcards to helpyou memorize word parts.Makeyour own flashcards or printout prepared flashcards. Alsoseethe game Time:20 minutes electronic flashcard E Cp-ROwILearning Activity 5.2: MEDICINElN ACTTON Listento normaland abnormalheartsounds.Time:5 minutes. E CO-nOU Learning Activity 5.3: DISEASEAND OTHER WORD PARTSFLASHCARDS A continuation learningactivity. of the flashcard Time:20 minutes. E CO-nOU Learning Activity 5.4: MEMORY AIDS Usememoryaidsto helpyou memorize medical wordsand meanings. Time:5 minutes. E CO-nOU Learning Activity 5.5: MEDIAL LANGIIAGE SPOKENHERE Listento actualmedicalreportsand spellthe missingmedical words.Time:20 minutes. E 1HALLENGE co-nou LearningActivity 5.6: spELLtNG Listento a pronouncedmedicalword and then spellit. Time: 5 minutes. E CO-nOU Learning Activity 5.7: MEDTCALANGUAGE PRONUNCIATION proListento a pronounced medicalword and then practice nouncingit. Time:30 minutes. FUN AND E CO-ROIVI Learning Activity 5.8: EDIJCATIONAL GAMES yourknowledge. whilereinforcing Enjoythesefun activities T i m e :1 5 m i n u t e s .