Medical Terminology: Cardiology Cardiovascular System; Chapter 5

cardiovascular system
Thecardiovascular system is a continuous, circular body system that includes the heart and the vascular structures (blood vessels such as arteries, capillaries and veins. It is also known as the circulatory system.


blood vessel

pertaining to

having the function of

is a muscular organ that contracts at least once every
second to pump blood throughout the body. It also has an extensive electrical system that initiates and coordinates its contractions.


pertaining to

Each small upper heart chamber is an __________.

Each large lower heart chamber is a ___________.

Heart septum
a central wall, divides the heart into right and left sides.

The inferior tip of the heart

atrium (upper heart chamber)

-al pertaining to

ventricle (lower heart
chamber; chamber in the brain)

pertaining to

septum (dividing wall)

apex (tip)

Heart Diagram
Heart Diagram

Heart valves
Four _________ control the flow of blood through the heart. They are the tricuspid valve, pulmonary valve, mitral valve, and aortic valve.

tricuspid valve
between the right atrium and right ventricle. It has
three triangular cusps (leaflets). As the right atrium contracts, the tricuspid valve opens to allow blood to flow into the right ventricle. Then it closes to prevent blood from flowing back into the right atrium.

pulmonary valve
between the right ventricle and the pulmonary
trunk. As the right ventricle contracts, the pulmonary valve opens to allow blood to flow into the pulmonary trunk and pulmonary arteries. Then it closes to prevent blood from flowing back into the right ventricle.

mitral valve
between the left atrium and left ventricle. It has two
cusps and is also known as the bicuspid valve. As the left atrium contracts, the mitral valve opens to allow blood to flow into the left ventricle. Then it closes to prevent blood from flowing back into the left atrium.

aortic valve
between the left ventricle and the aorta . As the left ventricle contracts, the aortic valve opens to allow blood to flow into the aorta. Then it closes to prevent blood from flowing back into the left ventricle.



projection; point

resembling; source or origin


pertaining to

structure like a miter (tall hat with two points)



pertaining to

Chambers and Valves of the Heart
Chambers and Valves of the Heart

chordae tendineae
The tricuspid and mitral valves have ________ _____________, ropelike connective tissue attached to their valve leaflets.

the muscular layer of the heart. Its muscle fibers (muscle cells) respond to electrical impulses generated by a node within the right atrium. This process is discussed in a later

my/o- muscle

cardi/o- heart

a structure; period of time

Layers and Membranes of the Heart
Layers and Membranes of the Heart

Innermost layer of cells that lines the atria, ventricles, and heart valves. (Note: This layer also extends into the blood vessels where it is known as the endothelium or intima.)

Outermost layer. This membrane surrounds the heart as the pericardial sac and secretes pericardial fluid. The pericardial sac is U-shaped, and the heart is within the U. The part of the membrane that is next to the surface of the heart is the visceral pericardium or epicardium because it is upon the heart. The part that is the outer wall of the pericardial sac is the parietal pericardium. Pericardial fluid is a slippery, watery fluid that allows the two membranes to slide past each other as the heart contracts and relaxes.

innermost; within


large internal organs

upon; above

wall of a cavity

thorax (chest)

thoracic cavity
contains the lungs and the mediastinum, an irregularly
shaped central area between the lungs.

an irregularly shaped central area between the lungs which contains the heart and parts of the great vessels (aorta, superior vena cava, inferior vena cava, pulmonary arteries and veins), as well as the thymus, trachea, and the esophagus

reflects the close relationship between the heart and the thoracic cavity.

system composed of


cellular layer

refers to the blood vessels associated with a particular

Blood vessels have a central opening or ____________ through which the blood flows.

Blood vessels are lined with ______________, a smooth inner layer that promotes the flow of blood. This layer is also known as the intima.

large blood vessels that branch into smaller arteries
known as arterioles.

All arteries carry blood ________ from the heart to the body or to the lungs.

Most arteries lie deep beneath the skin. A few, however, lie near the surface. Their walls bulge each time the heart contracts, and this can be felt as a _________

drawn together; narrowed

action; condition

dilate; widen

the smallest blood vessels in the body. The lumen
of a capillary is so small that blood cells must pass through in single file. Capillaries are the connecting structures between arterioles and venules.

hairlike structure;

pertaining to


small thing

Small veins, known as __________, combine to form a large vein.

All veins carry blood from the body and lungs to the _________.

Valves in a vein
Valves in a vein

Arteries and veins around the heart
Arteries and veins around the heart

the largest artery in the body. It receives oxygenated blood from the left ventricle of the heart.

ascending aorta
travels from the heart in a superior direction.

____________ arteries branch off directly from
the ascending aorta.

structure that encircles like a crown

The __________ aorta then becomes the aortic arch, an inverted, U-shaped segment. Three major arteries branch off from the aortic arch.

stupor; sleep

below; underneath

clavicle (collar bone)

pertaining to

The _________ __________bring oxygenated blood to the neck, face, head and brain.
carotid arteries

bring oxygenated blood to the shoulders. Each subclavian arterygoes underneath the clavicle (collar bone) and then continues as the axillary artery (in the area of the armpit).

The _________ __________ divides into the brachial
artery, which brings oxygenated blood to the upper arm, and then into the radial artery and ulnar artery, which bring oxygenated blood to the lower arm
axillary artery


radius (forearm bone); x-rays; radiation

ulna (forearm bone)

Thoracic Aorta
The thoracic aorta travels inferiorly through the thoracic cavity. It branches into arteries that bring oxygenated blood to the esophagus, muscles between the ribs, diaphragm, upper spinal cord, and back.

abdominal aorta
brings oxygenated blood to organs in the abdominopelvic
cavity. These include the stomach, liver, gallbladder, pancreas, spleen, small intestine, large intestine, adrenal glands, kidneys (the renal arteries), ovaries (in a woman), testes (in a man), and the lower spinal cord.

iliac arteries
bring oxygenated blood to the hip and groin.

femoral artery
which brings oxygenated blood to the upper leg.

Near the knee joint, the femoral artery becomes
the ____________ ______.
popliteal artery

tibial artery
brings oxygenated blood to the front and back of the lower leg

peroneal artery
brings oxygenated blood to the little toe side of
the lower leg.


ilium (hip bone)

femur (thigh bone)

back of the knee

tibia (shin bone)

fibula (lower leg bone)


pulmonary arteries
originate from the pulmonary trunk, which comes from the right ventricle of the heart. They carry deoxygenated blood to the lungs.

superior vena cava
carries blood from the head, neck, arms, and chest to the right atrium.

inferior vena cava
carries blood from the rest of the body (abdomen, pelvis,
and legs, but not the lungs) to the right atrium.

pulmonary veins
carry oxygenated blood from the lungs to the left atrium of the heart.

jugular vein
blood from the head to the supe-
rior vena cava

portal vein
carries blood from the intestines to the liver

saphenous vein and femoral vein
carry blood from the leg to the groin).

jugular (throat)

point of entry

clearly visible

pertaining to

Systemic circulation
Arteries, arterioles, capillaries, venules, and veins
everywhere in the body, except in the lungs.

Pulmonary circulation
Arteries, arterioles, capillaries, venules, and veins
going to, within, and coming from the lungs.

movement in a circular route

the body as a whole

pertaining to

The heart contracts and relaxes in a regular rhythm that is coordinated by the ____________ ________ of the heart.
conduction system

sinoatrial node (SA node)
(in a channel in the posterior wall of the right atrium), is the pacemaker of the heart. It initiates the electrical impulse that begins each heartbeat. This impulse causes both atria to contract simultaneously.

carrying; conveying

hollow cavity; channel

atrium (upper heart chamber)

ventricle (lower heart chamber; chamber in the brain)



outside of a place

Irregularly shaped, central area in the thoracic cavity that lies between the lungs. It contains the heart, great vessels, thymus, trachea, and esophagus.

pulmonary circulation
The arteries, arterioles, capillaries, venules, and veins going to, within, and coming from the lungs

systemic circulation
The arteries, arterioles, capillaries, venules, and veins everywhere in the body, except in the lungs

acute coronary syndrome
Syndrome that includes acute ischemia of the myocardium (because of a blood clot or atherosclerosis blocking blood flow through a coronary artery) and unstable angina pectoris. Treatment: Nitroglycerin drug, thrombolytic drug, oxygen therapy.

keep back; block

condition of the blood; substance in the blood

angina pectoris
Mild-to-severe chest pain caused by ischemia of the myocardium. Atherosclerosis blocks the flow of oxygenated blood through the coronary arteries to the myocardium. Anginal pain is a crushing, squeezing, heaviness, or pressure-like sensation in the chest, with pain extending up into the jaw, teeth, neck, or down the left arm, often with extreme sweating (diaphoresis) and a sense of doom. Angina pectoris can occur during exercise, stress, after a heavy meal, or while resting. It is a warning sign of an impending myocardial infarction. Treatment: Nitroglycerin drug, oxygen therapy.

Enlargement of the heart, usually due to congestive heart failure. Treatment: Correct the underlying cause.


Any disease condition of the heart muscle that includes heart enlargement and heart failure. In dilated cardiomyopathy, the left ventricle is dilated and the myocardium is so stretched that it can no longer contract to pump blood. Idiopathic cardiomyopathy has an unknown cause. Treatment: Correct the underlying cause, if known.



unknown; individual

congestive heart
Inability of the heart to pump sufficient amounts of blood. It is caused by coronary artery disease or hypertension. During early CHF, the myocardium undergoeshypertrophy (enlargement). This temporarily improves blood flow, and the patient is in compensated heart failure. In the later stages of CHF, the heart can no longer enlarge. Instead, the myocardium becomes flabby and loses its ability to contract, and the patient is in decompensated heart failure. Either side or both sides of the heart may fail.
In right-sided congestive heart failure, the right ventricle is unable to adequately pump blood. Blood backs up in the superior vena cava, causing jugular venous distention (dilated jugular veins in the neck). Blood also backs up in the inferior vena cava, causing hepatomegaly (enlargement of the liver) and peripheral edema in the legs, ankles, and feet. Lung disease and increased pressure in the lungs cause the right ventricle to become enlarged; this condition is cor pulmonale. In left-sided congestive heart failure, the left ventricle is unable to
adequately pump blood. The blood backs up into the lungs, causing pulmonary congestion and edema that can be seen on a chest x-ray. There is also shortness of breath, cough, and an inability to sleep while lying flat. Treatment: Diuretic drug, digitalis drug, and antihypertensive drug. Severe left-sided heart failure is life-threatening; it may require surgery for a heart transplant or a left ventricular assist device (LVAD).

accumulation of fluid

pertaining to

above; more than normal

process of development

counterbalance; compensate

pertaining to a condition; composed of

reversal of; without

outer aspects

myocardial infarction (MI)
Death of myocardial cells due to severe ischemia. The flow of oxygenated blood in a coronary artery is blocked by a blood clot or atherosclerosis. The patient may experience severe angina pectoris, may have mild symptoms similar to indigestion, or may have no symptoms at all (a silent MI). The infarcted area of myocardium has dead tissue or
necrosis. If the area of necrosis is small, it will eventually be replaced by scar tissue. If the area is large, the heart muscle may be unable to contract and the patient will die. Also known as a heart attack. Treatment: Baby aspirin taken to prevent an MI or at the first sign of an MI. Thrombolytic drug to dissolve a clot during an MI.

area of dead tissue

dead cells, tissue, or body

condition; abnormal condition; process

Inflammation and bacterial infection of the endocardium lining a heart valve. This occurs in patients who have a structural defect of the valve. Bacteria from an infection elsewhere in the body travel through the blood, are trapped by the structural defect, and cause infection.
Acute endocarditis causes a high fever and shock, while subacute bacterial endocarditis (SBE) causes fever, fatigue, and aching muscles. Treatment: Antibiotic drug.

inflammation of; infection of

mitral valve prolapse (MVP)
Structural abnormality in which the leaflets of the mitral valve do not close tightly. This can be a congenital condition or can occur if the valve is damaged by infection. There is regurgitation as blood flows back into the left atrium with each contraction. A slight prolapse is a common condition and does not require treatment. Treatment: Valvoplasty or valve replacement surgery.

flow backward

Abnormal heart sound created by turbulence as blood leaks through a defective heart valve. Murmurs are described according to their volume (soft or loud), their sound, and when they occur. Functional murmurs are
mild murmurs that are not associated with disease and are not clinically significant. Treatment: Surgery to correct the defective heart valve (valvuloplasty), if needed.

Inflammation or infection of the pericardial sac with an excessive accumulation of pericardial fluid. When the fluid compresses the heart and prevents it from beating, this is cardiac tamponade. Treatment: Antibiotic drug. Surgery to remove the fluid (pericardiocentesis), if necessary.


stop up

action; process

rheumatic heart disease
Autoimmune response to a noncardiac streptococcal infection, such as strep throat. Rheumatic heart disease occurs most often in children and is known as rheumatic fever. The body makes antibodies to fight the bacteria, but the antibodies attack connective tissue in the body, particularly in the joints and/or the heart. The joints become swollen with fluid and inflamed. The mitral and aortic valves of the heart become inflamed and damaged. Vegetations (irregular collections of platelets, fibrin and bacteria. The valves become scarred and narrowed, a condition known as stenosis. Treatment: Antibiotic drug to treat the initial infection. After rheumatic heart disease has occurred, a prophylactic (preventive) antibiotic drug
is given prior to any dental or surgical procedure that might release bacteria that could further damage the valves. Valve replacement surgery, if needed.

watery discharge


narrowness; constriction

Any type of irregularity in the rate or rhythm of the heart. It is also known as dysrhythmia. Arrhythmias include bradycardia, fibrillation, flutter, heart block, premature contraction, sick sinus syndrome, and tachycardia.
Electrocardiography is performed to diagnose the type of arrhythmia. Treatment: Antiarrhythmic drug, cardioversion, or insertion of a pacemaker, depending on the type of arrhythmia.

away from; without


condition; state; thing

A patient with bradycardia is bradycardic. Treatment: Intravenous atropine (drug). Surgery to insert a pacemaker.


Arrhythmia in which there is a very fast, uncoordinated quivering of the fibrillation, a life-threatening emergency in which the heart is unable to pump blood, can progress to cardiac arrest. Treatment: Defibrillation.

Arrhythmia in which there is a very fast but regular rhythm (250 beats per minute) of the atria or ventricles. The chambers of the heart do not have time to completely fill with blood before the next contraction. Flutter can
progress to fibrillation. Treatment: Antiarrhythmic drug; cardioversion.

heart block
Arrhythmia in which electrical impulses cannot travel normally from the SA node to the Purkinje fibers. In first-degree heart block, the electrical impulses reach the ventricles but are very delayed. In second-degree
heart block, only some of the electrical impulses reach the ventricles. In third-degree heart block (complete heart block), no electrical impulses reach the ventricles. In right or left bundle branch block, the electrical impulses are unable to travel down the right or left bundle of His.
Treatment: Antiarrhythmic drug. Surgery to insert a pacemaker.

premature contraction
Arrhythmia in which there are one or more extra contractions in between systole and diastole. This is also known as an extrasystole. There are two types of premature contractions: premature atrial
contractions (PACs) and premature ventricular contractions (PVCs). A repeating pattern of one premature contraction followed by one normal contraction is bigeminy. A repeating pattern of one premature
contraction followed by two normal contractions is trigeminy. Two premature contractions occurring together is a couplet. Treatment: Antiarrhythmic drug. Surgical insertion of a pacemaker.

pull together

outside of


sick sinus syndrome
Arrhythmia in which bradycardia alternates with tachycardia. It occurs when the sinoatrial node and an ectopic site elsewhere in the myocardium take turns being the hearts pacemaker. Treatment: Antiarrhythmic drug. Surgery to insert a pacemaker.

Arrhythmia in which there is a fast but regular rhythm (up to 200 beats/ minute) tachycardic. Sinus tachycardia occurs because of an abnormality in the sinoatrial
(SA) node. Atrial tachycardia occurs when an ectopic site somewhere in the atrium produces an electrical impulse that overrides the SA node rhythm. Supraventricular tachycardia occurs when an ectopic site superior to the ventricles produces an electrical impulse. Paroxysmal
tachycardia is an episode of tachycardia that occurs suddenly and then goes away without treatment. Treatment: Antiarrhythmic drug. Cardioversion. Surgery to insert a pacemaker.



Complete absence of a heartbeat, this is also known as
cardiac arrest. Treatment: Cardiopulmonary resuscitation (CPR).

An uncomfortable sensation felt in the chest during a premature contraction of the heart. It is often described as a thump. Treatment: None, unless it becomes an arrhythmia.

to throb

a process; being or having

Area of dilation and weakness in the wall of the artery.
This can be congenital or where arteriosclerosis has damaged the artery. With each heartbeat, the weakened artery wall balloons outward. An aneurysm can rupture without warning. A dissecting aneurysm is one that enlarges by tunneling between the layers of the artery wall. Treatment: Placement of a metal clip on the neck (narrowest part) of a small aneurysmal dilation to occlude the blood flow. Surgical excision of a large aneurysm and replacement with a synthetic tubular graft.

to cut apart


Normal Abdominal Aorta
Normal Abdominal Aorta

Abdominal Aortic Aneurysm
Abdominal Aortic Aneurysm

Dissecting Aneurysm
Dissecting Aneurysm

Progressive degenerative changes that produce a narrowed, hardened artery. The process begins with a small tear in the endothelium caused by chronic hypertension. Then low-density lipoproteins (LDLs) in the
blood deposit cholesterol and form an atheroma or atheromatous plaque. Collagen fibers form underneath the plaque, so that the artery wall becomes hard and nonelastic. An artery with arteriosclerosis is said to be arteriosclerotic. This is also known as arteriosclerotic cardiovascular disease (ASCVD). Fatty plaque deposits enlarge more rapidly in patients who eat high-fat diets, have diabetes mellitus, or have a genetic predisposition
(family history). As plaque grows on an artery wall, it makes the . This condition is atherosclerosis. Pieces of atheromatous plaque easily break off, travel through the blood, and block other arteries. The rough edges of the
plaque can trap red blood cells and form a blood clot.
the carotid arteries to the brain, this can cause a stroke. In the coronary arteries to the heart muscle, this can cause angina pectoris and a myocardial infarction. In the renal arteries to the kidney, this can cause kidney failure. Treatment: Lipid-lowering drug. Surgery: Angioplasty or
stent to press down the plaque or endarterectomy to remove the plaque.

hard; sclera (white of the eye)

soft, fatty substance

tumor; mass

fatty deposit or mass

A harsh, rushing sound made by blood passing through an artery narrowed and roughened by atherosclerosis. The bruit can be heard when a stethoscope is placed over the artery.

coronary artery disease (CAD)
Arteriosclerosis of the coronary arteries. They are filled with atheromatous plaque, and their narrowed lumens cannot carry enough oxygenated blood to the myocardium. This results in angina pectoris. Severe atherosclerosis (or a blood clot that forms on an atherosclerotic plaque) can completely block the lumen of a coronary artery. This causes a myocardial infarction.
Treatment: Lipid-lowering drug. Surgery: Percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG).

Elevated levels of lipids (fats) in the blood. Lipids include cholesterol and triglycerides. Hypercholesterolemia is an elevated level of cholesterol in the blood. Hypertriglyceridemia is an elevated level of triglycerides
in the blood. Normal levels are below 200 mg/dL for cholesterol and below 150 mg/dL for triglycerides. Treatment: Lipid-lowering drug.

hypertension (HTN)
Elevated blood pressure. A normal blood pressure reading in an adult is less than 120/80 mm Hg. Those between 120/80 mm Hg and 140/90 mm Hg are categorized as prehypertension. Blood pressures above 140/90 mm Hg are categorized as hypertension, and the patient is said
to be hypertensive. Several blood pressure readings, not just one, are needed to make a diagnosis. Essential hypertension, the most common type of hypertension, is one in which the exact cause is not known. Secondary hypertension has a known cause, such as kidney disease.
Treatment: Lifestyle changes (decreased salt intake, increased exercise, weight loss) followed by an antihypertensive drug.

lipid (fat)

pressure; tension

before; in front of

Blood pressure lower than 90/60 mm Hg, usually because of a loss of blood volume. A patient with hypotension is hypotensive.Orthostatic hypotension is the sudden, temporary, but self-correcting decrease in systolic blood pressure that occurs when the patient changes from a
lying to a standing position and experiences lightheadedness. Treatment: Correct the underlying cause.

below; deficient


standing still; staying in one place

peripheral artery disease (PAD)
Atherosclerosis of the arteries in the legs. Blood flow (perfusion) to the extremities is poor, and there is ischemia of the tissues. While walking, the patient experiences pain in the calf (intermittent claudication). In severe PAD, the feet and toes remain cool and cyanotic and may become necrotic as the tissues die. Treatment: Lipid-lowering drug. Surgery: Angioplasty and stent in the iliac or femoral artery. Possible amputation of the foot.

through; throughout


limping pain

peripheral vascular disease (PVD)
Any disease of the arteries of the extremities. It includes peripheral artery disease as well as Raynauds disease.

Inflammation of a vein, usually accompanied by infection. The area around the vein is painful, and the skin overlying the vein may show a red streak. A severe inflammation can partially occlude the vein and slow the flow of blood. Thrombophlebitis is phlebitis with the formation
of a thrombus (blood clot). Treatment: Analgesic drug for pain, anti- inflammatory drug for inflammation. Antibiotic drug. Thrombolytic drug to dissolve a blood clot.

thrombus (blood clot)

Raynauds disease
Sudden, severe vasoconstriction and spasm of the arterioles in the fingers and toes, often triggered by cold or emotional upset. They become white or cyanotic and numb for minutes or hours until the attack passes. This can lead to necrosis. Treatment: Vasodilator drug.

varicose veins
Damaged or incompetent valves in a vein that allow blood to flow backward and collect in the preceding section of vein. The vein becomes distended with blood, twisting and bulging under the surface of the skin. There is pain and aching; the legs feel heavy and leaden. Varicose veins can be caused by phlebitis, injury, long periods of sitting with the legs crossed, or occupations that require constant standing. Also, during pregnancy, pressure from the enlarging uterus restricts the flow of blood in the lower extremities and can cause varicose veins. There is a family tendency to develop varicose veins. Treatment: Injecting a sclerosing solution or foam to harden and occlude
the vein. Laser or radiowaves to destroy the vein. These procedures redirect the blood into deeper veins.

varix; varicose vein

full of

cardiac enzymes
Test to measure the levels of enzymes that are released into the blood when myocardial cells die during a myocardial infarction. (These enzymes are not released during angina pectoris.) The higher the levels, the more severe the myocardial infarction and the larger the area of
infarct. Creatine kinase (CK) is found in all muscle cells, but a specific form of it (CK-MB) is only found in myocardial cells. The CK-MB level begins to rise 26 hours after a myocardial infarction. It is also known as creatine phosphokinase (CPK). Lactate dehydrogenase (LDH) is
found in many different cells, including the heart. The LDH level begins to rise 12 hours after a myocardial infarction. An elevated LDH can support the CK-MB results but cannot be the only basis for a diagnosis of myocardial infarction. Cardiac enzymes are measured every few hours for several days. This test is done in conjunction with troponin.

C-reactive protein (CRP)
Test to measure the level of inflammation in the body. Inflammation from sites other than the cardiovascular system (such as inflammation of the gums or from a chronic urinary tract infection) can produce inflammation of the walls of the blood vessels. This can lead to blood
clot formation and a myocardial infarction. The high-sensitivity CRP test can detect a lower blood level of CRP and is used to predict a healthy persons risk of developing cardiovascular disease.

Test included as part of a cardiac risk assessment. This amino acid damages the blood vessel walls. An elevated level increases the patients risk of arteriosclerosis and a blood clot that can cause a heart attack or stroke.

lipid profile
Test that provides a comprehensive picture of the levels in the blood of cholesterol and triglycerides and their lipoprotein carriers (HDL, LDL, VLDL).

Test to measure the level of two proteins that are released into the blood when myocardial cells die. Troponin I and troponin T are only found in the myocardium. The troponin levels begin to rise 46 hours after a myocardial infarction. More importantly, they remain elevated for
up to 10 days, so they can be used to diagnose a myocardial infarction many days after it occurred. Troponin levels are done in conjunction with cardiac enzyme levels.

cardiac catheterization
Procedure performed to study the anatomy and pressures in the heart. During a right heart catheterization, a catheter is inserted into the femoral or brachial vein and threaded to the right atrium. The catheter is used to record right heart pressures. Then a radiopaque contrast dye is injected through the catheter to outline the chambers of the heart to diagnose congenital heart defects. During a left heart catheterization, a catheter is inserted into the femoral or brachial artery and threaded to the left atrium. Then radiopaque contrast dye is injected to outline the coronary arteries and show narrow or blocked areas. If blockage of a coronary artery is present, an angioplasty can be performed at that time.
This procedure is also referred to as a cardiac cath.

process of making, creating, or inserting

cardiac exercise stress test
Procedure performed to evaluate the hearts response to exercise in patients with chest pain, palpitations or arrhythmia’s.The patient walks on a motorized treadmill (treadmill exercise stress test) or rides a stationary bicycle while an ECG is performed. The speed of the treadmill and the steepness of its incline (or the resistance of the
bicycle) are gradually increased while the patients heart rate, blood pressure, and ECG are monitored. The procedure is stopped if the patient complains of angina, palpitations, shortness of breath, or tiredness, or if
the ECG pattern becomes abnormal. The patients resting heart rate and maximum heart rate are compared to standards for other people of the same age and sex. Any abnormality in the ECG pattern is analyzed.

electrocardiography (ECG, EKG)
Procedure that records electrical activity of the heart.
Electrodes (metal pieces in adhesive patches) are placed on the limbs (both arms and one leg) to send the electrical impulses of the heart to the ECG machine. These are the three limb leads (leads IIII). Electrodes placed on the chest are known as the precordial leads (V 1 V 6 ). A 12-lead
ECG records the electrical activity between different combinations of electrodes to give an electrical picture of the heart from 12 different angles. Samples of each of these 12 tracings are printed out and mounted on a backing for an electrocardiogram. A longer sample of
just a single lead tracing (usually lead II) is known as a rhythm strip.


process of recording

record or a picture

electrophysiologic study (EPS)
Procedure to map the hearts conduction system in a patient with an arrhythmia. While an ECG is performed, catheters are inserted into the femoral vein and subclavian vein. X-rays are used to guide the catheters
to the heart. The catheters send out electrical impulses to stimulate the heart and try to cause an arrhythmia to pinpoint the ectopic site where the arrhythmia is coming from.

physical function

Holter monitor
Procedure during which the patients heart rate and rhythm are continuously monitored as an outpatient for 24 hours. The patient wears electrodes attached to a small portable ECG monitor (carried in a vest or placed in a pocket). The patient also keeps a diary of activities, meals, and symptoms. A Holter monitor procedure is used to document infrequently occurring arrhythmias and to link them to activities or symptoms such as chest pain.

pharmacologic stress test
Cardiac stress test performed in patients who cannot exercise vigorously. The vasodilator drug dipyridamole (Persantine) is given to cause normal coronary arteries to dilate. Occluded arteries cannot dilate, and this stresses the heart and causes angina in a way that is similar to an
exercise stress test.

Procedure to monitor a patients heart rate and rhythm in the hospital. The patient wears electrodes connected to a device that continuously transmits an ECG tracing to a central monitoring station in the coronary care unit or intensive care unit. A nurse at the station constantly watches all of the patients cardiac monitors.


process of measuring

Procedure in which radiopaque contrast dye is injected into a blood vessel to fill and outline it. In arteriography, it is injected into an artery venography, it is injected into a vein to show weakened valves and dilated walls. The x-ray image is an angiogram or, more specifically, an arteriogram or venogram. In coronary angiography, a catheter is inserted into the femoral artery and threaded to the aorta. The radiopaque contrast dye is injected to
outline the coronary arteries and show narrowing or blockage. The x-ray is a coronary angiogram.
In rotational angiography, multiple x-rays are taken as the x-ray machine goes around the patient. This technique is particularly helpful in documenting tortuous blood vessels in three dimensions. Digital subtraction angiography (DSA) combines two x-ray images, one taken without radiopaque contrast dye and a second image taken after radiopaque contrast dye has been injected to outline the blood
vessel. A computer compares the two images and digitally subtracts or removes the soft tissues, bones, and muscles, leaving just the image of the arteries.

Procedure that uses a transducer to produce ultra high-frequency sound
waves (ultrasound) that are bounced off the heart to create an image.
Two-dimensional echocardiography (2-D echo) creates a real-time
picture of the heart and its chambers and valves as it contracts and

Transesophageal echocardiography (TEE)
may be ordered when a standard echocardiogram has a poor-quality image. For a TEE, the patient swallows an endoscopic tube that contains a tiny, sound-emitting transducer. This is positioned in the esophagus directly behind, and closer to, the heart.

Doppler ultrasonography
images the flow of blood in an artery or vein. The two-dimensional ultrasound image shows blockages or clots in the blood vessel. Doppler technology shows how fast blood is traveling in that artery or vein. Doppler technology is also used in automatic blood pressure machines, in hand-held devices that give the heart rate if placed on the skin over an artery, and in fetal monitors that, when placed on the mothers abdomen, give the heart rate of the fetus. Color flow duplex ultrasonography combines the ultrasound image with a color-coded Doppler image. Variations in blood flow and turbulence are shown with faster flow in red and slower flow
in blue. Color flow duplex ultrasonography is the gold standard for evaluating tortuous varicose veins.

multiple-gated acquisition (MUGA) scan
Nuclear medicine procedure that uses the radioactive tracer technetium- 99m. First, pyrophosphate is injected intravenously to allow red blood cells to bind with technetium-99m. Then technetium-99m is injected. A gamma camera records gamma rays emitted by the technetium-99m bound to red blood cells. The camera is coordinated (gated) with the patients ECG so that images of the heart chambers (with bloodand red blood cellsin them) are taken at various times. A MUGA scan also calculates the ejection fraction (how much blood the ventricle can eject with one contraction). The ejection fraction is the most accurate indicator of overall heart function. This procedure is also known as a radionuclide ventriculography (RNV) or gated blood pool scan.

myocardial perfusion scan
Nuclear medicine procedure that combines a cardiac exercise stress test with intravenous injections of a radioactive tracer. The radioactive tracer collects in those parts of the myocardium that have the best perfusion (blood flow). A gamma camera records gamma rays emitted by the radioactive tracer and creates a two-dimensional image of the heart. Areas of decreased uptake (cold spots) indicate poor perfusion from a blocked coronary artery. The artery must be about 70% blocked
before any abnormality is evident on the image. Areas of no uptake indicate dead tissue from a previous myocardial infarction. Technetium- 99m is joined to a synthetic molecule (sestamibi). The combination of technetium-99m with sestamibi is the drug Cardiolite, so this test is also known as a Cardiolite stress test. In a thallium stress test,
thallium-201 is the radioactive tracer, or thallium-201 and technetium- 99m can be used. Myocardial perfusion PET scans are used to image the metabolism of the heart.

single-photon emission computed tomography (SPECT) scan
A variation of the procedure done during a myocardial perfusion scan or a MUGA scan. Instead of being stationary above the patients chest, the gamma camera is moved in a circle around the patient. The computer
creates many individual images or slices (tomography) and compiles them into a three-dimensional image of the heart.

Procedure that uses a stethoscope to listen to the heart sounds. It can determine the heart rate and detect arrhythmias and murmurs.

cardioversion Procedure to treat an arrhythmia (atrial flutter, atrial fibrillation, or ventricular tachycardia) that cannot be controlled with antiarrhythmic drugs. Two large, hand-held paddles are placed on either side of the
patients chest. The machine generates an electrical shock coordinated with the QRS complex of the patients heart to restore the heart to a normal rhythm. For a patient with ventricular fibrillation, the same machine is used (it is now called a defibrillator) to give a much stinger electrical shock. An automatic implantable cardioverter/defibrillator (AICD) is a small device that is implanted in a patient who is at high risk for developing a serious arrhythmia. The AICD is implanted under the skin of the chest. It has leads (wires) that go to the heart, sense its rhythm, and deliver an electrical shock, if needed. An automatic external defibrillator (AED) is a portable computerized device kept on emergency response vehicles and in public places like airports. It analyzes the patients heart rhythm and
delivers an electrical shock to stimulate the heart in cardiac arrest. An AED is designed to be used by nonmedical persons.

Procedure in which a sclerosing drug (liquid or foam) is injected into a varicose vein. The drug causes irritation and inflammation that later becomes fibrosis that occludes the vein. The blood flow is redirected to
another, deeper vein, and the varicose vein is no longer distended.

vital signs
Procedure during a physical examination to measure the temperature, heart rate (pulse), and respirations (TPR) as well as the blood pressure (BP). Sometimes an evaluation of pain is included and it is known as the fourth vital sign.
The heart rate is measured by counting the pulse. The pulse can be felt in several different parts of the body. Pulse points include the carotid pulse in the neck, apical pulse on the anterior chest, axillary pulse in the armpit, brachial pulse at the inner elbow, radial pulse at the wrist, femoral pulse in the inguinal area (groin), popliteal pulse at the back of the knee, posterior tibial pulse at the back
of the lower leg, and the dorsalis pedis pulse on the dorsum of the foot. The radial pulse in the wrist is the most commonly used site. In an emergency, the carotid pulse is used because, if the patient is in shock, there is less blood flowing to the extremities. The apical pulse (at the apex of the heart) can be heard with a stethoscope
and is also used to evaluate the heart rhythm and heart sounds. The presence of peripheral vascular disease can be determined by comparing the strength of the pulse in the right leg to the same pulse on the left.

Procedure to remove an aneurysm and repair the defect in the artery wall. If an aneurysm involves a large segment of artery, a flexible, tubular synthetic graft is used to replace the segment.

cardiopulmonary bypass
Procedure used during open heart surgery in which
the patients blood is rerouted through a cannula in the femoral vein to a heart-lung machine. There, the blood is oxygenated, carbon dioxide and waste products are removed, and the blood is pumped back into the patients body through a cannula in the femoral artery. Cardiopulmonary bypass takes over the functions of the heart and lungs during the surgery.

carotid endarterectomy
Procedure to remove plaque from an occluded carotid artery. It is used to treat carotid stenosis due to atherosclerosis.

coronary artery bypass graft (CABG)
The procedure to bypass an occluded coronary artery and restore blood flow tothe myocardium. A blood vessel (either the saphenous vein from the leg or the internal mammary artery from the chest) is used as the bypass graft. If the saphenous vein is used, it must be placed in a reversed position so that its valves will not obstruct the flow of blood. The suturing of one blood vessel to another is an anastomosis. Oxygenated blood flows through the graft, around the blockage in the coronary artery, and back into the coronary artery. The abbreviation CABG is pronounced cabbage.

heart transplantation
Procedure to remove a severely damaged heart from a patient with end-stage heart failure and insert a new heart from a donor (a person who has recently died). The patient is matched by blood type and tissue type to the donor. Heart transplant patients must take immunosuppressant drugs for the rest of their lives to keep their bodies from rejecting the foreign tissue of their new heart. Some patients receive an artificial heart
made of plastic, metal, and other synthetic materials.
While awaiting a donor heart, the patient may have a left ventricular assist device (LVAD) temporarily implanted. This battery- or pneumatic- powered pump is placed in the abdomen and connected by tubes to the left ventricle and the aorta. In some patients, it becomes a permanent solution.

pacemaker insertion
Procedure in which an automated device is implanted to control the heart rate and rhythm in a patient with arrhythmia. A pacemaker uses a wire positioned on the heart to coordinate the heartbeat with an electrical impulse.

percutaneous transluminal coronary angioplasty (PTCA)
Procedure to reconstruct a coronary artery that is narrowed because of atherosclerosis. A catheter is inserted into the femoral artery and threaded to the site of the stenosis. Also known as percutaneous coronary intervention (PCI). During a balloon angioplasty, a balloon
within the catheter is inflated. It compresses the atheromatous plaque and widens the lumen of the artery. Then the balloon is deflated and catheter is removed. Alternatively, an intravascular stainless steel mesh stent (unexpanded) can be inserted on the catheter. The stent is expanded, the catheter is removed, and the expanded stent remains in the artery.

Procedure that uses a needle to puncture the pericardium and withdraw inflammatory fluid accumulated in the pericardial sac. It is used to treat pericarditis and cardiac tamponade.

radiofrequency ablation (RFA)
Procedure to destroy ectopic areas in the heart that are emitting electrical impulses and producing arrhythmias. A catheter is inserted into the heart. Radiofrequency electrical current is used to produce enough heat to kill the cells causing the arrhythmia. Radiofrequency catheter
occlusion uses heat to collapse and seal large varicose veins.

valve replacement
Procedure to replace a severely damaged or prolapsed heart valve. There are several types of prosthetic (replacement) heart valves that can be used. If the replacement heart valve comes from an animal, it is known as a xenograft.

Procedure to reconstruct a heart valve to correct stenosis or prolapse. A valvulotome is used to cut the valve. This procedure is also known as a valvuloplasty.

ACE (angiotensin- converting enzyme) inhibitor
Treat congestive heart failure and hypertension. ACE inhibitor drugs produce vasodilation and decrease the blood pressure by blocking an enzyme that converts angiotensin I to angiotensin II (a vasoconstrictor). captopril (Capoten), lisinopril (Prinivil, Zestril), trandolapril (Mavik)

antiarrhythmic drugs
Treat arrhythmiasIntravenous atropine for heart block, intravenous lidocaine (Xylocaine) for ventricular arrhythmias. See beta-blocker drugs and calcium channel
blocker drugs.

anticoagulant drugs
Prevent a blood clot from forming in patients with arteriosclerosis, atrial fibrillation, previous myocardial
infarction, or an artificial heart valve heparin, warfarin (Coumadin), clopidogrel (Plavix)

antihypertensive drugs
Treat hypertensionSee ACE inhibitor drugs, beta-blocker drugs, calcium channel blocker drugs, and diuretic drugs.

Prevents heart attacks. Prevents blood clots from forming by keeping platelets from sticking together. aspirin (81 mg)

beta-blocker drugs
Treat angina pectoris and hypertension. Beta-blocker drugs decrease the heart rate and dilate the arteries by blocking beta receptors. atenolol (Tenormin), nadolol (Corgard), propranolol (Inderal), metoprolol (Lopressor)

calcium channel blocker drugs
Treat angina pectoris and hypertension. These drugs block the movement of calcium ions into myocardial cells and smooth muscle cells of the artery walls, causing the heart rate and blood pressure to decrease. amlodipine (Norvasc), diltiazem (Cardizem), nifedipine (Adalat, Procardia), verapamil (Calan)

digitalis drugs
Treat congestive heart failure. Digitalis drugs decrease the heart rate and strengthen the hearts contractions.
digoxin (Lanoxin)

diuretic drugs
Block sodium from being absorbed from the tubule (of the nephron of the kidney) back into the blood. As the
sodium is excreted in the urine, it brings water and potassium with it because of osmotic pressure. This process is known as diuresis. This decreases the volume of
blood and is used to treat hypertension and congestive heart failure. Laypersons call these drugs water pills. furosemide (Lasix), hydrochlorothiazide (HCTZ)

drugs for cardiac arrest
Treat a nonbeating heart (asystole) by stimulating it to contract intracardiac epinephrine (Adrenalin)

drugs for hyperlipidemia
Treat hypercholesterolemia. They are often referred to as statin drugs because of the common ending of the
generic drug names. atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor), simvastatin (Zocor)

nitrate drugs
Treat angina pectoris. Nitrate drugs dilate the veins (to decrease the amount of work that the heart must do) and
dilate the arteries (to decrease the blood pressure) isosorbide (Isordil), nitroglycerin (Nitro-Dur)

thrombolytic drugs
Treat a blood clot that is blocking blood flow through an artery. Thrombolytic drugs lyse (break apart) a clot. alteplase (Activase)

abdominal aortic aneurysm

angiotensin-converting enzyme

Acute Coronary Syndrome

Automatic External Defibrillator

Aortic Insufficiency

Automatic Implantable Cardioverter-defibrillator

Acute Myocardial Infarction

Aortic Stenosis

Arteriosclerotic Cardiovascular Disease

Atrial Septal Defect

Arteriosclerotic Heart disease


Blood Pressure

Beats per minute

coronary artery disease

coronary care unit

congestive heart failure

creatine kinase-MB

creatine phosphokinase-MB

C-reactive protein


digital subtraction angiography


High-density lipoprotein


Jugular venous distention

left atrium

left bundle branch block

lactic dehydrogenase

low-density lipoprotein

left ventricle

left ventricle assist device

left ventricular hypertrophy

myocardial infarction

mm Hg
millimeter of mercury

mitral regurgitation

multiple-gated acquisition (scan)

mitral valve prolapse

normal sinus rhythm

pulse (rate)

premature atrial contraction

peripheral artery disease

percutaneous coronary intervention

patent ductus arteriosus

point of maximum impulse

percutaneous transluminal coronary angioplasty

premature artery contraction

peripheral vascular disease

right atrium

right bundle branch block

radiofrequency ablation

radionuclide ventriculography

subacute bacterial endocarditis

supraventricular tachycardia

transesophageal echcardiography

temperature, pulse and respiration

V fib
ventricular fibrillation

very low-density lipoprotein

ventricular septal defect

V tach
ventricular tachycardia

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