1
NR
NR 507 CARDIOVASCULAR EXAM QUESTIONS AN
X X X X X
D ANSWERS UPDATED (2024/2025) (VERIFIE
X X X X
D ANSWERS) X
CAD should strongly be suspected and further testing to assess the extent of
x x x x x x x x x x x x x
the patient's disease including: -
x x x x
xANS ✓Electrocardiogram (ECG), cardiac enzymes & troponin, lipids, and cardiac s
x x x x x x x x x x
tress test. In most cases, the patient will be referred to and co-
x x x x x x x x x x x x
managed by a cardiologist. Treatment will include both non-
x x x x x x x x
pharmacological and pharmacological management of the disease. x x x x x x
Heart Failure - x x
ANS ✓Heart failure is a very complex disease state that can be the result of struct
x x x x x x x x x x x x x x x x
ural or functional impairment of the heart, which then leads to the heart's impaire
x x x x x x x x x x x x x
d ability to fill or eject sufficient amounts of blood out to the body. Let's review so
x x x x x x x x x x x x x x x x
me basic concepts related to this disease:
x x x x x x
-
Cardiac Output (CO): The amount of blood that the heart pumps in 1 minute.
x x x x x x x x x x x x x
CO is also known as cardiac contractility. x x x x x x x
-CO Formula: CO=heart rate (HR) x stroke volume (SV).
x x x x x x x x
-
SV: The volume of blood pumped out of the left ventricle during each systoli
x x x x x x x x x x x x x
c cardiac contraction. x x
-
Afterload: The force, or load, which the heart must contract against in order
x x x x x x x x x x x x x
to pump blood. Afterload is also known as systemic vascular resistance (SV
x x x x x x x x x x x
R).
-
Preload: The amount of stretch that the cardiac muscle exhibits at the end of
x x x x x x x x x x x x x
ventricular filling. x x
NR 507 x
, 2
NR
Not all patients present with the same signs and symptoms of heart failure a
x x x x x x x x x x x x x
nd symptoms are dependent upon which side of the heart is affected. Let's d
x x x x x x x x x x x x x
iscuss the difference. x x
Right-sided Heart Failure - ANS ✓-Right ventricle x x x x x x
-Superior vena cava (preload) x x x
-Pulmonary artery (afterload) x x
Let's shift to right heart failure (Cor Pulmonale). This is defined as the inabil
x x x x x x x x x x x x x
ity of the right ventricle to provide adequate blood flow into the pulmonary
x x x x x x x x x x x x x
circulation.
Causes of right heart failure include:
x x x x x
1) pulmonary disease that causes pulmonary hypertension. This is the most
x x x x x x x x x x x
common cause; x
2) right ventricular myocardial infarction (MI), which weakens the cardiac
x x x x x x x x x x
muscle;
3) right ventricular hypertrophy (secondary to cardiac damage);
x x x x x x x
4) tricuspid valve damage (causing backflow of the blood into the right atriu
x x x x x x x x x x x x
m or right ventricle after ejection); x x x x x
5) secondary failure as a result of left heart failure due to the build-
x x x x x x x x x x x x x
up of pressure in the damage left ventricle. x x x x x x x
Since pulmonary hypertension is the most common cause of right-
x x x x x x x x x
sided heart failure, it will be used to outline the disease process. Again, keep
x x x x x x x x x x x x x
in mind that regardless of the cause of right heart failure, the overall proces
x x x x x x x x x x x x x x
s outlined here will be the same. x x x x x x
High pulmonary vascular pressure (increased afterload) will cause an incre
x x x x x x x x x
ased right ventricular contraction force in order to eject the blood. Overtim
x x x x x x x x x x x
e, this will reduce the ejection fraction and the right ventricle will be unable
x x x x x x x x x x x x x x
to eject the normal amount of blood. This will increase the amount of blood
x x x x x x x x x x x x x x
remaining in the right ventricle and, as a result, increase right ventricular p
x x x x x x x x x x x x
reload, resulting in the inability for the right atrium to eject the normal amo
x x x x x x x x x x x x x
NR 507
x
NR
NR 507 CARDIOVASCULAR EXAM QUESTIONS AN
X X X X X
D ANSWERS UPDATED (2024/2025) (VERIFIE
X X X X
D ANSWERS) X
CAD should strongly be suspected and further testing to assess the extent of
x x x x x x x x x x x x x
the patient's disease including: -
x x x x
xANS ✓Electrocardiogram (ECG), cardiac enzymes & troponin, lipids, and cardiac s
x x x x x x x x x x
tress test. In most cases, the patient will be referred to and co-
x x x x x x x x x x x x
managed by a cardiologist. Treatment will include both non-
x x x x x x x x
pharmacological and pharmacological management of the disease. x x x x x x
Heart Failure - x x
ANS ✓Heart failure is a very complex disease state that can be the result of struct
x x x x x x x x x x x x x x x x
ural or functional impairment of the heart, which then leads to the heart's impaire
x x x x x x x x x x x x x
d ability to fill or eject sufficient amounts of blood out to the body. Let's review so
x x x x x x x x x x x x x x x x
me basic concepts related to this disease:
x x x x x x
-
Cardiac Output (CO): The amount of blood that the heart pumps in 1 minute.
x x x x x x x x x x x x x
CO is also known as cardiac contractility. x x x x x x x
-CO Formula: CO=heart rate (HR) x stroke volume (SV).
x x x x x x x x
-
SV: The volume of blood pumped out of the left ventricle during each systoli
x x x x x x x x x x x x x
c cardiac contraction. x x
-
Afterload: The force, or load, which the heart must contract against in order
x x x x x x x x x x x x x
to pump blood. Afterload is also known as systemic vascular resistance (SV
x x x x x x x x x x x
R).
-
Preload: The amount of stretch that the cardiac muscle exhibits at the end of
x x x x x x x x x x x x x
ventricular filling. x x
NR 507 x
, 2
NR
Not all patients present with the same signs and symptoms of heart failure a
x x x x x x x x x x x x x
nd symptoms are dependent upon which side of the heart is affected. Let's d
x x x x x x x x x x x x x
iscuss the difference. x x
Right-sided Heart Failure - ANS ✓-Right ventricle x x x x x x
-Superior vena cava (preload) x x x
-Pulmonary artery (afterload) x x
Let's shift to right heart failure (Cor Pulmonale). This is defined as the inabil
x x x x x x x x x x x x x
ity of the right ventricle to provide adequate blood flow into the pulmonary
x x x x x x x x x x x x x
circulation.
Causes of right heart failure include:
x x x x x
1) pulmonary disease that causes pulmonary hypertension. This is the most
x x x x x x x x x x x
common cause; x
2) right ventricular myocardial infarction (MI), which weakens the cardiac
x x x x x x x x x x
muscle;
3) right ventricular hypertrophy (secondary to cardiac damage);
x x x x x x x
4) tricuspid valve damage (causing backflow of the blood into the right atriu
x x x x x x x x x x x x
m or right ventricle after ejection); x x x x x
5) secondary failure as a result of left heart failure due to the build-
x x x x x x x x x x x x x
up of pressure in the damage left ventricle. x x x x x x x
Since pulmonary hypertension is the most common cause of right-
x x x x x x x x x
sided heart failure, it will be used to outline the disease process. Again, keep
x x x x x x x x x x x x x
in mind that regardless of the cause of right heart failure, the overall proces
x x x x x x x x x x x x x x
s outlined here will be the same. x x x x x x
High pulmonary vascular pressure (increased afterload) will cause an incre
x x x x x x x x x
ased right ventricular contraction force in order to eject the blood. Overtim
x x x x x x x x x x x
e, this will reduce the ejection fraction and the right ventricle will be unable
x x x x x x x x x x x x x x
to eject the normal amount of blood. This will increase the amount of blood
x x x x x x x x x x x x x x
remaining in the right ventricle and, as a result, increase right ventricular p
x x x x x x x x x x x x
reload, resulting in the inability for the right atrium to eject the normal amo
x x x x x x x x x x x x x
NR 507
x
