ST MARY’S UNIVERSITY CARDIAC WORKBOOK

Cardiac Workbook
This booklet is a self-directed learning tool for you to consolidate your learning
around the heart.
1. Anatomy
Label the anatomy of the heart on the diagram below.
 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

2. Coronary Arteries
Label the coronary arteries on the diagram below.

Describe the risk factors for coronary artery disease in the space below.

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 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

3. Flow
Draw a ‘heart box diagram’ and label the chambers, the valves, main vessels, body
and lungs. Then beneath it, describe the direction of flow of blood through this.

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4. Electrical conduction of the heart

Label the conduction anatomy of the heart below. And then describe electrical
conduction of the heat.

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 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

5. Electro Cardio Grams

Using the diagram above to assist you, explain what each letter (P, Q, R, S & T) in the
ECG waveform relates to in the cardiac cycle.

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6. Cardiac Rhythms
Identify and label the following cardiac rhythms. (Choose from normal sinus rhythm,
sinus bradycardia, sinus tachycardia, atrial fibrillation, atrial flutter, ventricular
fibrillation, ventricular tachycardia, supraventricular tachycardia)
ST MARY’S UNIVERSITY CARDIAC WORKBOOK
 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

7. Cardiac Investigations
What do these abbreviations of investigations stand for, and what does each
investigate?

ECG
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ECHO
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TTE
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TOE
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CARDIAC MRI
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ANGIOGRAM
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8. Bloods / Laboratory Results

What do these abbreviations stand for, what are the normal values and what is the
clinical significance? Consider implications for physiotherapy.

TROPONIN
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PLATELETS
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APTT
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INR
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BNP
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LIPID PROFILE
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K
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 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

Na
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Ca
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Hb
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CREATININE
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WCC
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ALBUMIN
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LACTATE
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9. Common Cardiac Conditions

Briefly describe the common conditions below.

CORONARY ARTERY DISEASE

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ISCHAEMIC HEART DISEASE (IHD)

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HEART ATTACK
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STEMI
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NSTEMI
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ANGINA
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CARDIOMYOPATHIES
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Briefly describe the cardiomyopathies below.

DILATED CARDIOMYOPATHY
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RESTRICTIVE CARDIOMYOPATHY
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HYPERTROPHIC CARDIOMYOPATHY
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HEART FAILURE
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HFrEF
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HFpEF
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10.Common Cardiac Procedures

Briefly describe the procedures below and the indication for these.

ANGIOPLASTY
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PCI
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ABLATION
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CARDIOVERSION
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BAV
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TAVI
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 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

ICD
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PPM
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CRT
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11. Common Cardiac Surgeries

Briefly describe the surgeries below, the usual surgical approach and the indication
for these.

CABG
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MVR
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AVR
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PEARS PROCEDURE
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12.Common Cardiothoracic Surgical Sites and Precautions

Briefly describe the surgical sites below, the precautions for these and the
implications this may have on therapy including evidence-based timeframes (ie.
Lifting / range of movement restrictions/ common problems).

MIDLINE STERNOTOMY
Location:_____________________________________________________________
Precautions:___________________________________________________________
Considerations for physio:________________________________________________
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MINI STERNOTOMY
Location:_____________________________________________________________
Precautions:___________________________________________________________
Considerations for physio:________________________________________________
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THORACOTOMY
Location:_____________________________________________________________
Precautions:___________________________________________________________
Considerations for physio:________________________________________________
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VATS (VIDEO ASSISTED THORASCOPIC PROCEDURE)

Location:_____________________________________________________________
Precautions:___________________________________________________________
Considerations for physio:________________________________________________
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SUBCLAVICULAR INCISION
Location:_____________________________________________________________
Precautions:___________________________________________________________
Considerations for physio:________________________________________________
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13. Chest Drain Management

The indications for chest drain insertion are summarised below. Define the terms:

Indications
CHYLOTHORAX
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HAMEOTHORAX
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PLEURAL EFFUSION
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PNEUMOTHORAX
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EMPYEMA
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POST CARDIOTHORACIC SURGERY

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Identifying types of chest drains

Describe how the following types of chest drains work and label the components:

UNDER WATER SEAL DRAINAGE SYSTEM (UWSD)

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ROBINSONS DRAINS
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 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

THOPAZ SUCTION UNIT

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Physiotherapy assessment of chest drains

1. Indication
2. Location (Anterior / Posterior / Basal / Left / Right)
3. Pain
4. Swing (if not on suction)
Swinging indicates: __________________________________________________
Lack of swinging indicates: ____________________________________________
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5. Air leak
Bubbling indicates: __________________________________________________
Lack of bubbling indicates: ____________________________________________
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6. Drainage
Volume:___________________________________________________________
Colour:____________________________________________________________
Speed:____________________________________________________________

7. Suction
Pressure:__________________________________________________________
Precautions advised regarding disconnection from suction (ie. For mobility):
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8. Auscultation
9. CXR

In the event of accidental disconnection of a chest drain one should:

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 ST MARY’S UNIVERSITY CARDIAC WORKBOOK

14.Physiotherapy and Cardiac Surgery

Eg. CABG / AVR / MVR

Briefly outline the main physiotherapy input / aims of managing a postoperative
CABG or valve replacement patient days 1-3.

Risk assessment
NEWS score and observations:
Heart rate/ rhythm:
Bloods:
Surgical incision:
Expected lines/drains/attachments:
Post-op precautions:

Problem List (List expected/common problems)

Respiratory:

Rehabilitation:

Problem-Based Treatment
Respiratory aims
Eg. Lung volume recruitment – DBEs/ incentive spirometry
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Rehabilitation aims
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Discharge considerations and onward referrals

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