Your Cardiac Mastery Day
Hey, future Nursing Officers! Day 179 at logyanlo.in brings you the most repeated Cardiovascular System topics in NORCET, RRB, AIIMS, JIPMER, SGPGI & DSSSB 2025: Bacterial Endocarditis, Constrictive Pericarditis, IABP, Cardiac Tamponade, Pacemaker, Cardioversion, Defibrillator, Cardiac Monitor, PCWP & Pulmonary Artery Catheter. These 10 topics appear every single year – master them now and lock maximum marks! Let’s conquer with our Nursing Test Series 2025!
Why Cardiovascular Nursing Matters
Cardiac topics = rank deciders:
- 12–18% weightage in every nursing officer exam
- ICU & emergency questions (tamponade, IABP, pacemaker) are repeated yearly
- Instrumentation (Swan-Ganz, defibrillator) favourite image-based questions
- PCWP values & waveforms are direct 1-mark questions
logyanlo.in gives you every high-yield point to score full from this unit!
Key Topics in Cardiovascular Nursing
Bacterial Endocarditis
Quick Fact
Bacterial endocarditis is infection of endocardium (usually valves).
Complete Coverage
- Types: Acute (S. aureus) vs Subacute (S. viridans).
- Duke Criteria: 2 major or 1 major + 3 minor or 5 minor.
- Major Criteria: Positive blood culture (typical organism), echo evidence (vegetation/ abscess).
- Clinical Signs: Fever, new murmur, Janeway lesions, Osler nodes, Roth spots, splinter haemorrhage.
- Risk Factors: Prosthetic valve, IV drug use, rheumatic heart disease.
- Diagnostics: 3 sets blood culture, transthoracic/transoesophageal echo.
- Complications: Valve destruction, emboli, heart failure.
- Exam Pearl: New regurgitant murmur + fever = endocarditis until proven otherwise.
Constrictive Pericarditis
Quick Fact
Constrictive pericarditis is rigid pericardium impairing diastolic filling.
Complete Coverage
- Pathophysiology: Thick fibrotic pericardium → equalisation of diastolic pressures.
- Clinical Signs: Kussmaul sign, pericardial knock, ascites > oedema.
- Diagnostics:
- Echo: Thick pericardium, septal bounce
- CT/MRI: Pericardial thickening >4 mm
- Cath: Square root sign, equalisation of diastolic pressures
- Complications: Low cardiac output, liver cirrhosis.
- Exam Tip: Kussmaul sign positive + ascites disproportionate to oedema = classic.
Intra-Aortic Balloon Pump (IABP)
Quick Fact
IABP inflates in diastole, deflates in systole.
Complete Coverage
- Purpose: ↑ Coronary perfusion, ↓ afterload.
- Timing: Inflation at dicrotic notch, deflation just before systole.
- Indications: Cardiogenic shock, unstable angina, post-cardiac surgery.
- Complications: Limb ischaemia, thrombocytopenia, aortic dissection.
- Waveform: Assisted systolic pressure < unassisted, augmented diastolic peak.
- Exam Favourite: Correct timing errors (early/late inflation/deflation).
Cardiac Tamponade
Quick Fact
Cardiac tamponade is compression of heart by pericardial fluid.
Complete Coverage
- Beck’s Triad: Hypotension, muffled heart sounds, raised JVP.
- Pulsus Paradoxus: >10 mmHg drop in SBP on inspiration.
- Diagnostics: Echo – diastolic RA/RV collapse, swinging heart.
- Emergency: Pericardiocentesis (subxiphoid approach).
- Exam Pearl: Electrical alternans on ECG = pathognomonic.
Permanent Pacemaker
Quick Fact
Pacemaker codes: 1st letter = chamber paced, 2nd = chamber sensed, 3rd = response.
Complete Coverage
- Common Modes: VVI, DDD, AAI.
- Indications: Complete heart block, sick sinus syndrome, trifascicular block.
- Complications: Lead dislodgement, infection, pacemaker syndrome.
- Nursing: Avoid MRI, no diathermy, check incision site.
- Exam Tip: Failure to capture = pacing spike without QRS.
Cardioversion vs Defibrillation
Quick Fact
Cardioversion is synchronised, defibrillation is unsynchronised.
Complete Coverage
- Cardioversion: For VT with pulse, AF, atrial flutter – energy 50–200 J biphasic.
- Defibrillation: VF/pulseless VT – 150–200 J biphasic first shock.
- Pad Position: Antero-lateral or antero-posterior.
- Exam Favourite: Synchronised shock for haemodynamically stable VT.
Cardiac Monitor & Defibrillator
Quick Fact
Biphasic defibrillator is more effective than monophasic.
Complete Coverage
- Monitor Leads: Lead II best for P wave, V1 for bundle branch blocks.
- Alarm Settings: HR, arrhythmia, ST segment monitoring.
- Defibrillator Energy: Adult 150–200 J biphasic, paediatric 4 J/kg.
Pulmonary Capillary Wedge Pressure (PCWP)
Quick Fact
PCWP reflects left atrial pressure (normal 6–12 mmHg).
Complete Coverage
- High PCWP (>18): Cardiogenic pulmonary oedema, mitral stenosis.
- Low PCWP (<6): Hypovolaemia, sepsis.
- Exam Classic: PCWP normal but PAP high = pulmonary hypertension.
Pulmonary Artery Catheter (Swan-Ganz)
Quick Fact
Swan-Ganz has 4 lumens + balloon + thermistor.
Complete Coverage
- Ports: Proximal (CVP), distal (PAP), balloon, thermistor (CO).
- Waveforms: RA → RV → PA → PCWP.
- Normal Values:
- CVP 2–6 mmHg
- PAP 15–30/8–15
- PCWP 6–12
- CO 4–8 L/min
- Complications: Arrhythmia, pulmonary artery rupture, infection.
- Exam Favourite: Giant v waves = tricuspid regurgitation.
Mini FAQ: Cardiac Nursing Hacks
Q: Beck’s triad? A: Hypotension + muffled sounds + raised JVP (tamponade)
Q: IABP inflation timing? A: At dicrotic notch (diastole)
Q: Normal PCWP? A: 6–12 mmHg
Q: Most common organism in native valve endocarditis? A: Streptococcus viridans
Q: Synchronised vs unsynchronised shock? A: VT with pulse = synchronised
Why logyanlo.in?
Your rank-guarantee platform with free daily notes, image-based quizzes & previous year discussions. Join thousands topping 2025!
Conclusion: Your Cardiac Crown Is Ready
Day 179 just gave you the complete cardiac nursing arsenal! From tamponade triad to Swan-Ganz waveforms – you now own every repeated question. Keep practising on our Daily Question Bank and watch your rank soar!
Call to Action
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