GLOSSARY OF TERMS AND ACRONYM EXPANSIONS FOR PERFUSION TECHNOLOGY, OPEN HEART SURGERY AND CARDIOLOGY

The following list of perfusion technology terms is offered as a service to the community by the Cardiovascular Perfusion Education Program & Life Support Departments of the Medical University of South Carolina. If you do not find the term or acronym that you are looking for, or perhaps you disagree with a definition or have coined a new term or acronym, please contact Jeffrey R. Acsell CCP with your request to include a term or abbreviation in this glossary, or for further information on a term, leave your e-mail address and you will be contacted.

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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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[ ]:

Symbol for concentration, usually expressed as moles per liter (M/l). [H⁺] = Hydrogen ion concentration

A

a-:

away from, opposite

AAA (triple A):

abdominal aortic aneurysm

AACP:

American Academy of Cardiovascular Perfusion

A-aDO2:

alveolar arterial oxygen gradient

ABCP:

American Board of Cardiovascular Perfusion; the national body regulating and managing certification (CCP) of perfusion technologists

abd.:

abdomen

ABG:

arterial blood gas, a collection of pO2, pCO2, pH, BE and HB SaO2 measurements from an arterial blood sample

ABO blood group system:

the most important of several systems for classifying human blood used in transfusion therapy

ACE:

angiotensin-converting enzyme

acid:

A substance which can donate H⁺. Large amounts are produced in the body as a by product of metabolism and to aid digestion. H₂CO₃ is a volatile acid that can be removed from the body as CO₂ by the lungs. Nonvolatile acids such as lactic acid are produced in small amounts by metabolism and are removed by the kidneys. (the lungs excrete approximately 13,000 mEq of H₂CO₃ in the form of CO₂ per day, the kidneys eliminate 50 - 100 mEq of nonvolatile acids per day) Excess acids are harmful to the body because they increase the [H⁺] which interferes with the bodys normal cellular and chemical function.

acid-base balance:

the maintanence of a normal level of acid and base in the blood and plasma

acidemia:

abnormally high level of acid in the blood, low pH (< 7.35)

acidosis:

a pathologic condition resulting from accumulation of acid in, or loss of base from the body

ACLS:

Advanced Cardiac Life Support

ACT:

activated clotting time

ACTH:

adrenocorticotropic hormone

acute myocardial infarction:

an acute process of myocardial ischemia with sufficient severity and duration to result in permanent myocardial damage

ADP:

adenosine diphosphate

adventitia:

the outside coat of a tissue or structure (see t. adventitia)

AF bypass:

aortofemoral bypass

affinity:

the force of attraction holding two elements together, such as hemoglobin affinity for oxygen

A Fib:

atrial fibrillation

A Flt:

atrial flutter

agglutination:

the process of blood cells clumping together as result of antibody interactions

AI:

aorticinsufficiency: aortic valvular incompetence: failure of the aortic valve to close during diastole causing back flow into the left ventricle

AICD:

automatic internal cardioverter/defibrillator

AIDS :

acquired immune deficiency syndrome; a serious, fatal condition in which the immune system is broken down by the HIV virus and does not respond normally to infections

AIVR:

accelerated idioventricular rhythm

A-line:

arterial line

alkalemia:

an arterial blood pH above normal (> 7.45) due to abnormally high base to acid ratio in the blood

alkalosis:

a pathologic condition resulting from accumulation of base in, or loss of acid from the body

allograft:

tissue graft from animal of the same species, not same genotype

alpha stat:

ventilation scheme where the total CO2 remains constant as temperature falls and the non-temperature corrected ABG appears normal. So called because it keeps the alpha imidazole moiety of histadine in the alpha charge state. This promotes respiratory alkalosis (about 0.01465 pH units per ^oC rise; Rosenthal Correction Factor) in the CPB blood.

ALT:

see SGPT

alveoli:

the small, sac-like structural unit of the lung where oxygen is exchanged for carbon dioxide

AMP:

adenosine monophosphate

AmSECT:

American Society of Extra-Corporeal Technology; the largest professional organization representing perfusion technologists

anaphylactic shock:

a severe hypersensitivity reaction to the injection or ingestion of a substance to which the organism has been previously exposed

ancrod:

anticoagulant derived from Malayan pit viper venom, depletes fibrinogen

aneurysm:

the abnormal dilation or out-pouching of a blood vessel or ventricle

anginapectoris:

a clinical syndrome typically characterized by a deep, poorly localized chest or arm discomfort that is reproducibly associated with physical exertion or emotional stress and relieved promptly by rest or sublingual NTG.

angiographically significant CAD:

CAD is typically judged "significant" at coronary angiography if there is at least a 70 percent diameter stenosis of one or more major epicardial coronary segments or at least a 50 percent diameter stenosis of the left main coronary artery

antegrade:

with the normal direction of flow

anti-:

against, or opposed to

antibody :

a complex molecule produced by specialized cells in response to the presence of an antigen

anticoagulant:

any agent that inhibits coagulation , see; heparin, ancrod, hirudin

antigen:

any substance percieved as foreign by the body that induces antibody production

anxiolytic therapy:

treatment to counteract or diminish anxiety

A&Ox3:

alert and oriented to person place and time

aorta:

the large single artery arising from the left ventricle carrying blood to the systemic circulation

aortic:

of or pertaining to the aorta

aortic atresia :

small or undeveloped aortic valve

aortic valve:

the semilunar valve separating the left ventricle from the aorta that prevents backflow of blood into the ventricle

aortotomy :

a surgical incision into the aorta

apheresis:

the separation or removal of a blood component or chemical to treat a disease or condition

aPPT:

activated partial thromboplastin time

AR:

aortic regurgitation, aortic insufficiency (AI)

ARDS:

adult respiratory distress syndrome; a disease process where the patient's lung fail to remove sufficient carbon dioxide and provide sufficient oxygen during ventilation

ARF:

acute renal failure

arrhythmia:

irregularity or loss of rhythm of the heartbeat

ART:

arterial

arteriole:

a small artery branching off of an artery giving rise to the capillary network

arteriosclerosis:

the process thickening and loss of elasticity in the walls of arteries

artery:

a blood vessel that carries blood away from the heart; arteries usually carry oxygenated blood

AS:

aortic valvular stenosis:narrowing of the normal aortic valve area causing a pressure drop across the aortic valve during ventricular systole

ASA:

aspirin

ASD:

atrial septal defect,

ASCVP:

Australasian Society of Cardiovascular Perfusionists, represents all perfusionists in Australia and New Zealand

ASPVD:

atherosclerotic peripheral vascular disease

AST:

see SGOT

ASV:

autogenous saphenous vein

ATIII:

antithrombin III, an albumin cofactor that normally binds free thrombin in the blood, heparin catalyzes the anti-thrombin action of ATIII 1000 times normal

atherosclerosis:

a form of arteriosclerosis in which atheromas containing cholesterol, lipoid material and lipophages are formed within the intima and inner media of large and medium-sized arteries

ATN:

acute tubular necrosis:ischemic damage to the tubule cells of the kidney causing renal failure

ATP:

adenosine triphosphate

atrial:

of or referring to the atrium or atria

atrialization:

appearing or becoming atrial like

atrium:

a chamber affording entrance to another structure or organ;

r. atrium the upper right cardiac chamber that receives blood from the venae cavae and delivers blood to the right ventricle

l. atrium the upper left cardiac chamber that receives blood from the pulmonary veins and delivers blood to the left ventricle (pleural form is atria)

ATS:

autotransfusion system; an extracorporeal circuit designed to collect a patient's shed blood during a surgical procedure and reinfuse the blood back to the patient; blood may be collected by pre-donation, intraoperative salvage or post operative wound drainage

autograft:

tissue graft from self

autologous:

referring to self, or tissue coming from the self

autoregulation:

the ability of an organ system to dilate or constrict the arteriols that enter it in order to control the blood flow to the organ to meet it's metabolic needs

AV:

1. atrioventricular;

2. aortic valve;

3. arterio venous

AVA:

aortic valve area

AVB:

atrio-ventricular block

AV canal:

atrioventricular canal

AV node:

atrioventricular node

AVG:

aortic valve gradient

AVR:

aortic valve replacement; open heart surgery to replace a diseased aortic valve with a prosthetic, artificial valve

B

base:

a substance capable of accepting or binding a hydrogen ion (H+) in a chemical reaction; The bicarbonate ion [HCO₃^-] is the most important base in the body.

base excess (BE):

a measurement of the total acid base ratio; the difference between the actual blood buffer concentration and the normal blood buffer concentration, reflects mainly the [HCO₃^-] in the plasma compaired with the expected [HCO₃^-].

BB:

blood buffer , the sum of all of the plasma and RBC blood buffer systems: bicarbonate, hemoglobin, phosphate and proteins that serve to prevent changes in the pH of the blood

BBB:

bundle branch block

beta blocker (beta-adrenergic blocking agent):

a drug that blocks the effect of catecholamines, producing a decrease in heart rate and oxygen demand in the myocardium

bicarbonate [HCO3-]:

the most common base found in the plasma and RBC

BiVAD:

bi-ventricular assist device; the use of two blood propulsion devices or ECCs to assist the failing right and left ventricles

blood volume:

the amount of blood circulating throughout the body in the vascular system

Blood Gas (ABG):

Laboratory test that usually includes the pH, pO₂, pCO₂, Total CO₂, HCO₃^-, BE, Hb Saturation, HCT, and possibly the K⁺, Ca⁺⁺, and Glucose.

		Normal Adult Values:
	Source	HWD	ZWD	MUSC Lab
pH	arterial	7.35-7.45	7.38-7.42	7.350-7.450
	venous			7.320-7.420
pCO2	arterial	35-48(mmHg)	38-42(mmHg)	35-45(mmHg)
	venous			41-51(mmHg)
pO2	arterial			80-100(mmHg)
	venous			25-40(mmHg)
[HCO3 -		23-28(mEq/L)	22-26(mEq/L)	22-26(mEq/L)
[K+]	serum			3.4-5.3(mEq/L)
[Na+]	serum			136-146(mEq/L)
[Cl-]	serum			95-105(mEq/L)

Horace W. Davenport, The ABC of Acid-Base Chemistry (sixth edition) The University of Chicago Press 1974

Zagelbaum, Welch, Doyle. Basic Arterial Blood Gas Interpretation. Little Brown and Company 1988

BLS:

basic life support

BMR:

basal metabolic rate

bohr effect:

the influence of carbon dioxide on the affinity of hemoglobin to bind with oxygen, increasing the carbon dioxide level decreases the affinity of hemoglobin for oxygen

BPG:

bypass graft

BPM:

beats per minute

bronchioles / bronchi:

the tubes or airways for the lungs that lead from the trachea to the alveoli

BSA:

body surface area (usually in square meters)

BSBE:

breath sounds bilateral and equal

BTBV:

beat to beat variability

BT Shunt :

Blalock-Taussig Shunt .

BQ:

blood flow

buffer:

a chemical system that prevents change in concentration of another chemical substance; a substance which acts in a solution to resist any change in pH of the solution when acid or base is added; the combination strong acid and a week conjugate base.

Percentage of Buffers in Whole Blood
Hemoglobin & Oxyhemoglobin	35%
Phosphate	5%
Plasma Proteins	7%
Total non-bicarbonate -		47%
Plasma Bicarbonate	35%
RBC Bicarbonate	18%
Total bicarbonate -		53%
	TOTAL BUFFER	100%

BUN:

blood urea nitrogen

bundle branch block:

An ECG change characterized by an intraventricular conduction delay affecting the left ventricular wall and septum. Acute occurrences most commonly result from myocardial ischemia.

BVH:

biventricular hypertrophy

C

CABG:

coronary artery bypass graft

CABRI:

coronary artery bypass revascularization investigation

CAD:

coronary artery disease

calcium channel blocker:

drug that blocks entry of calcium into cells and inhibits the contractility of smooth muscle, resulting in dilation of blood vessels and reduction in blood pressure

cannula(e):

tubes or catheters placed in the great vessels or cardiac chambers to allow decompression or selective propulsion of blood flow to the structure or vessel

capillaries:

the smallest blood vessels in the body that connect arterioles and venules

(CO2)carbon dioxide:

a colorless, odorless nonflammable produced in respiration, and given off by the tissue to the blood

carbonic acid(H2CO3):

an weak acid resulting from the reaction of H20 and CO2 to form H2CO3 which dissociates into H+ and HCO3-

carbonic anhydrase :

an enzyme found primarily in the kidney and red blood cells that accelerates the reversible reaction of H20 and CO2 to form H2CO3-

cardiac:

of or referring to the heart

cardiac mortality:

death due to cardiac cause

cardiac catheterization:

passage of a catheter into the heart through a blood vessel leading to the heart for the purpose of measuring intracardiac pressure abnormalities, obtaining cardiac blood samples, and/or imaging cardiac structures by injection of radio-opaque dye

cardiac output:

the volume of blood displaced by the left ventricle over one minute

cardiac index:

cardiac output normalized to body surface area or body weight

cardiogenic shock:

failure to maintain blood supply to the tissues because of inadequate cardiac output, such as may be caused in myocardial infarction

cardiomegaly:

hypertrophy of the heart

cardiomyopathy:

a general diagnostic term designating primary myocardial disease

cardioplegia:

1. interruption of myocardial contraction, as by use of chemical compounds or cold in cardiac surgery

2. a solution infused into the heart to interrupt myocardial contraction

cardiopulmonary:

pertaining to the heart and lungs

cardiopulmonary bypass :

use of an extracorporeal circuit to circulate blood around the heart and lungs

cardiopulmonary resuscitation:

an emergency measure to maintain a person's breathing and heartbeat when they have stopped as a result of myocardial infarction, trauma, or other disorder.

cardiotomy:

1. surgical opening in the heart

2. component of extracorporeal circuit serving as a reservoir for blood

carotid:

referring to the large arteries in the neck carrying blood to the brain and scalp

catecholamine :

any of a group of sympathomimetic amines (including dopamine, epinephrine, and norepinephrine)

cath:

catheterization

CAVH:

continuous arterio-venous hemofiltration

CBC:

complete blood count

CCP:

Certified Cardiovascular Perfusionist; the professional credential for the certified perfusion technologist

CCSC:

Canadian Cardiovascular Society Classification

CCU:

coronary care unit

cerebral:

referring to the cerebellium or brain

CHD:

congenital heart disease

CHF:

congestive heart failure

cholesterol :

chol, a monatomic alcohol found in animal fats and oils, bile, blood , brain tissue, milk, egg yolk, myelin sheaths of nerves, liver, kidneys and adrenal glands, increased blood levels of which are a risk factor for the development of coronary artery disease

chronic obstructive pulmonary disease (COPD):

group of conditions in which the patient has an expiratory airflow obstruction such as chronic bronchitis or emphysema

CI:

1. cardiac index,

2. confidence interval

circ art:

circumflex artery

CK:

creatinine kinase

clot:

see thrombus

CMV:

cytomegalovirus

CO:

cardiac output

c/o:

complaining of

coag:

coagulation

coar/Ao:

coarctation of the aorta

colloidal osmotic pressure (COP) :

the osmotic force due to the presence of proteins or other large molecular weight substances

co-morbidity:

concomitant but unrelated pathologic or disease process,usually used to indicate coexistence of two or more disease processes.

compensation:

the process where one acid base imbalance offsets another imbalance in an effort to bring the pH back within normal limits. Ex. metabolic acidosis with a [HCO₃^-] less than 22 mEq/L causes tachypnea causing a pCO₂ less than 35 mmHg (respiratory alkalosis)

congestive heart failure :

failure of the heart to maintain adequate circulation of blood.

COP:

colloidal osmotic pressure

COPD:

chronic obstructive pulmonary disease

cor:

heart

coronary :

encircling in the manner of a crown; especially to the arteries of the heart,and by extension, to pathologic involvement of them

coronary sinus:

the opening into the right atrium to which the veins of the left coronary circulation drain

coronary artery bypass graft :

vein or artery grafted surgically to permit blood to travel from the aorta to a branch of the coronary artery at a point past an obstruction.

coronary artery disease (CAD):

Although a number of disease processes other than atherosclerosis can involve coronary arteries, in this guideline the term CAD refers to the atherosclerotic narrowing of the major epicardial coronary arteries.

coronary thrombus:

blood clot that obstructs a blood vessel of the heart

coronary stenosis:

narrowing or constriction of any arteries, orifices or chambers leading into or from the heart

C/P:

cardiopulmonary

CPB:

cardiopulmonary bypass

CPK:

creatine phosphokinase

CPR:

cardiopulmonary resuscitation

Cr:

creatinine

Cr cl:

creatinine clearance

CRF:

chronic renal failure

CRI:

chronic renal insufficiency

cross-matching:

the mixing of a donor's blood with a potential recepient's blood to test for compatibility

cryoprecipitate:

the thin white layer obtained from freezing and thawing blood

CTICU:

cardiothoracic intensive care unit

CVP:

central venous pressure

cx:

circumflex artery

CXR:

chest x-ray

D

D1 or D2:

diagonal branch of the LAD artery

D5W:

dextrose 5% in water

DBP:

diastolic blood pressure

D/C:

discontinue / discharge

Defib:

defibrillate

DHCA:

deep hypothermic circulatory arrest

dialysis :

the process of separating crystalloids and colloids in solution by the difference in their rates of diffusion through a semipermeable membrane, used to remove metabolites and toxins from body fluids

diastole :

referring to the period of time during relaxation of the ventricle(s)

DILV:

double inlet left ventricle

DIC:

disseminated intravascular coagulapathy; an abnormal process that occurs when clot formation and clot lysis occurs simultaneously in the microcirculation

diffusion :

the spontaneous mixing of the molecules of two or more substances from an area of high concentration to low, resulting from random thermal motion: it's rate is proportional to the concentrations of the substances and increases with the temperature

DKS:

Damus-Kaye-Stansel

DM:

diabetes mellitus

DORV:

double outlet right ventricle

DOLV:

double outlet left ventricle

DOE:

dyspnea on exertion

DVT:

deep venous thrombosis

dx:

diagnosis

dyspnea :

shortness of breath, difficulty breathing

E

EAST:

Emory Angioplasty Study Trial

ECA:

external carotid artery

ECC:

extra-corporeal circulation (or circuit); the propulsion of blood outside the body to perform an artificial organ function

ECCO2R:

extra-corporeal carbon dioxide removal; the agressive removal of carbon dioxide from a portion of the venous blood before it enters the right atrium to provide support to a patient in respiratory failure

ECD:

endocardial cushion defect

ECG :

electrocardiogram

ECHO:

echocardiogram

echocardiography:

the process of reflecting ultrasound doppler signals off the heart and surrounding anatomical structures to visualize cardiac activity and structure, and acilitate diagnosis

ECMO:

extracorporeal membrane oxygenation; the process of propelling blood outside the body (often in neonates, or newborns) to perform artificial ventilation of the blood with a blood oxygenator that allows for diffusion of oxygen and carbon dioxide across a continuous membrane material separating gas and blood

ECT:

Extracorporeal Circulation Technology; the study of maintaining blood flow outside the body to perform artificial organ(s) functions

-ectomy:

to surgically excise

EEG:

electroencephalogram

EF:

ejection fraction; the percent of the left ventricular volume that is ejected in one cardiac contraction; stroke volume divided by ventricular end-diastolic volume

ejection fraction (EF):

the percent of the left ventricular volume that is ejected in one cardiac contraction; stroke volume divided by ventricular end-diastolic volume

EKG:

electrocardiogram

embolus:

a small solid particle or gas bubble that is carried in the blood flow stream; (plural is emboli)

EMT:

1. emergency medical transport;

2. emergency medical technitian

endothelium :

the monocellular lining of blood vessels, heart and lymphatic system

erthrocyte :

a mature red blood cell that contains molecular hemoglobin

erythropoiesis:

the process by which the bone marrow produces red blood cells and other cellular elements

ET:

endotrachial tube

exercise tolerance testing:

stress test, a diagnostic test in which the patient exercises on a treadmill, bicycle, or other equipment while heart activity is monitored by an ECG.

extracorporeal:

outside the body

extravascular:

outside the vascular system, or fluid that is contained in the interstitial space

F

FFP:

fresh frozen plasma; the non-cellular component of donor blood that is removed and frozen for later transfusion to treat hypocoagulable states

FTT:

failure to thrive

fibrin :

the insoluble protein formed in the blood to produce clot by the action of thrombin on fibrinogen

fibrinogen :

the protein produced in the liver, present in the blood that is the precursor to fibrin in the clotting process

fistula:

a duct or other passage formed surgically or by the imperfect closing of a wound or abscess and leading either to the body surface or to another holow organ

AV fistula - a fistula connecting an artery and vein bypassing the capillary bed, often surgically placed in patients undergoing renal dialysis

FiO2:

fraction of inspired oxygen, the percent concentration of oxygen in the gas entering the lungs, ventilator or a blood oxygenator

G

GEA :

gastroepiploic artery

GI:

gastrointestinal

GME:

gaseous microemboli; a small embolus of gas that is carried in the blood flow stream

great vessels:

the large arteries and veins arising from the heart and pericardium

GTT:

glucose tolerance test

H

H⁺:

hydrogen ion, also known as a proton

haldane effect:

the influence of oxygen on the affinity of hemoglobin to bind with carbon dioxide, increasing the oxygen level decreases the affinity of hemoglobin for carbon dioxide

[HCO₂^-]:

bicarbonate ion concentration in mEq/L. The bicarbonate ion is the most important base in the body. The amount of HCO₂^- in the blood is expressed in mEq/L and is regulated by the kidneys. The kidneys regulate the [HCO₂^-] by increasing or decreasing the resorption of HCO₂^- in the renal tubule. The HCO₂^- is the metabolic component of the acid-base balance. The normal [HCO₂^-] is maintained between 22 - 26 mEq/L with a mean of 24 mEq/L

hct:

hematocrit

HCTZ:

hydrochlorothiazide, (type of diuretic)

hematocrit :

the percent of the blood which is cellular elements, normally 35 - 43 %

hemo-:

referring to blood

hemoconcentration:

the process of removing fluid and electrolytes from the blood to increase the concentration of hemoglobin and red blood cells

hemodialysis:

the separation of waste products from the blood by osmosis across a semi-permeable membrane

hemodilution:

the decrease in the concentration of hemoglobin and red blood cells in the blood

hemodynamic instability:

i nstability of the blood pressure.

hemoglobin :

the red pigmented complex protein found in the red blood cells that functions to carry oxygen and carbon dioxide

hemolysis :

the freeing of hemoglobin from the inside of the red blood cell by normal breakdown or mechanical destruction

hemostasis :

the cessation of bleeding through normal coagulation or by surgical procedure

Henderson - Hasselbach equation:

pH = pK + log [HCO₂^-]/[CO₂d][H₂CO₃]
pH = pK + log [HCO₂^-]/(0.03 * pCO₂)

(The carbon dioxide solubility coefficient 0.03 converts pCO₂ in mmHg to mm/L, the pK is 6.10 at 37^oC). Relates the ratio of the metabolic component to the respiratory component.

heparin :

a negatively charged polysaccharide normally found in lung or gut mucosa that naturally prolongs the time it takes blood to clot by catalyzing anti-thrombin III

hepatic :

pertaining to the liver

hepatitis:

inflammation of the liver usually caused by a virus transmitted by contact or blood transfusion

hepatomegaly:

enlargement of the liver

heterograft:

see xenograft

heterologous:

referring to a different species, or tissue coming from a different species

heterothermic:

cold blooded; poikilothermic; animals whose body temperature changes with the environment

Hgb:

hemoglobin

hirudin :

coagulation inhibitor isolated from leeches, inhibits thrombin without requiring ATIII

HIV:

human immunodeficency virus; a retrovirus that converts RNA to DNA and inserts it in the host cell, and is responsible for the fatal disease AIDS

HLHS :

hyperplastic left heart syndrome; congenital defect characterized by atretic underdeveloped or absent left ventricle

HMD:

hyaline membrane disease

H/O:

history of

homeostasis:

the maintanence of a normal state of balance in a physiologic system

homeothermic:

warm blooded; animals whose body temperature are maintained within a narrow range by its metabolic processes

homograft:

see allograft

homologous:

referring to the same species, or tissue coming from the same species

HR:

heart rate

HTN:

hypertension

Hx:

history

hydrogen ions (H+)

ion produced when hydrogen looses an electron, a proton, the ions released when an acid is placed in solution such as in water or plasma

hyper:

above normal

hypercapnea :

a measurement of an abnormally high CO2 level in the blood, pCO2 > 45 mmHg

hypercholesterolemia :

excessive cholesterol in the blood.

hyperlipidemia:

excessive quantity of fat (cholesterol and triglycerides) in the blood.

hyperthermia:

temperature above normal

hypertrophiccardiomyopathy:

disease of the myocardium produced by the enlargement of the cells of the myocardium; often the result of increased oxygen demand in ischemic heart disease.

hypertrophy :

enlargement or overgrowth of an organ or part due to increase in seze of its constituent cells.

hypervolemia :

blood volume increase above normal

hypo:

below normal

hypoperfusion :

decreased blood flow to an organ or tissue such as in shock

hypotension :

decrease of systolic and diastolic blood pressure below normal.

hypothermia :

temperature below normal

hypovolemia:

decreased blood volume below normal

hypoxemia:

reduction of oxygen level in the blood below normal

hypoxia :

reduction of oxygen level in tissues below normal

I

IABP:

intra-aortic balloon pump

ICA:

internal carotid artery

ICS:

intercostal space

ICU:

intensive care unit

IDDM:

insulin dependent diabetes mellitus

immune system:

the system of blood cells and chemicals that protects the body from invasion by foreign organisms; the system that produces antibodies in response to antigens

in situ:

in place, but isolated in a living organism

intima:

an innermost structure (see tunica intima)

in vitro:

in the laboratory or in the test tube outside a living organism

in vivo:

within a living organism

interstitial:

between cells; the space in the tissues between cells outside the vascular system

intra-aortic balloon pump :

Use of a balloon attached to a catheter inserted through the femoral artery into the descending thoracic aorta for producing alternating inflation and deflation during diastole and systole, respectively.

intra-coronary stenting:

use of a prosthetic metal device to provide and maintain an enlarged coronary lumen at the site of an obstructive atherosclerotic plaque.

I&O (I/O):

intake and output

ischemia:

the need for oxygen exceeds the supply of oxygen leading to tissue cellular damage and possible death or necrosis

ischemic heart disease:

a form of heart disease whose primary manifestations result from myocardial ischemia due to atherosclerotic CAD.

isthmus:

a narrow connection between two larger bodies or parts

IV:

intravenous

IVC:

inferior vena cava

IVCD:

interventricular conduction defect

J

JVD:

jugular venous distention

K

Konno:

Surgical procedure to treat patients with congenital aortic stenosis.

L

KVO:

keep vein open

L

LA LA:

left atrium

LAD:

left anterior descending coronary artery

LBBB:

left bundle branch block

LDH:

lactate dehydrogenase

left ventricular function:

function of the main pumping chamber of the heart (left ventricle) that receives blood from the left atrium and pumps it out into the general circulation through the aortic valve.

left main (LM) disease:

stenosis of the left main (LM) coronary artery.

LIMA :

left internal mammary artery

LLL:

left lower lobe

LM:

left main coronary artery.

LV:

left ventricle

LVH:

left ventricualr hypertrophy

lysis:

destruction or decomposition, as of a cell or other substance

M

MAP:

mean arterial pressure

MB:

cardiac muscle

mec:

meconium

media:

middle,(see tunica media)

mediastinum :

The mass of tissues and organs separating the sternum in front and the vertebral column behind, containing the heart and its large vessels, trachea, esophagus, thymus, lymph nodes, and other structures and tissues

metabolic:

refers to the process of the chemical reactions at the tissue level

metabolic acidosis:

abnormal physiological process characterized by the primary gain of strong acid or primary loss of bicarbonate from the extracellular fluid. Reflected by a low [HCO₃^-] and low pH. (HCO₃^- less than 22 mEq/L) Treat by increasing perfusion of tissues and give NaHCO₃.

metabolic alkalosis:

mbnormal physiological process characterized by primary gain of strong base or loss of strong acid. Reflected by a high [HCO₃^-] and high pH. (HCO₃^- greater than 26 mEq/L) Normally no need to treat.

MI:

1. mitral insufficiency; back flow or regurgitation of flow through the mitral valve during ventricular systole

2. myocardial infarction

MICU:

medical intensive care unit

milliequivalent:

one thousandths of an equivalent: An equivalent is the amount of a substance (mg or mM) that can enter into a reaction with one mole of hydrogen ions, or replace one mole of H⁺ in the reaction (gram molecular weight/valence).

mitral :

referring to the bicuspid valve separating the left atrium and ventricle to prevent back flow into the atrium during ventricular systole

mitral regurgitation :

abnormal systolic back flow of blood from the left ventricle into the left atrium, resulting from imperfect closure of the mitral valve

mitral stenosis :

mitral valvular stenosis;narrowing of the normal area of the mitral valve causing a pressure drop across the valve during left ventricular filling

modified ultrafiltration :

hemoconcentration of patients blood, post bypass prior to decannulation, using the extracorporeal circuit for blood access

mole:

the gram molecular weight of any substance, which always contains 6.023 X 10²³ molecules of that substance. The number of molecules of a substance in one gram molecular weight of the substance. one mole of hydrogen ions, or replace the H⁺ in the reaction (gram molecular weight/valence).

MR:

mitral regurgitation

MS:

1.mitral stenosis

2. multiple sclerosis

MUF:

modified ultrafiltration

MUGA:

multiple gated acquisition test; a radionuclide test of myocardial performance

multivessel disease:

disease in two or more of the coronary arteries

MV :

mitral valve

MVR:

mitral valve repair, or replacement; open heart surgery to repair or replace a diseased mitral valve with a prosthesis or artificial heart valve

myocardial ischemia:

condition in which oxygen delivery to and waste removal from the myocardium falls below normal levels with oxygen demand exceeding supply.

myocardial infarction (Ml):

damage to the heart muscle caused by occlusion of one or more of the coronary arteries.

myocardium :

the muscular wall of the heart located between the inner endocardial layer and the outer epicardial layer.

N

necrosis :

death of individual cells or groups of cells, or of localized areas of tissue

NHLBI:

National Heart, Lung, and Blood Institute

NIDDM:

non-insulin dependent diabetes mellitus

nitrate:

a drug whose metabolites produce a relaxation of vascular smooth muscle, causing dilation of the veins, reducing preload and myocardial oxygen demand.

nitrogen:

chemical element at. no. 7, symbol N, molecular N2. It forms about 78% of the atmosphere and 78% of dissolved gas in the blood

N/G:

naso gastric

NICU:

neonatal intensive care unit

NKA:

no known allergies

NKDA:

no known drug allergies

non-Q-wave myocardial infarction:

myocardial infarction that is not associated with the evolution of new Q waves on the ECG.

npo:

nothing by mouth

NSR:

normal sinus rhythm

NTGNTG:

nitroglycerin

O

OHDC:

oxyhemoblobin disassociation curve

obtuse marginal:

branches of the circumflex coronary artery

OM1 OM2:

obtuse marginal

osmosis:

the passage of pure solvent from a solution of lesser to one of greater solute concentration, when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent

osmotic pressure :

the negative pressure created by a dissolved non-diffusable substance across a membrane permeable to solvent but not to the solute

ostia:

opening

-otomy:

to make a surgical opening into

oxygen :

chemical element at. no 8, symbol O, molecular O₂; an odorless, colorless gas that is essential to all plants and animals for respiration

oxygenator :

an artificial device that functions like the lung to exchange oxygen and carbon dioxide with the blood

P

P50:

hemoglobin P50, the partial pressure of oxygen where hemoglobin is 50% saturated with oxygen, normally about 27 mmHg

PA:

pulmonary artery

PAC:

premature atrial contraction

PaO₂ :

the partial pressure exerted by O₂ dissolved in arterial (a) plasma and RBC water,(in the venous blood - PvO₂)

PFO:

patent foramen ovale

PaCO₂ :

the partial pressure exerted by CO₂ dissolved in arterial (a) plasma and RBC water, (in the venous blood - PvCO₂)

palliative:

to relieve the symptoms of without fixing or repairing the underlying condition

partial pressure :

the pressure exerted by a gas dissolved in plasma and RBC water, for example pO₂ is the partial pressure exerted by dissolved oxygen

pCO₂ :

The partial pressure (tension) exerted by CO₂ in mmHg. The respiratory component. Carbon dioxide (CO₂) is produced by metabolism and carried by the blood to the lungs where it diffuses into the alveoli and is eliminated by exhaled breath. The amount of CO₂ dissolved in the blood is measured by the partial pressure it exerts and is reported in mmHg. When CO₂ dissolves in H₂O it combines to form H₂CO₂ (carbonic acid) the most important acid in the body. The [H₂CO₂] is directly proportional to the CO₂ dissolved in the blood (paCO₂) and the paCO₂ is a measurement of the ventilation status of the patient. Therefor the paCO₂ is known as the respiratory component of the acid-base balance. As with pH, the body maintains the pCO₂ within strict limits. The normal pCO₂ is 35 - 45 mmHg with a mean of 40 mmHg.

PCWP:

pulmonary capillary wedge pressure

PDA:

1. patent ductus arteriosus

2. posterior descending artery

PE:

1. pulmonary embolus

2. pulmonary edema

3. peripheral edema

percutaneous transluminal coronary angioplasty (PTCA):

percutaneous transluminal coronary angioplasty; compression of an athromatous lesion by inflating an intracoronary balloon catheter to dilate the vessel

PERLA:

pupils equal and reactive to light and accommodation

perfusion :

1. flowing over or through;

2. blood flow through the organs and tissues of the body;

3. the profession of the study and implementation of blood flow through an extracorporeal circuit for life support

perfusion scan:

a test to determine the status of blood flow to an organ.

perfusion balloon angioplasty:

a variation of PTCA in which a catheter is inserted in the artery that permits blood flow during balloon inflation.

perfusionist :

see perfusion technologist

perfusion technologist:

perfusionist; the health professional educated to operate the heart lung machine and other life support devices

peri-:

surrounding, around

pericardium :

the tough non-elastic membrane surrounding the heart that attached to the great vessels and other anatomical structures in the mediastinum

pericarditis :

inflamation of the pericardium

pH :

the inverse log of the hydrogen ion activity; a measure of the alkalinity or acidity of the blood or solution on a 14 point scale with 1 being acidic and 14 being alkaline. The body normally maintains the [H⁺] and therefor the pH within very strict limits. Normal pH is 7.35 - 7.45 with a mean of 7.40.

PH₂ O:

water vapor pressure, the partial pressure exerted by the presence of water vapor

phagocyte :

a white blood cell that engulfs and distroys foreign organisms and debris in the blood

pharmacologic stress test:

a test of heart function during intentional drug-induced stress.

pH stat :

ventilation scheme where the total CO₂ increases as the temperature falls and the temperature corrected ABG appears normal. So called because the temperature-corrected, actual blood pH equals 7.40 during all temperatures of CPB

PI:

pulmonary insufficiency

PICU:

pediatric intensive care unit

PJC:

premature junctional contractions

pK:

a constant that describes the rate or degree to which a chemical reaction goes to completion, depending on temperature and pH

plasma free hemoglobin:

hemoglobin released from dying or damaged red blood cells

plasma :

the acellular, colorless liquid portion of the blood

plasmin :

the substance found in the blood that digests fibrin resulting in clot dissolution

plasminogen :

the precursor to plasmin that is activated by tissue plasminogen activator (TPA)

platelet :

thrombocyte;

PND:

paroxysmal nocturnal dyspnea

pO₂:

partial pressure of oxygen; Oxygen is used by the body as a metabolic substrate to produce energy. A constant supply of oxygen is needed to maintain living tissue. 21% of the air we breath is oxygen and at sea level it exerts a pO₂ of ~159 mmHg. The air is taken into lungs with each inhalation and moved into the alveoli where the pO₂ is ~100 mmHg. The O₂ diffuses into the blood and dissolves in the plasma where it exerts a pO₂ of ~95 mmHg. In normal arterial blood with a pO₂ of ~95 mmHg the blood is ~98% saturated with oxygen. The oxygen is carried to the tissue by the blood and by the time the venous blood returns to the lungs it has a pO₂ of ~40 mmHg and is ~75% saturated. The paO₂ is assessed on the ABG to provide a measure of the arterial oxygenation.

poikilothermic:

cold blooded; heterothermic; animals whose body temperature changes with the environment

polycythemia :

a serious condition characterized by too many red blood cells in the circulation

pooled platelets:

platelets collected from multiple donors and mixed together for use in transfusion

post-Ml angina:

angina occurring from 1 to 60 days after an acute MI.

PR interval:

ECG PR segment, interval of time between the P wave and the R wave on the ECG

prime (pump):

1. to fill the extracorporeal circuit with fluid;

2. the fluid that is required to initially fill and debubble the extracorporeal circuit before connection to the patient's vascular system

prinzmetal's angina:

variant angina, a clinical syndrome of rest pain and reversible ST-segment elevation without subsequent enzyme evidence of acute MI. In some patients, the cause of this syndrome appears to be coronary vasospasm alone often at the site of an insignificant coronary plaque, but a majority of patients with variant angina have angiographically significant CAD.

PS:

pulmonary valvular stenosis;

PT:

prothrombin time, protime

PTCA:

percutaneous transluminal coronary angioplasty;

PTT:

partial thromboplastin time

pulmonary :

referring to the lung or the bicuspid valve separating the right ventricle and the pulmonary artery to prevent back flow into the ventricular during diastole

pulmonary edema:

condition, usually acute, but sometimes chronic, where fluid builds up in the lungs. This often occurs as a response to left ventricular failure in ischemic heart disease, hypertension, or aortic valve disease.

pulmonary atresia :

small or undeveloped pulmonary valve

pulmonary insufficiency :

pulmonary valvular incompetence; back flow or regurgitation of flow through the pulmonary valve during ventricular diastole

pulmonary stenosis :

pulmonary valvular stenosis; narrowing of the normal area of the pulmonary valve causing a pressure drop across the valve during left ventricular systole

pump:

1. the blood propulsion device included in the extracorporeal circuit to replace the left ventriclar function

2. slang for the heart

pumptech:

1. slang for the technologist that is a perfusionist

2. a technician that is responsible for operating heart lung machine durring surgery

3. a member of the 'pump team'

PV :

pulmonary valve

PVC:

premature ventricular contraction

PVD:

peripheral vascular disease

PVR:

1. pulmonary vascular resistance; resistance to the flow of blood through the pulmonary vascular beds

2. peripheral vascular resistance; resistance to the flow of blood through the peripheral vascular beds

3. pulmonary valve repair, or replacement; open heart surgery to repair or replace a diseased pulmonary valve with a prosthesis or artificial heart valve valve

Q

QIP:

quality improvement process

R

RA:

right atrium

radionuclide test:

A diagnostic test in which a radioactive substance is injected into the bloodstream and the emitted radioactivity is detected by a scanner; used to visualize the heart and vessels.

RBBB:

right bundle branch block

RBC :

red blood cell; erythrocyte

RCA:

right coronary artery

renal:

referring to the kidney(s)

renal failure:

failure of the kidney to cleanse the blood causing the build up of waste products in the blood

respiration :

the chemical processes that occur at the tissue cellular level converting oxygen and water to heat, ATP and carbon dioxide

respiratory acidosis:

an abnormal physiological process in which there is a primary reduction in alveolar ventilation relative to the rate of CO₂ production. Reflected by a high pCO₂ and low pH. (pCO₂ greater than 45 mmHg) Treat by increasing ventilation.

respiratory alkalosis:

an abnormal pyhsiological process in which there is a primary increase in the rate of alveolar ventilation relative to the rate of CO₂ production. Reflected by a low pCO₂ and high pH. (pCO₂ less than 35 mmHg) Treat by decreasing ventilation.

re-stenosis:

the recurrence of a stenosis

retrograde:

against the normal direction of flow

revascularization :

restoration, to the extent possible, of normal blood flow to the myocardium by surgical or percutaneous means or with removal or reduction of an obstruction as occurs when CABG or PTCA is performed

RH:

relative humidity

Rh:

rhesus monkey factor

RHD:

rheumatic heart disease

RIMA:

right internal mammary artery

RISC:

Research Group on Instability in Coronary Artery Disease

Risk:

high, intermediate, and low risk in this guideline refer to the probability of future adverse cardiac events, particularly death or MI.

RITA:

Randomized Intervention Treatment of Angina

RM:

Right Main Coronary Artery

RRR:

regular rate and rhythm

RV:

right ventricle

RVH:

right ventricular hypertrophy

Rx:

therapy or treatment

S

SA node:

sinoatrial node

SBP:

systolic blood pressure

SCOPA:

South Carolina Organ Procurement Agency

sed. rate:

erythrocyte sedimentation rate

SEM:

systolic ejection murmur

SGOT :

serum glutamic oxaloacetic transaminase (AST)

SGPT :

serum glutamic pyruvic transaminase

shock :

acute peripheral circulatory failure due to derangement of circulatory control or loss of circulating fluid, marked by hypotension, coldness of skin, usually tachycardia, and often anxiety; decreased cardiac output;

sinus node :

bundle of excitatory tissue found in the right atrium that functions as the pacemaker of the heart

Sinus of Valsalva :

the portion of the aortic root just distal to the aortic valve containing the coronary ostia

sO2:

percent saturation of hemoglobin with oxygen, in the arterial blood - SaO2, in the venous blood - SvO2

solubility:

the ability of a gas to dissolve into plasma and RBC water

S tach:

sinus tachycardia

stenosis :

a narrowing or blockage of a coronary artery

STICU:

surgical trauma intensive care unit

sublingual:

beneath the tongue.

supraventricular arrhythmia:

an irregular heart beat that originates in the atria or AV node.

SV:

a device placed in an vessel to keep it open, coronary stent

SV:

stroke volume

SVCSVC:

superior vena cava

SVG:

saphenous vein graft

SVO2:

mixed venous oxygen saturation

SVR:

systemic vascular resistance ([MAP-CVP]/CO)

SV tach:

supraventricular tachycardia

systole :

referring to the period of time during contraction of the ventricle(s)

T

TAPVR:

total anomalous pulmonary venous return

TEE:

transesphogeal echocardiography, a doppler echocardiographic transducer is inserted in the esophogus to visualize the lungs, heart and great vessels

technician:

a person highly skilled in a certain field or process

technologist:

a person who applies scientific knowledge in a specialized field or process

temperature correction:

The mathematical process to correct for the physical changes that pH, pO₂, pCO₂ go through when a blood sample is warmed or cooled in vitro during analysis.

tetralogy of fallot (TOF):

congenital heart condition characterized by; 1. over riding aorta, 2. VSD, 3. RV outflow tract obstruction and, 3. PDA, if ASD is present the condition is called a "pentology of fallot"

TGA:

transposition of the great arteries

thebesian veins:

the small veins terminating into the right sided chambers of the heart draining the right coronary circulation of the heart

thrombocytopenia:

abnormal decrease in number of the blood platelets.

thrombocyte :

platelet; the small, disc shaped enucleated body found in the blood that initiates the coagulation process

thrombolytic therapy:

Pharmacologic treatment with a class of drugs that can break up fibrin blood clots.

thrombus :

blood clot, blood that has gone from a liquid state to a gel to stop bleeding

tricuspid atresia :

small or undeveloped tricuspid valve

TI:

tricuspid insufficiency

TM:

thrombolysis in myocardial infarction

TIA:

transient ischemic attack

TOF:

tetralogy of Fallot

total CO₂ content:

consists of HCO₃^-, H₂CO₃, and dissolved CO₂ (pCO₂). (Since CO₂ and H₂CO₃ are interchangable) total CO₂ = dissolved CO₂ gas + HCO₃^-. or total CO₂ = HCO₃^- + (0.03 * pCO₂). (The CO₂ solubility coefficient, 0.03, converts pCO₂ in mm/L to meq/L) In normal plasma, more than 95% of the total CO₂ is contributed by HCO₃^-, the other 5% by dissolved CO₂ and H₂CO₃.

TPA:

tissue plasminogen activator; a substance that converts plasminogen to plasmin to dissolve clot

TR:

tricuspid regurgitation

trans-:

across or through

transcutaneous :

through the skin

transfusion :

the injection of whole blood or blood products into the blood stream

transvenous pacemaker:

cardiac pacemaker using a pacing electrode or wire passed through a vein into the chambers of the heart that stimulates and maintains a normal heart rate; may be permanent or temporary

triage:

screening and classification of sick, wounded, or injured persons to determine priority of need and proper place of treatment

tricuspid valve:

the valve between the right atrium and the right ventricle

TS:

tricuspid stenosis; stenosis of the tricuspid valve

tunica:

in anatomy, a general term for a membrane or other structure covering or lining a body part or organ

t. adventitia the outer coat of various tubular structures including blood vessels

t. intima the innermost coat of a blood vessel

t. media the middle coat of a blood vessel

TV :

tricuspid valve

U

UAC:

umbilical artery catheter

UO:

urine output

ultrafiltration:

the separation of fluid and electrolytes from the blood by seiving across a porous membrane

unstable angina:

angina or chest pain that occurs at rest, new onset of pain with exertion, or pain that has accelerated (more frequent, longer in duration, or lower in threshold).

V

VA:

Veterans Administration

VAD:

ventricular assist device; a blood propulsion devices or ECCs to assist the failing right or left ventricles

valvuloplasty :

surgical repair of a cardiac valve

valvulotomy :

to make an incision into a diseased and stenosed cardiac valve to increase the valve area

variant angina:

prinzmetal's angina, a clinical syndrome of rest pain and reversible ST-segment elevation without subsequent enzyme evidence of acute MI. In some patients, the cause of this syndrome appears to be coronary vasospasm alone often at the site of an insignificant coronary plaque, but a majority of patients with variant angina have angiographically significant CAD.

vasa vasorum:

the small blood vessels providing nutrient blood flow to large arteries and veins

vascular :

pertaining to blood vessels or indicative of a copious blood supply

vasoconstrict:

the arterioles decrease in diameter restricting blood flow to an organ or portion of the body

vasodilate:

the arterioles increase in diameter allowing more blood flow

vein :

a blood vessel that carries blood toward the heart; veins usually carry deoxygenated blood

vena cava (e):

the large vein(s) collecting the venous return from the head, neck and shoulders (superior vena cava) and the legs and gut (inferior vena cava) draining into the right atrium of the heart

ventilation :

the movement of gas in and out of the lungs to facilitate blood oxygenation and carbon dioxide removal

ventricle :

a small cavity or chamber, as in the brain or heart

right v. the lower chamber of the right side of the heart, which pumps venous bloood through the pulmonary trunk and arteries to the capillaries of the lung

left v. the lower chamber of the left side of the heart, which pumps oxygenated blood out through the aorta to all the tissues of the body

ventriculography:

a procedure for visualization of ventricles of the heart by x-ray after injection of a radio opaque contrast dye.

V fib:

ventricular fibrillation

Von Willebrand Disease :

coagulation disorder caused by lack of or non functional Von Willebrand Factor

VSD:

ventricular septal defect

V tach:

ventricular tachycardia

VWF:

Von Willebrand Factor

W

WBC:

white blood cell(s), leukocyte(s); neutrophils, basophils, esonophils, monocytes, and lymphocytes

WNL:

within normal limits

X

XC:

cross clamp

xenograft :

tissue taken from another species, treated and implanted

Y

Y Connector:

bifurcation junction resembling alphabet "Y" used for dividing or merging the flow through two pieces of tubing

Z

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ASA Glossary of transfusion medicine abbreviations.