Download CCN Cardiac and Vascular Terminology Reference Guide

Cardiac and Vascular Terminology
Medical terms are often used interchangeably by clinicians, frequently using acronyms in
replace of the full terms. These terms may be confusing to non-clinicians entering data into the
Registry. In an effort to provide clarity and context for the terminology used in the Registry, this
document is created with brief definition and/or explanation of the commonly used terms.
Generic Medical Terms
Diagnostic – refers to a procedure or test used to find out information on what is happening to
the patient; a test is considered ‘diagnostic’ e.g., a blood test is diagnostic as it can indicate if
you do or do not have something in your blood (such as an infection or low blood cell count).
Treatment or Therapeutic – used to treat the diagnosis, for example, antibiotics are used to
treat infections.
Cardiac Related Terms
Abdominal Aortic Aneurysm (AAA or ‘triple A’) – a bulging of the wall of the major artery
(aorta) in the abdomen. Over time aneurysms may grow and rupture.
Ablation – is the process of creating scar to destroy the specific area in the heart causing the
patient’s problem (e.g., atrial fibrillation or abnormal heart rhythm). The two types of ablation
are catheter and surgical. Catheter ablation uses extreme heat or cold with the use of
specialized catheters while surgical ablation utilizes small incisions or cuts to scar the tissue
(e.g., Maze procedure).
Atherosclerosis - is the build-up of material (e.g., cholesterol) called plaque inside the lining of
the blood vessels which over time become thick and hard.
Angina Pectoris (also called angina or chest pain) - chest pain that usually occurs as a result of
restriction of blood flow to the heart due to coronary artery disease.
Angiogram or Coronary Angiogram or Cardiac Catheterization (also called ‘cath’) – is a
diagnostic procedure involving the injection of ‘dye’ into the coronary arteries to determine the
presence and extent of blockages. Angiogram can also be done in other arteries such as in the
legs, kidneys, and brain.
Angioplasty (see PCI) – a procedure where the plaque in the arteries is ‘pushed’ out of the way
by a balloon to restore blood flow.
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Annuloplasty Ring – a device that is implanted around an existing damaged valve to restore
normal shape and function.
Antiarrhythmic Agent - group of drugs used to treat various heart arrhythmias.
Anticoagulant – a class of medication that reduces or impairs the ability of the blood to form
clots. This group of drug is also called ‘blood thinners’.
Aortic Valve Stenosis (AS) – is the narrowing of the aortic valve which limits the hearts ability to
eject blood from the heart’s left ventricle to the rest of the body.
Aortic Valve Repair (AVR) – is an open surgery to repair or replace the aortic valve.
Aorto-Iliac – involving the aorta and iliac arteries.
Arrhythmias – refer to any heart rhythm abnormality.
Atria - refers to the top 2 chambers of the heart that collect blood i.e., the left and right atria.
Atrial Fibrillation (AF or A Fib) - a type of arrhythmia where the top chambers of the heart
(atria) have disorganized activity resulting in fast and irregular beat. Atrial fibrillation is the
most common cardiac rhythm disturbance.
Atrial Flutter (A Flutter) - a type of arrhythmia that is characterized by abnormally rapid but
regular atrial activity. A Flutter can be identified with the ‘sawtooth’ pattern of p waves on an
ECG.
Atherosclerotic Plaque - a collection of fatty substances, cholesterol, and cellular waste
products that can build up on the inner lining of an artery.
Atrial Tachycardia – a type of arrhythmia with an abnormally fast atrial rhythm. This may also
result in abnormally fast ventricular response.
Atrial Ventricular Node Ablation (AV node ablation) - the AV node is located in between the
upper (atria) and lower (ventricle) chambers on the right side of the heart. This AVN tissue
slightly delays the electrical signal from the top chambers (atria) to allow the bottom chambers
(ventricle) to fill with blood. Some patients with atrial fibrillation have a fast ventricular
response that is unable to be controlled with medication. Treatment with AVN ablation is
accomplished with radiofrequency ablation where the AVN tissue is destroyed. The destruction
of the tissue removes the electrical connection between the top and bottom heart chambers
which requires the implantation of a permanent pacemaker.
©Cardiac Care Network of Ontario
Automatic External Defibrillator (AED) – a defibrillator with built-in capability to determine the
patient’s heart rate and rhythm based on which the machine provides a shock or no shock
advice. AEDs are usually placed in the community (malls, airports, ice rinks) for lay persons to
use until EMS arrives.
Balloon Angioplasty (or angioplasty; also called ‘POBA – plain old balloon angioplasty’) – is
the use of a balloon-tipped catheter in which the balloon is inflated at the site of blockage (or
plaque) inside an artery, stretching the intima and ‘pushing’ the plaque towards the wall of the
artery.
Beta- Blocker - a group of drugs that block the B- adrenergic system responsible for the
increased cardiac action. This drug is used to control heart rhythm, treat angina, and reduce
blood pressure. This is one of the main drugs used for CAD patients to help reduce the
workload of the heart.
Biventricular Pacing (Bi- V Pacing) - this is another term for cardiac resynchronization therapy
(CRT) where both the right and left sides of the heart are paced to allow for a coordinated heart
contraction.
Bradycardia- a type of arrhythmia that occurs when the heart beats slower than normal.
Blood pressure (BP) – is a measurement of the force of blood against the artery walls. The
blood pressure consists of two readings: the systolic (upper #) and diastolic (lower #)
pressure. The systolic measurement is the maximum blood force against the artery, and the
diastolic measurement is the minimum force against the artery.
Cardiac Arrest - is the sudden, abrupt loss of heart function. Most cardiac arrests occur when
the electrical impulses in the heart become rapid (ventricular tachycardia) or chaotic
(ventricular fibrillation) or both. The abnormal heart rhythm causes the heart to suddenly stop
beating. Cardiac arrest may be reversed if treated within a few minutes by cardiopulmonary
resuscitation (CPR) and electric shock (defibrillation).
Cardiac Output- the amount of blood that is pumped by the heart to the body in 1 minute. The
average cardiac output is 5-6 Litres/minute.
Cardiac Resynchronization Therapy (CRT) - this device is used in heart failure patients to pace
the right and left sides of the heart to help coordinate the heart’s contractions. The device can
provide pacing alone to the heart’s right and left sides. This device can also cardiovert or
defibrillate (deliver electric shock) in case of abnormally fast heart rhythms.
©Cardiac Care Network of Ontario
Cardiopulmonary Resuscitation (CPR) – provided to a patient that has had a sudden cardiac
arrest. Involves chest compressions with or without ventilation.
Cardiomyopathy - is a disease of the heart muscle. This causes the muscle of the heart to
become weakened (enlarged and/or stiff), resulting in the inability of the heart to meet the
body's demands. There are several types of cardiomyopathy, with dilated cardiomyopathy
being the most common.
Cardioversion – is the application of an electrical shock to convert an abnormally fast heart
rhythm back to normal. This therapy can performed using an external defibrillator or through
an implantable cardioverter-defibrillator (ICD) and cardiac resynchronization (CRT) devices.
Congestive Heart Failure or Heart Failure (CHF; HF) - the inability of the heart to pump
effectively to meet the body's demands. With the heart’s impaired ability to pump blood to
other organs, fluid may accumulate in the lungs and other tissues causing swelling of the hands,
legs and feet.
Coronary Arteries- these arteries surround the heart which supply the heart muscle with
oxygenated blood.
Coronary Artery Disease (CAD) - is the result of atherosclerosis which is the most common
form of heart disease. It occurs when the plaque within the heart arteries become hardened
causing partial or complete blockage.
Coronary Artery Bypass Graft (CABG) - a type of open heart surgery that transplants a section
of a blood vessel from another part of the body (usually the leg or chest wall) to make a detour
around a blockage in a coronary artery. The procedure can be done while circulation is
supported by a heart-lung machine (cardiopulmonary bypass machine or ‘pump’) or as an "off
pump" procedure. “Off pump” surgery is also called ‘beating heart’ surgery.
Defibrillation – treatment for pulseless ventricular tachycardia (very fast heart beat) or
ventricular fibrillation where pads/ paddles applied either externally on the chest wall or
internally directly to the heart (if chest is open during open heart procedure or via an ICD).
Defibrillation is the delivery of unsynchronized electrical current to attempt to treat VF and
pulseless VT.
Dilated Cardiomyopathy - a disease of the heart muscle that causes it to become
oversized. This enlargement does not allow the heart to effectively contract and pump blood.
Echocardiogram (Echo) – an ultrasound (using sound waves) to create moving pictures of the
heart. Uses a wand on the outside of chest (transthoracic echo) or a probe inserted in the
©Cardiac Care Network of Ontario
esophagus (transesophageal echo) to create moving images of the heart and examine its
function. This is considered a diagnostic test.
Ejection Fraction (EF) - is a measure of how well the heart pumps blood with each heartbeat. It
is expressed as the percentage of blood that the heart ejects in one heartbeat. Ejection fraction
of 55-70% is considered normal.
Electrocardiogram (ECG/EKG) – is a recording of the electrical activity of the heart. This is
considered a diagnostic test to identify abnormality in the heart. Sometimes referred to as a
“12 or 15-lead ECG” depending on the number of leads used to record the tracing.
Electrophysiology (EP) – is the field of study focusing on diagnosing and treating abnormal
electrical activity within the heart.
Electrophysiology Study (EPS) – a test used to diagnose or identify the source of a heart rhythm
disturbance. Several catheters are inserted through a vein (sometimes also include the artery)
and advanced into the heart. The catheters have electrodes that detect the heart’s electrical
system and are recorded.
Emergency Medical Services (EMS) – a community-based emergency personnel who respond
to 911 calls (fire, police, ambulance).
Endovascular Aortic Repair (EVAR) – the insertion of a large stent graft in the aorta to cover
the area of the bulge (i.e., aneurysm or dissection) through a catheter- based procedure. TEVAR
refers to an EVAR procedure performed in the first part of the aorta called the thoracic aorta.
Facilitated Angioplasty (Facilitated PCI) –a planned PCI (percutaneous coronary intervention)
after the administration of fibrinolytic (clot-busting drug) therapy for a patient with ST elevation
myocardial infarction (STEMI).
Fibrinolysis – the therapy with clot dissolving drugs also referred to as thrombolytic therapy
(e.g., tenecteplase or TNK).
Heart Block - a group of heart rhythm disorders where the electrical signals originating in the
heart’s nodes (sinoatrial (SA) or atrioventricular (AV)) get blocked or delayed to the
ventricle. Types of heart block include first, second, and third degree. Treatment of a heart
block can be the implantation of a pacemaker.
Heart Failure (HF) - occurs when the heart cannot efficiently pump enough blood to the
body. Some of the more common reasons heart failure can occur are related to damage to the
heart muscle caused by heart attack or cardiomyopathy.
©Cardiac Care Network of Ontario
Holter – is a battery-operated external recorder of electrocardiograms (similar to an ECG only
on a smaller scale – not 12 leads) that is applied to a patient for 24 to 48 hrs. Information on
the patient’s heart activity is recorded on the device which is later analyzed.
Iliac Arteries – branch of the aorta and are the two major arteries that supply blood
(circulation) to the legs.
Implantable Cardioverter- Defibrillator (ICD) - is a device that is implanted in patients to
prevent the risk of sudden cardiac death. This device has the ability to deliver synchronized and
unsynchronized electrical shock to convert an abnormal and fast heart rhythm back to normal
as well as pace the heart if it beats too slowly.
Implantable Loop Recorder (ILR or loop; also called Cardiac Monitor Recorder (CMR)) - is a
small device that is implanted under the skin of patients that have syncope (fainting or other
symptoms such as palpitations) to determine if the cause of symptoms is from an abnormal
heart rhythm. Information on the patient’s heart activity is recorded on the device which is
later analyzed.
Left Ventricular Assist Device (LVAD) - this device is used for patients who have poor
ventricular function or needs hemodynamic support. The pump may be located inside the heart
(catheter-based heart pump e.g., Impella device) or outside the body (surgically-inserted LVAD).
The surgically-inserted device can allow a heart transplant patient to be discharged from
hospital until a donor heart becomes available.
Left Ventricular End Diastolic Pressure (LVEDP) – the pressure in the ventricle at the beginning
of ventricular contraction. This pressure reflects the ability of the left ventricle to receive blood
from the left atrium during diastole.
Minimally Invasive – surgery that is done through small skin incisions instead of a larger
opening.
Mitral Regurgitation (MR) - is the backward flow of blood from the left ventricle into the left
atrium caused by the inability of the mitral valve to open and close efficiently and/or
appropriately.
Myocardial Infarction (MI) - is another term for a heart attack. MI occurs as a result of a
blockage of the coronary arteries which stops blood from flowing to the heart muscle. MI
results in cardiac muscle/tissue death and scarring.
Morbidity – incidence of ill-health or disease state.
Mortality rate - number of deaths usually expressed per 1,000 people.
©Cardiac Care Network of Ontario
NYHA - New York Heart Association. NYHA has four categories or classes to classify heart
failure patients, with NYHA 1 being the mildest form of heart failure and NYHA IV as the most
severe form of heart failure.
Operating Room (OR) - a room designed and equipped for the purpose of performing open
surgical procedures.
Pacemaker (PPM or permanent pacemaker) - is a device that is implanted in the chest to
prevent the heart from beating too slowly. The device is connected to a lead or leads that are
placed in the heart to send an electrical signal which causes the heart to contract. The
pacemaker usually has a sensor that can detect how active patients are and adjust the heart
rate as needed.
Percutaneous Coronary Intervention (PCI) - a type of heart procedure that includes a balloon
angioplasty (percutaneous transluminal coronary angioplasty or PTCA) and stent implantation.
The balloon is used to open a blocked artery while the stent is used to help keep the artery
open after the balloon is removed. PCI may also include procedures such as rotablation,
thrombectomy, and atherectomy.
Prolapse – see Valve prolapse
Primary Percutaneous Coronary Intervention (PPCI) - is an emergency procedure in which an
angioplasty (with or without stent and/or thrombectomy) is performed to reopen lifethreatening blocked arteries for patients with an ST elevation myocardial infarction (STEMI).
Peripheral – refers to areas away from the core of the body (in arms, legs, etc.) e.g., peripheral
angiogram.
Remote Patient Monitoring - a patient with an implantable device may have the ability to be
monitored in a remote location such as their home. Information may be sent via telephone or
internet to a monitoring station to have the information from the device evaluated.
Renal – pertaining to the kidneys.
Renal Denervation (RND) – is a catheter-based procedure where the renal nerve is ‘burned’
using radio frequency in attempt to treat persistent and resistant high blood pressure.
Reperfusion- Restoration of blood flow to an area that was ischemic (without sufficient blood
supply), in the heart, this is usually due to a myocardial infarction or blocked artery.
©Cardiac Care Network of Ontario
Revascularization- a procedure or treatment undertaken to restore blood flow to ischemic
areas due to weakened or blocked arteries. This can apply to coronary arteries as well as other
areas of the body (e.g., arteries in the legs, brain, kidneys).
Stent - a metal tube or mesh that is inserted into an artery to prevent constriction and closure.
Sudden Cardiac Death - is an unexpected death caused by cardiac issue.
ST Elevation Myocardial Infarction (STEMI) – is the most serious form of heart attack. The ECG
tracing shows the ST interval is higher than the baseline. This, together with symptoms of
angina may indicate STEMI which requires immediate and sometimes aggressive treatment.
STEMI is treated by restoring circulation to the heart, called reperfusion therapy, by angioplasty
(PPCI) and/or thrombolysis (with drug called TNK).
Tachycardia - refers to a heart rate that beats too fast. Tachycardia could be a normal response
to exercise or abnormal where a patient may feel palpitations, dizziness, or may lose
consciousness. Tachycardia can originate in the upper chambers (atria) or lower chambers
(ventricles).
Transcatheter Aortic Valve Implantation (TAVI) - this procedure treats patients with aortic
stenosis that are not suitable for replacing the aortic valve through conventional open heart
surgery. A prosthetic valve is delivered via a catheter usually inserted in the femoral artery at
the groin and placed into the aortic valve position. The valve can also be placed in the aortic
valve area through techniques such as transapical (through the bottom of the left ventricle),
direct aortic (DA) or subclavian artery.
Thrombolysis – is the administration of a ‘clot-dissolving’ drug (e.g., TNK).
Thrombus - a blood clot that is formed within the body.
Transesophageal Echocardiogram (TEE) is a special type of echocardiogram or heart
ultrasound. The echo probe is inserted into the esophagus to obtain a view from behind the
heart.
Tilt Table Test - is done to determine the cause of syncope (fainting). The test is usually done
with a patient lying down on the test table which is tilted upright, to specific angles or to a
standing position. The heart rate and blood pressure of the patient will be monitored. A test is
considered positive if the patient's symptoms are reproduced when the table is tilted upright.
Valve Prolapse - occurs when the valves of the heart are unable to close properly but instead
collapse backward into the heart chamber.
Valve Regurgitation – occurs when the valves of the heart do not close properly as in valve
prolapse, and regurgitation or backward flow of blood occurs.
©Cardiac Care Network of Ontario
Valve Stenosis – occurs when the valves of the heart is a narrowed preventing the efficiently
flow of blood through the narrowed valve opening.
Valve Surgery (Tricuspid, Mitral, Aortic, and Pulmonic) – is a surgery to repair the valves of the
heart that are diseased or not functioning properly. Repairs or replacement of valves can be
done through conventional open heart surgery, or through a minimally invasive transcatheter
approach. The valves can be repaired using sutures and rings, or be replaced with a mechanical
or tissue valve.
Ventricle - refers to the bottom 2 chambers of the heart (the heart’s ‘pump’), the left and right.
Ventricular Tachycardia (VT) - is a type of arrhythmia with rapid ventricular rate in the range of
100-300 beats/min; a life-threatening heart rhythm. A patient with VT may be pulseless or with
a pulse.
Ventricular Fibrillation (VF) - a type of arrhythmia with very rapid, disorganized, ventricular
rate in the range of 200-300 beats/min; a life-threatening heart rhythm. VF may be the rhythm
during a cardiac arrest which requires immediate defibrillation.
©Cardiac Care Network of Ontario