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21 Cards in this Set
- Front
- Back
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atrio-ventricular ring
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support structure for mitral and tricuspid
insulates atria and ventricles from electric signals - means only electrical activity can go down the his bundle |
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sinus node dysfunction
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persistent bradycardia
weakness, fatigue, decrease exercise tolerance see sudden pauses - greater than 3 seconds -> syncope (stokes-adams attacks) |
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electrical conduction system of the heart
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SA node -> atrial muscle -> AV node -> bundle of his
bundle of his -> RBBB + LBBB LBBB -> Left posterior fascicle + left anterior fascicle |
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AV node
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acts like a filter - for atrial conductions to pass through to venticles
slow, decremental conduction Ca++ channel dependent |
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left bundle branch block conduction pathway
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damage in the left bundle branch prevents signals from passing through
electrical conduction must got through RBB conduct through the RV and into the LV widened QRS complex |
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right bundle branch block conduction pathway
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must conduct through LBB -> septum -> LV -> RV
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causes of his bundle/bundle branch blocks
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ischemia
calcific valvular disease |
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causes of AV node dysfunction
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ischemia
congenital iatrogenic drugs neural mediated normal/athletes |
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2nd degree AV block Mobitz type 1 - site of dysfunction in conduction system
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likely in AV node if normal QRS
if BBB then it can be in AV node or in His bundle or bundle branch |
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2nd degree AV block Mobitz type 2 - site of dysfunction in conduction system
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likely below the AV node in distal conduction system
risk of complete heart block |
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paroxysmal supraventricular tachycardia
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tachycardia induced through an abnormal electrical pathway
the abnormal pathways allow signals sent down the conduction pathway to pass through the ventricles and back up into the atria and to the AV node creating a cycle of conduction doesn't stop until there is a refractory state that breaks the cycle - can use medications to increases refractory state of AV node (verapamil, adenosine) can use catheter ablation to destroy the abnormal conducting pathway |
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atrial fibrillation vs flutter
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both don't see p-waves
atrial fib - irregularly irregular - chaotic flutter - has a repeating sawtooth pattern - more organized |
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treatment of afib
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slow ventricular rate - diltiazem (watch for bradycardia after sinus conversion)
block AV node - digitalis, b-blocker, ca-blocker terminate the attack - quinidine, flecainide, aniodarone, ibutilide, (anti-arrhythmics) shock |
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afib complications
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STROKE - clot formation - embolism
put afib patients on coumadin |
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ventricular tachycardia/ventricular fibrillation
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VERY BAD
need shock anti-arryhthmic drugs - lidocaine, amiodarone cardiac compressions, IV epinephrine |
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hypertensive heart
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weight > 500g
LV thickeness > 2cm concentric thickening - reduction in chamber size microscopic - boxcar nuclei in enlarged myocytes, interstitial fibrosis |
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cardiac hypertrophy
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increased work -> increased size/wall thickness
eventually with decompensate due to volume overload -> dilation and stretching (dialated hypertensive heart) risk factor for sudden death, arrhythmias, aortic aneurysm, cerebral infarct |
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left sided heart failure
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will see effects of right heart failure as right sided heart failure is caused by left sided failure
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right sided heart failure
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rare in isolation
its caused by left sided heart failure most common cor pulmonale "heart lung" - increased resistance of blood flow through lung -> right side hypertrophy -> failure |
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cor pulmonale
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pulmonary fibrosis or emphysema -> increased resistance through pulmonary vessels -> right sided hypertrophy -> failure
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T/F atrial diatation can cause atrial fibrillation
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true
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