Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
58 Cards in this Set
- Front
- Back
|
Normal Axis
|
upright QRS Lead I and aVF
|
|
|
Left Axis Deviation
|
Lead I UP aVF DOWN
|
|
|
Right Axis Deviation
|
Lead I DOWN aVF UP
|
|
|
Irregular Rhythm, ventricular rhythm
|
no P before each QRS
|
|
|
AV block
|
PR>200msec or P and NO QRS after
|
|
|
LBBB
|
QRS>120 no R in V1 tall R in I V5 and V6
|
|
|
RBBB
|
QRS>120 RSR' complex WIDE R in V1 QRS with S pattern in I V5 V6
|
|
|
Long QT syndrom
|
QTc>440 msec undiag. cong. disorder predisposes to VTACH
|
|
|
Wave forms Q > 40 (or >1/3 QRS)
|
= Old MI
|
|
|
Wave forms T inverted
|
Ischemia
|
|
|
Chamber enlargement RAA hypertrophy
|
P amp > 2.5 Lead I
|
|
|
Chamber enlargement LAA
|
P width Lead II > 120 msec
|
|
|
Chamber enlargement LVH
|
R in aVL+S in V3 >_24mm Men >_20 Women
|
|
|
Chamber enlargement RVH
|
rt axis dev and R wave V1.7mm
|
|
|
Treat afib is ABCD
|
Anticoag, BBB-rate, Cardioconvert-CCB, Digoxin
|
|
|
Dilated cardiomyopathy
|
Most common cardiomyopathy
|
|
|
Whats req for Dx of Dilated CM
|
LV dilation + Sys dysfx (Low EF)
|
|
|
Cause of DCM
|
most idiopathic, alcohol, wet beri beri, coxsackie, Chagas, parasites, cocaine myocarditis, doxorubicin, HIV AZT
|
|
|
2 MCC of 2nd DCM
|
ischemia and Long standing HTN
|
|
|
HX/PE DCM
|
gradual CHF, Cardiomegaly S3 gallop TVR and MVR
|
|
|
Dx DCM
|
Echocardiograph is Diagnostic
|
|
|
ECG changes in DCM
|
nonspecific ST-T , Low volt. QRS, Sinus Tachy, ectopy, LBBB common
|
|
|
CXR of DCM
|
enlarged, balloon like heart and Pulm congestion
|
|
|
S3 Gallop signifies
|
end of rapid ventricular filling in setting of fluid overload in DCM
|
|
|
Tx of DCM
|
stop OH, treat sx of CHF=diurectic, ACEIs, BB, Anticoags dec risk of thrombus, ICD if EF <35%
|
|
|
Hypertrophic CM
|
LVH cant relax and fill (diastolic dysfx)
|
|
|
Hypertrophy frequently involves
|
IV septum-->LV outflow obstruction and impaired ejection of blood
|
|
|
IHSS
|
idiopathic hypertrophic subaortic stenosis
|
|
|
IHSS inheritance
|
auto dominant 50% risk
|
|
|
IHSS is MCC of
|
sudden death in young, healthy athletes in US
|
|
|
Other causes of Marked Hypertrophy of heart
|
HT, AS
|
|
|
HX of HCM
|
asymptomatic, syncope, dyspnea, palpitation, angina, suddent cardiac death
|
|
|
PE of HCM
|
MR, sustained apical pulse, S4, Systolic ejection crescendo-decrescendo louder with dec preload (valsalva, squatting)
|
|
|
obstruction in HCM made worse by
|
inc. myocardial contractility or dec LV filling (exercise, valsalva, vasodilators, dehydration)
|
|
|
S4 signifies
|
stiff ventricle, and inc "atrial kick" assoc with HCM
|
|
|
Dx of HCM
|
Echocardiography is diagnostic shows THICKENED LV walls and dynamic obstruction of BF
|
|
|
ECG changes of HCM
|
LVH
|
|
|
CXR changes of HCM
|
LA enlargement from MR
|
|
|
Tx of HCM
|
BB first therapy for sx relief, CCB second line
|
|
|
TX of HCM
|
surg option for IHSS=dual chamber pacing, partial excision of myocard, ICD, avoid intense athletics
|
|
|
Restrictive CM
|
Dec elasticity of myocardium-->impair diastolic filling without significant systolic dysfunction (EF nl or slight dec)
|
|
|
Causes of RCM
|
infiltrative disease (sarcoid, hemochrom
|
|
|
Hx/PE of RCM
|
Left and Rt side HF, RHF sym (JVD, Peripheral edema) predominate
|
|
|
DX of RCM
|
CXR and Echo NON diagnostic, Cardiac Bx->show fibrosis or infiltrates
|
|
|
ECG changes with RCM
|
LBBB
|
|
|
Tx of RCM
|
symptoms, diuretics for fluid overload, vasodilators to dec filling pressure, Anticoags of no CI
|
|
|
CHF is a clinical syndrome caused by
|
inability of heart to pump enough blood for O2 needed by hrt and periph tissue
|
|
|
CHF risk factors
|
CAD, HTN, CM, valve disease, DB
|
|
|
Systolic dysfx leading to HF
|
dec EF by 50% and inc LVEDV
|
|
|
Cause of syst. dysfx HF
|
inadequate ventricular contractility or inc afterload
|
|
|
Mechanism of HF in syst dysfx HF
|
hrt compensates for low EF and inc PL through hypertrophy and ventricular dilation (FSlaw) then fail, lead to inc myocard work and worse sys fx
|
|
|
Hx/PE systol HF
|
dyspnea** MC and earliest sx, chronic cough, fatigue, PND, Cheyne-stokes, abd. fullness
|
|
|
CHF is a
|
CLINICAL Syndrome based on Sign and Sxs
|
|
|
Stages of CHF
|
ABCD
|
|
|
A of CHF
|
high risk for CHF NO structural or fx or SS
|
|
|
B of CHF
|
struct heart disease(MI hx, LVSys Dysfx, Valve disease) but NO sym of CHF
|
|
|
C of CHF
|
structure + sx (dyspnea, fatigue, dec exercise tol)
|
|
|
D of CHF
|
Marked sx of CJF despite max treatment
|
