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Flashcards in Cardiac abnormalities Deck (43)
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1
Q

Cardiac valve abnormalities cause stenosis upstream or down stream?

A

Upstream
-Thus right side - systemic
Left side- pulmonary capillaries have increased pressure

2
Q

What predominates in edema, hydrostatic or osmotic pressures?

A

Increase in hydrostatics leads to edema

3
Q

Venules usually have high oncotic or hydrostatic pressure?

A

higher oncotic pressures (resorption)

4
Q

What are the 4 valve abnormalities of the left heart?

A
  1. Mitral valve insufficiency and stenosis
  2. Aortic insufficiency and stenosis
    - similar conditions can occur on the right
5
Q

What is the characteristic signs of aortic stenosis?

A
  1. Subnormal aortic pressure due to increased ventricular pressure
  2. Low pulse pressure
  3. high ejection velocity of blood leads systolic murmur
6
Q

What are the consequences can rise from aortic insufficiency and what is its cause?

A

Left ventricular hypertrophy due to increase afterload

7
Q

What are the characteristic signs of mitral stenosis?

A
  1. increased pressure in atria during diastole
8
Q

When is the murmur heart in mitral stenosis?

A

Diastolic murmur

9
Q

What are some of the consequences of mitral stenosis?

A

Left atrial hypertrophy which can lead to pulmonary edema due to congestion leading to SOB

10
Q

What are the characteristic signs of Aortic insufficiency?

A
  1. Aortic pressure falls faster than normal during diastole
  2. low diastolic pressure
  3. Large pulse pressure
11
Q

What happens to EDV and EDP in aortic insufficiency?

A

Both increased due to leaking

12
Q

When is the murmur heard during aortic insufficiency?

A

Diastolic murmur

13
Q

What is the primary physiologic consequence of aortic insufficiency?

A

reduced EF and increased workload

14
Q

What is the characteristic sign of mitral regurgitation?

A

Left atrial pressure is abnorally high

15
Q

What happens to EDV and EDP in mitral regurg?

A

Both increase

16
Q

When is the murmur heard in mitral regurg?

A

Systole which can lead to pulmonary SOB symptoms

17
Q

Which lead can usually dx any excitation problems in the heart?

A

Lead 2

18
Q

What are the consequences of abnormal excitation and conduction?

A
  1. Evokes tachycardia, limits ventricle filling time

2. Reduces SV through decrease myocyte coordination

19
Q

How frequent should QRS complexes show up and how long is its normal duration ?

A

1 per second

120 msec

20
Q

How long should a PR interval be?

A
21
Q

How long should a QT interval be?

A

Less than half than the R-R interval

22
Q

What are 4 ways to see clinically cardiac abnormalities

A
  1. HR
  2. Rhythm
  3. Site of origin
  4. Complexes on EKG
23
Q

Where do Suprventricular abnormalities originate?

A

Atria or AV node

24
Q

What is Paroxysmal suprventricular tachy?

A

PSVT

  • Rapid usually regular rhythm
  • but comes and goes abrubtly
25
Q

What are some signs and consequences of PSVT?

A

P and T waves superimposed on one another

- low blood pressure and dizziness

26
Q

What it called when you have a 3 second pause or more without a heart beat?

A

Sinus arrest

27
Q

What is first degree heart block?

A

slow conduction causing long PR interval

28
Q

What is 2nd degree heart block?

A

not all impulses travel through AV node and thus

- thus some but not all P waves are followed by a QRS wave

29
Q

What is 3rd degree heart block?

A

No impulses are transmitted through the AV node. His is default ventricular pace make and thus atrial and ventricle are completely dissociated.
- P waves have no correlation with QRS complexes

30
Q

What are PAC’s?

A

Early extra beats that originate in the atria

31
Q

What is characteristic of accessory pathway tachycardias?

A

Delta Waves

32
Q

What are the 3 divisions of AV nodal reentrant tachycardia?

A
  1. Atrial tach
  2. Atrial fibrillation
  3. Atrial Flutter
33
Q

What is a result of many disordered impulses competing to travel through the AV node leading to loss of coordinated atrial contraction?

A

Atrial fibrillation

  • no P waves
  • Ventricular rate normal
  • Atrial depole and repole random
34
Q

What abnormal rhythm is known as the sawtooth rhythm?

A

Atrial flutter

35
Q

Where do ventricular abnormalities originate?

A

Ventricles or His-Purkinjes.

36
Q

What is EKG characteristics of a bundle branch block? Where do they originate

A
  1. often due to MI
  2. Widing of QRS more the .12 secs
  3. Splitting of R wave
    - usually inconsequential and occur in septum or Purkinjes
37
Q

What are PVCs? Their relation?

A

Premature ventricular contractions.

  • Early extra beats
  • Usually asymptomatic and due to stress, nicotine, caffeine, and exercise
  • can be HD or electrolyte imbalance
38
Q

What are some characteristics of PVCs?

A

Large amplitudes and long QRS

39
Q

What is V-Tach? What does it precede?

A

Ventricular tachycardia

  • Rapid rhythm from lower chambers of the heart.
  • Decrease ventricular filling
  • Ventricular fibrillation
40
Q

What is long QT syndrome?

A

Longer than 450ms

  • should be less than 50% of R-R interval (except high HR)
  • increased risk or Torsades and V-Tach
41
Q

What are some causes of long QT syndrome?

A

Delayed repolarization

  • Due to inappropriate Na+ channels opening or prolonged closure of K+ channels
  • puts at risk for extra stimuli during refractory period
42
Q

What is ventricular fibrillation?

A

Erratic disorganized firing of impulses from the ventricles

- can discern P waves from QRS

43
Q

When is the ventricle susceptible to fibrillation?

A

premature excitation at the end of a T-wave