Cardiac abnormalities

Question 1

Cardiac valve abnormalities cause stenosis upstream or down stream?

Answer 1

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

Question 2

What predominates in edema, hydrostatic or osmotic pressures?

Answer 2

Increase in hydrostatics leads to edema

Question 3

Venules usually have high oncotic or hydrostatic pressure?

Answer 3

higher oncotic pressures (resorption)

Question 4

What are the 4 valve abnormalities of the left heart?

Answer 4

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

Question 5

What is the characteristic signs of aortic stenosis?

Answer 5

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

Question 6

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

Answer 6

Left ventricular hypertrophy due to increase afterload

Question 7

What are the characteristic signs of mitral stenosis?

Answer 7

1. increased pressure in atria during diastole

Question 8

When is the murmur heart in mitral stenosis?

Answer 8

Diastolic murmur

Question 9

What are some of the consequences of mitral stenosis?

Answer 9

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

Question 10

What are the characteristic signs of Aortic insufficiency?

Answer 10

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

Question 11

What happens to EDV and EDP in aortic insufficiency?

Answer 11

Both increased due to leaking

Question 12

When is the murmur heard during aortic insufficiency?

Answer 12

Diastolic murmur

Question 13

What is the primary physiologic consequence of aortic insufficiency?

Answer 13

reduced EF and increased workload

Question 14

What is the characteristic sign of mitral regurgitation?

Answer 14

Left atrial pressure is abnorally high

Question 15

What happens to EDV and EDP in mitral regurg?

Answer 15

Both increase

Question 16

When is the murmur heard in mitral regurg?

Answer 16

Systole which can lead to pulmonary SOB symptoms

Question 17

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

Answer 17

Lead 2

Question 18

What are the consequences of abnormal excitation and conduction?

Answer 18

1. Evokes tachycardia, limits ventricle filling time

2. Reduces SV through decrease myocyte coordination

Question 19

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

Answer 19

1 per second

120 msec

Question 20

How long should a PR interval be?

Question 21

How long should a QT interval be?

Answer 21

Less than half than the R-R interval

Question 22

What are 4 ways to see clinically cardiac abnormalities

Answer 22

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

Question 23

Where do Suprventricular abnormalities originate?

Answer 23

Atria or AV node

Question 24

What is Paroxysmal suprventricular tachy?

Answer 24

PSVT

• Rapid usually regular rhythm
• but comes and goes abrubtly

Question 25

What are some signs and consequences of PSVT?

Answer 25

P and T waves superimposed on one another | - low blood pressure and dizziness

Question 26

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

Answer 26

Sinus arrest

Question 27

What is first degree heart block?

Answer 27

slow conduction causing long PR interval

Question 28

What is 2nd degree heart block?

Answer 28

not all impulses travel through AV node and thus | - thus some but not all P waves are followed by a QRS wave

Question 29

What is 3rd degree heart block?

Answer 29

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

Question 30

What are PAC's?

Answer 30

Early extra beats that originate in the atria

Question 31

What is characteristic of accessory pathway tachycardias?

Answer 31

Delta Waves

Question 32

What are the 3 divisions of AV nodal reentrant tachycardia?

Answer 32

1. Atrial tach 2. Atrial fibrillation 3. Atrial Flutter

Question 33

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

Answer 33

Atrial fibrillation - no P waves - Ventricular rate normal - Atrial depole and repole random

Question 34

What abnormal rhythm is known as the sawtooth rhythm?

Answer 34

Atrial flutter

Question 35

Where do ventricular abnormalities originate?

Answer 35

Ventricles or His-Purkinjes.

Question 36

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

Answer 36

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

Question 37

What are PVCs? Their relation?

Answer 37

Premature ventricular contractions. - Early extra beats - Usually asymptomatic and due to stress, nicotine, caffeine, and exercise - can be HD or electrolyte imbalance

Question 38

What are some characteristics of PVCs?

Answer 38

Large amplitudes and long QRS

Question 39

What is V-Tach? What does it precede?

Answer 39

Ventricular tachycardia - Rapid rhythm from lower chambers of the heart. - Decrease ventricular filling - Ventricular fibrillation

Question 40

What is long QT syndrome?

Answer 40

Longer than 450ms - should be less than 50% of R-R interval (except high HR) - increased risk or Torsades and V-Tach

Question 41

What are some causes of long QT syndrome?

Answer 41

Delayed repolarization - Due to inappropriate Na+ channels opening or prolonged closure of K+ channels - puts at risk for extra stimuli during refractory period

Question 42

What is ventricular fibrillation?

Answer 42

Erratic disorganized firing of impulses from the ventricles | - can discern P waves from QRS

Question 43

When is the ventricle susceptible to fibrillation?

Answer 43

premature excitation at the end of a T-wave