Flashcards in Cardio Deck (106):
cardiac tissue conduction velocity
purkinje system --> atrial muscle --> ventricular muscle --> AV node
"Park AT VENTura AVenue"
conduction delay thru AV node (<200 ms)
ventricular depolarization (<120 ms)
mechanical contraction of ventricles (depol + repol)
T-wave inversion indicates?
U-wave caused be?
preference for Pacemaker activity?
SA > AV > bundle of His/Purkinje/ventricles
conduction pathway of heart?
SA node --> atria --> AV node --> common bundle --> bundle branch --> Purkinje fibers --> ventricles
AV node delay?
100 ms --> allow for ventricular filling
how do ventricles depolarize?
from apex to base and endocardium to epicardium
ST elevation indicates?
QRS interval prolongation indicates?
ventricular dyssynchrony or slowed intraventricular impulse conduction
prolonged QT interval
torsades de pointes
no discrete P-waves
"sawtooth" appearance of waves
no identifiable waves
common cause of Vfib in <30 y.o pt
PR interval prolonged
1st degree AV block
P-wave not followed by QRS complex
2nd degree AV block = Mobitz type I = Wenckebach
distinguishing feature of Wenckebach
progressive lengthening of PR interval until beat "dropped"
2 or more P-waves to 1 QRS complex
Mobitz type II
distinguishing feature of Mobitz type II
not preceded by lengthening of PR intervals
narrow QRS complex
3rd degree AV block (complete)
atria and ventricles beat independently of each other (P waves have no relation to QRS complex)
3rd degree AV block (complete)
atrial rate faster (SA node) than ventricular rate (AV node)
uses accessory pathway (bundle of Kent)
early ventricular depolarization w/ delta waves at beginning of QRS complex
where does ANP work?
medullary collecting tubule
what presents w/ sharp chest that is worsened by inspiration and relieved by sitting up/leaning forward?
striking physical finding of acute pericarditis
kussmaul's sign description + seen in?
INC in JVP on INSPIRATION instead of NORMAL DEC
pulsus paradoxus description + seen in?
dec in amplitude of systolic BP by >= 10 mmHg during INSPIRATION
severe cardiac tamponade
obstructive sleep apnea
bifurcation of abd aorta @ what level?
IVC courses through what?
abdomen and inferior thorax in location ANTERIOR to the right half of the vertebral bodies
renal veins join IVC @ what level?
common iliac veins merge to become IVC @ level
fibrinous pericarditis caused by?
serous pericarditis caused by?
SLE, RA, etc. (noninfectious inflamm dz)
suppurative/purulent pericarditis caused by?
cardiac tamponade triad?
increased venous pressure (JVD)
muffled heart sounds
"tree-bark" appearance of aorta
tertiary syphilis (disrupts vasa vasorum)
cardiac myxomas are ass w/?
multiple syncopal episodes
V1-V4 leads w/ Q waves implies infarct in?
anterior wall (LAD)
V1-V2 leads w/ Q waves implies infarct in?
V4-V6 leads w/ Q waves implies infarct in?
I, aVL leads w/ Q waves implies infarct in?
lateral wall (LCX)
II, III, aVF leads w/ Q waves implies infarct in?
inferior wall (RCA)
Cardiac Output (CO) = ?
HR x SV
CO = rate of O2 consumption/(arterial - venous O2)
PT for? PTT for?
PT = extrinsic
PTT = intrinsic
"my PET uPITT caused me to BLEED"
PET = PT extrinsic (PT less letter, less factors)
PITT = PTT intrinsic (PTT more letters, more factors)
reduced LV compliance indicates what?
diastolic dysfunction ("stiff ventricle")
predom mechanism of HF in restrictive cardiomyopathy
diastolic dysfunction ("stiffer ventricle")
predom mechanism of HF in dilated cardiomyopathy
what can lead to dilated cardiomyopathy?
loudest @ mitral area
aortic/pulmonary valve closure
loudest @ left sternal border
rapid ventricular filling phase
ass w/ increased filling pressures (mitral regurg, CHF) + common in dilated ventricles
normal in children + pregnant women
ass w/ ventricular hypertrophy
high atrial pressure (LA must push against stiff LV wall)
truncus arteriosus forms?
ascending aorta + pulm trunk
bulbis cordis forms?
SMOOTH parts of left/right ventricles (outflow tract)
primitive ventricle forms?
TRABECULATED left/right ventricles
primitive atria forms?
TRABECULATED left/right atria
left horn of sinus venosus forms?
right horn of sinus venosus forms?
SMOOTH part of RA (sinus venarum)
SVC formed from?
right common cardinal vein and right anterior cardinal vein
mean arterial output =
CO x TPR
pulse pressure is proportional to?
factors that increase SV
contractility and SV increased by
increased INTRAcell Ca
decreased EXTRAcell Na
Digitalis (blocks Na/K pump)
contractility and SV decreased by
histo in temporal (giant cell) arteritis?
focal granulomatous inflamm (branches of carotid a.)
histo in Takayasu's arteritis
granulomatous thickening (of media of aortic arch @ branch pts)
histo in polyarteritis nodosa (PAN)
transmural inflamm of arterial wall w/ fibrinoid necrosis (except in lungs)
weird tx in Kawasaki dz
aspirin (bc never given to children)
histo in Buerger's dz (thromboangiitis obliterans)
segmental thrombosing vasculitis (necrotizing vasculitis involving digits) - often of tibial/radial a.
histo in microscopic polyangiitis
segmental fibrinoid necrosis (can be caused by AB use - penicillins)
histo in Wegeners granulomatosis (granulomatosis w/ polyangiitis)
focal necrotizing vasculitis
necrotizing granulomas in lung
histo in Churgg-Strauss synd
granulomatous necrotizing vasculitis w/ eosinophilia (diff from MP)
histo in Henoch-Schonlein purpura
vasculitis 2ndary to IgA complex depositions
ECG changes in V1-V4, V5
LAD (anterior wall)
ECG changes in V1-V2
ECG changes in I, aVL
LCX (lateral wall)
ECG changes in V4-V6
ECG changes in II, III, aVF
RCA (inferior wall)
common cause of death BEFORE reaching hospital in MI pts
common cause of death in pt hospitalized for MI
cardiogenic shock (esp if large infarct)
cardiac tamponade in post-MI pt
ventricular wall rupture (up to 14 days after)
severe mitral regurg in post-MI pt
papillary muscle rupture
new VSD in post-MI pt
interventricular septum rupture
embolus from mural thrombus in post-MI pt
ventricular aneurysm formation (common 1 wk after)
friction rub 1-3 days after MI
pulmonary wedge pressure is pretty equivalent to?
murmurs heard @ right 2nd ICS adjacent to sternum (aortic area)
aortic stenosis (radiates to neck [carotids])
aortic valve sclerosis
murmurs heard @ left sternal border
aortic regurg (if caused by aortic root dilation, heard best @ RIGHT sternal border)
murmurs heard @ left 2nd ICS adjacent to sternum (pulmonic area)
systolic ejection murmurs!
flow murmur (ex. ASD [mid-systolic ejection murmur])
murmurs heard @ left 4th ICS adjacent to sternum (aka "left lower sternal border" or the tricuspid area)
tricuspid regurg (radiates to right sternal border)
murmurs heard @ left 5th ICS at midclavicular line (apex of heart) (mitral area)
mitral regurg (radiates toward axilla)
MVP (late systolic crescendo w/ midsystolic click; loudest @ S2)
murmur heard @ left infraclavicular region
valsalva increases intensity of what murmurs
MVP, hypertrophic cardiomyopathy
rapid squatting decreases the intensity of what murmurs
MVP, hypertrophic cardiomyopathy
in pacemaker action potential, what phase determines HR and how
slope of phase 4 (Na channels)
increasing afferent baroreceptor firing does what to HR?