Cardiac Abnormalities--Nordgren

Question 1

Stenosis

Answer 1

inability of valve to open fully

Question 2

Insufficiency

Answer 2

inability of valve to close completely

leads to regurgitation

Question 3

Stenosis can lead to…

Answer 3

hypertrophy

more force required to get blood out

Question 4

Insufficiency can lead to…

Answer 4

chamber dilation

additional volume requireed to get sufficient forward flow

Question 5

Aortic stenosis characteristics

Answer 5

large P difference between LV and aorta

very high interventricular P

low systolic aortic pressure

low pulse pressure

systolic murmur

Question 6

Mitral stenosis characteristics

Answer 6

large P difference across mitral valve during diastole

elevated L atrial P

diastolic murmur

Question 7

Aortic insufficiency characteristics

Answer 7

aortic P falls faster, further during diastole

low diastolic pressure (blood goes into LV intead of through circulation)

large pulse pressure

increased LV EDV and EDP

Question 8

Mitral regurgitation characteristics

Answer 8

high LA pressure

high LV EDV and EDP

Question 9

Two basic types of arrhythmias

Answer 9

supraventricular (originating in atria or AV node)

ventricular

Question 10

Answer 10

paroxysmal supraventricular tachycarida (PSVT)

regular rhythm

begins and ends suddenly

atria drive ventricles at high rate

low BP and dizziness common

Question 11

Answer 11

sinus node dysfunction

ie sinus arrest

abnormal SA node

slow heart rate

Question 12

Answer 12

conduction block

delay/block in pathway from SA node –> ventricles

Question 13

Answer 13

premature atrial contractions

extra early beats originating in atria

Question 14

Answer 14

accessory pathway tachycardia

rapid rhythms

extra, abnormal pathway between atria and ventricles

still goes through His-Perkinje system as well

Question 15

Answer 15

atrial fibrillation

many impulses begin in atria

signals compete for AV node

loss of coordinated atrial contraction

Question 16

Answer 16

atrial flutter

1+ rapid circuits in atria

more regular/organized than a-fib

Question 17

Answer 17

bundle branch block

“hemiblock”

either branch of Purkinje system of interventricular septum

MI is major cause

wide QRS > 120 ms

R wave splitting

not directly physiologically consequential

Question 18

Answer 18

premature ventricular contractions

common

usually benign

if recurrent, may be sign of heart disease

Question 19

Answer 19

ventricular repolarization time elongation

QT > 450 ms and > 50% of cycle

inappropriate Na+ or prolonged K+ channel openings during phase 2

Question 20

Answer 20

ventricular tachycardia (T-tach)

rapid rhythm originating in lower heart chambers

chambers do not fill fully

decreased CO

Question 21

Answer 21

ventricular fibrillation

eratic, disorganized filling of ventricles

CPR + defibrillation

Question 22

Provocation of long QT syndrome can cause this arrythmia

Answer 22

tosade de pointes

life threatening V-tach

QRS cyclically vary in amplitude, around baseline, rapid V-fib