CARDIAC CONDITIONS & ECG Flashcards
What is the acronym used to place leads for an ECG?
Snow over trees
Smoke over fire
Chocolate for your heart
Snow = white, trees = green, smoke = black, fire = red, choc. = brown
What is considered the pacemaker of the heart? Why?
Yes there is a reverse of this question. Need to know it both ways!
The SA node (pace for SA node)
It signals the heart to pump.
What is the SA node of the heart refered to as? Why?
Yes there is a reverse of this question. Need to know it both ways!
The pacemaker of the heart.
It signals the heart to pump.
What is considered the gate keeper of the heart? Why?
Yes there is a reverse of this question. Need to know it both ways!
The AV node
It controls rate of blood flow in the heart.
What is the AV node of the heart also called? Why?
Yes there is a reverse of this question. Need to know it both ways!
The gate keeper
It controls rate of blood flow in the heart.
What does the bundle of his do in the heart?
not sure if this is that important
Transfers electrical impulses to the right & left bundle branches.
On an ECG strip…
What does the P wave represent & look like?
How long is it?
above or below isometric line?
Atrial depolarization / contraction
Dome above isometric line
0.06-0.12 sec
On an ECG strip…
What does the QRS complex represent / look like?
How long is it?
Ventricle depolarization / contraction
Spike below, above, below iso line
0.06-0.12 sec
On an ECG strip…
What does the T wave represent / look like?
Ventricle repolarization / relaxation
Largest dome above iso line
On an ECG strip…
What does the PR interval represent?
How long is it?
From atrial depolarization to ventricle depolarization
0.12-0.20 sec
On an ECG strip…
What does the QT interval represent?
How long is it?
Time for left ventricle to contract and relax
Depolarize & repolarize
0.4-0.44 sec
On an ECG strip…
What does the ST segment represent?
How long is it?
Time for ventricle to repolarize after depolarization ends
0.08-0.12 sec
On an ECG strip…
What does the J point represent / look like?
Represents the end of ventricle depolarization: start of ST segment.
How long is each small box on a 6 second strip?
0.04 seconds
How long is each big box on a 6 second strip?
1 second
How do you determine the artial & ventricular rate on a 6 sec strip?
Atrial: count the P waves within the 6 sec.
Ventricular: count the R points within the 6 sec.
Times both by 10 to get a per minute value.
On a 6 second strip …
How do you identify the rhythm?
What is a regular rhythm called?
Measure the distance between points; if they are all equal it is regular.
Regular rhythm = sinus
What is infective endocarditis?
Infection in the heart valves and/or endocardial surface of the heart.
Endocarium is the inner most layer of the heart.
What are the classifications of IE?
Why is this important?
Left sided native OR prosthetic valve = emboli can travel to brain, limb, kidneys, liver, spleen, vascular.
Right sided IE = emboli can travel to the lungs.
Think of complications and side effects associated with left vs. right!
What typically causes infective endocarditis?
How?
Bacterium, mostly.
Anything that enters the body: PIC line etc.
What are some symptoms of Infective endocarditis?
Flu-like symptoms; fever
Murmurs
Petechiae (subacute)
P = small broken blood vessels appearing as small red purple dots.
What is typically used to treat infective endocarditis?
Long term antibiotics: aminoglucosides (-myocin’s)
What diagnostic tests should be done to confirm IE & its bacterium?
What is an important piece of this?
Obtain TWO sets of blood cultures
60 minutes apart
Keep sample for 2 weeks!
Bacteria can grow in the sample and appear when tested later.
What should be monitored when treating IE with antibiotics?
Monitor for Auto and Renal toxicity
What is acute pericarditis?
Inflammation of the outside layer of the heart.
Pericardium has fluid.
What is the connection between MI and acute pericarditis?
Acute pericarditis can develop hours after an MI. Sometimes weeks.
What are the manifestations associated with acute pericarditis?
Pulses paradoxus - SBP decreases by 10+ mmHg with inspiration.
Pleuritic pain (chest) - sharp & severe
Pericardial friction rub - scratching high pitch sound
Dyspnea
The 4 P’s! (dysPnea) + some S’s
What is the goal when treating acute pericarditis?
What is the treatment?
GOAL = reduce inflammation
1. Colchicine
2. NSAIDs
3. Pericardiocentesis
Corticosteroids are last resort
What are the possible complications of acute pericarditis?
Pericardial effusion = excess fluid in pericardium which can result in…
Cardiac tamponade = increased pressure on the heart and vessels.
What is myocarditis?
What does it effect?
Inflammation of the muscle layer of the heart = myocardium.
Effects the hearts ability to contract efficiently.
What are some symptoms of myocarditis?
- Infection symptoms: Fever, fatigue, nausea / vomitting
- Remember muscle issues = arrythmias… this hurts…
- Chest pain w/ Pericardial friction rub + Effusion
- SOB: cannot circulate oxygen!
- Possibly Heart failure symptoms
What is a common complication of myocarditis?
What are the manifestations?
The development of heart failure from decrease in cardiac output.
Symptoms of excess fluid: crackles, edema, extra heart sound.
What is the goal when treating myocarditis?
Focus on treating the symptoms heart failure / preventing it
