Cardio Flashcards
Stroke volume
EDV - ESV
Frank Starling
Increased preload –> increased contractility
Ejection Fraction
Stroke volume / EDV
Increased preload
Increased EDV, stroke volume, and EF
Increased afterload
Increased ESV, decreased stroke volume, decreased EF
Increased contractility
Changes ESPVR
Decreased ESV, increased SV, increased EF
Decreased compliance
Changes EDPVR
Decreased EDV, and increased EDP
Aortic stenosis PV Loop
Increased afterload
Decreased SV
Mitral regurgitation PV loop
Isovolumic contraction is disrupted
Aortic regurgitation PV loop
Isovolumic relaxation is disrupted
Mitral stenosis PV loop
Ventricle can’t fill properly
PV loop looks just slightly smaller than normal
Mitral stenosis murmur
Holodiastolic murmur with an opening snap
Worse = decreased time for opening snap
Louder with expiration
Aortic stenosis murmur
Systolic crescendo-decrescendo
Worse = murmur peaks closer to S2
Radiates to carotids and pulsus parves et tardus
Mitral regurgitation murmur
HoloSystolic
Louder with expiration, handgrip, and squatting
Aortic regurgitation murmur
Symptoms
Diastolic decrescendo
Increased pulse pressure
Louder with expiration and handgrip
Mitral valve prolapse murmur
Late ejection click during systole
Young healthy female/Marfan
Louder w/ Valsalva and standing (low preload)
Carcinoid heart disease
GI or lung tumors that metastasize liver –> serotonin
Flushing, abdominal pain, diarrhea, tricuspid or pulmonic valve disease
Ventral septal defect murmur
Holosystolic murmur
Patent ductus arteriosus
A continuous machine-like murmur
3 things associated with bicuspid aortic valve
Early ejection click
Marfan syndrome
Turner syndrome
Coarctation of the aorta
Atrial septal defect mumur
Fixed S2 split with systolic ejection murmur
S3
Occurs early diastole
Due to high RA pressure usually due to HF
Louder on exhalation
S4
Occurs in late diastole
Due to stiff ventricle
Subclavian steal syndrome
Severe stenosis of the proximal subclavian artery –> reversal in blood flow from the contralateral vertebral artery to the ipsilateral vertebral artery
Left axis deviation
LBBB
Ventricular rhythm
Lead II should be negative
Right axis deviation
RBBB
Right ventricular hypertrophy
Lead I should be negative
Normal PR interval
120-200ms
Normal QRS interval
<120
Cause of short QT interval
Hypercalcemia
Congenital long QT syndrome
Abnormal K/Na channels
Family history of sudden death, pass out recurrently
Sinus rhythm EKG
P waves regular and upright in leads II, II, and F
LBBB EKG
Wide QRS with negative V1
RBBB EKG
Wide QRS with positive V1
Tented T wave
U waves
Hyperkalemia
Hypokalemia
AFib EKG and concerns
No p waves
Irregularly irregular rhythm
Major concern is thrombus formation
Can also cause shock if person has Aortic Stenosis
Pericarditis findings
Diffuse ST elevation and PR depression
Friction rub
Pain worse laying down and better leaning forward
Tamponade
Constriction pericarditis
Restrictive cardiomyopathy
Pulsus paradoxus, electrical alternans, sharp x descent and blunted y
Kussmauls, rapid y descent, pericardial knock
Kussmauls
How to fix an AVNRT
Massage neck –> increase parasympathetic –> decreased conduction through AV node
ST segment depression
Stable/unstable angina (subendocardial ischemia)
ST segment elevation
Transmural ischemia
Prinzmetal angina
MI
Complications of returning blood to dead tissue
Contraction band necrosis (Ca+ --> contraction) Reperfusion injury (O2--> free radicals)
Timeline of microscopic changes after MI
<4 hrs --> no change Within 24 hrs --> coagulative necrosis 1-3 days --> neutrophils 4-7 days --> macrophages 1-3 weeks --> granulation tissue Months --> fibrosis
Timeline of complications after MI
<1 day –> arrhythmia
1-3 days –> pericarditis
4-7 days –> rupture of free ventricular wall, papillary muscle (RCA), or interventricular septum
Months –> aneurysms, mural thrombus, dressler syndrome
Dressler syndrome
Autoimmune pericarditis
VSD
Most common congenital defect
Associated with fetal alcohol syndrome
Complications: pulm HTN and Eisenmenger syndrome
ASD
Associated with Down syndrome
Split S2
Transposition of great vessels
Creates two separate circuits
Can give prostaglandin E to maintain ductus arteriosus
Associated with maternal diabetes
Coarctation of the aorta
Congenital exists between aortic vessels and PDA
Associated with Turner syndrome
Adult: associated with bicuspid aortic valve and rib notching
Hypertrophic cardiomyopathy
Gene mutation in sarcomere genes (beta myosin heavy chain)
Septum blocks LV outflow, arrhythmias, and mitral regurg
Common cause of sudden cardiac death in young athletes
Cardica myxoma histo
Benign mesenchymal proliferation with abundant ground substance
Obstructs the mitral valve
Rhabdomyoma
Benign hamartoma of cardiac tissue that arises in the ventricles of children
Associated with tuberous sclerosis
Dilated cardiomyopathy causes
Coxsackievirus Chagas Muscular dystrophy Doxorubicin Alcohol (beriberi) Pregnancy Hemochromatosis
Restrictive cardiomyopathy signs
Prominent y descent
Kussmaul sign
Restrictive cardiomyopathy causes
Amyloidosis
Sarcoidosis
Lysosomal storage diseases