Cardiology Flashcards
Name 2 physiologic arrhythmias
Sinus arrythmia, 1st/2nd degree AV block
Name 3 pathologic arrhythmias
3rd degree AV block
Ventricular Premature Complexes
Atrial Fibrillation
What are 3 DDx/underlying causes of pathologic arrhythmias
Quinidine toxicity
Electrolyte imbalance (K)
Systemic Disease/Inflam
What is the cause of physiologic arrhythmias
Vagally mediated - disappear with exercise
What is S1 associated with?
closure of AV valves
What is S2 associated with?
closure of semilunar valves
What is S3 associated wtih?
Rapid ventricular filling (early diastole)
What is S4 associated wtih?
Atrial depolarisation/kick
List 5 signs of cardiac disease
Poor athletic performance Jugular distension Ventral oedema Pale/cyanotic mm Tachycardia/altered PP
What does QUILTS stand for?
QUality Intensity Location Timing Shape
When are you indicated to tx VPCs?
when they are frequent +/- polymorphic
How do you treat polymorphic VPCs
- tx any underlying cause
- magnesium sulphate bolus
- lidocaine bolus –> CRI
- procainamide 1mg/kg/min CRI (up to 20mg/kg)
- propanolol 0.03mg/kg IV
- propofenone 1mg/kg in 5% D5W over 5min IV
What pathologic heart murmur is excluded if you hear S4
Atrial fibrillation
2 characteristics of supraventricular premature complexes
- Reduced R-R interval
- abnormal, monophasic P waves (usu. bi-phasic)
What are DDx for supraventricular atrial tachycardia
if P waves visible – sinus tachycardia
if P waves not visible - ventricular tachycardia
3 characteristics of atrial fibrillation
- irregularly irregular
- no S4
- variable heart sounds/pulse intensity
2 characteristics of ventricular premature contractions
- no P wave
- wide and bizarre QRS
What do VPCs predispose to?
VPCs –> Vtach –> V.Fib
Describe a Grade 1 heart murmur
a soft murmur audible only careful auscultation in a localised area of the thorax – often inconsistent. (Night time murmur)
Describe a Grade 2 heart murmur
a soft murmur which is clearly audible after a few seconds of auscultation.
Describe a Grade 3 heart murmur
a moderately loud murmur that is immediately audible even if off by 1-2 rib spaces. Similar intensity to S1 and S2.
Describe a Grade 4 heart murmur
a loud murmur that is immed. Audible over a wide area of the thorax w/ no precordial thrill. Radiates.
Describe a Grade 5 heart murmur
the loudest murmur that becomes inaudible when the stethoscope is removed from direct contact w/ thorax. Precordial thrill.
Describe a Grade 6 heart murmur
the loudest murmur that can still be heard when the stethoscope is removed from direct contact w/ thorax + precordial thrill.
What is the difference between pan and holosystolic?
Pan- can’t hear heart sounds
Holo - can hear heart sounds
What are the murmur qualities of mitral valve regurgitation?
Harsh Varied intensity L.apex (radiates dorsally) Holosystolic Band
What are the murmur qualities of tricuspid valve regurgitation?
Blowing-Harsh Varied intensity R. 4th ICS Pansystolic Band
What are the murmur qualities of aortic valve regurgitation?
Musical Varied L.base radiates bilaterally Band, Holo or early diastolic Decrescendo
What are the murmur qualities of VSD?
RIGHT SIDE = LOUD
Pansystolic
Band
LEFT SIDE (Base) = SOFT = relative pulmonic stenosis Systolic Crescendo-Decrescendo
What are the qualities of physiologic/flow murmur?
Soft, blowing
<2 in grade
L.base
Early/short systolic
What is the lead placement to collect an ECG in a horse?
RA = R.scap/R.jug. groove LA = behind L.elbow LH = left neck/scapula, jug. groove
what is a wide P wave indicative of?
L.atrial enlargement
what is a tall P wave indicative of?
R.atrial enlargement
what is a narrow/spiked T wave indicative of?
hyperkaelamia
what does a wide/bizzare QRS complex tell you? Vs. a normal one?
Origin; wide/bizarre - ventricular
vs. normal - supraventricular
what does a P wave w/out a QRS complex tell you?
there is an AV block
What does a QRS complex w/out a P wave tell you?
Ectopic foci
No P wave?
SA block
a 50mm/sec paper means 1 large box = how many seconds
0.1 seconds
a 50mm/sec paper means 1 small box = how many seconds
0.02 seconds
At a paper speed of 25mm/second, count the number of QRS complexes in 6 seconds (usually denoted by black ‘ticks’ on the paper) and multiple by ?
10
At 50mm/second, the same length of strip will be 3 seconds, so multiple the number of QRS complexes by ?
20
An irreg. rhythm w/ abnormal QRS morphology is more likely to be ? in origin.
ventricular
• A changing P wave morphology, normal rate and QRS complex after each P wave, and irreg. rhythm signals a ???? (as the electrical impulse originates in several different areas of the R.atrium that may/may not include the sinus node). Usually vagally-mediated and physiologic. (stops w/ sympathetic drive)
wandering pacemaker
