Cardiology Bundle branch blocks/Ventricular hypetropy Flashcards
What do the Bundle branches divide into
The left bundle branch goes down and splits into the Left anterior fascicle and the left Posterior Fascicle
The right bundle branch does not have any extra bifurcations of the bundle branch
What happens to the cells in a bundle branch block
the bundle branches are like fast highways, travelling the impulse quickly. However cardiac myocytes can still depolerise eachother in a wave like motion going from cell to cell it just takes longer
The cells in the bundle branch that aren’t blocked can deloperise, and then this impulse can filter through to the other non depolerised cells
What are Hemi blocks (fasicular blocks)
These only occur in the left bundle branch
ethier the left posterior fasicle or the left anterior fasicle
What are some causes of bundle branch blocks
What are 2 main concerns for bundle branch blocks
Left bundle branch blocks are more concerning from right bundle branch blocks
Bundle branch block can hide AMI
They also have the potential to deteriorate into complete heart blocks
What does a right bundle branch block look like
We get a widened QRS
In V1 we get a RSR pattern this is becuase we see the 2 paths of the depolerization coming from both the left anterior and left posterior fasicle
In lead V6, we will see slurred S waves
What is our criteria for our left bundle branch block
We see these daggered Q and or monomorphic R waves because there is only one fasicle for the right bundle branch
What is the criteria for a left anterior fascicular block
What is the criteria for a left posterior fasicular block
What do Concordant and Discordant mean?
Concordant = Same direction
Discordant = opposite direction
These are used in the Smith-Modified Sgarbossa criteria
What is Sgarbossa criteria
This is criteria for detecting an AMI in left bundle branch blocks
- Concordant ST elevation >-1mm in 1 lead
(STE going in the same direction as QRS) - Concordant ST depression >- 1mm in 1 lead of V1-V3
(STD going the same direction as the QRS)
Excessive Discordant ST elevation of >5mm in leads with neg QRS
(IMPORTANT discordent STE can be a normal finding it is >5mm when it is a concern)
What is the Sgarbossa criteria and Smith modified sgarbossa criteria
These both look at AMI in Left bundle branch blocks
The Smith modified scarbossa criteria is just a little more specific and alters some steps
What is the difference between Eccentric hypertropy and Concentric hypertropy
What goes on with out physiological changes in hypertropy
What is dangerous in pathological hypertropy
This is can be caused by constant demand or acute MI. It causes the myocytes to diw and be relaced with fibrotic material (losses its strech capabilities)
What are the criteria for Left ventricular hypertropy
What are the criteria for right ventricular hypertrophy
What does pericarditis look like on an ECG
