Cardiovascular Flashcards
What is SAN?
dominant pacemaker with intrinsic rate of 60-100 bpm
What is the fastest depolarising tissue?
SAN
What are ventricular cells?
back-up pacemaker with intrinsic rate of 20-45 bpm
ECG: what does one small box represent (horizontally)
0.04s
ECG: what does one large box represent (horizontally)
0.2s
ECG: what does one large box represent (vertically)
0.5mV
Heart sounds: S1?
mitral + tricuspid valve closure
Heart sounds: S2?
aortic + pulmonary valve closure
Heart sounds: S3?
In early diastole during rapid ventricular filling.
Normal in children + pregnant women.
Associated with mitral regurgitation + heart failure.
Heart sounds: S4?
‘Gallop’, in late diastole.
Produced by blood being forced into a stiff hypertrophic ventricle.
Associated with LV hypertrophy.
Where is the left ventricle (apex beat) palpated?
5th intercostal space at midclavicular line
Define preload
Volume of blood in LV which stretches cardiac myocytes before LV contraction; how much blood is in ventricles before it pumps (EDV)
Define afterload
Pressure LV must overcome to eject blood during contraction
Define elasticity
Myocardial ability to recover normal shape after systolic stress
Define diastolic distensibility
Pressure required to fill ventricle to same diastolic volume
Define aneurysm
if there is a permanent dilatation of the artery to TWICE the normal diameter (normal = 2cm)
List arteries from aorta –> peroneal
aorta –> common iliac –> external iliac –> internal iliac –> common femoral –> superficial femoral –> popliteal –> anterior tibial / posterior tibial / peroneal
Give an example of an alpha-1 adrenreceptor blocker
Doxazosin
Give an example of a centrally acting antihypertensive
Methyldopa
Give an example of a direct renin inhibitor
Aliskiren
Equation summarising BP control?
CO x peripheral resistance = BP
What are Class 1 anti-arrhytmics?
sodium channel blockers (e.g. Flecainide)
What are Class 2 anti-arrhytmics?
non-selective beta-blockers (e.g. Propanolol)
selective beta-1 blockers (e.g. Bisoprolol)
What are Class 3 anti-arrhytmics?
prolong action potential (e.g. Amiodarone, Sotalol)
What are Class 4 anti-arrhytmics?
CCBs (e.g. Amlodipine, Verapamil, Diazepam)
MOA of Digoxin?
inhibits Na/K pump
Outline the Vaughan Williams classification of anti-arrhythmics
Classes 1 + 3 = RHYTHM control
Classes 2 + 4 = RATE control
State the 2 types of cardiac natriuretic peptides
Atrial natriuretic peptide (ANP)
B-(brain) natriuretic peptide (BNP)
What are cardiac natriuretic peptides metabolised by?
neutral endopeptidase (NEP)
State 3 drugs that inhibit NEP (to increase levels of cardiac natriuretic peptides)
Sacubitril, Valsartan, Entresto
State 2 nitrate medications
Isosorbide mononitrate
GTN (spray/infusion)
