Cardiovascular Wk 3

Question 1

Ectopic Supraventricular Rhythms

Answer 1

Thythms that begin from an ectopic foci in, usually in the atria

Question 2

Atrial Premature Beats (APBs or PACs)

Answer 2

Seen in normal hearts or in organic pathology. Caused by emotion, fatigue, alcohol, tobacco, coffee, or other stimulants. Sx: palpitations. ECG: Premature P waves different from normal configuration, QRS complex normal, mb narrow, might not conduct to the ventricles.

Question 3

Atrial Escape Beats

Answer 3

Occur after long sinus pauses or arrest. Slow HR, abnormal P wave, shorter PR interval.

Question 4

Wandering Atrial Pacemaker

Answer 4

Multifocal atrial rhythm. Irregularly irregular, caused by random discharge from multiple ectopic foci in the atria. Elevated HR. In hypoxic or lung dz individuals. ECG: differing P waves from beat to beat (3+ morphologies)

Question 5

Infective Endocarditis

Answer 5

Bacterial/fungal infxn of endocardium. Occurs most often in L side of the

Question 6

Subacute Bacterial Endocarditis

Answer 6

Usu from Strep, sometimes Staph. Insidious onset. Vague sx of fatigue, low fever ,night sweats, wt loss, arthralgias, and valve insufficiency. PE may show *Petechiae and *Osler’s nodes on digits, *Roth spots in eyes, Janeway lesiosn, splinter hemorrhages on nails.

Question 7

Acute Bacterial Endocarditis

Answer 7

Usu Strep of Staph, maybe fungi after valve replacement. Abrupt & rapid, fever, toxic appearance,

Question 8

Noninfective Endocarditis

Answer 8

Platelet & fibrin thrombi on cardiac valves & endocardium in response to trauma, vasculitis, etc. Dx w/echocardiography & blood cultures. **Vegetations on echo & negative blood cultures are diagnostic!

Question 9

Pericarditis

Answer 9

Inflammation of pericardium, oft w/fluid accumulation. May result in pericardial effusion or cardiac tamponade. Sx include chest pain, pericardial friction rub, tamponade, htn, shock, or pulmonary edema. **Worse w/thoracic motion, better sitting up, leaning forward. **Dx: Elevated ST segment. Echocardiogram shows pericardial effusion or thickened pericardium.

Question 10

Pericardial Effusion

Answer 10

Muffled heart sounds, pericardial rub, might have decreased breath sounds & crackles. Dx: CXR shows enlarged cardiac silhouette, ECG shows decreased QRS voltage.

Question 11

Cardiac Tamponade

Answer 11

Like cardiogenic shock - Decreased CO, low arterial pressure, tachycardia, dyspnea. BP may fall, pulse may disappear (pulsus paradoxicus), muffled heart sounds. DX: Low voltage on EKG, echo if time allows. **DX &TX = immediate pericardiocentesis