CV II Flashcards
normal split
P2 delayed
increased venous return on inspiration
-longer RV ejection time
wide splitting
exaggerated normal split
-with delay RV emptying
fixed splitting
in atrial sepal defect
L > R shunt - increased RV volume - delay P2 closure
paradoxical split
P2 before A2
inspiration - P2 closer to normal - eliminate split
-paradoxical split
VSD listening
tricuspid
ASD listening
tricuspid
systolic at left sternal border
hypertrophic cardiomyopathy
continuous left infraclavicular
PDA
holosystolic blowing radiate to axilla - loudest at apex
mitral regurg
holosystolic blowing radiate to right sternal border
tricuspid regurg
systolic crescendo with midsystolic click
mitral valve prolapse
heard over apex
predispose infective endocarditis
can be caused by myxomatous degeneration
myxomatous degeneration
ehler danlos, marfan
predispose to mitral valve prolapse
blowing early diastolic decrescendo
aortic regurg
diastolic with opening snap
mitral stenosis
opening snap - halt in leaflet motion in diastole - rapid opening due to fusion at leaflet tips
continuous machine like
PDA
severity of mitral stenosis
corresponds to time between S2 and OS
shorter - worse
myocardial AP
0 - Na (fast) 1 - K 2 - Ca 3 - K 4 - resting - K
cardiac node cells
depolarize during diastole spontaneously
-If - funny current - slow mixed Na/K inward current
gap junctions
cardiac myocytes
-at intercalated discs
pacemaker AP
4 - If - Na and K
slow diastolic depolar - Na conductance increase
-slope = HR
0 - open Ca channels
-Ca - slow conduction velocity - at AV node
3 - K efflux
U wave
hypokalemia
speed of conduction
fast - purkinje atria ventricle AV node
park at ventura avenue
J point
junction end of QRS and start of ST
drug induced long QT
antiarrhythmic - IA and III macrolides haloperidol TCAs ondansetron
long QT
predispose torsades
congenital long QT
romano ward - auto dom - no deafness
jervell and lange neisen - auto recessive - deafness
defect ion channel
-increased risk of torsades
romano ward syndrome
congenital long QT
-auto DOMINANT
no deafness
jervell and lange neisen syndrome
congenital long QT
- auto RECESSIVE
- has deafness
brugada syndrome
auto dom
asian male
-pseudo right BBB and ST elevation V1-3
prevent with implantable pacer
WPW complication
supraventricular tachycardia
-from re-entrant circuit
delta wave
WPW
tx A-fib
catheter ablation
sawtooth
binge drinking holiday heart
A-fib
V-fib tx
defibrillation
AV block 1st degree
prolonged PR
AV block 2nd degree, type 1
mobitz type I - wenckebach
longer PR intervals - then dropped
AV block 2nd degree, type 2
mobitz type II
pattern of dropped QRS
PR same
AV block 3rd degree
complete
P and QRS independent
lyme disease complication
3rd degree block
ANP
from atria - act via cGMP
vasodilation
decreased Na reabsorption
dilate afferent renal arterioles
nesirtide
recombinant BNP
tx of HF
