Hemodynamic Disorder Lecture 3 Flashcards
Why is infective endocarditis so important?
it is 100% fatal if unDx and unTx and 20% fatal id Dx and Tx appropriately
Right sided infective endocarditis embolus always goes to ____
lung
myocardial abscess
forms when infective embolus goes to CA
What is a normal QT interval corrected for HE, QTc?
<440 miliseconds ***
What are causes of long QT
ischemic heart disease
low K, Ca, or Mg
channelopathy
many other things
What is the risk of early afterdepolairzations (aka long QT)
ventricular tachycardia
What is the risk of ventricualr tachycardia?
What is the preventative treatment for ventricular tachycardia?
sudden death
defibrillator
loss of fucntion in repolarizing outward K channel, I-KS
LQT1 (prolongation of phase 2)
inactivating mutation in Na channel
LQT3 (prolong phase 3)
loss of fucntion in repolarizing outward K channel, I-KR
LQT2
the type of polymorphic ventricular tachycardia typical of congenital LQT syndromes is called
torsades de pointes
What is life saving preventative Tx for torsades de pointes
defibrillator
group of channelopathies causing shorted cardiac myocyte APs –> ventricular tachycardia –> sudden death
brugada syndrome
brugada syndrome is most common in what age/race/gender
young asian males
persistently elevation of ST segments (>2 mm) descending with an upward convexity to an inverted T wave in leads V1-V3
(AT REST)
brugada pattern
Tx of brugada syndrome
defibrillator
mutations in ryanodine receptor
catecholaminergic
polymorphic ventricular tachycardia
What triggers arrhythmias?
high intracell Ca causing delayed afterpolarizations
Life saving-preventative treatment for arrythmias
Beta blockade or defibrillator
how many babies, children, and young adults die of cahnnelopathies each year
4,000
recognizing EKG signs of a _______ could save the life of a young person
channelopathy
Gross: pale mottled flabby dilated heart
viral myocarditis
pale septum
viral myocarditis
muations in genese encofding desomsomal proteins or myocyte adhesion; probably with a 2nd hit
RT ventricular cardiomyopahty
What does right ventricular cardiomyopathy cause?
re-entrant ventricular tachycardia
disease possibly assc with enteric viral infection of the right heart
Rt ventricualr cardiomyopathy
fatty replacement of myocytes frequently with lyphocytic inflitationd and later fibrous scarring
Rt ventricular cardiomyopathy
notch in terminal part of QRS is called ____ and can be a manifestation of ____
epsilon wave
Rt ventricular cardiomyopathy
life saving preventative treatment Rt ventricualr cardiomyopathy
defibrillator
describe the cardiac AP in the left ventricle, what channels are open and what/where ions move
phase 4 (-90): I-K1 moves K+ out of cells
Phase 0 (+10mV): I-Na moves Na+ into cells
Phase 1: I-to1,2 moves K+ out and Cl- out
phase 2: I-Ca-L and I-KS move Ca in and K+ out (at equal rates)
phase 3: I-KS, KR, K1 move K+ out (back to -90mV)
ST segment convex to top
Type 1 ECG brugada sign
ST segment downward straight
Type 1 ECG brugada sign
ventricular tachycardia or ventricular fibrillation during emotional or physical stress from a mutation in SR Ca release channel
familial catecholaminergic
polymorphic ventricular tachycardia
Microscopic: multifocal inflammation, intersitial, usually mononuclear and is assc with myocyte injury and necrosis
*predominant cells are lymphocytes and macrophages
viral myocarditis
