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Cardio Block > Hemodynamic Disorders III > Flashcards

Hemodynamic Disorders III Flashcards

1
Q

The most common cause of right heart failure is:

A

Increase in afterload due to left heart failure. Left heart failure causes increased pressure in pulmponary veins, capillary beds and then pulmonary arteries, which increases the afterload faced by the right heart.

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2
Q

Isolated Right heart failure is usually caused by what>

A

Pulmonary vascular or parenchymal disease.

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3
Q

Cor pulmonale

A

heart disease caused by lung disease

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4
Q

Causes of chronic cor pulmonale

A

pulmonary emphysema, recurrent pulmonary thromboembolism, interstitial lung disease, and ARDS

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5
Q

Clinical manifestations of Right heart failure

A

Lower leg Edema (though this is nowhere near specific for right heart failure), Right upper quadrant pain if blood backed up from the right heart stretches out the liver capsule. Hepatomegally, JVD, ascites, decresased appetite.

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6
Q

Asystole

A

total lack of cardiac pumping.

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7
Q

Slow death from heart failure is associated with what?

A

Increasing dyspnea

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8
Q

Sudden cardiac death is more common in what sex>

A

Males

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9
Q

80% of sudden cardiac deaths are associated with what?

A

Coronary artery disease

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10
Q

Second most common cause of cardia death?

A

hypertensive heart disease.

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11
Q

What is automaticity?

A

a cell’s ability to depolarize itself to a threshold generating a spontaneous action potential

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12
Q

How can myocytes acquire automaticity pathologically

A

Injured myocytes have leaky membranes and lose part of their concentration gradients of ions. This results in a less than normal membrane potential. When that membrane potential is less negative than -60 spontaneous depolarization can occur.

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13
Q

afterdepolarizations in stage 2 or 3 are referred to as early

A

true

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14
Q

Afterdepolarizations in ohase 4 are

A

delayed

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15
Q

afterdeploarization during the long phase 2 can be attributed to

A

increased calcium inflow which is due to defected calcium channels

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16
Q

afterdepolarization during phase 3

A

abnormal sodium inflow

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17
Q

What does the PR interval tell you

A

The length of time it takes a signal to propagate from the SA node through the AV node

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18
Q

Normal PR interval

A

.12-.20 seconds

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19
Q

First degree heart block

A

PR interval longer than .20 secs

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20
Q

QRS interval time

A

usually less than .1 secs

21
Q

wide complex

A

thats how you refer to a wide QRS. Its bad

22
Q

QT interval

A

ventricular repolarization

23
Q

QTc

A

QT interval corrected for heart rate

24
Q

Prolonged QT

A

BAD…most common cause is myocardial ischemia….can also be from blood electrolyte abnormalities

25
Q

how to differentiate sinus tacchycardia from taccharrythmia

A

sinus tacchycardia will not go over a rate of 220-the pts age

26
Q

sinus tacchycardia is not associated with heart disease

A

true

27
Q

atrial fibrillation on an EKG

A

regular rhythm, rate is high or normal, no P waves

28
Q

Most common tachyarrhythmia

A

A Fib

29
Q

Second most common

A

atrial flutter

30
Q

Ventricular tachyarrhthmias are the dangerous ones

A

truth

31
Q

Two major ventricular tacchyarhthmias

A

ventricular tachycardia and ventricular fibrilation

32
Q

ventricular tachycardia QRS

A 
wide QRS (over 120 ms or .12 secs)
If all the QRS complexes look alike, its monomorphic.
If the QRS vary in morphology, its polymorphic
33
Q

Ventricular fibrillation is immediately what

A

lifethreatening

34
Q

Totally disordered rapid stimulation of ventricles

A

Ventricular fibrilation

35
Q

A prolonged QT over how many milliseconds is dangerous

A

440

36
Q

acute cor pulmonale is characterized by what?

A

dilatation of the right heart chambers

37
Q

Chronic cor pulmonale

A

hypertrophy of the right heart….eventually if the workload comes to exceed the capability of the hypertrophied right ventricle it begins to dilate. You get dilation superimposed on hypertrophy

38
Q

What is pulmonary emphysema

A

permanant destructin of airspaces with the elimination of the capillaries in the alveolar walls that have been destroyed. THis is problematic for the heart because you are still pumping the same amount of blood through a decreased vascular bed. Causes increased afterload for the right heart. Can lead to occlusion of the pulmonary arteries.

39
Q

What type of cardiac environment predisposes to re-entry

A

Small pathces of myocardial ischemia or scarring. Re erntry occurs when signals are re-directed around areas of injury and encounter myocytes that are finished with their repolarization and no longer refractory. this abnormally conducted impulse can reenter the normal conduction pathway adding an extra impulse and causing a tacchyarrhythmia.

40
Q

If you see a cardiac conduction block in a young african american, what is it most likely?

A

Cardiac sarcoidosis

41
Q

Explain the conduction pathway after the AV node

A

AV node-> bundle of His -> Left and Right branches of the bundle of His -> Left bundle branch divides into anterior and posterior, right keeps going (now you have threeconducting fiber bundles

42
Q

How many leads are electrocardiograms

A

12

43
Q

How do you differentiate sinus tachycardia from an arrhythmia

A

Sinus tacchycardia will not go over a rate of 220 minus the patients age.

44
Q

Many supaventricular tacchyarrhythmias are innocent

A

truth

45
Q

What is a channelopathy?

A

hereditary diseases of sodium, potassium, or calcium channels

46
Q

Torsades de pointes is a channelopathy and features what?

A

closely spaced QRW complexes twisting around the baseline of the electrocardiogram

47
Q

What is the most common type of congenital long QT syndrome?

A

Type 1. It is caused by mutations in the gene for a subunit of the Iks potassium channel. DOesnt allow potassium to flow out like it should and thus presents problems with depolarization

48
Q

Brugada syndrome

A

young adult asian males. mutation in gene for cardiac sodium channels. Reduce action potential durations. Inverted T wave in leads V1-3 with ventricular fib

Cardio Block (42 decks)

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