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CV Module > Hemodynamics III > Flashcards

Hemodynamics III Flashcards

1
Q

What is the most common cause of Right side heart failure?

A

Left side heart failure

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2
Q

How does LHF cause RHF?

A

LHF causees increased pressure in pulmonary veins, capillary beds and then pulmonary arteries which increases Right heart afterload

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3
Q

What is the most common cause of isolated RHF?

A

1.Pulmonary vascular
2.Parenchymal disease
Things like Pulmonary emphysema, recurrent pulmonary thromboembolism, and interstitial lung disease

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4
Q

What is Cor pulmonale?

A

Right heart disease caused by pulmonary hypertensive diseases Things like Pulmonary emphysema, recurrent pulmonary thromboembolism, and interstitial lung disease

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5
Q

What are the characteristics of Acute Cor Pulmonale?

A

Dilation of the right heart chambers

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6
Q

What is the core characteristic of chronic Cor Pulmonale?

A

Right ventricular hypertrophy, with dilation if the workload exceeds its capacity

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7
Q

What do all the diseases that cause Cor Pulmonale have in common?

A

The cause pulmonary hypertension

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8
Q

What are the clinical manifestations of RHF?

A

!.Lower leg edema starting with the feet

  1. Chronic low-grade RUQ discomfort from hepatic hypertension
  2. Ascites (increased abdominal girth)
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9
Q

What are the signs of RHF?

A

Peripheral edema especially of the legs, hepatomegaly, ascites and JVD

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10
Q

What tools are helpful in diagnosing RHF

A

Echocardigraphy

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11
Q

What drugs can work to lower pulmonary blood pressure?

A

Sildenafil (viagra)

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12
Q

What is asystole?

A

Total lack of cardiac pumping

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13
Q

What is slow death from heart failure characterized by?

A

Progressive dyspnea due to pulmonary edema.

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14
Q

How does the incidence of sudden cardiac failure change with age?

A

Increases with age reaching its peak in the elderly

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15
Q

In what gender is sudden cardiac death more prevalent?

A

Males

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16
Q

What is the most common cause of sudden cardiac death?

A

Coronary Artery disease

2.Hypertensive heart disease

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17
Q

What is sudden cardiac death usually due to?

A

Ventricular tachyarrythmia

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18
Q

What is associated with Right ventricular cardiomyopathy?

A

Mutations in the genes for cell adhesion proteins that function in the low resistance gap junctions between myocytes

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19
Q

What is familial catecholeminergic polymorphic ventricular tachycrdia?

A

Mutation in the genes for the Ryanodine receptors

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20
Q

What are afterpolarizations?

A

tAbnormal triggered activity due to abnormal iron fluxes that interrupt repolarization

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21
Q

Afterdepolarizations that occur during phase 2 or 3 are called?

A

Early

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22
Q

Afterpolarization that occurs during phase 4 are called?

A

Delayed

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23
Q

What is the normal cause of Afterrepolarization during phase 2?

A

Increased Calcium inflow which can be due to defective calcium channels

24
Q

What is the normal cause of Afterrepolarization during phase 3?

A

Abnormal sodium inflow due to defective sodium channels

25
Q

What causes delayed after polarizations?

A

High intracellular levels of calcium which can be due to marked catecholamine stimulation

26
Q

What do Afterdepolarizations lead to?

A

Lead to tachyarrhythmias

27
Q

Where is reentrant tachyarrhythmia mostlikely to happen?

A

In an area of patchy myocardial ischemia or scarring

28
Q

What causes reentry?

A

Injured or abnormal myocytes intiating a signal that encounters a pathway of myocytes no longer refractory. The abnormal impulse e

29
Q

Which blocks cause a cessation of conduction of electrical signal from Atria to ventricles?

A

Trifascicular block and AV node blockade

30
Q

What are some of the causes of signal blockade?

A
  1. Myocardial scarring from infarction
  2. Amyloidodid
  3. Sarcoidosis
31
Q

What does sarcoidosis in the heart do?

A

Sarcoidosis in the heart favors the base and this fibrosing disease causes conduction block or arrhythmias especially in young African Americans

32
Q

What causes prolongation of the PR interval?

A

Delays in getting through the AV node most commonly

33
Q

What is the normal PR interval?

A

120-200 milliseconds (0.12 and .20 seconds)

34
Q

What is first degree AV block?

A

PR intervals longer than 200 milliseconds but with all impulses from Atria getting through

35
Q

What is the QT interval?

A

From the beginning of QRS to end of T wave

36
Q

What is the most common cause of prolonged QT interval?

A

Myocardial ischemia also low potassium calcium or magnesium or a channelopathy

37
Q

Where would the defect most likely be with abnormalities in leads V1-V4?

A

Anterior left ventricle served by the left anterior descending coronary artery.

38
Q

Where would the defect most likely be with abnormalities in leads V5-V6?

A

Lateral left ventricle served by the Left circumflex coronary Artery

39
Q

Where would the defect most likely be with abnormalities in leads II, III, and aVF?

A

Inferior left ventricle served by the right coronary artery

40
Q

What does acute blockage of a major epicardial coronary artery present as on the EKG?

A

ST segment elevation

41
Q

What is the ST segment?

A

The portion of the wave between the end of the QRS wave and the T wave

42
Q

What does acute blockage of a major epicardial coronary artery also present as on the EKG?

A

Inverted T wave

43
Q

What are the EKG features of Atrial fibrillation?

A

Irregular rhythm, the rate is high or normal and there are no P waves.

44
Q

What is the cause of Atrial flutter?

A

A reentrant circuit around the tricupid valve

45
Q

What are the features of Atrial flutter?

A

Two P waves for each QRS and yeilds a heart rate around 150 per minute

46
Q

What is the cause of supraventricular tachycardia?

A

Reentrant pathway in the atria right near the AV node

47
Q

What is a home remedy one can do that would help with supraventricular tachycardia?

A

Valsalva manuver, carotid sinus massage or immersion of the face in a pan of ice

48
Q

What is important about Ventricular fibrillation?

A

It is immediately life-threatening

49
Q

What is the cause of Ventricular Fibrillation?

A

Due to fragmentation of the wave of depolarization into numerous tiny wavelets going every which way

50
Q

How would Ventricular fibrillation appear on ECG?

A

Chaotic pattern without discrete QRS complexes

51
Q

What is the treatment for ventricular fibrillation?

A

Electrical defib if not available a punch to the sternum

52
Q

What is the characteristic arrhythmia associated with long QT syndrome?

A

Torsades de Pointes

53
Q

What is the cause of congenital long QT syndrome

A

Mutations in the gene for a subunit of the Iks potassium channel resulting in decreased outward potassium current, which impairs the repolarizing current prolonging the QT interval and allowing early afterdepolarizations

54
Q

In what subset of patients is Brugada syndrome most prevalent?

A

Young adult Asian males

55
Q

What is the cause of Brugada?

A

Genetic mutations in gene for cardiac sodium channel

56
Q

What are the effects of the mutated sodium channels in Brugada

A
  1. Reduced duration of action potentials
  2. Persistently elevated ST segments
  3. Inverted T-Wave in leads V1-V3
  4. Ventricular Fibrillation

CV Module (24 decks)

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