Lecture 2 Flashcards
Systole
Atrial contraction Isovolumetric contraction Rapid ejection Reduced ejection Isovolumetric relaxation Rapid filling Reduced filling
How long does a contraction last
200- 300ms
Effects of increased HR
Decreased diastole
Same systole
Diacritic notch
Aortic pressure increased transiently due to transient back flow that closes valve
A wave
Atrial systole
C wave
Mitral valve closes causing an increase in pressure
Xd
X descent
The atrial pressure transiently decreases as the base of atrial is pulled down when the ventricles contract
V wave
Atrial pressure gradually increases due to venous return
Yd
Y descent
Atrial pressure decreases as mitral valve opens
EDV
End diastolic volume
Max filling of ventricles
IVC
Isovolumetric contraction
No change in ventricular volume
All valves closed
ESV
End systolic volume
Lowest ventricular volume
After rapid ejection (systole)
After ESV
Rapid filling as mitral valve opens
Diastasis
Last 10% of filling due to atrial contraction
IVR
Isovolumetric relaxation
Decline in pressure
Volume stays the same
All valves are closed
Diastasis
Rate of filling decreases as ventricles reach inherent relaxed volume
90% full
S1
All valves closed
Lub
Before Q wave
S2
All valves closed
Dub
After T wave
S3
Normally silent
Ventricular filling
Normal in children
Pathological in adults
Stenosis
Valve doesn’t open enough - narrowed
Obstruction to blood flow
Regurgitation
Valve doesn’t close properly
Back flow
Causes of aortic stenosis
Degenerative - senile calcification and fibrosis
Congenital - bicuspid
Chronic rheumatic fever - inflammation and commissary fusion of leaflets
Effects of aortic stenosis
LV hypertrophy Left sided heart failure Syncope - fainting Angina Microangiopathic haemolytic anaemia
Crescendo-decrescendo heart murmur
Aortic valve regurgitation
Aortic root dilation - leaflets pulled apart Endocarditis Rheumatic fever (valvular damage)
Effects of aortic regurgitation
Increase in SV - increased systolic pressure
Left ventricle hypertrophy
Bounding pulse (head bobbing and Quinke’s sign)
Early decrescendo diastolic murmur
Mitral valve stenosis
Rheumatic fever
Mitral stenosis effects
Increased left atrium pressure
Pulmonary oedema
Dysopnea - difficult breathing
Pulmonary hypertension
RV hypertrophy
Left atrial dilution - atrial fibrillation, thrombus formation
- oesophagus compression, dysphagia
Diastolic rumble
Mitral valve regurgitation causes
Myxomatous degeneration - weakened tissue that prolapses
Damaged papillary muscles post MI
Left sided heart failure - LV dilation stretches valves
Rheumatic fever
Pansystolic (holosystolic)
Effects of mitral regurgitation
Increased preload
LV hypertrophy
Holosytolic murmur
