Midterm Study Guide Flashcards
The rate pressure product, or double product, is a clinically useful tool to estimate the myocardial oxygen demand and is calculated by multiplying ____ by _____ blood pressure. During aerobic exercise, heart rate and systolic blood pressure are the two main factors determining the workload on the heart. If these factors increase, the heart has to work (less harder/harder) and will require (less/more) oxygen and nutrients to keep going, requiring greater
myocardial blood flow.
heart rate; systolic; harder; more;
1) Know the formula for Cardiac Output, Mean Arterial Pressure MAP, Blood Pressure, Pulse pressure.
CO = __ X __
An adequate volume of blood must be ejected out of the heart to sustain life and activity. The
cardiac output reflects the volume of blood ejected out of the left ventricle into the
systemic vasculature per minute. It is a function of the number of heartbeats per minute
(heart rate) and the volume of blood ejected per beat (stroke volume). On average, the
cardiac output at rest is between 4 and 6 L/min to allow for sufficient tissue perfusion.
SV=(___ - ____ )
The (RPP/SV) is the volume of blood ejected out of the heart per beat and is affected by the preload, contractility, and the afterload.
MAP = ___
Normal MAP: - mmHg
The mean arterial pressure (MAP) is the average arterial blood pressure during a single cardiac cycle, and it reflects the hemodynamic perfusion pressure of the vital
organs. The MAP is the average pressure
tending to push blood through the circulatory system, and it reflects the tissue perfusion
pressure.
The MAP is the same in all parts of the cardiovascular system when the patient is (supine/prone). The MAP is closer to the (systolic/diastolic) than the (systolic/diastolic) pressure because the duration of
diastole is greater than that of systole. The MAP is not, therefore, a true arithmetic mean
of systolic and diastolic pressures, but rather slightly less than the average of the two pressures. The acceptable MAP varies between 70 and 110 mm Hg
MAP (less/more) than 60 mmHg can result in decreased perfusion of vital organs.
Consult with the medical team if MAP less than 65 mmHg to determine appropriateness of activity.
Blood pressure= ___ X ___
“Blood pressure is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system.”
Pulse pressure = __ - ___
Pulse pressure is the difference between systolic and diastolic blood pressure. It is measured in millimeters of mercury. It represents the force that the heart generates each time it contracts.
HR X SV; EDV-ESV; SV; {(2xDBP) + Systolic} / 3 ; 70-110; supine; diastolic; systolic; less; CO X TPR; SBP - DBP
2) Know the Definitions of: Paroxysmal nocturnal dyspnea, orthopnea, preload, afterload.
Paroxysmal Nocturnal Dyspnea
Another common complaint of individuals suffering from CHF is paroxysmal nocturnal
dyspnea (PND), in which sudden, unexplained episodes of shortness of breath occur as patients with CHF assume a more (upright/supine) position to sleep.
5 After a period of time in a
supine position, excessive fluid fills the lungs. Earlier in the day, this fluid is shunted to
the lower extremities and the lower portions of the lungs because upright positions and activities permit (more/less) effective minute ventilation (V) and perfusion (Q) of the lungs
(correcting the V/Q mismatch) and the effects of gravity keep the lungs relatively fluid free. Individuals who suffer from PND frequently place the head of the bed on blocks or
sleep with (less/more) than two pillows. Patients with marked CHF often assume a sitting
position to sleep and are sometimes found sleeping in a recliner instead of a bed.
Orthopnea - describes the development of dyspnea (difficulty breathing) in the recumbent position. Sleeping with two or more pillows elevates the upper body to a more upright position and enables gravity to draw excess fluid from the lungs to the more distal parts of the body. The severity of CHF can sometimes be inferred from the number of pillows used to prevent orthopnea. Thus the terms two-, three-, four-, or more pillow orthopnea indirectly allude to the severity of CHF (e.g., four-pillow orthopnea suggests (more/less) severe CHF than two-pillow orthopnea). Cannot lay (upright/supine) - Never lay pt with heart failure flat or have feet in the air. Fluid will be drained into heart that is already overflooding with fluid Orthopnea is the sensation of breathlessness in the recumbent position, relieved by sitting or standing. Paroxysmal nocturnal dyspnea (PND) is a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.
Preload- blood returning to the heart (LVEDP/LVESP) a reflection of the volume of blood returning to the heart. It is often correlated with the end-(diastolic/systolic) volume (EDV), which is the maximum amount of blood that can be in the ventricles immediately before contraction. In normal cardiovascular physiology, the preload is directly proportional to the (hr/stroke volume). In other words, as more blood returns to the heart, a greater volume of blood leaves the heart with every contraction. Two physiologists, Otto Frank and Ernst Starling, demonstrated an intrinsic property of heart muscle to increase stroke volume based on the precontractile myocardial cell length. Within physiologic limits, the strength of ventricular contraction resulting in increased stroke volume varies proportionally to its precontraction length. This length is influenced by the volume of blood in the ventricles before contraction. This is termed the Frank–Starling mechanism and in summary explains how a greater volume of blood is ejected out of the ventricles when a (greater/lesser) volume of blood is returned to the heart (Fig. 2-15). Clinically the term preload, directly influenced by the EDV, refers to the amount of stretch, or load, on the myocardial wall before contraction (precontraction).
The left ventricular end-diastolic pressure is often referred to as the (preload/afterload). This filling pressure (the pressure in the LV before the ejection of the stroke volume) is analogous to the pulling backward on the rubber band of a slingshot before releasing the rubber band to eject an object
Afterload- Blood flows from areas of high pressure to areas of low pressure. Therefore to enable blood to be ejected out of the ventricle into the aorta, the pressure generated within the ventricle must (be less than/exceed) the pressure within the systemic vasculature. The pressure within the arterial system during the diastolic phase of the cardiac cycle, while the heart is filling, is a function of the total peripheral resistance. An increase in the total peripheral resistance increases the pressure within the systemic vasculature. The afterload is a reflection of the pressure against which the heart has to contract to pump blood into the aorta. The total peripheral resistance presents a hindrance to the ejection of blood from the ventricles or represents an afterload on the ventricular wall after contraction has begun (Fig. 2-17). The afterload is inversely proportional to the stroke volume. Thus an increase in the afterload or total peripheral resistance (increases/reduces) the amount of blood ejected with each contraction. It is valuable to note that a reduced stroke volume from an increased afterload triggers compensatory mechanisms to maintain the cardiac output at a normal level of approximately 5.5 L/min. Initially, as blood has greater difficulty being ejected because of an increase in the afterload, a greater volume of blood builds within the ventricle, triggering the Frank–Starling mechanism and a resultant greater myocardial contraction to help increase the stroke volume. An inability of the heart to compensate in this way leads to congestive heart failure and a compensatory (decrease/increase) in the heart rate to maintain the cardiac output at a normal level of approximately 5.5 L/min. The resistance (or afterload), therefore, is essentially the peripheral vascular resistance. Much of the treatment for CMD involves lowering both the preload and afterload of the cardiovascular system.
supine; more; more; more; supine; LVEDP; diastolic; stroke volume; greater; preload; exceed; reduces; increase;
3) Know what high levels of potassium, RBC, and hematocrit cause
Potassium - Dangerously low levels of potassium (lower than 3.5 mEq/L) can cause serious, life-threatening (arrhythmias/contractility of the myocardium). Dangerously high levels of potassium (greater than 5.0 mEq/L) can affect the (arrhythmias/contractility of the myocardium). Heart can beat irregularly which can lead to failure. Often due to kidney disease because the kidneys can’t remove the excess potassium from your blood.
RBC - cause (polyurethra/polycythemia): too many RBC. with too many cells in the blood, blood becomes (flexible/viscous) and can clog smaller vessels and capillaries.
Hematocrit - Elevated hematocrit levels suggest that the flow of blood to the tissues may be impeded because of an (decrease/increase) in the viscosity of the blood. Elevated hematocrit levels are often seen in individuals with (CHF/chronic obstructive pulmonary disease) (a response to chronic low PO2 ).
arrhythmias; contractility of the myocardium; polycythemia; viscous; increase; COPD
4) Understand regional differences in ventilation perfusion and optimal V/Q matching
For optimal respiration or gas exchange to occur, the distribution of gas (ventilation, abbreviated V) and blood (perfusion, abbreviated Q) at the level of the alveolar capillary interface must be (different/matched). Position plays a vital role in the distribution of ventilation and perfusion to different aspects of the lung. In the upright position, gravity allows for a (lesser/greater) amount of blood flow or perfusion to the base of the lung relative to the apices. In addition, alveoli in the upper portions or apices of the lung have greater RV of gas and are subsequently larger. The larger alveoli have greater surface tension and have relatively more difficulty inflating because of less compliance than the smaller alveoli toward the base of the lung. In light of this, ventilation and perfusion are relatively greater toward the base of the lung, favoring better matching and resultant respiration or gas exchange. A change in the position of the patient changes areas of ventilation and perfusion. Generally, greater ventilation and perfusion occur in gravity (dependent/independent) areas. Supine is the worst, prone is better, upright is the best.
An effective noninvasive tool to measure respiration is the pulse oximeter. It is important for clinicians to monitor pulse oximeter readings and observe for signs of distress when changing patient positions that alter the V/Q matching. Abnormal V/Q ratios cause concomitant (reductions/improvements) in pulse oximetry that are noted in patients with pneumonia, pulmonary embolus, edema, emphysema, bronchitis, and other pulmonary disorders.
Shunt: when (greater/lesser) perfusion compared to ventilation
Dead space: (greater/lesser) ventilation compared to perfusion
(Pulse ox/Arterial blood gas) (ABG) - Gold Standard
matched; greater; dependent; reductions; greater; greater; ABG;
Oxygen Disassociation Curve
Right-shifted curve: Implications: (increased/reduced) oxygen affinity, (increased/decreased) oxygen delivery to tissues Caused by: (low/high) pH (more acidic/acidemia) (low/high) temperature (low/high) 2-3 BPG (Low/High) O2 affinity Hb variants (Low/High) 2,3-diphosphoglycerate
Left-shifted curve: Implications: (reduced/increased) oxygen affinity, (increased/reduced) oxygen delivery to tissues Caused by: (Adult/Fetal) Hb (HbF) (low/high) pH (more basic/alkalemia) (low/high) temperature (low/high) 2-3 bisphosphoglycerate (BPG) Methemoglobinemia (Low/High) O2 affinity Hb variants
A shift to the right means the hemoglobin is releasing oxygen at a higher rate – caused by ^^^ C – carbon dioxide A – acidic /adidemia D – diphosphoglycerate E – exercise T – temperature CADET face right Alll of these cause a right hand shift – oxygen is offloaded to hemoglobin at a higher rate
Left-shifted curve – hold on to more oxygen
reduced; increased; low; high; high; Low; High; increased; reduced; Fetal; high; low; low; High
6) What pleura are innervated and where referred pain would be located?
Parietal Pleura is innervated by the (vagus/phrenic) nerve and (intercostal/spinal accessory) nerve.
The referred pain from the parietal pleura would be to the thoracic level of the (intercostal/spinal accessory) nerve, (feet/neck), (triceps/shoulder) on the (contralateral/ipsilateral) side
The Visceral pleura (is/isn’t) innervated → (pain/no pain) sensation
phrenic; intercostal; intercostal; neck; shoulder; ipsilateral; isn’t; no pain ;
7) What does tamponade mean and where does pericardial or pleural effusion reside?
Pericarditis is an injury to the (myocardium/pericardium) of the heart (between the visceral and parietal pericardium) and may cause inflammation of the pericardial sac and leads to pericardial effusion.
A large enough inflammation of the pericardial sac can cause (Cardiac tamponade/CHF).
Cardiac Tamponade: (minimal/excess) fluid and inflammation that comprises down on the heart and causes:
(Lowered/Elevated) intracardiac pressure
Limit ventricular (systolic/diastolic) filling
(Increase/Reduce) SV
pericardium; Cardiac tamponade; excess; Elevated; diastolic; Reduce;
8) What are normal SV, EF values and what are critical values?
The ejection fraction is the (best/worst) indicator of cardiac function and represents a ratio or
percentage of the volume of blood ejected out of the ventricles relative to the volume of
blood received by the ventricles before contraction.
In other words, the ventricles
receive a certain volume of blood during the diastolic phase, then contract and surge out
a certain volume of blood. The ejection fraction reflects the ratio of the volume of ejected
relative to what was received before systole or contraction of the ventricles. This can be
mathematically presented as ______
Normal EF = _ - _ % APTA 2021 (brossman’s slides)
Systolic HF: EF less than _ % - Heart Failure with reduced ejection fraction and results in (low/high) CO at rest and with exertion
SV
Normal = __ - __ ml .. _ ml on the PPT
Critical = ???
NEED TO ANSWER ^^
best; (EDV-ESV)/EDV; 55-75; 40; low; 50-100; 70
9) What does valvular dysfunction cause and which chambers would the damaged valve impact?
Valvular dysfunction causes murmurs (backflow into the chamber with the valve problem).
Stenosis (blocked valves) and Incompentent valves causes the heart muscle to contract (more/less) forcefully which produces myocardial (hypotrophy/hypertrophy).
Incompetent valves are often associated with myocardial (constriction/dilation). The myocardium becomes so fatigued that the myocardium becomes (constricted/dilated) → not able to pump with sufficient pressure.
An aortic valve damage can cause (Left/right) sided HF
FIND OUT THE MECHANISM…
more; hypertrophy; dilation; dilated; left;
10) How does HF impact other organs in the body and how does this impact function?
Left side HF:
Caused frequently due to (Right/Left) ventricular insult
Also: (MI, HTN, aortic valve disease/pulmonary HTN, pulmonary embolus, right ventricular infarction)
Fluid backs up to the left atrium, pulmonary veins, pulmonary capillaries and (system/lungs)
Accumulation of fluid into lungs → leading to pulmonary hypertension and eventually → right sided HF
Right side HF: Caused by (MI, HTN, aortic valve disease/pulmonary HTN, pulmonary embolus, right ventricular infarction) and left sided HF Results in fluid backing up into the the (lungs/system) and organs (edema) - Liver, abdomen, bilateral ankles, hands
Left; MI, HTN, aortic valve disease; lungs; pulmonary HTN, pulmonary embolus, right ventricular infarction; system;
11) What do B1 and B2 receptors impact when stimulated or blocked
a. Beta1 receptors
i. Stimulates (increase/decrease) HR and myocardial force of contraction
b. Beta2 receptors
i. Promotes (vasoconstriction/vasodilation) of capillary bed and muscle relaxation of bronchial tracts
c. Beta-blockers
i. (Increase/Reduce) heart rate to (increase/decrease) duration of diastole
1. (Decreases/Increases) amount of time the heart can feed itself
increase; vasodilation; Reduce; Increase; Increases
- What is pulmonary capillary wedge pressure and how does this impact the human body when increased?
Pulmonary capillary wedge pressure (PCWP) is an integrated measurement of the compliance of the (right/left) side of the heart and the pulmonary circulation
In most cases, the PCWP is also an estimate of (right/left) ventricular end-diastolic pressure (LVEDP). The normal pulmonary capillary wedge pressure is between - mmHg. (Reduced/Elevated) levels of PCWP might indicate severe left ventricular failure or severe mitral stenosis.
left; left; 4-12; Elevated;
- What contributes to the reliability of pulse oximeters?
a. Sitting still, not moving (decreases/increases) reliability
b. Temperature (cold) - if measuring cold extremity, you’re probably (less/more) hypoxic than the pulseox is measuring
c. Placing the probe on the (1st or 2nd/3rd or 4th) finger (middle or ring)
d. Clean surface (no dirt, blood, nailpolishetc)
e. Lighter color skin give (less/more) accurate readings than darker colored skin
i. Weak signals may occur in patients with (good/poor) perfusion giving innacruate readings
ii. Weak signals also occur in afib due to irregular rate - may also cause inaccurate results
increases; more; 3rd or 4th; more; poor;
- Understand Frank Starling mechanism
a. Cardiac output increases or decreases in response to changes in heart rate or stroke volume. The strength of the ventricular contraction (afterload) the heart is able to achieve is (inversely related/directly proportional) to the amount of stretch placed on the myocardial tissue during ventricular filling (preload).
directly proportional;
- Describe and understand the different heart failure: diastolic, systolic, hypertrophic, restrictive, dilated,
a. Diastolic HF- inability of the ventricles to accept the blood ejected from the atria during rest or (systole/diastole). Caused by impaired relaxation of the (LV/RV). And passive LVent. Compliance resulting in stiffness and increased (diastolic/systolic) pressure.
i. Causes a major issue with regard to perfusing the myocardium in diastole
ii. S4 heart sound?? I think
b. Systolic HF - The impaired contraction of the ventricles during (diastole/systole) that produces an inefficient expulsion of blood - low (HR/SV). Creates a deficit in cardiac output to metabolic demands at rest and with exercise.
i. Heart failure with reduced ejection fraction (HFrEF) = EF < 40%
ii. (S3/S4) sound
c. Hypertrophic HF - Hypertrophic cardiomyopathy should be thought of as the opposite of dilated cardiomyopathy, both functionally and etiologically. Furthermore, the dysfunction of hypertrophic cardiomyopathy is one of (systolic/diastolic) dysfunction, which impairs the filling of the ventricles during diastole. 10 This increases the left ventricular end-diastolic pressure and eventually increases left atrial, pulmonary artery, and pulmonary capillary pressures, all of which cause a hypercontractile LV. In addition, hypertrophic cardiomyopathy has a high risk of sudden cardiac death. The characteristic findings of hypertrophic cardiomyopathy are (slow/rapid) ventricular emptying and (low/high) ejection fraction (EF), which are the opposite of those found in dilated cardiomyopathy but somewhat similar to those found in restrictive cardiomyopathy.
d. Characteristic findings: rapid ventricular emptying and high ejection fraction (EF)
e. Genetic abnormality in heart muscle cells, leads to decreased contractility. Leads to hypertrophy of ventricular walls. Leads to less space in ventricular chambers, less blood in chambers, less blood ejected out of chambers. Shortened diastolic filling.
f. Signs and symptoms: dyspnea, fainting, sudden death, chest pain, heart murmur
g. Restrictive HF - Restrictive cardiomyopathy, like hypertrophic cardiomyopathy, is a cardiomyopathy of (systolic/diastolic) dysfunction and frequently unimpaired contractile function. One pharmacologic intervention worth mentioning is β-adrenergic blockade, which appears to improve symptoms and survival through five means: 10 ▪ Negative chronotropic effect with reduced myocardial oxygen demand ▪ Reduced myocardial damage because of decreased catecholamines ▪ Improved diastolic relaxation ▪ Inhibition of sympathetically mediated vasoconstriction ▪ Increase in myocardial β-adrenoceptor density These factors are important because they are the basic mechanisms supporting the use of β blockers for dilated, restrictive, and hypertrophic cardiomyopathies, as well as CHF in general, because “treatment is on the same basis as that for heart failure.
h. What is restrictive cardiomyopathy? Restrictive cardiomyopathy (RCM) is a condition where the chambers of the heart become (flexible/stiff) over time. Though the heart is able to squeeze well, it’s not able to relax between beats normally. This makes it harder for the heart to fill with blood
i. Dilated HF - The dilation that occurs in this type of cardiomyopathy, and that sets it apart from hypertrophic cardiomyopathy, appears to be a result of myocardial mitochondrial dysfunction. Dysfunction of myocardial mitochondria leads to a lack of energy necessary for proper cardiac function, causing the heart to be a less effective pump. Ineffective pumping (increases/decreases) both the left ventricular end-diastolic volume and pressure, which dilate the LV (and frequently the other heart chambers). Because of inappropriate energy sources, the LV is unable to contract properly or to relax individual muscle fibers in response to increased workload, thereby preventing myocardial hypertrophy but producing ineffective systolic (pumping) function. “
j. There is (systolic/diastolic) failure, heart contracting inefficiently, ejection fraction (increases/reduces), more blood left in ventricles, so to compensate the chambers dilate (thus dilated cardiomyopathy). Now that chambers dilated even tho the ejection fraction is reduced, the total volume in the chambers is large enough to still get adequate blood flow to body. Dilation gets worse until you get backup and heart failure. Not enough blood to brain, blood backed up behind heart which leads to edema of abdomen and ankles.
diastole; LV; diastolic; systole; SV; S3; diastolic; rapid; high; diastolic; stiff; increases; systolic; reduces;
- Understand the pathology with myocardial ischemia and infarction
a. Myocardial Ischemia - not having enough (co2/oxygen) supply to meet the demands of the myocardium. Narrowing of coronary arteries, HF or arrhythmia cause a lack of oxygenated blood flow.
i. Angina pectoris (stable angina) Chronic stable angina, as its name implies, usually has a well-established level of onset and is the result of not enough blood supply to meet the metabolic demand (Fig. 3-5). Patients (are able/aren’t able) to predict reliably those activities that provoke their discomfort; this condition is usually associated with a set level of myocardial oxygen demand.
ii. Acute coronary syndrome -Acute coronary syndrome (ACS), an umbrella term used to define acute myocardial (infarction/ischemia) that is further divided into three components - Unstable angina
a. (Known/Not known) to be a mismatch of supply and demand
b. Can occur during rest - Not usually brought on by activity
c. Most common symptom: chest discomfort for greater than 20 minutes
d. signs or symptoms of inadequate blood supply to myocardium
i. usually provoke imbalance (e.g., in a person at rest)
e. Factors that contribute to unstable angina
i. Circadian variations in catecholamine levels
ii. (Decreases/Increases) in plasma viscosity
iii. (Decreases/Increases) in platelet activation
iv. Pathological changes in atherosclerotic plaques
f. Potentially related to development of myocardial infarction - STEMI- (does not develop/develops) a Q wave on the ECG in the subsequent 24 to 48 hours, and these previously were defined as Q wave or transmural (full- or near-full-thickness) infarctions. 1 A STEMI with transmural injury occurs distal to a totally occluded coronary artery that has become occluded secondary to a thrombus that occluded an area of plaque or ruptured plaque.
- Non-STEMI - does not develop a Q wave on the ECG and has been referred to as a non–Q-wave infarction or subendocardial (nontransmural, or affecting only the subendocardial region) infarction.
b. Myocardial infarction - tissue is occluded and becomes necrotic resulting in stiff, dysfunctional myocardial scar tissue. - Heart attack
1. Troponin normal < 0.03 ng/mL
a. Should be very close to (one/zero) - If trending upward à active myocardial infarction, active ischemia of the heart
b. Reperfusion is key to prevent transition from infarction to necrosis. Capture early and reperfusion so that the infarcted area doesn’t become necrotic. Hospitals track door to time to angioplasty ballooning JCAHO recc 20-30 min
oxygen; are able; ischemia; Not known; Increases; Increases; develops; zero
22) Know the NYHA classifications and determinants, and associated patient education
The New York Heart Association (NYHA) Classification provides a simple way of classifying the extent of heart failure.
Got it
- Know the BP classifications and determinants, and associated patient education
Normal:
Systolic - Less than _
(and/or)
Diastolic - Less than _
Elevated:
Systolic - _ -_
(and/or)
Diastolic - Less than _
High blood pressure (hypertension stage 1):
Systolic - -
(and/or)
Diastolic - -
High blood pressure (hypertension stage 2):
Systolic - _ or higher
(and/or)
Diastolic - _ or higher
Hypertensive crisis (consult your doctor immediately) Systolic - higher than _
(and/or / or)
Diastolic - higher than _
120; and; 80; 120-129; and; 80; 130-139; or; 80-89; 140; or; 90; 180; and/or; 120
30) What are the normal EKG values for QRS complex duration, R-R wave, P-R interval, PR segment
● PR interval: _ - ._ s - looking at duration
○ Interval = line between two points NOT INCLUDING the points → not including the waves themselves
● PR segment: is it isoelectric? Positive/elevated? negative/depressed?
○ Normal is (depressed/isoelectric)
○ Segment = line between two points INCLUDING the points
● QRS: _ - _ s (ideally (less/more) than .12 s)
● RR wave: determines heart rate (Normal rhythm requires a regular RR interval throughout; however, a discrepancy of up to 0.12 second between the shortest and the longest RR interval is acceptable for normal respiratory variation)
The PR interval reflects whether impulse conduction from the atria to the ventricles is normal. The PR interval must not be shorter than 120 msec or longer than 220 msec. The PR segment is the flat line between the end of the P-wave and the start of the QRS complex and reflects the slow conduction through the AV node.
.12-.2; isoelectric; .06-.10; less;
32) What does atrial fibrillation, premature ventricular contraction, V-tach look like on ECG?
A. Atrial fibrillation:
Chaotic rhythm, QRS (not present/present)
P waves are (present/absent), leaving a (sawtooth/flat or wavy) baseline
QRS duration is between 0.06 and 0.10 second
R-R interval is irregularly irregular - there (is a/is no) pattern to their frequency. This is commonly described as varying RR intervals.
Chaotic rhythm but still have QRS complexes. - AV node bombarded with impulses and cant coordinate proper contraction.
Characteristics:
Absent P wave
Narrow QRS
Irregular rhythm
Damage to structure of heart via disease/age
Lose atrial kick (atrial contraction before ventricular contraction) = decreased CO
Risk of thrombus
present; absent; flat or wavy; is no
