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PAR2021 Cardiology > Week 12 > Flashcards

Week 12 Flashcards

1
Q

What ST changes do you see in men aged under 40 for STEMI

A

> or equal to 2.5mm STE in leads V2-3

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2
Q

What ST changes do you see in men aged over 40 for STEMI

A

> or equal to 2mm STE in leads V2-3

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3
Q

What ST changes do you see in women for STEMI

A

> or equal to 1.5mm STE in leads V2-3

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4
Q

What ST changes do you see in leads other than V2 and V3 for STEMI

A

> or equal to 1mm

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5
Q

What blood vessels are involved in Septal region of ECG

A

Leads V1 and V2

Left Anterior descending

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6
Q

What blood vessels are involved in Anterio region of ECG

A

Leads V3 and V4

Left Anterior Descending

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7
Q

What blood vessels are involved in Lateral region of ECG

A

V5 and V6 and Lead 1 and aVL

Left circumflex artery

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8
Q

What blood vessels are involved in Inferior region of ECG

A

Lead 2, 3, and aVF

Right coronary artery

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9
Q

How to do you diagnose a Right ventricular infarct on an ECG?

A

V1 - STE - only lead looking directly at RV

STE greater in Lead 3 than Lead 2 - because lead 3 is more rightward facing

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10
Q

Why don’t we give GTN to inferior and RVMI patients?

A

Pts with RVMI are preload sensitive.

GTN reduces venous return, reducing preload. Thus administration can create severe hypotension

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11
Q

What is systolic heart failure?

A

Weakened heart muscle, can’t squeeze and eject enough.

Heart loses ability to pump blood properly

  • ejection fraction low
  • low stroke vol
  • normal end diastolic vol
  • high end systolic vol
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12
Q

What is diastolic heart failure?

A

myocardium loses ability to relax

decreased compliance

  • ejection fraction normal
  • low stoke vol
  • low end diastolic
  • normal/low end systolic vol
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13
Q

What are symptoms of right sided heart failure?

A
  • fatigue
  • increased peripheral venous pressure
  • ascites
  • enlarged liver and spleen
  • distended jugular veins
  • anorexia and GI distress
  • weight gain
  • dependent oedema
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14
Q

What are symptoms of left sided heart failure?

A
  • Paroxysmal nocturnal dyspnea
  • pulmonary congestion
  • > cough, crackles, wheezes, blood tinged sputum, tachypnea
  • Restlessness
  • Confusion
  • Orthopnea
  • Tachycardia
  • Fatigue
  • Cyanosis
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15
Q

What causes acute pulmonary oedema?

A
  • Heart failure causes a decrease in LV function
  • Activation of compensatory mechanisms
  • Increase LV end diastolic pressure
  • Transmission of pressures back through LA into pulmonary arteries
  • increased capillary hydrostatic pressure
  • Leakage of serous fluid into alveoli
  • loss of surface area for gas exchange causes decrease in SpO2 and increase in PCO2
  • loss of surfactant causes alveoli collapse
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16
Q

What are the signs and symptoms of APO?

A
  • SOB
  • Anxious
  • High work of breathing
  • Decreased speech
  • Hypertensive often 150+
  • Decreased SpO2
  • Tachycardia
  • Fine inspiratory crackles
  • Bilateral
17
Q

What is cardiogenic shock?

A

persistant hypotension and tissue hypoperfusion caused by cardiac disfunction in the presence of adequate intravascular volume

18
Q

How do you manage cardiogenic shock?

A
  • R+R
  • MICA
  • 12 lead
  • Fluid is a mica skill
    Comfort - pain and nausea
  • Adrenaline
19
Q

What is automaticity?

A

ability of a cardiac cell to spontaneously depolarise without being externally stimulated

  • determined by permeability of cell during phase 4
20
Q

what cells have automaticity?

A

pacemaker cells NOT myocardial cells

21
Q

What causes ectopic beats?

A

High automaticity

22
Q

Whats the name for 2 PVC’s occuring after eachother?

A

Couplet PVC

23
Q

Whats the name for 3 PVC’s occuring after eachother?

A

Salvo’s

24
Q

How to determine VT?

A

3 or more PVCs or 30 seconds of PVCs

25
Q

What stages of AP do pacemaker cells have?

A

Only 4, 3, and 0

26
Q

How can pacemaker cells create own AP?

A

They have a slow flow of current following repolarisation which gets more positive until threshold is reached

27
Q

What ECH changes do you see with the Zone of Ischemia?

A
  • ST depression with or without T wave inversion
28
Q

What ECH changes do you see with the Zone of Injury?

A
  • ST elevation with or without loss of R wave
29
Q

What ECH changes do you see with the Zone of Infarction?

A

deep pathological Q waves

30
Q

Explain the 3 zones of ischaemia, injury and infarction?

A

Zone of ischaemia

  • Hypoxia
  • may have ST depression or T wave inversion

Zone of Injury

  • Prolonged ischaemia
  • STE

Zone of infarction

  • irreversible death of tissue
  • pathological Q waves
31
Q

How would you expect ECG to change over time with infarction

A
  1. Normal
  2. Increased T waves (0-30mins)
  3. Marked STE (0-6hrs)
  4. Market STE with T wave inversion (6-12 hours)
  5. Pathological Q waves, less STE, terminal T wave inversion (12-24 hours)
  6. Pathological Q waves, T wave inversion (>24 hrs)
  7. Path Q, Upright T waves (months to years)

PAR2021 Cardiology (12 decks)

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