-
sick sinus syndrome?
- altering brady/tachycardia
- often requires mechanical pacemakers
-
premature atrial contractions/beats
extra or ectopic beats. atrial muscles are irratable.
-
atrial fibrilliation
- over 350bpm
- pooling of blood in atria= risk for thrombus
-
atrial flutter
- 160-350bpm
- delays AV node, ventricular rate slowed
-
1st degree heart block
delays conduction of AV node, prolongs PR interval
-
2nd degree heart block
delays conduction of AV node, increase PR interval until one contraction is missed.
-
3rd degree heart block
- no transmission of impulse from atria and ventricles
- ventr contract independently at 30-45/min
-
bundle branch block
- interference of one of the bundle branches
- wide QRS wave
-
effects of ventricular tachcardia
red. CO as red. diastle occurs.
-
ventricular fibrillation
- musc fibers contract irregularly and rapidly... so no cardiac output
- cardiac standstill
-
premature ventricular contractions
- ectopic beats
- may lead to ventricular fibrillation
-
How do you treat a dysrhmythimias?
digoxin, Ca+ channel blockers, find out the cause, antiarrhymic drug, beta blockers, pacemaker, defibrillator (conversion of ventricular fib)
-
What is CHF?
- Congestive heart failure ocurs when the blood cannot pump out enough to meet metabolic needs
- CO and SV decr, and blood begins to back up and become congested
-
Flow of blood in CHF
- Output of ventricle is less than the inflow of blood
- passive pooling
- backflow
-
Left and right side of heart during CHF
- Left blood flows back to the lungs
- right blood backs up into ther peripheries.
-
What causes left sided CHF?
- ischemic heart disease
- HTN
- aortic stenosis/regurgitation
- mitral regurgatation
- hyperthyroidism
-
what causes right sided CHF
- all the causes of LS-CHF
- right ventricular infarction
- tricuspid pulmonary valve disease
- Cor pulmonale (2ndary to lung disease, COPD, hypoxia)
-
conpensation mechanisms for chf
- daytime oliguria
- tachcardia
- cutaneous and visceral vasoconstriction
-
signs and symptoms of left sided CHF
- paroxsymal nocturnal dyspnea
- cough, hemopytsis
- dyspnea and orthnopnea
- cold intolerance
- polycytemia
-
signs/symptoms RS-CHF
- edema in legs, feet, presacral
- hepatomegaly
- splenomegaly
- ascites
- digestive disturbances
- flushed faced, distended neck veins, HA, visual disturbance
- cold intolerance
- polycytemia
-
congenital heart defects
problems squatting, feeding difficulties, pallor, tachycardia, delayed growth/devel... etc
-
what is the most common congenital heart defect?
Ventricular Septal Defect (VSD)
-
what happends during VSD?
- their is an opening in the interventricular septum
- shunt from left to right due to higher pressure in left
- pulmonary HTN
- incr right side pressure= cyanosis
-
Valvular defects most commonly effects?
aortic and pulmonary
-
stenosis?
failure of valve to open to completely
-
valuvular incompetence
- VI- valves dont close completely, regurgitates/backflow
- mitral valve prolapse- enlarged floppy leaflets (normal)
- pulmonary stenosis- right ventricle hypertrophy
-
Tetralogy of fallot
- right to left shunt (bypasses pulmonary circ)= cyanotic
- lungs receive small oxy blood, rest of body receive mixed blood
-
which abnormalities do tetralogy of fallot include:
- pulmonary vavle stenosis
- VSD
- overriding of aorta
- right ventricular hypertrophy
-
What is rheumatic fever?
- multisystem inflamm disease
- abnormal immune rxn
- due to untreated pharyngitits (group A beta hemolytic streptococci)
- 5-15yo
- heart and joints swell
-
long term effects of rheumatic fever
- rheumatic heart disease
- infective endocarditis
- heart failure
-
acute rheumatic fever
- inflam of all heart layers + incompetent valves
- large joints
- erythema marginatum
- involuntary jerk movements
- non tender subcutaneous nodules
- low grade fever, leukocytsis, tachcardia, malaise, anorexia,
-
how do you diagnose acute rheumatic fever
- echocardiography
- ASO titer (anti strepilysin O antibody)
-
rheumatic heart disease, and what is most common result?
repeated bouts of infection and valve damage
mitral valve stenosis
-
prevention of rheumatic heart disease?
- prophylactic antibacterial agent
- anti-inflamm agent
-
what is infective endocarditis? what causes subacute and acute?
- life threatening colonization of microbial agents in the heart valves
- subacute- strep. viridans
- acute- staph. aureas
-
acute endocarditis
- sudden marked onset- fever, chills, drowsiness
- heart valves badly damaged
- systemic emboli to brain, kidney, spetic infarcts
-
subacute endocarditis
- insidious
- low grade fever
- CHF
- strp. virilus
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