Term
| When does the CRP level increase? |
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Definition
| The C-reactive protein, a protein produced by the liver, increases when there is systemic inflammation. Like in CAD. |
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Term
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Definition
| The earliest lesions of atherosclerosis that are characterized by lipid-filled smooth muscle cells (first stage of atherosclerosis) |
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Term
| What is the fibrous plaque stage? |
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Definition
| The 2nd stage in atherosclerosis. The beginning of progressive changes in the endothelium of the arterial wall. Results in narrowing of the vessel lumen and reduction in blood flow to the distal tissues |
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Term
| What is the third stage of atherosclerosis? |
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Definition
| complicated lesion. As the fibrous plaque grows, continued inflammation can result in plaque instability, ulceration, and rupture. LEADS TO THROMBUS. DANGEROUS |
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Term
| Discuss the normal conduction system of the heart |
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Definition
| A normal cardiac impulse begins in the sinoatrial (SA) node in the upper right atrium. It spreads over the atrial myocardium via intra-atrial pathways (Bachmann's bundle) and internodal pathways, causing atrial contraction. The impulse then travels to the atrioventricular (AV) node, through the bundle of His, and down the left and right bundle branches. It ends in the Purkinje fibers, which transmit the impulse to the ventricles. |
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Term
| Describe atrial fibrillation |
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Definition
| A total disorganization of atrial electrical activity due to multiple ectopic foci resulting in loss of effective atrial contraction. Afib is the most common dysrhythmia. |
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Term
| Does atrial fibrillation cause increased CO or decreased? |
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Definition
| A DECREASE in CO because of ineffective atrial contractions and/or a rapid ventricular repsonse.Thrombi (clots) form in the atria because of blood stasis. |
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Term
| What is the treatment for atrial fibrillation? |
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Definition
Decrease in ventricular response (less than 100bpm), prevention of cerebral embolic events, and conversion to sinus rhythm.
Ventricular rate is priority! Calcium channel blockers= diltiazem, b-adrenergic blockers= toprol, digoxin, multaq, Drugs used for conversion to sinus rhythm= amiodarone, ibutilide. If in afib for longer than 48 hours, need warfarin therapy before cardioversion. If neither of these work, long-term anticoagulation therpay is required. |
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Term
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Definition
| an atrial tachydysrhythmia identified by recurring, regular, sawtooth-shaped flutter waves that originate from a single ectopic focus in the right atrium or, less commonly, the left atrium |
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Term
| What is normal atrial rate? |
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Definition
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Term
| ECG Characteristics of atrial flutter |
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Definition
| QRS complex is usually normal. The PR interval is variable and not measurable. It could be a 2:1 ratio or 4:1 conduction. |
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Term
| Primary goal in atrial flutter |
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Definition
Slow the ventricular response by increasing AV block. Calcium channel blockers and b-adrenergic blockers. Antidysrhythmia drugs- Amiodarone, Propafenone, Ibutilide, Flecainide.
Radiofrequency catheter ablation is the treatment of choice for atrial flutter. |
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Term
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Definition
| Asystole represents the total absence of ventricular electrical activity. Occasionally, P waves are seen.No ventricular contration occurs because depolarization does not occur. Patients are unresponsive, pulseless, and apneic. REQUIRES IMMEDIATE ATTENTION. |
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Term
| What is the treatment for asystole? |
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Definition
| CPR with initiation of ACLS measures which include epinephrine and atropine, intubation, and possibly a pacemaker |
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Term
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Definition
| Pulseless electrical activity (PEA) describes a situation in which electrical activity is observed on the ECG, but there is no mechanical activity of the ventricles and the patient has no pulse. |
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Term
| Explain premature ventricular contractions |
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Definition
| A contraction originating in an ectopic focus in the ventricles. It is the premature occurrence of a QRS complex, which is wide and distorted in shape. PVC's are associated with caffeine, alcohol, nicotine, epinephrine, digoxin. Also with electrolyte imbalances hypoxia, fever, exercise, etc. |
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Term
| Define Ventricular tachycardia |
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Definition
| When there are three or more consecutive PVCs |
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Term
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Definition
| VT is life-threatening because of decreased CO and possibility of development of ventricular fibrillation (which is lethal). If VT is monomorphic and patient is stable, IV procainamide, sotalol, amiodarone or lidocaine is used. If patient is unstable, IV amiodarone. VT is polymorphic? b-adrengergic blockers |
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Term
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Definition
| The conduction pathway is the same as that in sinus rhythm but the SA node fires at a rate less than 60 beats/min |
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Term
| Treatment for Sinus Bradycardia |
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Definition
The patient will be pale, coolskin, hypotension, weakness, angina dizziness, confusion, shob.
Treament is: administration of atropine. pacemaker therapy may be required. |
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