Carlos Shared "11 Cardio" - 97 Picmonics

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11 Cardio

Heart Embryology
Primitive atrium (PA): Trabeculated part of left and right atria
Primitive ventricle (PV): Trabeculated part of left and right ventricles
Right horn of sinus venosus (RHSV): Smooth part of right atrium (sinus venarum)
Primitive pulmonary vein (PV): Smooth part of left atrium
Bulbus cordis (BC): Smooth parts (outflow tract) of left and right ventricles
Left horn of sinus venosus (LHSV): Coronary sinus
Truncus arteriosus (TA): Ascending aorta and pulmonary trunk
Right common cardinal vein (RCCV) and right anterior cardinal vein (RACV): Superior vena cava
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Fetal Erythropoiesis
3–8 weeks
6 weeks–birth
10–28 weeks
Bone marrow
18 weeks to adult
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Fetal Circulation
Umbilical Vein
Ductus Venosus
Right Atrium
Foramen Ovale
Left Atrium
Right Ventricle
Ductus Arteriosus
Umbilical Arteries
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2 mins
Postnatal Circulation
Infant Breathes
Decreased Pressure in Pulmonary Vasculature
Decreased Right Heart Pressure
Increased Left Atrial Pressure
Closes Foramen Ovale
Increased O2
Decreased Prostaglandins
Closed Ductus Arteriosus
Pharmacologic Intervention of Ductus Arteriosus
Open with Prostaglandins
Closed with Indomethacin
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3 mins
Coronary Arteries
Aortic Root
Right Coronary Artery (RCA)
Right (Acute) Marginal Artery
Posterior Descending Artery (PDA)
Left Coronary Artery (LCA)
Left Anterior Descending (LAD) Artery
Circumflex Artery
Left Marginal Artery
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1 min
Cardiac Cycle - Systole
AV Node
AV Node Conducts Signal to Bundle of His
Bundle of His Signals Purkinje Fibers to Contract Ventricles
Tricuspid Valve Closes
Pulmonary Valve Opens
Mitral Valve Closes
Aortic Valve Opens
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2 mins
Cardiac Cycle - Diastole
Aortic Valve Closes
Pulmonary Valve Closes
Ventricles Relax
Mitral Valve Opens
Tricuspid Valve Opens
Ventricles Fill
Sinoatrial (SA) Node Fires
Atrial Contraction
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3 mins
High Blood Pressure Response
Atria Release Atrial Natriuretic Peptide
Antagonizes Aldosterone
Na+ and Water Excreted
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1 min
Low Blood Pressure Response
Posterior Pituitary Releases Vasopressin
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
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1 min
Inotropy Curve
Changes in contractility lead to altered CO for a given RA pressure (preload)
Inotropy is related to the amount of intracellular Calcium (Ca 2+)
Catecholamines (SNS) and Digoxin increase Calcium, therefore increase Inotropy
Uncompensated HF (RAAS, SNS and Frank no longer work)and narcotic overdosed (decreased pulmonary center in medulla decreases HR) decrease Inotropy
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Venous return
VR = Blood returning from the tissues that is filling up the RA
Anything that increases Venous Pressure (VP) or decreases Right Atrium Pressure (RAP) leads to increases Venous Return (VR)
Changes in circulating volume or venous tone lead to altered RA pressure for a given CO.
Mean systemic pressure (x-intercept) changes with volume/venous tone.
Mean systemic pressure (x-intercept) is the pressure that would force blood back into the RA if the heart was not beating (only dependent in the amount of blood creating pressure in the arteriole and veous circulation)
IV Fluids and Sympathetic activity increase VR
Acute hemorrhage and spinal anesthesia decrease VR
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Total Peripheral Resistance (TPR)
At a given mean systemic pressure (x-intercept) and RA pressure, changes in TPR leads to altered CO.
Arterioles are responsible for TPR
Vasopressors (like Norepinephrine) increase resistance, causing the heart to have more trouble pushing out blood
Exercise (Increased Beta adrenergic activity) and AV shunt (Bypasses arterioles that manage resistance) decrease TPR
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Pressure-volume loop
Phases—left ventricle
Isovolumetric contraction: period between mitral valve closing (S1 sound is heard) and aortic valve opening. Period of highest O2 consumption
Systolic ejection: period between aortic valve opening and closing
Isovolumetric relaxation: period between aortic valve closing (S2 can be heard) and mitral valve opening
Rapid filling: period just after mitral valve opening (S3 occurs)
Reduced filling: period just before mitral valve closing
Increased Preload (Moves to the right like the letter P)
Increased Afterload (Tall and Skinny like the letter A)
Increased Contractility (Moves to the left like the letter C)
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Aortic Stenosis
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Helmet Cells
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2 mins
Tricuspid Regurgitation
Blowing Murmur
Radiates to Right Sternal Border
Enhanced by Inspiration
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1 min
Mitral Regurgitation
Blowing Murmur
Loudest at Apex
Radiates toward Axilla
Louder by Squatting
Hand Grip
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1 min
Ventricular Septal Defect (VSD)
Opening at Intraventricular Septum
Most Common Congenital Heart lesion
High-pitched Holosystolic Murmer (over left sternal border)
Dyspnea and Respiratory Distress
Loud Pulmonic S2
Small VSDs Close Spontaneously
Large VSD requires Surgery
Eisenmenger's Syndrome
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2 mins
Aortic Regurgitation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Can Cause Austin Flint Murmur
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1 min
Mitral Stenosis
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
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2 mins
Patent Ductus Arteriosus
Machine like murmur
Often Due to Congenital Rubella
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1 min

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