SEMIO CH18 TRIGGER

PHYSIOLOGICAL PACEMAKER =

SA NODE

SA NODE LOCATION

RIGHT ATRIUM

P WAVE =

ATRIAL DEPOLARIZATION

PR INTERVAL

TIME BETWEEN ATRIAL DEPOLARIZATION AND VENTRICULE DEPOLARIZATION

QRS COMPLEX =

VENTRICULAR DEPOLARIZATION

T WAVE

VENTRICULAR REPOLARIZATION

NORMAL HEART RATE

60-100

BRACHYCARDIA VALUE

<60

TACHYCARDIA VALUE

>100

DISORDER OF NORMAL CARDIAC RYTHM =

ARRHYTHMIA

2 TYPES OF ARRYTHMIA

ALTERATIONS IN AUTOMATICITY → PROBLEME DE GÉNÉRATION ELEC°

ALERATIONS IN CONDUCTION → PROBLEME DE CONDUCTION ELEC°

ALTERNATIVE PACEMAKER ?

AV NODE → ABLE TO GENERATE ELECTRIC IMPULSE

IN NORMAL CONDITION AV NODES GENERATES IMPULSE ?

NO NEVER

WHEN AN ABNORMAL AREA GENERATES ELECTRIC IMPULSE ITS CALLED =

ECTOPIC FOCI

EXTRASYSTOLE =

SECONDARY PREMATURE BEAT CAUSED BY ECTOPIC FOCI

WHEN THERE IS MULTIPLE ECTOPIC FOCI WE CALL IT ?

FIBRILLATION

TRIGGER → ATRIAL FIBRILLATION ON EKG

NO P WAVE → BECAUSE P WAVE SHOWS SYNCHRONOUS ATRIAL CONTRACTION

FILLING PROBLEM ASSOCIATED W/ ATRIAL FIBRILLATION ?

NO VENTRICULAR ACTIVE FILLING

→ ACTIVE FILLING COMING FROM ATRIAL CONTRACTION CANNOT OCCUR BECAUSE ATRIAS CANNOT CONTRACT PROPERLY

ATRIAL FIBRILLATION ASSOCIATED W/ WHICH RISK ?

INTRA ATRIAL THROMBUS FORMATION RISK ↑

PREVENTIVE TREATMENT : ATRIAL FIBRILLATION → THROMBUS FORMATION ?

ASPIRIN / WARFARIN

CARDIAC OUTPUT WHEN VENTRICULAR FIBRILLATION ?

CO = 0

CONSEQUENCE OF VENTRICULAR FIBRILLATION

CARDIAC ARREST

ABNORMAL EXTRA CONDUCTION PATHWAY GENERATE ?

TACHYCARDIA

CONDUCTION BLOCK IN A NORMAL PATHWAY GENERATE ?

BRADYCARDIA

TRIGGER SUPRAVENTRICULAR TACHYCARDIA

BENIGN + NARROW QRS

TRIGGER VENTRICULAR TACHYCARDIA

MALIGNANT + WIDE QRS

TRIGGER ANXIETY + HR >100

SINUS TACHYCARDIA

TRIGGER PROLONGED PR INTERVAL

1° DEGREE AV BLOCK (DELAY)

TRIGGER → SOME P WAVE ARE NOT FOLLOWED BY QRS

2° DEGREE AV BLOCK (PARTIAL BLOCK)

TRIGGER → NONE OF THE ATRIAL IMPULSES GOES TO THE VENTRICLE

3° DEGREE AV BLOCK → COMPLETE BLOCK

ATRIAL FLUTTER DEF

ATRIAL ELECTRIC ACTIVITY VERY FAST BUT ORGANIZED

TRIGGER ATRIAL FLUTTER ON EKG

P WAVES ARE REPLACED BY F WAVES

TRIGGER VENTRICULAR FIBRILLATION EKG

CHAOTIC EKG + NO ORGANIZED QRS

TRIGGER ATRIAL FIBRILLATION

NO P WAVE + NO SYNCHRONOUS ATRIAL CONTRACTION + THROMBUS RISK