Cardio Mod I Etiologies and Pathophys

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Normal variant, RVH, mechanical shifts, RBBB, LPFB, dextrocardia, ventricular ectopic rhythms, WPW, lateral wall MI, secundum ASD

Normal variant, RVH, mechanical shifts, RBBB, LPFB, dextrocardia, ventricular ectopic rhythms, WPW, lateral wall MI, secundum ASD

What may cause a RAD?

Normal variant, LVH, mechanical shifts, LBBB, LAFB, congenital heart disease, emphysema, hyperkalemia, ventricular ectopic rhythms, WPW, inferior MI

What may cause LAD?

P pulmonale, valvular heart disease (tricuspid/pulmonary), COPD, pulmonary HTN, PE

What might cause Right Atrial Enlargement?

Valvular disease (aortic/mitral), restrictive cardiomyopathy, LVH, hypertrophic cardiomyopathy, severe HTN, LV failure, obstructions to forward flow

What might cause Left atrial enlargement?

COPD, pulmonary HTN, PE, chronic left heart failure, ASD, VSD, ToF

What causes RVH?

RBBB, peds, WPW, posterior wall MI

False positives for RVH

Outflow problem, HTN, volume overload, valvular heart disease (aortic/mitral), hypertrophic cardiomyopathy, coarctation of aorta, patent ductus arteriosus, acromegaly

What might cause LVH?

Thin chest wall, S/P radical mastectomy, LBBB, Acure MI, LAFB, WPW

False positives for LVH

Atrial escape beat (ectopic - late beat)

What occurs when the heart stops beating for some reason so something else kicks in to pace?

normal variant, enhance automaticity, COPD, HF, atrial insult, acute respiratory failure, CAD, myocardial irritation, electrolyte imbalance, pain, anxiety, fatigue, fever, hypoxia, medications that prolong refractory of SA node (procainamide, quinidine, digoxin, EtOH, caffeine, nicotine)

What may cause a PAC?

AVNRT

What rhythm is due to the formation of a reentry circuit in the AV node and perinodal Atrial tissue?

atrial flutter

What rhythm is due to a “macro-re-entrant” atrial rhythm and is caused by anything that leads the heart to have irration?

A. fib

What rhythm is due to multiple tiny renentrant circuits whirling around in a totally unpredictable fashion or enhace automaticity in one/more depolarizing foci?

PE, iatrogenic, rheumatic heart disease, acute coronary syndrome, hyperthyroidism, EtOH, Obstructive sleep apnea, heart failure

What causes a patient to flip into A fib?

idiopathic, changes in vagal tone, digoxin toxicity, inflammation of atrial tissue, valvular heart disease

What causes a wandering atrial pacemaker?

MAT

What rhythm is maybe caused by abnormal automaticity in several foci within the atria OR triggered activity?

PAT

What rhythm is the result of automaticity of an atrial ectopic site or from a reentrant circuit?

normal variant, digitalis toxicity, elevated sympathetic tone

What causes a PAT?

increased automaticity, myocardial irritation, drugs, electrolyte imbalance, dilated heart, metabolic acidosis, ischemia/infarct, MVP

What may cause a PVC?

PVC

What rhythm is caused by a ectopic ventricular focus firing an action potention?

medications, failure of SA/AV, conduction blocks, MI/HF, profound ischemia, sick sinus

What may cause an idioventricular rhythm?

Idioventricular rhythm

What rhythm is the result of both the SA and AV node quitting their jobs?

failure of SA/AV, MI, AV or intraventricular conduction block, post MI

What might cause an accelerated idioventricular rhythm?

structural heart disease (HF, long QTs, valvular disease, congenital heart abnormalities)

Common causes of V tach?

brugada syndrome, cardiomyopathies, arrhythmogenic right ventricular dysplasia

Uncommon causes of V tach?

fusion beat

What occurs in V tach when a sinus beat falls on a spot that allows some innervation of the ventricle to occur through the normal conduction system?

capture beat

What occurs in V tach when one atrial depolarization gets through and we get one good wave?

Monomorphic V tach

What rhythm is the result of ONE structural abnormality that supports a reentry circuit

Polymorphic V tach (torsades)

What rhythm is the result of multiple ectopic foci or a continually changing reentry circuit

QT prolongation, hypokalemia, hypomagnesium, alcohol, diarrhea, drug induced, persistent bradycardia

What may cause torsades?

V fib

What rhythm is the result of disordered rapid stimulations of the ventricles with no coordinated contractions?

MI, myocardial ischemia, acid base disorders, untreated V tach, electrical shock, hypothermia

What may cause V fib

hyperkalemia, hypoxia, hypothermia, acidosis, hypovolemia, hypoglycemia, tamponade, tension pneumo, thrombosis, toxins, traume

What may cause a PEA?

diseases/insult to SA node, increased parasympathetic tone, hypoxia, drugs that block the SA node, cardiomyopathies, old age, HTN, open heart surgery, pericarditis, rheumatic heart disease

What might cause Sick Sinus Syndrome?

normal, age, medications that slow conduction through the AV node

What causes a 1st degree AV block?

Second degree type I

What rhythm is due to a block within the AV node?

high vagal tone, elderly, AV blocking meds

What causes a wenckebach block?

medications, large MI, damage to AV ndoe

What causes a Mobitz II?

damage to AV node, inferior MI, extensive MI

What causes a 3rd degree AV Block?

normal variant

What causes a RBBB?

MI, structural heart disease, acute/chronically increased ventricular pressure, myocarditis, endocarditis, neuromuscular diseases

What causes a LBBB?

congenital

What causes WPW?