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Cardiovascular basic science, Physiology, Embryology, Anatomy - Coggle…

- - - - polymorphic ventricular tachycardia
      - shifting sinusoidal waveform on ECG
      - predispose to TdP
      - caused by drugs, ↓K⁺, ↓Mg²⁺, congenital abnormalities
      - treat with magnesium sulfate
    - - ↑risk of SCD
      - Rumano-Ward syndrome: AD
      - myocardial repolarization disorder, ion channel defect
      - Jervell and Lange-Nielsen syndrome: AR, sensorineural deafness
    - - pseudo-right bundle branch block and ST elevation in V₁-V₃
      - ↑risk of ventricular tachyarrhythmias and SCD
      - AD
      - prevent SCD with implantable cardioverter-defibrillator; ICD(植込み型除細動器)
    - - result in supraventricular tachycardia
      - characteristic delta wave and shortened PR
      - abnormal fast accessory conduction pathway
      - most common ventricular pre-excitation syndrome
  - - - fatal arrhythmia without iimediate CPR and defibrillation
      - completely erratic rhythm with no identifiable wave
    - - second degree
        
        mobitz type 1(Weckebach)
        
        progressive lengthening of PR interval until a beat is dropped
        
        mobitz type 2
        
        dropped beat that are not preceded by achange in the length of PR
        
        often treat with pacemaker, may progress to 3rd
      - third degree
        
        atria and ventricle beat independently
        
        treat with pacemaker
        
        can be caused by Lyme disease
      - first degree
        
        PR is prolonged
    - - treat like atrial fibrillation, catheter ablation
      - identical, back to back atrial depolarization wave, "sawtooth"
    - - chaotic and erratic baseline with no discrete P wave in between irregularly QRS complex
      - risk factor: hypertension, coronary artery disease
      - treatment: anticoagulation, rate control, rhythm control, cardioversion
- - - - due to aortic dilation, bicuspid aortic valve, endocarditis, rheumatic fever
      - progress to left HF
      - early diastolic decrescendo murmur
    - - chronic MS lead to LA dilatation→dysphagis, hoarseness
      - opening snap, delayed rumbling
  - - - often due to congenital rubella or prematurity
      - best heard at left infraclavicular area
  - - - MR: loudest at apex and radiates toward axilla, MR is due to ischemic heart disease, MVP(僧帽弁逸脱症), LV dilatation
      - TR: loudest at tricupsid area, caused by RV dilatation
      - holosystolic, high pitched blowing murmur
      - rheumatic fever and infective endocarditis can cause either MR or TR
    - - apex
      - late systolic crescendo murmur with midsystolic click
    - - crescendo-decrescendo systolic ejection murmur and soft S2
      - loudest at heart base
      - radiate to carotid
      - related to age and bicuspid aortic valve
      - lead to syncope(失神), angina, dyspnea
    - - loudest at tricuspid area
      - holosystolic, harsh-sounding murmur
- - - - carotid and aortic bodies are stimulated by ↓Po₂, ↑Pco₂, ↓pH
    - - stimulated by changes in pH and CO₂ fo braininterstitial fluid
      - do not directly respond to O₂
- - - - neural crest and endocardial cell migration→truncal and bulbar ridges that spiral and fuse to form aorticopulmonary septum→ascending aorta and pulmonary trunk
      - failure of neural crest cell to migrate: transposition of great vessel, tetralogy of fallot, persistent truncus arteriosus
    - - muscular interventricular septum forms
      - aorticopulmonary septum rotate and fuse with muscular ventriculr septum to membranous intraventricular septum
      - growth of endocardial cushion separete atria from ventricles and contribute to both atrial septation and membranous portion of the interventricular septum
      - ventricular septal defect: most common congenital cardiac anomaly, usually in membranous septum
    - - septum primum (一次中隔) grows toward endocardial cushion, narrowing foramen primum(一次口)
      - foramen secundum forms in septum primum
      - septum secundum develops as foramen secondum maintain right-to-left shunt
      - septum secundum expands and covers most of foramen secundum, the residual foramen is foramen ovale(卵円孔)
      - remaining portion of septum primum forms valve of foramen ovale
      - fuse
      - close (↑LA pressure)
      - patent foramen ovale: failure of two septums to fuse, can lead to paradoxical wmboli(奇異性塞栓)