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Achy Breaky Heart, like, normal ECG, Examples, Occurs, classified into,…
Achy Breaky Heart
Fetal circulation
placenta (fetal lungs)
blood vessels connected to placenta
umbilical vein
R/L umbilical arteries
shunts/ bypass channels
foramen ovale
ductus venosus
ductus arteriosus
blood distribution
45% to tissues of fetus
15% to upper limbs
18% to lower limbs
12% to lungs
55% to placenta
fetal respiration
oxygen saturation of fetus > 80%
HbF has more oxygen affinity than HbA
fetal blood has higher Hb content
Lab investigations
radiography
Usage of very small dose of ionizing radiation with variable penetration to show images of the inside of the chest
used to evaluate
airways
heart
lungs
blood vessels
bones
chest
spin
ECG
ECG Measures the electrical activity of the heartbeat impulses
graphing the electrical impulses generated in the heart.
consists
QRS complex
T wave
p wave
large VSD
Left ventricular hypertrophy (LVH)
Tall R waves in V5 & V6
Right ventricular hypertrophy (RVH)
Tall R waves in V4 & V1
ESR
The speed at which erythrocytes settle at the bottom of a test tube containing a blood sample (mm/hr).
fast ESR
inflamation
low ESR
Polycythemia
Sickle cell anemia
Leukocytosis
high ESR
Infection
Heart disease
Vascular disease
Rheumatic fever
echocardiogram
A type of ultrasound scan that gives a moving image of the internal structures of the heart.
Doppler echocardiography
Special type of echo that shows direction
speed of blood flow in the heart.
blood test
CBC
hemoglobin test
RBC indices
Mean corpuscular volume( MVC)
Mean corpuscular hemoglobin concentration(MCHC)
Development of the systemic arteries
R and L Dora aorta
Pharyngeal arch arteries
Second a.
Stapedial artery
Third a.
Common carotid arteries
Forth a.
Right
R subclavian a.
Left
Arch of aorta
Fifth a.
Degenerate
Sixth a.
Right
R pulmonary a.
Left
Ductus arteriosus and L pulmonary a.
First a.
maxillary artery
Aortic sac
Intersegmental arteries
Left 7th intersegmental a. Forms the L subclavian a.
Cardiac cycle
atrial diastole
80 % ventricular filling ( rapid )
All chambers are relaxed
atrial systole
20 % of ventricular filling
contraction of the atrium
SA node
Action potential
ventricular systole
isovolumetric ventricular contraction
closure of the AV valves
First heart sound
AV NODE
ejection
ventricular diastole
isovolumetric ventricular relaxation
closure of seminular valves
second heart sound
ventricular relaxation
Heart murmurs
Abnormal heart sound due to turbulence of blood flow in the heart chambers
Diastolic murmurs
During diastole from S2 to S1
Mitral stenosis
Aortic regurgitation
Continuous murmurs
During both diastole and systole
Patent ductus arteriosus
Systolic murmurs
During systole from S1 to S2
Aortic stenosis
Mitral regurgitation
Ventricular septal defect
Development of the heart
Splanchnic Mesoderm
Neural Crest Cells
The formation of
The heart loop
Bulboventricular portion
ventrally and caudally
Atrium and sinus venosus
Dorsally and cranially
Endocardial cushion
Fuse and divide the atrioventricular canal into 2
The canalization of the two heart tubes and fusion
Single heart tubes
Primitive ventricle
Primitive atrium
Bulbous cordis
Sinus Venosus
Truncus arteriosus
Septums
Atrial
Septum primum
Septum secundum
Foramen
Ventricular
Muscular part
Membranous part
Aorticopulmonary septum
Conotruncal ridges
Angioblastic cords from the mesenchymal cells
Sinus venosus
Right sinus horn
Form the smooth wall of the RA
Left sinus horn
Form the Coronary sinus and oblique vein
changes after birth
pulmonary circulation starts (lungs are functional)
placenta removal
Constriction of blood vessels
closure of bypass channels
foramen ovale
fossa ovalis
ductus arteriosus
arteriosum ligamentum
Congenital vs inherited
Congenital heart conditions
Septal defects
Atrial Septal Defects (ASD)
types
Secundum.
Primum.
Sinus venosus.
Coronary sinus.
complications
Right-sided heart failure
arrhythmias
Increased risk of a stroke
Shortened life span
Pulmonary hypertension.
Eisenmenger syndrome.
leads to
Reversal of blood flow
Cyanosis
Pulmonary hypertension
A condition that results from abnormal circulation caused by a defect in the heart
Ventricular Septal Defects (VSD)
types
Membranous VSD.
Muscular VSD.
Atrioventricular canal type VSD.
Conal septal VSD.
complication
Lung problems
Heart failure
arrhythmias
Heart valve problems
Poor growth and development
Coarctation of the aorta
Pulmonary valve stenosis
Inherited heart conditions
Cardiomyopathies
Familial hypercholesterolemia (FH)
arrhythmias
History taking & Physical examination
History taking
asking specific and relevant questions that lead to the right diagnosis
asking about
Onset of pain
Lifestyle
Body's systems
Family history
Past medical history
Associated symptoms
Severity
Site of pain
Concerning symptoms
Palpitation
Shortness of breath
Chest pain
Edema
Syncope
Physical examination
Measuring
Blood pressure
Heart rate
Weight & height
Respiratory rate
Overall appearance
Cyanosis
Bluish discoloration of skin & mucous membrane due to increase level of deoxygenated hemoglobin
Types
Central cyanosis
Peripheral cyanosis
Clubbing fingers
abnormality where the end of finger & toes enlarge, and the nails curve
Auscultation
Using stethoscope to listen to the sounds inside the body
main regions
aortic
right 2nd intercostal space
pulmonary
left 2nd intercostal space
tricuspid
left 4th intercostal space
mitral
left 5th intercostal space in the midclavicular line
Study Designs
Analytic
Test hypotheses
Observational
Cross-sectional
Exposure and outcome simultaneously
"Are we related?" questions
Case-control
"Why me?" questions
Outcome first
Cohort
Exposure first
"What will happen to me?" questions
Experimental
RCT
Therapeutic questions
Descriptive
Generate hypotheses
Case series and reports
like
normal ECG
small VSD
Examples
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