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my heart skipped a beat, mainly include, which is, its, include, divided…

- - - - Right atrium near the entrance of the superior vena cava
      - Initiates all heartbeat and determines heart rate
    - - Interatrial bundle
    - - Right atrium near the AV valve
      - It delays the passage of electrical impulses to the ventricles
  - - - Phase 0
        
        Phase 3
        
        Phase 4
    - - Phase 0
        
        Phase 1
        
        Phase 2
        
        Phase 3
        
        Phase 4
- - - - rapid close of the thickened mitral valves
    - - the valve snapping into the left ventricle
        
        low-pitched decrescendo-crescendo diastolic murmur
- - - - Delayed repolarization
      - Prolonged QT interval
        
        Torsade de pointes
    - - Pulmonary fibrosis, neuropathy, blue-gray skin discoloration
  - - - Slow heart rate and conduction velocity
  - - - diminish phase 4
        
        decrease HR & contractility
  - - - Slows down AV nodal conduction
      - AFib to slow ventricular rate
    - - Decreases conduction velocity and prolongs refractory period
      - Acute supraventricular tachycardia (IV)
    - - Blocks influx of calcium into cells
      - Acute management of torsade de pointes
  - - - intermediate association/dissociation to Na channels
        
        moderate effect on depolarization
      - inhibit K+ channels
        
        increase EFP
      - oral
      - Quinidine
        
        cinchonism
      - procainamide
      - disopyramide
        
        anticholinergic effects
    - - rapidly dissociate from Na+ channels
        
        weak effect on phase 0
      - shortens phase 3
        
        decrease action potential duration
      - lidocaine
        
        ventricular tachycardia
        
        CNS effects
      - Mexiletine
        
        ventricular arrhythmia
        
        nausea/vomiting
      - IV
    - - slowly dissociate from Na+ channels
        
        markedly slows phase 0
      - orally
      - flecainide
        
        blurred vision, dizziness, nausea, vomiting
      - propafenone
- - - - Paroxysmal supraventricular tachycardia
        
        reentrant circuit that loops within the AV node
        
        Rate 150-250 bpm
        
        Absence of normal P-wave
        
        Narrow QRS complex
        
        Retrograde P waves
        
        Regular Rhythm
      - Electrical activity is trapped in a circular electric racetrack, altering normal conduction
      - Atrial fibrillation
      - Atrial Flutter
    - - Multifocal atrial tachycardia
        
        multiple ectopic foci firing from the atrium
        
        Irregularly irregular rhythm
        
        HR 100 to 200 bpm
        
        P-waves are present but varies in size
      - Electrical activity originates from a place other than the sinus node
    - - Sinus Bradycardia
        
        normal P waves before each QRS complex.
        
        regular rhythm
        
        HR below 60
        
        Pathologically
        
        Increased intracranial pressure
        
        Hypothyroidism
        
        Hypothermia
        
        Medications
        
        Beta-blocker
        
        Calcium channel blocker
        
        Physiologically
        
        During sleep
        
        In athletes
      - Sinus Tachycardia
        
        normal P waves before each QRS complex.
        
        regular rhythm
        
        HR above 100
        
        Physiologically
        
        During exercise
        
        In pregnancy
        
        Pathologically
        
        acute heart failure
        
        Hypovolemia
        
        hyperthyroidism
        
        Hyperthermia
        
        Anemia
- - - - Disturbed blood flow
      - Hypercoagulation
      - endothelial injury
    - - Venous thrombus
        
        Fibrin, RBCs, WBCs, platelets
        
        Deep vein thrombosis
        
        Pulmonary Embolism
      - arterial thrombus
        
        mainly platelets
        
        renal infarction
        
        gangrene
        
        Stroke
- - - - Increase risk of strokes and lead to heart Failure
    - - Upper chambers to quiver
  - - - Valvular abnormalities
- - - - inerventicular septum depolarisation
    - - Ventricular apex depolarisation
    - - Ventricular base depolarisation
  - - - hyperkalemia
    - - Hypokalaemia