FAISAL WORKS IN HIS GARDEN

conduction system of the heart
1. AP in ventricular myocyte
  1. phase 0: Na+ influx
  2. phase 1: Na+ close & K+ open
  3. phase 2: Ca2+ influx (L-type)
  4. phase 3: K+ efflux
  5. phase 4: K+ conductance
2. AP in SA node
  1. phase 0: Ca2+ influx
  2. phase 4: Na+ influx by HCN channels
  3. phase 3: K+ efflux
Heart anatomy
1. Grooves
  1. Atrioventricular (coronary) groove
  2. Anterior interventricular groove
  3. Interatrial groove
  4. Posterior interventricular groove
2. Pericardium
  1. inner Serous pericardium
    1. Parietal layer
    2. Visceral layer
  2. Outer fibrous pericardium
3. Located in the inferior mediastinum
4. External features
  1. 4 Surfaces
    1. Sternocostal surface
      1. Atrial portion
      2. Ventricular portion
    2. Diaphragmatic surface
    3. Left “pulmonary” surface
    4. Right “pulmonary” surface
  2. 4 borders
    1. Left border
    2. Right border
    3. Superior border
    4. Inferior border
  3. Base
    1. Directed backward, to the right
    2. Formed by left atrium / part of right atrium.
  4. Apex
    1. Directed downwards, forwards,to the left
    2. Lie in the 5th IC
    3. Formed by left ventricle
5. Heart wall
  1. Epicardium
  2. Myocardium
  3. Endocardium
Sick Sinus Syndrome
1. Causes
  1. Neuromuscular diseases
  2. Inflammatory diseases
  3. Age
  4. Obstructive sleep apnea
  5. Rare genetic mutations
2. Pathophysiology
  1. Mechanism of sinus bradycardia
    1. lower MDP
    2. Higher threshold
    3. Reduced sodium current flow
  2. Mechanism of tachycardia
    1. AV node ectopic focus
    2. Enhanced SA automaticity
3. manifestations
  1. Bradychardia-tachycardia syndrome
  2. Sinus arrest
  3. SA block
  4. chronotropic incompetence
4. Management
  1. Non-Pharmacological
    1. Pacemaker
  2. Pharmacological
    1. Class I: Na+ Channel Blockers
      1. Class Ia
      2. Class Ib
      3. Class Ic
    2. Class IV: Ca+2 -Channel Blockers
    3. Class II: Beta-blocker
    4. Class III: K+-Channel Blockers
5. Risk factors
  1. High blood pressure
  2. High cholesterol
  3. Excess body weight
  4. Lack of exercise
  5. history of congenital heart disease
Unconsciousness & Fainting
1. Signs to check for:
  1. Pain responds
  2. unresponsiveness
  3. Verbal stimulus
  4. Awake
arrhythmias
1. Brady arrhythmias
2. tachyarrhythmias

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FAISAL WORKS IN HIS GARDEN

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	Creado por Mai Hussein hace casi 4 años