Normal Heart Stuff
This is the conduction gateway to the ventricles.
What is the atrioventricular (AV) node?
- What specific characteristics of the AV node allow it to ensure functional syncytium?
This cause of atrial fibrillation is related to a very stretched heart.
What is congestive heart failure OR dilated cardiomyopathy?
- How would an increased stretch of the heart trigger atrial fibrillation?
This cause of atrial fibrillation is a life-style choice and leads to increased sympathetic nervous system stimulation of the heart.
What is cocaine/methamphetamine use?
- How does the SNS increase heart rate at the cellular level?
This medication inhibits sodium-potassium ATPase, increasing sodium levels which increases the calcium concentration, producing more efficient contractions. It also provides parasympathetic stimulation.
What is digoxin?
- How do the effects of digoxin work to treat atrial fibrillation?
This class of medications operates on phase 2 and 3 of the cardiac conduction cycle to control atrial fibrillation.
What is class III antiarrhythmics? (Amiodarone and Sotalol)
This phase of normal cardiac conduction of action potentials involves the influx of calcium and the efflux of potassium.
What is phase 2?
- What role does calcium play inside the contractile cells?
This cause of atrial fibrillation can start in early childhood and involves mitral stenosis and increased risk for infective endocarditis.
What is rheumatic heart disease?
- How does rheumatic heart disease trigger atrial fibrillation?
This cause of atrial fibrillation includes hot flashes, increased sweating, weight loss, brittle hair/hair loss, prominent eyes, and difficulty sleeping. A person with these symptoms is most likely suffering from...
What is hyperthyroidism?
This medication can be used as a reversal agent for direct oral anticoagulants.
What is Kcentra OR Andexxa?
- What is the MOA of these drugs?
- What are the reversal agents for other anticoagulants?
This form of rate control in atrial fibrillation treatment prevents norepinephrine and epinephrine effects on the heart.
What is beta-1 adrenergic blockers? (Metoprolol)
This receptor binds to this neurotransmitter, sent by the parasympathetic nervous system to decrease heart rate.
What is the muscarinic type 2 receptor and acetylcholine.
- What happens at the cellular level after Ach binds to the M2 receptor?
This cause of atrial fibrillation can lead to dilation of the left atrium and decreased left ventricular filling.
What is mitral stenosis?
- How would mitral stenosis trigger atrial fibrillation?
A man is celebrating at his retirement party and consumes a large amount of alcohol. A day later, he presents to the emergency room with shortness of breath, fatigue, and palpitations. With an increase in reactive oxygen species, increased sympathetic nervous system stimulation, and electrolyte abnormalities, he is most likely suffering from atrial fibrillation due to...
What is holiday heart syndrome?
This side effect of warfarin requires bridging with heparin.
What is the paradoxical procoagulant effect?
- Can someone explain this effect?
This class of calcium channel blockers is used to treat atrial fibrillation.
What is non-dihydropyridine calcium channel blockers? (Diltiazem and Verapamil)
- What is the difference between dihydropyridine calcium channel blockers and non-dihydropyridine calcium channel blockers?
This refers to the 20-30% of blood that is pumped into the ventricle at the end of atrial systole.
What is the atrial kick?
- What can happen if the heart is not able to perform the atrial kick?
- What disease processes can decrease/eliminate atrial kick?
- How does a loss of atrial kick lead to atrial fibrillation?
- What complication can occur do to decreased atrial kick?
This cause of atrial fibrillation is a common disease process that can lead to left ventricular hypertrophy.
What is hypertension?
This cause of atrial fibrillation involves elevated white blood cell counts and fevers and increases sympathetic nervous system stimulation of the heart.
What is sepsis?
This drug prolongs the refractory period by blocking potassium and sodium channels and has antisympathetic properties.
What is Amiodarone?
- What class does this drug belong to in the Vaughn-Williams Classification of antiarrhythmics?
A patient with a history of gastroesophageal reflux disease, on omeprazole, is stable with persistent atrial fibrillation. On echocardiogram there is a left atrial clot noted. The patient will be started on this anticoagulant medication.
What is rivaroxaban OR apixaban OR dabigatran?
- Can anyone draw the normal clotting pathway and point out where each anticoagulant exerts its effects? Where would aspirin exert its effects?
- What is the significance of omeprazole use and concomitant warfarin use?
This form of conduction does not require outside stimulation to produce cardiac contraction.
What is intrinsic cardiac conduction?
- Can anyone explain how this occurs at the cellular level?
- How do the nodal cells communicate to the contractile cells?
This cause of atrial fibrillation involves ischemia.
What is coronary artery disease OR myocardial infarction?
This cause of atrial fibrillation can lead to hypoxemia and decreased oxygen supply to the heart.
What is chronic obstructive pulmonary disease OR pneumonia OR pulmonary embolism?
This class of antiarrhythmics prolongs phase 0 of normal cardiac action potentials.
What is class I antiarrhythmics?
- What drugs are in this class? Double Quarter Pounder - Lettuce, Mayo, Tomato - Fries please
These two scoring systems are used to determine anticoagulation treatment in patients with atrial fibrillation.
What is the CHA2DS2-VASc score and the HAS-BLED score?
- Can anyone explain the CHA2DS2-VASc scoring system?