NBME CBSE
Bulbus cordis –
Smooth parts (outflow tract) of left and right ventricles
endocardial cushions –
Atrial septum, membranous interventricular septum; AV and semilunar valves
neural crest
left horn of the sinus venosus –
coronary sinus
posterior, sub cardinal, and supra cardinal veins –
IVC
Right common cardinal vein and right anterior cardinal vein –
SVC
Right horn of sinus venosus –
Smooth part of right atrium (sinus venarum)
Patent foramen ovale –
failure of septum primum and septum secundum to fuse after birth
Transposition of the great vessels
Tetralogy of Fallot
Persistent truncus arteriosus –
Conotruncal abnormalities associated with failure of neural crest cells to migrate
ductus venosus –
connects the umbilical vein to the inferior vena cava, bypassing the liver
becomes ligamentum venosum
phrenic nerve –
innervates the diaphragm and pericardium
S3 heart sound –
Increased ventricular filling pressure (e.g., mitral regurgitation, HF), common in
dilated ventricles
normal in kids and pregnant women
,S4 heart sound –
atrial kick late diastole, right before S1
best heard at apex in LLD position
High atrial pressure.
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
Always abnormal
atria contract –
a wave of JVP
c wave –
RV contraction (closed tricuspid valve bulging into atrium) wave of JVP
x descent –
JVP wave corresponding to downward displacement of closed tricuspid valve
during rapid ventricular ejection phase
reduced or absent in tricuspid regurge
V wave –
JVP wave corresponding to inc'd RA pressure due to filling against closed
tricuspid valve
y descent –
JVP wave corresponding to RA emptying into RV
absent in cardiac tamponade
plusus parvus et tardus –
pulses are weak with delayed peak
Aortic stenosis
PR interval –
0.12-0.20 seconds
120 milliseconds
QT interval length –
9 - 11 squares = .36 to .44 seconds
Hypokalemia –
, U wave present on ECG
Mg sulfate –
for torsades de pointe, hypokalemia (can lengthen QT and cause torsades), and
pre-eclampsia (prevent seizures)
Romano-Ward syndrome –
-Congenital long QT syndrome
-Autosomal dominant, pure cardiac phenotype (no deafness).
Jervell and Lange-Nielsen syndrome –
-Congenital long QT syndrome
-Autosomal recessive, sensorineural deafness
Brugada syndrome –
-Autosomal dominant disorder affecting Na channels most common in Asian
males.
-ECG pattern of pseudo-right bundle branch block and ST elevations in V1-V3
(anterior ventricular septum)
-inc risk of ventricular tachyarrhythmias and sudden cardiac deatgh
Prevent SCD with implantable cardioverter-defibrillator (ICD).
Wolff-Parkinson-White Syndrome –
Most common type of ventriuclar pre-excitation sydnrome. Abnormal fast
accessory conduction pathway from atria to venricle bypasses the rate-slowing
AV node causing a delta wave and widening QRS with shortened PR interval.
Could lead to a reentrant circuit and suprvaventicular tachy.
First degree AV block –
- PRI >5 boxes/.20 sec (200 msec)
- Fixed but prolonged PRI
(consistent but long)
- normally get bradycardia here
second degree AV block mobitz type 2 –
-PR interval is constant
-atrial conduction to ventricle is intermittent: dropped QRS without increasing PR
interval length
-disease below AV node in His bundle
may progress to 3rd degree/complete AV block
Second Degree AV Block Mobitz Type 1 (wenckebach) –
Progressive lengthening of pr interval leading to dropped QRS
Bulbus cordis –
Smooth parts (outflow tract) of left and right ventricles
endocardial cushions –
Atrial septum, membranous interventricular septum; AV and semilunar valves
neural crest
left horn of the sinus venosus –
coronary sinus
posterior, sub cardinal, and supra cardinal veins –
IVC
Right common cardinal vein and right anterior cardinal vein –
SVC
Right horn of sinus venosus –
Smooth part of right atrium (sinus venarum)
Patent foramen ovale –
failure of septum primum and septum secundum to fuse after birth
Transposition of the great vessels
Tetralogy of Fallot
Persistent truncus arteriosus –
Conotruncal abnormalities associated with failure of neural crest cells to migrate
ductus venosus –
connects the umbilical vein to the inferior vena cava, bypassing the liver
becomes ligamentum venosum
phrenic nerve –
innervates the diaphragm and pericardium
S3 heart sound –
Increased ventricular filling pressure (e.g., mitral regurgitation, HF), common in
dilated ventricles
normal in kids and pregnant women
,S4 heart sound –
atrial kick late diastole, right before S1
best heard at apex in LLD position
High atrial pressure.
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
Always abnormal
atria contract –
a wave of JVP
c wave –
RV contraction (closed tricuspid valve bulging into atrium) wave of JVP
x descent –
JVP wave corresponding to downward displacement of closed tricuspid valve
during rapid ventricular ejection phase
reduced or absent in tricuspid regurge
V wave –
JVP wave corresponding to inc'd RA pressure due to filling against closed
tricuspid valve
y descent –
JVP wave corresponding to RA emptying into RV
absent in cardiac tamponade
plusus parvus et tardus –
pulses are weak with delayed peak
Aortic stenosis
PR interval –
0.12-0.20 seconds
120 milliseconds
QT interval length –
9 - 11 squares = .36 to .44 seconds
Hypokalemia –
, U wave present on ECG
Mg sulfate –
for torsades de pointe, hypokalemia (can lengthen QT and cause torsades), and
pre-eclampsia (prevent seizures)
Romano-Ward syndrome –
-Congenital long QT syndrome
-Autosomal dominant, pure cardiac phenotype (no deafness).
Jervell and Lange-Nielsen syndrome –
-Congenital long QT syndrome
-Autosomal recessive, sensorineural deafness
Brugada syndrome –
-Autosomal dominant disorder affecting Na channels most common in Asian
males.
-ECG pattern of pseudo-right bundle branch block and ST elevations in V1-V3
(anterior ventricular septum)
-inc risk of ventricular tachyarrhythmias and sudden cardiac deatgh
Prevent SCD with implantable cardioverter-defibrillator (ICD).
Wolff-Parkinson-White Syndrome –
Most common type of ventriuclar pre-excitation sydnrome. Abnormal fast
accessory conduction pathway from atria to venricle bypasses the rate-slowing
AV node causing a delta wave and widening QRS with shortened PR interval.
Could lead to a reentrant circuit and suprvaventicular tachy.
First degree AV block –
- PRI >5 boxes/.20 sec (200 msec)
- Fixed but prolonged PRI
(consistent but long)
- normally get bradycardia here
second degree AV block mobitz type 2 –
-PR interval is constant
-atrial conduction to ventricle is intermittent: dropped QRS without increasing PR
interval length
-disease below AV node in His bundle
may progress to 3rd degree/complete AV block
Second Degree AV Block Mobitz Type 1 (wenckebach) –
Progressive lengthening of pr interval leading to dropped QRS
