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Questions and Answers
At what time during fetal growth is the heart first fully developed?
40 Days
Which of the following L-R shunts is the last to close in the normal postpartum period, and when does it close?
Patent Foramen Ovale, closing at the end of the first week
During the resting state, which of the following ions are pumped out of the cells of the myocardium?
Sodium
Following electrical depolarization of the myocardial cell membrane, which ion rushes in first, and which ion rushes in later?
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Which ion helps slow heart muscle contraction?
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In the cardiac cell action potential, what phases are included in the absolute refractory period?
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When contracting against which of the following pressures will the velocity of muscle cell contraction be most rapid?
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What happens to the beat following a premature ventricular depolarization?
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All of the following increase preload?
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All of the following increase afterload?
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What is the predominant echo finding associated with increased preload?
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In a patient with a VSD, which of the following sites will provide a measure of pulmonic flow?
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Which of the following best describes a patient with severe MR?
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All are cardiac responses to increased sympathetic stimulation?
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During the cardiac cycle, which valve most closely follows the T wave on the ECG?
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Which flow pattern is most likely to be the longest?
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What is the normal O2 saturation of blood in the pulmonary artery?
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Where is oxygen saturation of blood the lowest?
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During systole, the aortic and LV pressures are quite different. What is this finding indicative of?
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During diastole, the RA pressure is much higher than RV pressure. What does this indicate?
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A patient has an ECG with five premature ventricular contractions in succession. What is this called?
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What is the minimum length of time that echo records need to be kept?
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Normally, how much fluid is found in the pericardial sac?
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Study Notes
Fetal Heart Development
- The heart is fully developed by 40 days of fetal growth.
Postpartum Heart Shunt Closure
- The last L-R shunt to close after birth is the Patent Foramen Ovale, typically closing by the end of the first week.
Ion Movement in Myocardium
- Sodium ions are pumped out of myocardial cells during the resting state.
- Following depolarization, sodium enters first, followed by calcium.
Heart Muscle Contraction
- Potassium ions help to slow down heart muscle contraction.
- Muscle cell contraction is most rapid against the lowest pressure; higher pressures hinder contraction.
Ventricular Depolarization Effects
- A premature ventricular depolarization results in a stronger than normal heart beat.
Preload and Afterload Influences
- Preload is increased by mitral regurgitation (MR), aortic insufficiency (AI), and volume overload.
- Afterload is increased by aortic stenosis (AS), aortic stenosis with hypertension (ASH), and hypertension (HTN).
Echo Findings
- Increased preload is predominantly indicated by left ventricular (LV) dilatation.
VSD and Pulmonic Flow
- In a patient with a ventricular septal defect (VSD), the mitral valve (MV) site measures pulmonic flow.
Severe Mitral Regurgitation Characteristics
- In patients with severe MR, the ejection fraction (EF) can range between 25% to 55% while regurgitant fraction (RF) can range from 25% to 50%.
Sympathetic Stimulation Responses
- Increased sympathetic stimulation leads to higher heart rates, enhanced contractility, and increased cardiac irritability.
Cardiac Cycle Velocities
- The atrioventricular (AV) valves close shortly after the T wave on the ECG during the cardiac cycle.
Flow Patterns
- The flow pattern with the longest duration observed is the diastolic deceleration time (PI).
Oxygen Saturation Levels
- Normal oxygen saturation in the pulmonary artery is around 75%.
- The lowest oxygen saturation is found in the coronary sinus.
Pressure Changes During Cardiac Phases
- During systole, significant pressure differences between aortic and LV pressures indicate aortic stenosis (AS).
- Elevated right atrial (RA) pressure in diastole compared to the right ventricle (RV) suggests tricuspid stenosis (TS).
Arrhythmia Identification
- Five consecutive premature ventricular contractions identified on an ECG indicate ventricular tachycardia.
Echo Record Keeping Requirements
- Minimum retention time for echo records is 7 years.
Pericardial Fluid Volume
- Normal volume of fluid in the pericardial sac is approximately 40 cc.
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Description
Test your knowledge on key concepts related to fetal heart development and cardiovascular physiology. This flashcard quiz covers important topics regarding the heart's growth and post-partum changes. Perfect for students preparing for the CCI exam in cardiovascular care.
