Heart Rhythms: Normal or Abnormal (Arrhythmias)

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Heart Rhythms Normal or Abnormal (Arrhythmias)

• Anatomy Physiology L3

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Electrical Conduction

• SA Node (sinoatrial)
• Group of specialized myocytes near Sup. Vena cava
• Create action potential
• Creates an action potential approx 70-80 bpm
• Innervated by Brain stem
• Sympathetic Increase HR
• Vagus decrease HR

• AV node (atrioventricl.)
• Decremental conduction (AV delay 0.01 sec)
• Prevents premature contraction of ventricles
• Alone, can create a beat approx 40 bpm
• NOT strong enough to sustain life

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Interior anatomy of heart

• Bundle of His
• Collection of cardiac cells creating the AV node
• Conduct impulses along septum to the Purkinje
  fibers in walls of the ventricles
• Takes impulse about 0.03-0.04 sec to travel to
  the ventricles

• Purkinje fibers thin filaments
• Located on inner wall of endocardium
• Carry electrical impulse from SA and AV nodes
• Move from left to right

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Normal sinus rhythm
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Electrocardiogram (ECG or EKG)

• 12-lead (multi-angle)

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Acute MI
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Myocardial Infarction (heart attack)

• Mortality 500K 700K per year in US
• 1.3 million reported cases of MI
• 600 per 100K
• Complete obstruction of coronary artery(s)
  leading to portion of heart muscle to die

• Signs Symptoms
• Persistent chest pain
• Tightness in chest
• Difficulty breathing
• Jaw, neck, shoulder pain (referred pain)
• Sweating

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What do I Do?

• Recognize the signs
• Get immediate medical help
• BLS, Meds, Hospital
• Try to stabilize in the ER
• Time for Dr Burke

• Surgery
• Angioplasty
• Use of a stent
• Coronary Bypass

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TEST TIME! Good Luck!

• Anatomy of the Heart
• Pathway of blood flow
• Electrical conduction
• Common problems (ex atherosclerosis, pulmonary
  embolism, coronary thrombosis)
• Myocardial Infarction and the treatment of
• Common ECG readings