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Closure of the interventricular foramen with formation of the interventricular membranous septum results from the fusion of tissue from three sources: A. coronary sinus, myocardium, and endocardial cushions. B. left bulbar ridge, right bulbar ridge, and the endocardial cushions. C. septum primum, septum secundum, and endocardial cushions. D. septum primum, septum secundum, and myocardium. E. sinus venarum, crista terminalis, and endocardial cushions.   Notes: Comprehension Answers A, D, & E are unrelated to the interventricular septum. Ans C is related to septation in the atria. Ans B, the left and right bulbar ridges and the endocardial cushions compose the interventricular membranous septum.

In mitral stenosis the ECG is often normal. Pathological changes in the ECG include: *.left atrial hypertrophy: *.causes P mitrale *.increased voltage in the later part of the P wave gives it a large, bifid appearance in leads II, III and aVF *.the second half of the P wave is negative in V1 *.atrial fibrillation is present in 60 to 70% *.right ventricular hypertrophy: *.a dominant R wave in V1 and V2 indicates pulmonary hypertension *.right axis deviation *.there may be digitalis effects

1. Which of the following is NOT an inward current? A. I Na B. I Ca C. I f D. I Na-K (pump) Correct Answer: D 2. In the image, which curve represents the IK1? A. A B. B C. C D. D E. E Show answer Correct Answer: B 3. Which of the following would cause the change from curve A to curve B in heart contractility? A. Norepinephrine B. Acetylcholine C. Intracellular acidosis D. Ca channel blockers Show answer Correct Answer: A 4. Which letter indicates the point in the cardiac cycle that the mitral valve opens? A. A B. B C. C D. D E. F Show answer Correct Answer: D 5. Which letter in the image represents the pressure reaction in the left atrium as the mitral valve bulges during ventricular contraction followed by the stretching of the atrium due to tension of the AV ring? A. L B. K C. F D. D Show answer Correct Answer: B 6. Which letter in the image represents the isovolumetric contraction o...

Regular rhythm in presence of fixed AV block. Ventricular rate ~150 bpm in presence of 2:1 AV block. Flutter waves / ‘saw-tooth pattern’ best seen in leads II, III, aVF and V 1. Flutter wave morphology depending on type of atrial flutter (see above). QRS complexes usually  < 120 ms unless pre-existing bundle branch block, accessory pathway, or rate related aberrant conduction. Variable AV block will result in an irregular rhythm. Absence of an isoelectric baseline. Atrial flutter with a 3:1 block

WORD W PW O ld MI R BBB D extrocardia

I schemia N ormality [esp. young, black] V entricular hypertrophy E ctopic foci [eg calcified plaques] R BBB, LBBB T reatments [digoxin]

D rooping valve (MVP) E nlargement of LV with strain P otassium loss (hypokalemia) R eciprocal ST- depression (in I/W AMI) E mbolism in lungs (pulmonary embolism) S ubendocardial ischemia S ubendocardial infarct E ncephalon haemorrhage (intracranial haemorrhage ) D ilated cardiomyopathy S hock T oxicity of digitalis, quinidine

E lectrolytes L BBB E arly repolarization V entricular hypertrophy A neurysm T reatment (eg pericardiocentesis) I njury (AMI, contusion) O sborne waves (hypothermia) N on-occlusive vasospasm

A mnemonic to remember the ECG changes is WiLLiaM MaRRoW, i.e. with Left bundle branch block there is a W in V1 and a M in V6 and with a RBBB there is a M in lead V1 and a W in lead V6

Rate pressure product , also known as Cardiovascular Product or Double Product , is used in cardiology and exercise physiology to determine the cardiovascular risk of subjects. Rate Pressure Product (RPP) = Heart Rate (HR) * Systolic Blood Pressure (SBP) HR (beats per minute) SBP (mmHg) RPP (bpm*mmHg) Rate pressure product is a measure of the stress put on the cardiac muscle based on the number of times it needs to beat per minute (HR) and the arterial blood pressure that it is pumping against (SBP). It will be a direct indication of the energy demand of the heart and thus a good measure of the energy consumption of the heart. Rate pressure product allows you to calculate the internal workload or hemodynamic response. Hemodynamic Response RPP High more than 30000 High Intermediate 25000 - 29999 Intermediate 20000 - 24999 Low Intermediate 15000 - 19999 Low 10000 - 14999