Objectives

1. 1. Compare and contrast the action potential characteristics of pacemaker and nonpacemaker cells; identify the relationship between action potential characteristics and the functions of these two cell types
  2. Identify the stages of the EKG and the events of the cardiac cycle associated with each stage
  3. Describe the cellular mechanisms of autonomic control of heart rate
  4. Describe the ways that changes in membrane excitability contribute to arrhythmias
  5. Describe the ways that changes in cell-to-cell action potential conduction contribute to arrhythmias
  6. List the risk factors for atrial fibrillation, and identify the ways that some of these risk factors relate to general mechanisms of arrhythmia generation
  7. Describe the cellular basis of myocardial contraction and relaxation
  8. Describe the concepts of preload, afterload, and contractility and the way each of these affects stroke volume and cardiac output
  9. Identify the events of the cardiac cycle with the correlated electrical activity, heart sounds, changes in left atrial, left ventricular, and aortic pressures, and ventricular blood volume
  10. Describe the effects of increased sympathetic nervous system activity on myocardial contractility and rate of relaxation—what are the mechanisms of these changes?
  11. Describe the normal pattern of blood flow to the left heart and the right heard—how does it differ from other vascular beds?
  12. List the factors that determine myocardial oxygen supply and myocardial oxygen demand
  13. describe different patterns of atherosclerotic coronary artery occlusion that result in the clinical syndromes of angina, non-ST segment elevation MI, and ST segment elevation MI.
  14. Identify unique aspects of coronary artery disease presentation and pathophysiology in women, compared to men.
  15. Describe the concept of heart failure (HF) and the two major subtypes of HF
  16. Relate the clinical manifestations of HF to their pathophysiological antecedents, considering the effect in the forward direction (the vascular bed normally supplied by the affected side of the heart) and the backward direction (the vascular bed that is filling that side of the heart)
  17. Identify the neurohormonal systems activated in a patient with HF; describe the ways in which these symptoms may be helpful in the short term while worsening outcome in the long term
  18. Distinguish between the types of valve disorders associated with systolic versus diastolic murmurs, and explain the differences between them
  19. Explain the pathophysiological basis of the clinical findings in a patient with aortic stenosis
  20. Classify the congenital heart disorders by the presence or absence of shunting or cyanosis and explain the differences between those disorders.
  21. Identify the congenital heart defects that may not be found until adulthood and explain their different trajectory of development

Pre-Lecture Review

Suggested Reading and Pre-Lecture Review

Draw It To Know It_Pre-Lecture Review_Heart and Circulation Review. (Links to an external site.)This tutorial is a review of the heart and circulatory system.

Chapter 10: The Heart [pg 325-387]. This is a dense chapter, please use the objectives as a reading guide.

Lecture

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Lecture:

Assignments

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Supplemental

Read and Review

Draw It To Know It Heart

Tandon, R., Sharma, M., Chandrashekhar, Y. et al. Revisiting the pathogenesis of rheumatic fever and carditis. Nat Rev Cardiol 10, 171–177 (2013). https://doi.org/10.1038/nrcardio.2012.197