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  • Question 1 - A 72-year old man has presented to the emergency room with sweating, nausea,...

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    • A 72-year old man has presented to the emergency room with sweating, nausea, chest pain, and an ECG that shows ST elevation. The ST segment of the ECG corresponds to a period of slow calcium influx in the cardiac action potential.
      This equates to which phase in the cardiac action potential?

      Your Answer: Phase 2

      Explanation:

      Understanding of the cardiac action potential helps with the understanding of the ECG which measures the electrical activity of the heart. This is reflected in its waveform.
      The rapid depolarisation phase is reflected in the QRS complex. After this phase comes the plateau phase which is represented by the ST segment. Lastly, the T wave shows repolarisation, phase 3.

      The cardiac action potential has several phases which have different mechanisms of action as seen below:
      Phase 0: Rapid depolarisation – caused by a rapid sodium influx.
      These channels automatically deactivate after a few ms

      Phase 1: caused by early repolarisation and an efflux of potassium.

      Phase 2: Plateau – caused by a slow influx of calcium. (ST segment)

      Phase 3 – Final repolarisation – caused by an efflux of potassium. (T wave)

      Phase 4 – Restoration of ionic concentrations – The resting potential is restored by Na+/K+ATPase.
      There is slow entry of Na+into the cell which decreases the potential difference until the threshold potential is reached. This then triggers a new action potential

      Of note, cardiac muscle remains contracted 10-15 times longer than skeletal muscle.

      Different sites have different conduction velocities:
      1. Atrial conduction – Spreads along ordinary atrial myocardial fibres at 1 m/sec

      2. AV node conduction – 0.05 m/sec

      3. Ventricular conduction – Purkinje fibres are of large diameter and achieve velocities of 2-4 m/sec, the fastest conduction in the heart. This allows a rapid and coordinated contraction of the ventricles

    • This question is part of the following fields:

      • Physiology And Biochemistry
      5.3
      Seconds

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