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ECG > 27.8.2013(AV block) > Flashcards

27.8.2013(AV block) Flashcards

0
Q

Causes of first degree AV block

A 
Drugs
 Beta blockers
 CCB
 digitalis
Hypothyroidism 
Rheumatic fever
Enhanced Vagal tone 
Disease of conduction system
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1
Q

First degree AV block

A

PR Interval more than 0.20s

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2
Q

When does first degree AV block become symptomatic?

A

When p wave falls within QT interval of previous cycle

Synchronous contraction of both atria and ventricles,reduced cardiac output

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3
Q

S1 in first degree AV block

A

Intensity is diminished

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4
Q

Types of second degree AV block

A

Mobitz type 1 or wenkebach
Mobitz type 2
High degree AV block

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5
Q

Advanced second degree AV block

A

When two or more p waves are not followed by QRS complexes

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6
Q

How to diagnose type 1 second degree AV block

A

PR interval after pause is shortest and before pause is longest

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7
Q

ECG findings in type 1 Second degree AV block

A

Two or more consecutive p waves are conducted
Only single p waves are blocked
There is gradual prolongation of PR interval before a ventricular complex is dropped
PR intervals always shorten immediately after pause
QRS complexes are usually narrow
Group beating is present
RR intervals are variable

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8
Q

AV block and MI

A

Inferior MI- nodal AV block

Anterior MI- infra nodal block

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9
Q

Physiological causes of type 1 AV block

A

Sleep,due to increased Vagal tone

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10
Q

Causes of type I AV block

A 
Sleep
Intense Vagal stimulation due to cough or vomiting
Drugs
Myocarditis
Acute Rheumatic fever
Lyme disease
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11
Q

Cause of infra nodal AV block

A

Structural heart disease

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12
Q

Infra-nodal AV block is almost always associated with

A

Bundle branch block

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13
Q

Rx of first degree heart block

A

Permanent pacing is indicated only if PR interval is more than 0.30s and ventricular filling is impaired

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14
Q

Indications for pacemaker implantation in type 1 second degree AV block

A

Symptomatic patients with LV systolic dysfunction
Asymptomatic pts with infra nodal AV block
Asymptomatic pts with any level of AV block but with third degree block developing during exercise without myocardial ischemia and pts with myotonic dystrophy,erbs dystrophy,Peroneal muscular dystrophy

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15
Q

ECG findings in type 2 second degree AV block

A

Two or more consecutive p waves are conducted
Only single p waves are blocked
PR intervals are fixed and do not vary
QRS complexes are wide due to presence of bundle branch block
RR intervals are fixed

16
Q

Finding that is a must for diagnosis of type 2 second degree AV block

A

Presence of RBBB or LBBB with or without fascicular block

17
Q

Cause of type 2 second degree AV nodal block

A

One bundle has fixed block

Other bundle has intermittent block

18
Q

Acute infarct with type 2 second degree AV block,the mortality is higher because

A

It is usually due to extensive anterior wall infarct

19
Q

Etiologies of type 2 block

A

Sclerosis and calcification due to ageing
Infarct
Sarcoidosis
Amyloid
Neuromuscular dystrophy
After cardiac surgery or ablation procedures

20
Q

Autonomic nervous system and conduction system of heart

A

Sinus node and AV node are under the influence of both sympathetic and parasympathetic nervous system
Intra ventricular conduction system below AV node is influenced mainly by sympathetic nervous system

21
Q

Diff btw type 1 and type 2 second degree block,autonomic manoeuvres

A

Sympathetic stimulation improves type 1 block and worsens type 2 block
Parasympathetic stimulation improves type 2 block

22
Q

Ventriculophasic sinus arrythmia in 2:1 AV block

A

PP interval with QRS is shorter than PP without QRS

23
Q

Atropine is not effective if the AV block is

A

Infra nodal

24
Q

normal AH interval

A

60-125 msec

25
Q

Normal HV interval

A

35-55 msec

26
Q

Regular RR interval in AF

A

Complete heart block

27
Q

non respiratory cause of sinus arrythmia

A

digitalis

28
Q

Drug that can be given in place of pacemaker in sick sinus syndrome

A

theophylline 200-400mg/day

29
Q

Manoeuvre that can terminate a sinus arrest

A

forceful coughing

ECG (10 decks)

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