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Cardio CP1 > 7 Arrhythmias + EKG practice > Flashcards

7 Arrhythmias + EKG practice Flashcards

1
Q

How would you classify this rhythm?

A

Atrial fibrillation

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2
Q

How would you classify this rhythm?

A

Atrial fibrillation

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3
Q

How would you classify this rhythm?

A

Ventricular tachycardia

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4
Q

How would you classify this rhythm?

A

Ventricular Fibrillation

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5
Q

How would you classify this rhythm?

A

Ventricular asystole

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6
Q

The length of action potential correlates with what part of the EKG?

A

The QT interval

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7
Q

How do drugs target fast versus slow response cells in the heart?

A
  • Na blockers target fast response cells (rely on Na for depolarization)
    • class I (quinidine)
  • Ca blockers target slow response cells (rely on Ca for depolarization)
    • verapamil, diltiazem
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8
Q

How does the recovery of excitability differ between fast and slow response cells?

A

Fast response= prompt recovery (ends with repolarization)

Slow response= delayed recovery (outlasts repolarization)

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9
Q

How does para/symp innervation affect fast and slow response cells?

A
  • Fast response
    • Catecholamine (SNS)= little effect on depolarization
    • Acetylcholine (PS)= no effect on depolarization
  • Slow response
    • Catecholamine (SNS)= enhances depolarization
    • Acetylcholine (PS)= significantly depresses depolarization
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10
Q

What are the 3 main mechanisms of arrhythmias?

A
  1. abnormal automaticity (enhanced/reduced)
  2. triggered automaticity (afterdepolarizations)
  3. reentry (abnormal impulse conduction… most common)
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11
Q

What 3 characteristics of an AP can be altered to increase the rate of automaticity?

A
  1. increase the slope of phase 4 (slow/leaky Ca depolarization before threshold)
  2. make the threshold potential more negative (easier to reach)
  3. make maximum diastolic potential (MDP; how negative the cell is repolarized to) more positive
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12
Q

Contrast early and late afterdepolarizations

A
  • Early
    • disrupts repolarization
    • can progress to torsades de pointes
  • Delayed/late
    • occurs after repolarization
    • triggered by leaky ryanodine receptors (increase Ca)
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13
Q

What is CPVT?

A

Catecholaminergic polymorphic ventricular tachycardia

**an inherited arrhythmogenic disease caused by a genetic mutation of the ryanodine receptor (results in the aberrant release of Ca from the SR)

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14
Q

What are the 3 requirements for establishing a reentrant circuit

A
  1. multiple parallel pathways
  2. unidirectional block
  3. conduction time > effective refractory period
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15
Q

Describe the mechanism of AVNRT

A
  • AV Node Reentry
  • Patient normally has sinus rhythm because slow pathway conduction is blocked due to collission with the fast
  • A critically timed atrial premature beat allows conduction down the slow but not the fast pathway (fast still in refractory from previous beat)
    • allows slow pathway to “reenter” and come up the fast pathway retrograde
    • enters a cycle of continous atrial/ventricular depolarization
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16
Q

How does AVRT look on EKG? What are the common symptoms?

A
  • Narrow QRS complex tachycardia
  • Symptoms
    • palpitations
    • dizziness
    • dyspnea
    • chest pain
17
Q

What are the 4 main ways antiarrhytmic drugs reduce spontaneous discharge in autonomic tissues?

A
  1. Decreased phase 4 slope
  2. Increased AP threshold (decrease # of Na channels)
  3. Increased maximum diastolic potential
  4. Increased AP duration
18
Q

How would you classify this rhythm?

A

Atrial flutter

19
Q

How would you classify this rhythm?

A

Slow-Fast AV nodal re-entrant supraventricular tachycardia

**Retrograde P waves in II

**ST and/or T wave abnormality consistent with myocardial ischemia

20
Q

How would you classify this rhythm?

A

Sinus rhythm with 1st degree AV block

21
Q

How would you classify this rhythm?

A
  • Sinus rhythm
  • Mobitz Type 1, 2nd degree AV block
    • “5:4 nodal wenckebach”
  • Acute Inferolateral wall myocardial infarction (ST elevation in II, III and avF)
22
Q

How would you classify this rhythm?

A

Third degree AV block with ventricular escape (Atrial rate: 95/min, Ventricular rate: ~36/min)

23
Q

How would you classify this rhythm?

A
  • Sinus rhythm
  • 1st degree AV block (PR interval ~210 msec)
  • PVCs (with RBBB morphology)
  • Possible Inferior wall MI (Q waves inferior leads)
24
Q

How would you classify this rhythm?

A

Wide QRS tachycardia with LBBB / Inferior QRS axis

25
Q

How would you classify this rhythm?

A

RBBB VT with “Northwest” frontal plane axis

26
Q

What are the hallmarks of ventricular tachycardia?

A
  1. Wide often bizarre QRS
  2. Frontal QRS axis markedly different from sinus rhythm
  3. R wave peak time in lead II > 50 msec
  4. Onset of QRS to nadir of S wave > 100 msec in precordial leads
  5. AV dissociation
  6. Absence of an R wave in all precordial leads

Cardio CP1 (16 decks)

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