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Year 1 > Arrhythmia > Flashcards

Arrhythmia Flashcards

1
Q

Symptoms?

A 
Palpitations
SOB
Dizzy
Presyncope, syncope
Sudden cardiac death
angina, heart failure
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2
Q

Investigations?

A 
ECG 12 ld
CXR
Stress ECG
24hr ECG holter
Event recorder
EP study
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3
Q

When would a 24hr Holter ECG be used?

A
  • assess paroxysmal arrhythmia

- link symptoms to heart rhythm

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4
Q

When would a excersise ECG be used?

A
  • assess for ischaemia

- assess for excerise induced arrhythmia

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5
Q

What is an EP study?

A

Electrophysiological study
Trigger clinical arrhythmia and study mech/pathway
Opportunity to treat via radiofrequency ablation if extra pathway

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6
Q

T/F

Bradycardia is always pathological

A

F
found in athletes with low muscle tone
path - drug induced or ischaemia

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7
Q

Treatment for bradycardia?

A 
Acute: Atropine
Haemodynamic compromise (prevent blood flow): pacing
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8
Q

Treatment for tachycardia?

A

Treat underlying cause e.g. anxiety,fever, hypotension, drugs
Beta blockers for -ve chrono

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9
Q

T/F

Generally, atrial ectopic beats get no treatment

A

T
Lead to early QRS but usually followed by pause as rhythm reasserted
Beta blockers and avoiding stimulants may help

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10
Q

T/F

atrial ectopic beats can be asymptomatic

A

T

may also present with palpitations

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11
Q

T/F

Sinus arrhythmia is always pathological

A

F

phases of variation in HR with respiration in CHILDREN & ADOLESCENTS

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12
Q

Causes supraventricular tachycardia?

A
  • frequently ectopic (from either atria)
  • AV re entry
  • AV re entry due to accessory pathway
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13
Q

AVNRT?

A

AV node reentrant tachycardia

Re entry originates circuit WITHIN AV node

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14
Q

AVRT

A

AV re entry via path outside AV node - usually accessory pathway

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15
Q

What is the management for ACUTE supraventricular tachycardia?

A

Increase vagal tone - valsalva manouvere or carotid massage
Slow conduction in AVN
IV adenosine or verapamil

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16
Q

What is the management for CHRONIC supraventricular tachycardia?

A

Avoid stimulants
EP study and radiofrquency ablation (FIRST LINE IN YOUNG SYMPTOMATIC PATIENTS)
Beta blockers
antiarrhythmic drugs

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17
Q

How does EP study work?

A

ECG catheters placed in heart via femoral veins
Intracardiac ECG recorded during sinus rhythm, tachycardia & pacing manoevers to find location and mechanism of tachycardia
Ablate focus

18
Q

Causes heart block?

A

Ageing
MI
Myocarditis
Drugs (beta blockers, Ca2+ blockers)

19
Q

T/F

1st degree heart block not treated

A

T
rule out other pathology
long term follow up - could dveleop more advanced h block

20
Q

T/F

Mobitz I is usually vagal in origin

A

T

21
Q

T/F

Mobitz II is usually 5:1 normal beats to dropped beats

A

F
2:1 or 3:1
ventricular contraction only intiated every 2nd or 3rd beat

22
Q

T/F

Pacemaker is indicated in Mobitz II

A

T

23
Q

On an ECG 3rd degree AV block will present as…

A

Disassociation between P wave and QRS complex

24
Q

On an ECG Mobitz II AV block will present as…

A

Alternating completion of beats - lone p wave for 2, p wave with qrs for one

25
Q

On an ECG Mobitz I AV block will present as…

A

continual lengthening of PR until QRS goes missing

26
Q

When is pacing indicated?

A

Mobitz II and Type 3 Heart block

27
Q

What are features of transcutaneous pacing?

A

Painful for patient

Temporary - use until venous access gained for trans venous pacer

28
Q

What are features of transvenous pacing?

A
  • Via internal jugular vein, subclavian or femoral vein
29
Q

When is dual chamber pacemaker indicated?

A
  • dual chamber paces RA and RV
    maintains AV synchrony
    used for AVN disease
30
Q

What are premature ventricular contractions?

A
  • contractions with ventricular ectopic focus
  • because originate ventricles spread slowly
  • Broad QRS complex on ECG
31
Q

Premature ventricular contractions can predispose to more serious arrhythmias if..

A

develop during or after MI

32
Q

Causes of ventricular ectopics?

A

LVH
hert failure
Ischaemic heart disease

33
Q

Treatment ventricular ectopics?

A

Beta blockers

Ablation

34
Q

What is ventricular tachycardia?

A

ventricular ectopic beats

life threatening but may be haemodynamically stable

35
Q

What is monomorphic VT?

A

the QRS complex have similar configuration

Indicates stable re entrant pathway - MI scar?

36
Q

What is polymorphic VT?

A

Configuration QRS varies, HR varies

suggest multiple ectopic foci or unstable reentrant pathway - during or soon after MI

37
Q

rare causes of VT?

A

Long QT syndrome

Brugada syndrome

38
Q

What is VF?

A

Chaotic ventricular rhythm, incompatibility with cardiac output
deadly

39
Q

What is the treatment for VF?

A

Defibrillation

Cardiopulmonary resuscitation

40
Q

What is the treatment for acute VT?

A

Direct current cardioversion
If stable consider pharmacologic cardio version
Look for causes and correct (hypoxia, ischemia etc.)

41
Q

What is the treatment for chronic VT?

A

Correct ischemia
Optimise heart failure therapies
ICD if life threatening
Vt ablation

42
Q

T/F

Antiarrhythmic drugs are a good option for treating VT

A

F

Ineffective and associated with worse outcomes

Year 1 (15 decks)

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