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Cardiology > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

Two shockable rhythms

A

Ventricular tachycardia and ventricular fibrilation

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2
Q

Two non-shockable rhythms

A

Pulseless electrical activity and asystole

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3
Q

Treatment of tachycardia in an unstable patient

A

Consider 3 synchronicsed shocks or consider amiodarone infusion

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4
Q

Treatment of atrial fibrilation in a stable patient

A

Rate control with beta blocker or diltiazem

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5
Q

Treatment of atrial flutter in a stable patient

A

Contral rate with beta blocker

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6
Q

Treatment of SVT in a stable patient

A

Vagal manoeuvres and adenosine

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7
Q

Treament of ventricular tachycardia in stable patient

A

Amiodarone infusion

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8
Q

What causes an atrial flutter

A

Re-entrant rhythm in either atria, which is where the signal re-circulates in a self-perpetuating loop due to an external pathway.

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9
Q

bpm of atria in atrial flutter

A

Atrial contraction of 300bpm as signal goes around without interuption

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10
Q

bpm of ventricles in atrial flutter

A

150bpm as the signal makes it into to ventricles every second lap due to long refractory period of AV node

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11
Q

Appearance of atrial flutter on ECG

A

Sawtooth appearance - P wave after P wave

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12
Q

Associated conditions with atrial flutter

A

Hypertension, ischaemic heart disease, cardiomyopathy, thyrotoxicosis

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13
Q

Treatment of atrial flutter

A

Treat underlying condition, rate/rhythm control, radiofrequency ablation of re-entrant rhythm and risk score

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14
Q

Cause of supraventricular tachycardia

A

electrical signal re enters the atria from the ventricles, then travels through AV node resulting in another ventricular contraction, causing a self-perpetuating loop

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15
Q

ECG of supraventricular tachycardia

A

Narrow complex tachycardia of QRS <0.12, where T wave immediately follows a QRS

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16
Q

Three main types of SVT

A

Atrioventricular nodal re-entrant tachycardia. Atrioventricular re-entrant tachycardia. Atrial tachycardia (other than SAN)

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17
Q

Stepwise approach for treating stable patient with SVT

A

Valsalva manoeuvre, carotid sinus massage, adenosine, verapamil, direct current cardioversion

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18
Q

How does adenosine work

A

Slows cardiac conduction primarily through the AV node, interupting the pathway

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19
Q

When should you avoid giving adenosine to a patient

A

asthma, COPD, heart failure, heart block, severe hypotension

20
Q

How to administer adenosine

A

Fast IV bolus into a large proximal cannula. 6mg, then 12mg then further 12 is no improvement

21
Q

What is paroxysmal SVT

A

Situation where SVT reoccurs and remits in the same patient over time

22
Q

Prevention measures in patients with paroxsymal SVT

A

Medication - beta blockers, calcium channel blockers, amiodarone. Radiofrequency ablation

23
Q

Cause of Wolff-Parkinson White Syndrome

A

Extra electrical pathway connecting the atria and ventricles.

24
Q

Treatment of WPW syndrome

A

Radioferquency ablation of accessory pathway

25
Q

ECG changes in WPW syndrome

A

Short PR interval, wide QRS complex, delta wave (slurred upstroke on QRS compex

26
Q

When are most antiarrhythmic medications contraindicated in a patient with WPW syndrome

A

Combination of WPW syndrome and AF or atrial flutter

27
Q

What is torsades de pointes

A

Polymorphic ventricular tachycardia, occuring in patients with a prolonged QT interval

28
Q

Causes of prolonged QT interval

A

Long QT syndrome, medications and electrolyte disturbances

29
Q

Which medications can cause prolonged QT

A

antipsychotics, citalopram, flacainide, sotalol, amiodarone, macrolide antibiotics

30
Q

Which electrolytes disturbances can cause long QT

A

hypokalaemia, hypomagnesaemia, hypocalcaemia

31
Q

Acute management of torsades de pointes

A

Correct the cause, magnesium infusion, defibrilation if VT occurs

32
Q

Long term management of prolnoged QT syndrome

A

Avoid medications, correct electrolyte disturbances, beta blockers, pacemaker or implantable defibrilator

33
Q

What are ventricular ectopics

A

Premature ventricular beats caused by random electrical discharges from outside the atria.

34
Q

ECG of ventricular ectopies

A

Individual, random, abnormal broad QRS complexes on a backgruond of a normal ECG

35
Q

What is Brugada syndrome

A

Genetic condition involving sodium channels

36
Q

Symptoms of Brugada syndrome

A

Asymptomatic, palpitations, syncope,

37
Q

Cause of Brugada syndrome

A

Arrhythmias such as AV nodal re-entry tachycardias, VT or VF

38
Q

Diagnosis of Brugada syndrome

A

ECG and one of the following: VF/polymorphic VT, FHx of sudden cardiac death<45, syncope/ECG signs in family, inducible VT, nocturnal agonal breathing

39
Q

Management of Brugada syndrome

A

Avoidance of risks, ICD to reudce risk of sudden death from arrhythmias

40
Q

Risks to avoid in Brugada syndrome

A

Fever, excess EtOH, dehydration, electrolye imbalances, certain drugs

41
Q

What is Torsades de Pointes

A

Polymorphic VT that can occur in patients with a long QT interval

42
Q

Complications of Torsades de Pointes

A

Degenerate into VF, causing haemodynamic compromise

43
Q

Causes of Torsades de Pointes (TIIMMES)

A

Toxins, Inherited, Ischaemia, Myocarditis, Mitral valve prolapse, Electrolyte abnormalities, Subarachnoid haemorrhage

44
Q

Management of Torsades de Points in unstable patients

A

Direct current cardioversion

45
Q

Management of Torsades de Pointes in stable patients

A

IV magnesium sulphate, 2g over 1/2 mins

Cardiology (22 decks)

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