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CABS cardiology > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What is a PAC

A

premature atrial contraction

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2
Q

Where does a PAC originate

A

Either atrial tissue or AV node

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3
Q

If a PAC originates in the AV node, what is it known as

A

Junctional

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4
Q

What are causes of PAC

A

idiopathic
Toxins
ACS
COPD
Atrial myopathy

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5
Q

What are PVCs

A

Premature ventricular contractions

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6
Q

Where do PVCs originate

A

Ventricular myocardium

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7
Q

What are some causes of PVCs

A

Reentry from cardiac scarring
Ischemia
Catecholamine surge
Electrolyte abnormality

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8
Q

What is it called when there are multiple PVCs occurring but from different areas of the myocardium

A

multiform PVC

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9
Q

What is Bigeminy

A

Every 2 beats there is a PVC

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10
Q

What is trigemini

A

2 normal beats and then a PVC

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11
Q

What are the subtypes of PVCs

A

Bigeminy
Trigeminy
Quadreminy

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12
Q

How are PVCs classified

A

Morphology
Frequency
Symptomatic vs. asymptomatic
exertional or not

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13
Q

What is a block

A

Delay in conduction along the ventricular pathway

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14
Q

What is a first degree AV block

A

a delay in transmission from atria to ventricles

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15
Q

What will first degree block look like on EKG

A

Prolonged PR interval

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16
Q

What can cause first degree AV block

A

increased vagal tone
Fibrosis / scarring
Idiopathic
Familial disease

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17
Q

What is second degree AV block

A

Intermittent Av conduction

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18
Q

What are the two subtypes of second degree AV block

A

Mobitz type 1
Mobitz type 2

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19
Q

What is mobitz type 1

A

Wenckebach
*Progressive prolongation until beat drop
-First PR is normal

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20
Q

What is Mobitz type 2

A

PR is maintained but will occasionally not conduct through the ventricles

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21
Q

What is the cause of second degree AV block

A

MI near the conducting system
cardiomyopathy
myocarditis
endocarditis (abscess)

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22
Q

what is third degree Av block

A

complete heart block, no atrial impulses reach the ventricle

  • atria and ventricles firing separately
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23
Q

What is the cause of third degree AV heart block

A

Myocardial ischemia
cardiomyopathy
myocarditis
myxedema
iatrogenic
hypervagotonia

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24
Q

How may a patient present with third degree heart block

A

lightheadedness
palpitations
syncope
weakness
fatigue
chest pain (diminished O2)

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25
Q

What is a bundle branch block

A

disruption of electrical conduction down one of the bundle branches coming off the bundle of his

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26
Q

What is a right bundle branch block associated with

A

increased RV hypertrophy
PE
MI
inflammation
iatrogenic

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27
Q

What is a left bundle branch block associated with

A

endocarditis
post surgical changes

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28
Q

What will be seen on and EKG if someone has a LBBB

A

Wide QRS

29
Q

What will you see on an EKG with someone who has a RBBB

A

Bunny ears

30
Q

What are examples of narrow / regular tachyarrythmias

A

sinus tachy
SVT
Atrial flutter

31
Q

What are examples of narrow/irregular tachyarrythmias

A

Multifocal atrial tachycardia
hyperkalemia

32
Q

What are examples of wide regular tachyarrhythmias

A

polymorphic ventricular tachycardia
Vfib

33
Q

What are tachyarrhythmias generally associated with

A

increased automaticity
increased triggering
re-entry circuit

34
Q

What are the 4 questions to ask first when looking at an EKG

A

Regular or irregular
fast or slow
wide or narrow
P waves

35
Q

What is the most common tachyarrythmia

A

sinus tachy

36
Q

What causes sinus tachy

A

Norepi and epi increase automaticity in the SA node

37
Q

What is paroxysmal SVT

A

sustained re-entry loop within the AV node

38
Q

Who is PSVT most commonly seen in

A

Women
early 20s
no CV disease

39
Q

How can you tell the difference between PSVT and sinus tachy

A

SVT will NOT have fluctuations
SVT has no PR interval

40
Q

What is the most commonly treated dysrhythmia

A

Afib

41
Q

What will afib look like on an EKG

A

irregularly irregular rhythm with a narrow QRS complex

42
Q

What is the most common source of afib

A

pulmonary veins

43
Q

What determines your heart rate

A

ventricles

44
Q

What is the cause of afib

A

**typically a secondary disease process
-ischemic heart disease
-valvular heart disease
-HTN
-congestive cardiomyopathy

45
Q

What are causes of new onset afib

A

pulmonary disease (COPD/PE)
Ischemia (ACS)
Mitral stenosis
Anemia
Thyrotoxicosis
Endocarditis
sepsis

46
Q

What are the 3 types of afib

A

paroxysmal
persistent
permanent

47
Q

What is paroxysmal afib

A

lasts less that 7 days with spontaneous conversion

48
Q

What is persistent afib

A

over 7 days long or requires cardio version

49
Q

What is permanent afib

A

long standing - will always be there

50
Q

What lead is best to look at for afib

A

V1

51
Q

What symptoms are associated with afib

A

SOB
Palpitations
Chest pain
nausea
lightheadedness
fatigue

52
Q

What is atrial flutter

A

atrial tachycardia with a single reentrant circuit

53
Q

What will atrial flutter look like on an EKG

A

sawtooth pattern
*single morphology P waves

54
Q

where in the heart does aflutter typically occur

A

above the tricuspid valve and inferior to the vena cava orifice

55
Q

What is vtach often associated with

A

previous MI

56
Q

What is the number 1 reason for vtach and sudden cardiac death

A

prolonged QT

57
Q

What are some causes of vtach

A

channelopathies
cardiomyopathy
myocarditis
CAD
valvular disease

58
Q

What is Torsades de pointes

A

Polymorphic VT

59
Q

What is the cause of torsades

A

Electrolyte abnormality
* decreased magnesium

60
Q

How do you treat someone with torsades

A

IV infusion of magnesium

61
Q

What is vfib

A

chaotic depolarization of the ventricular myocardium
*no cardiac output

62
Q

What can put someone at higher risk for vfib

A

scar tissue or infarcted area will have increased automaticity

high heart rate can induce

63
Q

what causes bradyarrhythmias

A

vagus nerve stimulation
-endurance athletes
-inferior wall MI

Medications that slow AV conduction

Metabolic changes

Electrolye abnormality

Brain herniation

64
Q

What is Cushings triad

A

bradycardia
respiratory change
increase bp

65
Q

What is another name for tachybrady syndrome

A

sick sinus dysfunction

66
Q

What is sick sinus syndrome

A

dysfunction with the SA node

67
Q

What is the pathophys of sick sinus syndrome

A

fibrosis of SA node
medications
familial disease (channelopathy)

68
Q

How can you treat sick sinus syndrome

A

pacemaker
medications

CABS cardiology (10 decks)

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