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Clin med cardiology > arrhythmias > Flashcards

arrhythmias Flashcards

1
Q

What are some sinus node disturbances

A

Sinus Brady
Sinus node dysfunction
Junctional Brady cardia
sinus arrest
sinus tachy

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2
Q

What drugs can cause bradycardia

A

beta blockers
calcium channel blockers

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3
Q

What is chronotropic incompetence

A

SA is not responding to stress placed on it

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4
Q

What is the cause of sinus exit block

A

an issue with transition cells

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5
Q

What is sinus arrest

A

Long pauses in between regular beats

*if longer than 3 seconds-> need a pacemaker

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6
Q

What is junctional bradycardia

A

AV node fires faster than the SA node

P waves are hidden within or after QRS

Narrow QRS

**because its originating in the AV node, it will be slow

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7
Q

What does an escape beat look like on an EKG

A

A beat that comes later than expected

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8
Q

What is asystole

A

complete absence of demonstrable electrical and mechanical cardiac activity

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9
Q

What is sick sinus syndrome

A

Sinus node dysfunction

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10
Q

What causes sick sinus dysfunction

A

fibrosis of the SA node
Medication suppression
Chronotropic incompetence
cardiorespiratory conditioning

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11
Q

How do you manage someone with sick sinus syndrome

A

Atropine (better for SA node vs junctional rhythm)

temporary pacing wire

possible pacer

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12
Q

What is a sinus arrhythmia

A

A normal cardiac cycle where you see and increase of HR on inspiration and a decrease on expiration

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13
Q

What causes sinus tachycardia

A

stimulation of the sinus node

*adrenergic response (fight or flight)

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14
Q

What is one of the most sensitive findings of a PE

A

sinus tachy

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15
Q

What is the first line treatment of sinus tachycardia

A

treat reversible causes

then consider beta blockers

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16
Q

What are atrial rhythm disturbances

A

Atrial fibrillation
atrial flutter
wandering atrial pacemaker
SVT

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17
Q

What is the mechanism of Aflutter

A

circuit of re-entrant activation (cavotricuspid isthmus)

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18
Q

Where does afib generally originate

A

transition tissue of the pulmonary vein

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19
Q

What is the mechanism of afib

A

wavelets of re-entrant activation

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20
Q

What is the management of afib/flutter

A

anticoagulate
rate control (beta blocker)
rhythm control (Na+ / K+ blocker)

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21
Q

What is a WAP rhythm

A

Wandering atrial pacemaker
rate <100bpm
polymorphic P waves

22
Q

What is a MAT rhythm

A

Multifocal atrial tachycardia
Rate >100
Polymorphic P waves

23
Q

Which patient population are at higher risk of developing MAT / WAP

A

Those with pulmonary disease
-COPD

24
Q

What is the mechanism behind WAP / MAT

A

multiple atrial ectopic foci

25
Q

How do you treat MAT / WAP

A

Oxygen levels
treat underlying causes

26
Q

What are the two kinds of SVT

A

AVNRT (most common)
AVRT

27
Q

How will someone with SVT present

A

Palpitations
lightheadedness
heart racing
pre syncope / syncope

28
Q

If someone complains that their heart feels funny when they bend forward, what is their most likely dx

A

AVNRT until proven otherwise

29
Q

How do you manage SVT acutely

A

Vagal maneuvers
Adenosine
Cardioversion

30
Q

Why do vagal maneuvers help with SVT

A

b/c vagus nerve innervates the AV node and will slow it down

31
Q

Why does Adenosine help treat SVT acutely

A

Adenosine blocks the AV node so the rate can get back to a regular rhythm

32
Q

Which patients do you NOT want to use adenosine on

A

Afib and WPW
*use procainamide instead

33
Q

How do you control chronic SVT

A

Rate control
antiarrythmics (flecainide)
ablation

34
Q

What will an EKG in someone with WPW look like

A

There will be no PR interval
Will see a delta wave

35
Q

What are the A-V junctional rhythm disturbances (heart block)

A

First degree
Second degree (mobitz 1&2)
Third degree

36
Q

What is second degree heart block known as

A

Wenckebach

37
Q

Which second degree heart block is more unstable

A

type 2

38
Q

What occurs in third degree heart block

A

complete atrial ventricular dissociation

39
Q

What causes junctional rhythm disturbances

A

Disease of the AV node
-lyme carditis
-congenital
-fibrosis (m/c)
-iatrogenic (TAVR)

40
Q

How will someone with a junctional rhythm present

A

SOB
Lightheadedness
syncope

41
Q

How do you manage junctional arrhythmias

A

Acute (HD unstable)
-Atropine / dobutamine
-temp pacer wire

Chronic
-pacer

42
Q

What causes ventricular dysrhythmias

A

VT
torsades
VF

43
Q

What is brugada’s sign

A

time from onset of R wave to lowest point of S wave >100ms

44
Q

What is Josephson’s sign

A

notching near the lowest point of the S wave

45
Q

What are the mechanisms of ventricular tachyarrythmias

A

Ischemia / infarct
drugs
toxicity
metabolic derangement
prolonged QT

46
Q

How will patients present with ventricular tachyarrythmias

A

unconscious / pulseless
SOB
Lightheadedness
palpitations

47
Q

How do you manage tachyarrythmias

A

Amioderone
Lidocaine
Cardioversion (if regular)
Defib (if irregular)
TdP: Mag, Mag, more Mag

48
Q

What is seen on both RBBB and LBBB EKGs

A

wide QRS complex

49
Q

What will be seen on an EKG with RBBB

A

Wide QRS
ST segment depression
T wave inversion
**rabbit ears in V1 or V2
**broad S wave in V6

50
Q

What will be seen on an EKG in someone with a LBBB

A

Wide QRS
RR in V6
Dominant S wave in V1

51
Q

When is Sgarbossas criteria used

A

A new LBBB w/ question of ACS

52
Q

What generally causes BBB

A

Fibrosis
Ischemia / infarct
Drugs / toxicity

Clin med cardiology (10 decks)

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