Arrhythmias Flashcards
LQTS is a disorder characterized by a prolongation of what interval on ECG? What arrhythmia does it have a propensity to? .
characterized by a prolongation of the QT interval on ECG and a propensity to ventricular tachyarrhythmia.
LQTS can either be inherited or acquired.
What diagnostic scoring tool is used in suspected Long QT syndrome (LQTS) & how many points are associated with a high probability of LQTS
patients whom LQTS is suspected, a diagnostic scoring tool using criteria developed by Schwartz (shown) can be helpful in determining the likelihood of LQTS. A score is given based on ECG findings as well as family and clinical history. A score of 4 or more is associated with a high probability of LQTS
What do CCBs do (MOA)?
And what can they treat besides HTN?
Name some CCB examples.
Prevent (antagonist) ca+ from entering the heart & vessels which relax those smooth muscles. Tx for: A-fib Angina PSVT Raynauds
CCB ex: Verapamil, diltiazem (cardizem, tiazac), amlodipene, & nifedipine
How do BB’s work?
Which BBs cause electrical impulses in the heart that cause contractions?
Why must abrupt withdrawal of BBs not be don?
1) Block beta receptors & decrease cardiac output
2) ex: propranolol, acebutolol, & betaxolol hcl
3) may cause MI, sudden death, or increase CP
What heart condition can an S3 sound be heard?
Is it a diastolic or systolic murmur?
Where is it heard best & where does it radiate to?
- Atrial regurgitation
- Diastolic, high pitched blowing
- 3rd left ICS & enhanced with leaning forward & forced expiration
What heart condition can an S4 sound be heard?
Is it a diastolic or systolic murmur?
Where is it heard best & where does it radiate to?
Aortic stenosis
Systolic
Right 2nd ICS & apex. Radiates to carotids
What heart condition is more common in children & young adults (mostly boys), & is caused by a congenital bicuspid valve with sx’s of longstanding hx of SOB w/increased activity?
Aortic stenosis
When found in older adults, usually the acquired form from calcification of the valves causing it to not open to its normal orifice.
What is the most common valvular heart problem that has a mid systolic click followed by a late systolic crescendo murmur w/a honking quality?
Work up includes what?
Mitral valve prolapse
Obtain ECG, referral to cardio, & echo,
Tx for MVP usually consists of what type of medication, but only if symptomatic tachycardia or palpitations are present?
Beta blocker (beta adrenergic receptor antagonist)
What chronic conditions are S3 & S4 heart sounds caused by?
S3: heart failure
S4: HTN, poorly controlled
What heart condition has a blowing systolic murmur w/a long haaaa or hooo?
Does it radiate anywhere, & if so where?
Where can this murmur best be heard?
What position increases the sound of this murmur?
- Mitral regurgitation
- Radiates to the axillae & often has laterally displaced PMI.
- Best heard at the right lower scapular border
- Squatting position
What can be seen on an ECG for a pt taking therapeutic dose of digoxin?
Slightly depressed, cupped st segments
Prolonged P-R interval
T wave inversion on an ECG represents what?
Deep Q-waves on an ECG is usually seen in a person w/recent MI w/in how many months?
Myocardial ischemia or previous MI
W/in 6 months
Tx for ACS includes what 3 main types of meds?
- AceI or ARB (start at low dose to avoid hypotension & monitor for hyper kalmia if pt on potassium sparing diuretic)
- BB
- Statin
What medications are the cornerstone of therapy for HF?
- AceI or ARB (start at low dose & monitor for hyper kalmia w/potassium sparing diuretic)
- BB (beta adrenergic receptor antagonist), Carvedilol can be used & is an alpha & beta blocker
- Diuretic, preferably potassium sparing unless contraindicated)
- Digoxin (monitor for serum levels for therapeutic dose)
