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Cardiovascular > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

causes first degree AV block

A

(conduction delay in AV node)

autnomic, transient AV ischemia, drugs, MI, degenerative aging

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1
Q

define Vtach

A

series of >3 PVCs

sustained VT>30seconds

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1
Q

long term therapy consideration for sustained VT

A

ICD

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2
Q

ECG mobitz II

A

QRS widened due to His disease

sudden loss of AV conduction without preceding gradual PR leegnthening

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2
Q

Torsades de pointes observed in pts with

A

QT prolognation due to drugs, brady carida, electorlyte distubances, or congenital long QT (ion channel abnormality)

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3
Q

WPW (in Atrioventricular reentrant tachy) ECG delta wave

A

short PR

Slurred QRS due to slow vent activations, wide

QRS coming out to meet P wave

(in orthodromic tachy, no delta wave as anterrade depol of ventricles occurs only over AV node path)

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3
Q

treatment Vfib

A

immediate defib,

later consider IV amiodarone

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5
Q

escape rhyhtm qualities

A

typically narrow

40-60bpm

not perceded by normal P wave

(may have retrograde - inverted after QRS in inferior leads)

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5
Q

treatment 3rd degree AV block

A

pacemaker

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6
Q

symptoms torsafes

A

lightheadedness

syncope

sudden cardiac death

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7
Q

ECG A fib

A

no distinct P waves,

irregularly irregular

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8
Q

ECG monomorphic VT

A

identical QRS (typically wide)

no p waves

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9
Q

chronic AV nodal reentrant tachy treatment

A

AV nodal block

cathetar ablation

Class I and III antiarrhythmics

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10
Q

ECG Atrial premature beats / atrial Tachycardia

A

early P wave with abnomral shape

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11
Q

underlying mechanism polymorphic VT

A

multiple ectopic focci or changing reentrant circuit

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12
Q

CHADVASc treatment levels

A

0 - no therapy or aspirin

1 - aspirin or oral anticoag

>2 oral anti coag

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14
Q

ECG Mobitz I (2 degree AV block)

A

(intermittent failrue of AV conduction)

PR gradually increases until completely blocked, then normalizes

(usually benign and asymptomatic)

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16
Q

pathophysiogy Mobitz II

A

conduction block distal to AVN > sudden intermittent lsos of AV conduction

> (may progress to 3 degree without warning = need pacemaker)

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17
Q

treatment atrial premature beats / atrial tachycardia

A

beta blockers (if symptomatic)

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17
Q

drugs that slow atrial flutter circuit (eg ___) may promote 1:1: Av conduction, increasing ventricular rate

A

felcainide

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18
Q

Bradyarrhythmias: 1:1 relationship between P and QRS =

A

sinus bradycardia

first degree AV block

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19
Q

Bradyarrhythmias interment block between P and QRS =

A

second degree AV block (Mobitz I or II)

2:1 AV block

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20
Q

ECG First degree AV block

A

PR elongation

PR > 200ms

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21
Q

ECG Vfib

A

all fucked up

22
Q

symptoms. Nodal Reentrant Tachycardia

A

palpitations,

dizziness

chest pain

dyspnea

22
Q

3 mutations of congenital long QT

A

decrease outward K (LQT1+2)

increase inward K (LQT3)

23
Q

pathophys atrial premature beats / atrial tachy

A

automaticity or reentry in an atrial focus outside of SA node

24
Q

Afib predisposing factors

A

ETOH

vavlular disease

elarged atria

htn, coronary disease, pulmonary disease

sleep apnea

hyperthyroidism

cardiothoracic surgery

25
Q

pathophysiology Av nodal reentrant tachycardia

A

fast and slow conduction pathways (typically antegrade from A to V occurs over slow path and retrorade limb is over fast path)

27
Q

presentation atrial flutter

A

asymptomaic

palpitations, dypsnea,

weakness

stroke from atrial thrombus

28
Q

associated causes Polymorhpic VT

A

long QT with Torsades

acute ishemia/infarct

inherited Ca handling abnormalities

29
Q

SInus tachycardia results from

A

increased sympathetic

decreased parasympathetic tone

30
Q

origin sinus tachycardia

A

SA node

31
Q

predisposing factors atrial flutter

A

prior heart surgery

coranary disease

cardiomyopathy

32
Q

ECG premature ventricular beats or contractions (PVCs)

A

widened QRS (impulse from ectopc ventriclar site)

no p wave relation (ventricular origin) OR inverted p in II III aVF (retrograde VA conduction)

33
Q

sustained polymorphic Vtach leads to

A

syncope

arrest

35
Q

sick sinus syndrome

A

intrinsic SA node disease causing inappropriate brady cardia with dizziness, confusion or syncope

36
Q

sustained monomorphic VT rypically result sfrom

A

reentry and indicates underlying tissue path (scar, structural heart disease)

37
Q

chronic Torsades treatment

A

correct underlying triggers

if congenital long QT - beta blocker

38
Q

ECG Third degree AV block

A

no relationship between P and QRS compelxes

proximal escape = narrow QRS

distal escape = wide QRS

complete failure of atrial>ventricle conduction

39
Q

Bradyarrhythmias: dissociated P and QRS =

A

complete heart block

40
Q

underlying mechanism afib

A

triggered by rapid firing from atrial foci often localized to atrial muscle extending into pulmonary veins

41
Q

PVCs tx

A

observation

beta block

42
Q

ECG AV nodal reentrant tachy

A

**antergrade fast path: **P waves superimpose on QRS, regualr RR (no pwave)

**anterograde slow path: **narrow complex tachy, regular RR, inverted P waves in inferior leads aVF II III

43
Q

ECG Polymorphic VT

A

QRS continually changes shape and rate (typically wide)

45
Q

Atrioventricular reeentrant tachycardias =

A

reentry utilizing bypass tract or acessory pathway - band of muscle cells connecting atria and ventricle

produces WPW

47
Q

acute treatment AV nodal Reentrant Tachycardia

A

valsalva

adensoine

beta block

ca block

48
Q

treatment atrial flutter

A

Rate control: beta blockers, Ca blockers, digoxin

Rhythm control - >48hrs = TEE to rule out left atrial thrombus OR 3 weeks coagulation > cardioversion

anticoagulation 4 weeks past cardioverion

pace termination (rapid atrial pacemaker)

Ablation of tricuspid caval isthmus

aniarrhythmics (class I, III)

49
Q

treatment AFib

A

Anticoag (acute:cardoversion) (chronic - CADSV score)
Rate control: AV blockage (beta block, Ca block, digoxin)

Resotoration of sinus rhythm: cardioversion, antiarrhythmatics,

cathetar ablation

50
Q

ECG atrial flutter

A

sawtooth pattern

AV conducion variable, commonly more flutter waves than QRS complexes

51
Q

acute treatment torsades

A

cardiovert sustained VT to restore sinus rhythm

IV magnesium

correct underlying abnormality (drugs)

elevate HR to shorten QT (beta agonists or pacing)

52
Q

treatment WPW

A

IV amiodarone or procainamide (I or II) to slow accessory pathway conduction

(NO digoxin, beta or Ca block - shorten refractory period of accessory = faster)

cardioversion if iunstable

high risk = cathetar ablation

53
Q

clinical consequences of afib

A

rapid ventricular response rate > hypotension or heart failure

blood stasis > clots > thrombus

54
Q

ECG Sinus Tachycardia

A

normal P and QRS

55
Q

CAD2-VASc criteria

A
  • *C**- congestive HF 1 pt
  • *H **Hypertension -1 pt

**A- **age > 65 1 pt

**D- **diabetes 1 point

V- vasc disease

**A2 **- age > 75 - 2 points

Sc - Sex female

56
Q

if atrial premature beats genreates consecutive beats resuling in HR >100 it is termed____

A

atria tachycardia

57
Q

Afib is sustained by multiple wanering reentrant circuits, minimum number of circuits is required thus Afib promoted by

A

elarged atrium

58
Q

symptoms 3rd degree AV block

A

lightheadedness

syncope

exercise intolerance

59
Q

counterclockwise atrial flutter

A

right atrial depol down septum >

>roof>

>down RA free fall >

>floor of RA between tricuspid and inf vena cava (isthmus)

Cardiovascular (39 decks)

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