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SPR2015_Week2 > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

Sinus Tachycardia

Characteristics of EKG

A

Normal P and QRS,

regular, fast heart rate >100bpm

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2
Q

Sinus Tachycardia

Causes

A

Sympathetic activation:

1) Exercise
2) emotion
3) hypotension,
4) acute lung pathology (pneumonia/cholecy)
5) thyrotoxicosis

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3
Q

Sinus Tachycardia

Treatment

A

Usually none

B blockers in thyrotoxicosis (high thyroid hormone)

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4
Q

Sinus Tachycardia symptom

A

symptom = angina

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5
Q

Sinus Bradycardia

Characteristics of EKG

A

Normal P, QRS,

regular slow HR< 60bpm

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6
Q

Sinus Bradycardia

Causes

A

Athletics

Vagotonic state (parasympathetic)
- faint (Vagovagal episodes)
  • sick sinus syndrome (sinus rate slows, ventricle stiffer, low SV)
  • inferior infarct (increased vagal activity)
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7
Q

Sinus Bradycardia

Treatment

A

none

atropine

pacemaker if sx

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8
Q

Sinus Bradycardia

symptoms

A

symptom = syncope, lightheadedness,

fatigue in elderly (sick sinus)

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9
Q

Sinus Rhythm

Characteristics of EKG

A

P before QRS, P upright in 2,

down in avR, 60-100 bpm

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10
Q

Atrial Fibrillation

Characteristics of EKG

A

1) No P wave but chaotic atrial depol at > 350b/min

2) irregular QRS (irregular R-R interval)
“irregularly irregular QRS”

Look for squiggles at baseline

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11
Q

Atrial Fibrillation

causes

A

1) aging (fibrosis of atria –> re-entry)
2) post operative (stress response)
3) heart disease (mitral valve disease/ DCM)
4) hyperthyroidism
5) Lone AFib = normal subjects (w/ stress)

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12
Q

Atrial Fibrillation

complications

A

Rapid HR

1) ischemia
2) heart failure

Loss of Atrial contraction
1) heart failure

Atrial thrombi
1) embolic stroke

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13
Q

Atrial Fibrillation

treatment

A

1) anticoagulation
2) rate control with drugs (B blockers, Ca 2+ channel blockers @ AV node)
3) cardioversion
4) ablation

Rhythm control (I,III,cardioversion, ablation, shock)

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14
Q

Atrial Fibrillation

picture

A

dfdf

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15
Q

Atrial Tachycardia

Characteristics of EKG

A

Abnormal P waves with narrow QRS

FAST rhythm. > 150/min

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16
Q

Atrial Tachycardia

causes

A

Patient in a little distress (nervous/agitated),

structural heart disease

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17
Q

Atrial Tachycardia

complications

A

not in notes

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18
Q

Atrial Tachycardia

treatment

A

1) adenosine (quick decr SA and AV node)
2) vagal manuever (stim vagus, slow rate via baroreceptor)
3) beta blocker
4) verapamil or diltiazem

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19
Q

Atrial Tachycardia

picture

A

dfdf

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20
Q

Atrial Flutter

Characteristics of EKG

A

1) Sawtooth pattern
2) P wave rate ↑200ish (240-320/min)
3) regular or irregular pulse

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21
Q

Atrial Flutter

causes

A

Structural heart disease

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22
Q

Atrial Flutter

complications

A

Embolic stroke,

rapid ventricular rates that are poorly tolerated

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23
Q

Atrial Flutter

treatments

A

1) Anticoagulation (to prevent risk of clot)
2) Adenosine,
3) rate control (verapamil, diltiazem)
4) cardioversion
5) ablation

(if have slow AV too - βB, Ca 2+ Blocker- so 1:1 recovery isn’t too fast = syncope),

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24
Q

Atrial Flutter

picture

A

dfdf

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25
Q

Premature Atrial Contraction (atrial premature beat)

Characteristics of EKG

A

Premature beat preceded by ABNORMAL P wave, narrow (normal) QRS

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26
Q

Premature Atrial Contraction

causes

A

Healthy young person with

occasional palpitations

27
Q

Premature Atrial Contraction

treatment

28
Q

Premature Ventricular Contraction

Characteristics of EKG

A

Wide/abnormal QRS, no P wave, pause before

normal rhythm restored

29
Q

Premature Ventricular Contraction

causes

A

Common in normal healthy patients

1) Acute MI
2) HF

extra:
Caffeine, ectopic ventricular focus conducted by
slow myocardium,

30
Q

Premature Ventricular Contraction

treatments

A

Usually nothing, B blockers (reduce symp involvement)

ablation in extreme cases (worry about HF)

31
Q

Premature Ventricular Contraction

picture

32
Q

Torsades de Pointes

Characteristics of EKG

A

Wide complexes at very rapid rate,
no p waves, sinusoidal pattern,
twisting around a point (sub type of VT)

33
Q

Torsades de Pointes

causes

A

Long QT interval

34
Q

Torsades de Pointes

complications

A

Death, Vfib

35
Q

Torsades de Pointes

treatment

A

Shock, if have time give

Mg 2+ (shortens QT)

36
Q

Torsades de Pointes

picture

37
Q

Ventricular Tachycardia

Characteristics of EKG

A

regular, wide QRS (100-200 bpm)

no P waves

sustained v-tach = > 30 secs

85% of wide complex tachycardia is VT

38
Q

Ventricular Tachycardia

causes

A

Ectopic ventricular focus conducted

by slow myocardium

39
Q

Ventricular Tachycardia

complications

A

Low blood pressure- not
enough time for filling.
>30s could lead to cardiac arrest

40
Q

Ventricular Tachycardia

treatments

A

If stable:

1) amiodaraone bolus, then IV.
2) lidocaine

if unstable:
cardioversion
Emergency defibrillation.
Automatic implantable cardiac defibrillator.

41
Q

what is sustained ventricular tachycardia

42
Q

Ventricular fibrillation

Characteristics of EKG

A

no consistent QRS complexes/coordinated contraction

No real pattern, no P.
Irregular baseline.
RANDOM.

43
Q

Ventricular fibrillation

causes

A

Abnormal ventricular contractions

44
Q

Ventricular fibrillation

complications

A

No blood leaving the heart in a
coordinated manner,
sudden death

45
Q

Ventricular fibrillation

treatments

A

Emergency defibrillation

46
Q

Ventricular fibrillation

picture

47
Q

1st degree AV block

Characteristics of EKG

A

Prolonged PR interval, > 0.2 s

incr junctional delay

48
Q

1st degree AV block

causes

A

Drug induced (B blockers, Ca 2+ blockers, digitalis)

conduction system disease

49
Q

1st degree AV block

complications

A

Mostly benign

50
Q

1st degree AV block

picture

51
Q

2nd degree AV block

Characteristics of EKG

A

Consistent PR intervals with dropped ventricular beats.
“A single dropped beat”

some P waves conduct, some don’t

52
Q

2nd degree AV block

causes

A

conduction disease

tone drugs)

53
Q

2nd degree AV block

complications

A

Syncope, confusion

54
Q

2nd degree AV block

treatments

A

Pacemaker if needed Isoproterenol,

Dopaminecan be used temporarily -
but bad if infranodal block.

55
Q

2nd degree AV block

Define 2 Mobitz Types

A

(Mobitz 1 = PR lengthen until P dosen’t conduct) = Wenckebach due to incr vagal tone

(Mobitz 2 = no change in PR)

56
Q

3rd Degree AV block

Characteristics of EKG

A

Both P and QRS show regular rhythm, but they are at different rates.

With P rate > QRS rate.

57
Q

3rd Degree AV block

causes

A

1) Severe conduction system disease (ischemia)
2) rarely drugs
3) sarcoidosis (interfere with conduction of AV node)

extra:
aging, infarct, cardiac surgery,
(AV node disease)

58
Q

3rd Degree AV block

complications

A

Syncope and sudden death

59
Q

3rd Degree AV block

treatments

A

Pacemaker if ventricular rate or BP too late

60
Q

3rd Degree AV block

picture

61
Q

Junctional Rhythm

Characteristics of EKG

A

1) regular
2) narrow QRS
3) no antecedent P waves (can see negative P wave b/c AV node is stim ventricle and backward stim atria)

P- waves upright in aVR,
negative in II, III and aVF

62
Q

Junctional Rhythm

picture

63
Q

Treatment for Mobitz 1

A

Atropine (decr vagal tone)

64
Q

Treatment for junctional rhythm

SPR2015_Week2 (19 decks)

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