Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

Where does the arrhythmia come from if the QRS complex is not widened?

A

Above the ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are ectopic beats?

A

Beats or rhythms which originate in areas of the heart other than the SA node.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What an ectopic beats cause?

A

Single beats to take over the entire pace of the heart and dictate the entire rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are examples of supraventricular arrhythmias?

A

Supraventricular tachycardia, atrial fibrillation/flutter, ectopic atrial tachycardia, sinus bradycardia/pauses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are AV node arrhythmias caused by?

A

AV node re-entry through an accessory pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are examples of ventricular arrhythmias?

A

Premature ventricular complex, ventricular tachycardia, ventricular fibrillation, asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some clinical causes of arrhythmias?

A

Anatomical abnormalities, autonomic factors, metabolic, inflammation, drugs, genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does altered automaticity mean?

A

The arrhythmia depends on an increase or decrease in he phase 4 AP slope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes an increase in the phase 4 AP slope?

A

Hyperthermia, hypoxia, hypercapnia, cardiac dilation, ischaemia/necrosis, hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes a decrease in the phase 4 AP slope?

A

Hypothermia and hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is triggered activity?

A

Sometimes in phase 3 AP a small depolarisation can occur which if it reaches a significant magnitude can cause a cascade of depolarisations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What 3 things does re-entry require?

A

Available circuit, unidirectional block and different conduction speed in limbs of circuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are common symptoms of arrhythmias?

A

Palpitations, SOB, dizziness, syncope, sudden cardiac death, worsening of a pre-existing condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What investigations are used for arrhythmias?

A

ECG, CXR, echo, stress ECG, 24 hour ECG, event recorder, electrophysiological study (triggers arrhythmia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of atrial ectopic beats and what can be used to treat it?

A

Often asymptomatic but can be palpitations- generally no treatment but beta-blockers and avoiding stimulants may help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can cause sinus bradycardia?

A

Can be physiological or can by due to drugs or ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can you treat sinus bradycardia?

A

Atropine (and temporary pacemaker if needed) if acute, pacing if chronic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can cause sinus tachycardia and how is it treated?

A

Physiological, anxiety, fever, hypotension, anaemia, drugs. Treat underlying cause and use beta-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most common arrhythmia in young women?

A

Supraventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you treat supraventricular tachycardia?

A

Vagal manoeuvres/adenosine/verapamil if acute and avoiding stimulants or class II/IV drugs if chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is ablation?

A

Selective cautery of cardiac tissue to prevent tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should you do before ablation?

A

Stop anti-arrhythmic drugs at least 3-5 days before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is 1st degree heart block and how is it treated?

A

PR interval longer than normal- no treatment, just follow ups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is 2nd degree heart block?

A

Intermittent block at the AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What will Mobitz type I show on an ECG?

A

Progressive PR lengthening until a beat is completely missed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What will Mobitz type II show on an ECG and how is it treated?

A

Usually 2 or 3 beats to every missed beat. Permanent pacemaker is inserted.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is 3rd degree heart block?

A

No APs get through the AV node (P wave and QRS complex are interdependent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of pacing is used for Mobitz type II and 3rd degree heart block?

A

Transcutaneous if acute and transvenous if chronic

29
Q

What can premature ventricular complex be to do with?

A

IHD, hypertension, LVH, heart failure

30
Q

When is treatment needed for premature ventricular complex?

A

If it is worse on exercise- give beta-blockers

31
Q

What does an ECG of VT show?

A

Large, sustained reduction in arterial pressure

32
Q

How would you treat VT?

A

If stable, consider pharmacological meausures, if unsure of diagnosis give adenosine, in long term, correct ischaemia and implant defibrillator

33
Q

What are some ECG patterns to look for in VT?

A

Broad QRS, fairly regular rhythm, no P waves or measurable PR interval

34
Q

What is VF?

A

Chaotic ventricular activity which causes the heart to lose its function as a pump

35
Q

How is VF treated?

A

Defibrillation and CPR

36
Q

What kind of heartbeat does AF have?

A

Irregular

37
Q

What is paroxysmal AF?

A

Lasting less than 48 hours but often recurrent

38
Q

What is persistent AF?

A

An episode of AF lasting longer than 48 hours which can be cardioverted to normal sinus rhythm but this is unlikely to occur spontaneously

39
Q

What is permanent AF?

A

No methods can restore normal sinus rhythm

40
Q

As well as many heart diseases, what can AF be associated with?

A

Thyroid disease, alcohol abuse, COPD, pneumonia, septicaemia and tumours

41
Q

What are the symptoms of AF?

A

Palpitations, dizziness, chest pain, dyspnoea, sweatiness and fatigue

42
Q

What is AF caused by?

A

Multiple wavelets of re-entry and an ectopic focus around the pulmonary veins

43
Q

What will AF show on an ECG?

A

Atrial rate of greater than 300bpm, irregularly irregular rhythm, absence of P waves, presence of F waves (just after QRS), normal QRS

44
Q

AF causes a loss of atrial kick. What can this result in?

A

Congestive heart failure, especially when there is already diastolic dysfunction

45
Q

What does a ventricular rate of less than 60bpm suggest?

A

AV node conduction disease

46
Q

What is the aim of rhythm control in AF and how is this done?

A

Maintain SR through pharmacological or direct current cardioversion

47
Q

What is the aim of rate control in AF and what drugs do this?

A

Control ventricular rate- digoxin, beta-blockers, verapamil or diltiazem alone or in combination

48
Q

When would you use anticoagulation in AF?

A

If the patient is at high risk for thromboembolism

49
Q

What factors increase the risk of bleeding?

A

Hypertension, abnormal renal/liver function, stroke, bleeding, labile INRs, elderly, drugs or alcohol

50
Q

Where can be ablated in AF?

A

Pulmonary veins or AV node

51
Q

What is Torsades de Pointes?

A

Very rare and deadly form of VT with a twisting configuration of QRS and prolonged repolarisation

52
Q

How is TdP recognised on an ECG?

A

Long QT interval, wide QRS, continuously changing QRS morphology

53
Q

What are some events leading to TdP?

A

Hypokalaemia, drug induced prolongation of AP, renal impairment

54
Q

What is atrial flutter?

A

Rapid and regular form of atrial tachycardia which is usually paroxysmal

55
Q

How is atrial flutter sustained?

A

Re-entrant circuit confined to the right atrium

56
Q

What do chronic cases of atrial flutter become?

A

AF, and many cases result in thrombo-embolism

57
Q

What does atrial flutter show on an ECG?

A

Fast rate, F waves, normal QRS, regular but variable rhythm

58
Q

What is the treatment for atrial flutter?

A

Ablation, pharmacological therapy to slow ventricular rate and maintain sinus rhythm, cardioversion and warfarin

59
Q

What is the most common mutation causing arrhythmias?

A

Mutations in the potassium voltage gated channels

60
Q

What does congenital long QT syndrome cause?

A

Polymorphic VT (TdP)

61
Q

What brings on a VT caused by LQTS?

A

Exercise, emotional stress, sleep

62
Q

Who is sudden cardiac death more common in?

A

Young males but adult females

63
Q

What should people with LQTS avoid?

A

AP prolonging drugs, strenuous swimming, loud noises

64
Q

What is Brugada syndrome?

A

Increases risk of polymorphic VT/VF, AF is also common

65
Q

What will Brugata syndrome show on an ECG?

A

ST elevation, RBBB in V1-V3 (may only be seen with provocation testing)

66
Q

Who is Brugata syndrome more common in?

A

Males

67
Q

What should you prescribe people with catecholaminergic Polymorphic Ventricular Tachycardia

A

Beta-blockers and flecainide

68
Q

What genes are affected in hypertrophic cardiomyopathies?

A

Myosin (sarcomeric) genes

69
Q

What is arrhythmogenic right ventricular cardiomyopathy?

A

Fibro-fatty replacement of cardiomyocytes- risk of SCD

Cardiovascular (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions