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Cardio - mine > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

1st degree heart block ECG feature

A

Prolonged PR interval

>0.2s

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2
Q

Subtypes of heart block

A

1st degree
2nd degree
3rd degree

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3
Q

Subtypes of 2nd degree heart block

A

Mobitz type 1

Mobitz type 2

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4
Q

Mobitz type 1 ECG feature

A

Progressive PR interval prolongation until a QRS complex is missed

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5
Q

Mobitz type 2 ECG feature

A

Every *th QRS complex is missed

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6
Q

3rd degree heart block ECG feature

A

No QRS complexes

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7
Q

> 60bpm is what type of arrhythmia

A

Bradycardia

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8
Q

<100bpm is what type of arrhythmia

A

Tachycardia

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9
Q

Treatment of Bradycardia

A

Atropine

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10
Q

Supraventricular tachycardia treatment

A

1st - vagal manoeuvres (pop ears)
2nd - carotid massage
3rd - adenosine IV
4th - verapamil, diltiazem, beta-blockers

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11
Q

what is Paroxysmal AF

A

lasts <48hrs

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12
Q

what is Persistent AF

A

lasts >48hrs

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13
Q

what is Permanent AF

A

lasts >48hrs + CANNOT be cardioconverted to normal rhythm

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14
Q

What would a typical ECG of a patient with AF look like

A

No p waves

QRS is rapid + irregular

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15
Q

An irregular irregular rhythm is associated with?

A

AF

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16
Q

ACUTE Treatment of AF

A 
Amiodrone OR flecainide (if haem stable)
DC cardioversion (if harm unstable)

If cardioversion isn’t possible within 24-48hrs then put on warfarin for 6-8wks then bring back to cardiovert.

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17
Q

Long-term treatment of AF

A

Beta-blockers
Ca2+ channel blocker (verampil)
Digoxin

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18
Q

What arrhythmia is associated with AF?

A

Atrial flutter

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19
Q

“saw-tooth” waves on ECG

A

Atrial flutter

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20
Q

Treatment of Atrial flutter

A

Electrical cardioversion

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21
Q

Treatment of recurrent Atrial flutter

A

1st - radio frequency ablation

2nd - amiodrone

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22
Q

What drugs can cause Bradycardia?

A

Beta-blockers

verapamil

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23
Q

Treatment of Bradycardia

A

treat underlying cause
atropine
pacing if haemodynamically compromised (CHF, angina, collapse, hypotension)

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24
Q

What arrhythmia does sick sinus syndrome cause?

A

Bradycardia

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25
Q

Athletes may have what arrhythmia?

A

Bradycardia

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26
Q

What arrhythmia is generally well tolerated?

A

Bradycardia

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27
Q

What would a typical ECG of a patient with ventricular Tachycardia look like?

A

Broad, abnormal QRS

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28
Q

Acute treatment of ventricular Tachycardia

A

haem unstable = emergency DC cardioversion

haem stable = IV Lidocaine/lignocaine OR amidrone

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29
Q

Symptoms of ventricular Tachycardia

A

pre-syncope, hypotension, cardiac arrest

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30
Q

Patient is pulseless and becomes rapidly unconscious, what arrhythmia do they have

A

V.fib

31
Q

What would a typical ECG of a patient with ventricular Fibrillation look like?

A

shapeless, rapid oscillations, no organisation

toddler’s scribble

32
Q

Acute treatment of V. Fib

A

Defib

33
Q

Long-term treatment of V.Fib

A

Implantable cardioverter Defib

34
Q

Most common cause of death following an MI

A

V.fib

35
Q

ECG is shapeless, rapid oscillations, no organisation

toddler’s scribble

A

V.Fib

36
Q

ECG has Broad, abnormal QRS

A

V.tach

37
Q

ECG has No p waves and QRS is rapid + irregular

A

AF

38
Q

What is Long QT syndrome?

A

ventricular repolarisation is greatly prolonged.

39
Q

Torsades de pointes is associated with?

A

Long QT syndrome

40
Q

where do SVT originate from

A

above the ventricle

includes: atrial muscle, av node,

41
Q

what are the 2 types of SVT

A

AF

Atrial flutter

42
Q

what are the 3 types of ventricular arrhythmias

A

V.tach
V.fib
asystole

43
Q

what are the 2 types of AV node arrhythmias

A 
AV block (3 subtypes)
AVN re-entry tachycardia
44
Q

what are ectopic beats

A

beats or rhythms that originate in places other than the SA node

45
Q

what is re-entry

A

requires more than 1 conduction pathway with different speed of conduction and recover of excitability

46
Q

how can ectopics cause tachycardia

A

may cause single beats or a sustained run of beats that is faster than sinus rhythm take over the intrinsic rhythm

47
Q

how can re-entry cause tachycardia

A

triggered by an ectopic beat it results in a self perpetuating circuit

48
Q

symptoms of arthymias (general)

A 
palpitations "pounding heart"
SOB
dizzy
loss of consciousness/faintness
sudden death
49
Q

investigations of arrhythmias (general)

A

ECG (12 lead, stress, 24hr)
CXR
echocardiogram

50
Q

what is an 12 lead ECG used for

A

assess rhythm

signs of previous MI or pre-excitation

51
Q

what is an exercise ECG used for

A

assess for ischaemia

to look for exercise induced arrhythmia

52
Q

what arrhythmia does an exercise ECG look for

A

exercise induced arrhythmia

53
Q

what arrhythmia does a 24hr ECG look for

A

paroxysmal arrhythmia

54
Q

what are the physiological causes of tachycardia

A

anxiety
fever
hypotension
anaemia

55
Q

treatment of sinus tachycardia

A

b-blockers

56
Q

acute management of SVT

A

haem stable: increase vagal tone via carotid massage
slow conduction in AV node via IV adenosine or Verapamil

haem unstable: cardioversion

57
Q

long-term management of SVT

A

b-blockers

ablation

58
Q

causes of heart block

A 
old age
MI
myocarditis 
drugs (b-blockers, Ca2+ channel blockers)
genetic
59
Q

what drugs can cause heart block

A

b-blockers

Ca2+ channel blockers

60
Q

treatment of 1st degree heart block

A

none

monitor

61
Q

what is lone/idiopathic AF

A

absence of any HR disease and no evidence of ventricular dysfunction

could be genetic

62
Q

what causes AF (physiology)

A

multiple waves of re-entry

63
Q

what is the atrial rate in AF

A

> 300bpm

64
Q

what drugs are used in rate control in AF

A

digoxin
B-blockers
Ca2+ channel blockers

65
Q

how is normal sinus rhythm achieved in AF

A 
pharmacological cardioversion (e.g. amidarone) 
direct current cardioversion (DCCV)
66
Q

what is the main mutation in long QT syndrome

A

potassium channel KCNQ1

67
Q

what ECG changes are observed in long QT syndrome

A

QT prolongation:
males >440ms
females>460ms

68
Q

what is the main mutation in brugada syndrome

A

cardiac sodium channel mutation SCNSA

69
Q

treatment for brugada syndrome

A

implantable cardiac device (unless asymptomatic without FHx)

70
Q

what arrhythmia is most commonly linked to sudden cardiac death

A

Long QT syndrome

71
Q

long term treatment of ventricular Tachycardia

A

revascularisation (correct ischemia)
implantable cardiovertor defibs
VT catheter ablation

72
Q

what is the treatment for 2nd degree heart block

A

ventricular pacing

73
Q

what is the treatment for 3rd degree heart block

A

ventricular pacing

Cardio - mine (15 decks)

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