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Cardiovascular Medicine > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What is the basic ECG algorithm?

A 
Rate
Rhythm
Axis
Intervals
ST/T wave changes
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2
Q

What is an ECG strip in seconds?

A

10 seconds

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3
Q

How do you calculate HR in a regular rhythm?

A

Count the number of QRS in 10 seconds and times by 6

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4
Q

What are the types of rhythm?

A

Regular, sinus arrhythmia, irregular

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5
Q

If AVL is the most positive, what kind go axis deviation does this show?

A

Left

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6
Q

If lead 3 is the most positive, what kind of axis deviation does it show?

A

right

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7
Q

What should the PR interval be in ms?

A

120-200ms

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8
Q

If the PR wave is short and there is a delta wave what does this show?

A

Wolf-parkinson-white syndrome

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9
Q

What should the QRS be in ms?

A

120ms

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10
Q

What should the QTc be in ms and squares?

A

around 400-440ms or 2 large squares

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11
Q

What ways can ST/Twaves be changed?

A

elevated, depression, inversion

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12
Q

What is bradycardia?

A

heart rate of less than 60bpm, however absolute is less than 40bpm, and relative if less than expected for the patient

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13
Q

What are the causes of sinus bradycardia?

A

sinus bradycardia, sick sinus syndrome, sinus arrest, medications, hypothyroidism, hypothermia and sleep apnoea, rheumatic fever, viral myocarditis, amyloidosis, haemochromatosis and pericarditis

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14
Q

What is the treatment for sinus bradycardia?

A

Pacemaker

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15
Q

What is first degree heart block?

A

PR interva above 0.2 seconds

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16
Q

What is one cause cause first degree heart block?

A

digoxin toxicity

17
Q

What is second degree heart block, mobitz type 1?

A

progressive lengthening of the PR, followed by the failure of an atrial impulse to conduct the ventricles

18
Q

When does second degree heart block mobitz type 1 occur?

A

In young fit patients with high vagal tone or after an inferior MI

19
Q

What is second degree heart block mobitz type 2?

A

constant PR interval followed by sudden failure of a P wave to be conducted to the ventricles

20
Q

What is complete or third degree heart block?

A

no conduction from the atria to the ventricles and therefore AV dissociation, no relationship between P waves and QRS complexes

21
Q

What are the causes of third degree heart block?

A

Anti-arrhythmic drugs, digoxin toxicity, inferio STEMI, anterior MI, hyperkalaemia,

22
Q

How is hyperkalaemia treated?

A

calcium chloride

23
Q

How is third degree heart block treated?

A

atropine and isoprenaline and then a pacemaker

24
Q

What are some complications of AF?

A

Haemodynamically instability due to tachyarrhythmias or bradyarrhythmias, ACS, Congestive cardiac failure or cardioembolic stroke

25
Q

What medications should be given to AF patients?

A

Anticoagulation, rate control, antiarrhythmics, ablation and cardioversion

26
Q

What symptoms can you get with AF?

A

Asymptomatic, breathlessness, palpitations, syncope/dizziness, chest discomfort and stoke or TIA, irregular pulse

27
Q

What investigations would you do to confirm AF?

A

ECG (irregularly irrregular), 24 hour cardiac monitor, ECHO

28
Q

What scoring system is used in AF to assess stroke risk?

A

CHA2DS2VaSc to quantify risk of stroke or systemic emboli

29
Q

What scoring system is used in AF to assess bleeding risk?

A

HAS-BLED- looks at hypertension, INR, concurrent medications (aspirin and NSAIDS) alcohol consumption

30
Q

What anticoagulants can be given in AF?

A

DOACs as inhibit factor Xa (apixaban)

31
Q

Why are DOACs better than warfarin?

A

do not require regular INR level monitoring, no restrictions on food or alcohol, lower bleeding rates and better reduction in strokes

32
Q

What are the two types of supra ventricular tachycardia?

A

AV node re-entry tachycardia or Atrio ventricular re entry tachycardia

33
Q

How can SVTs by terminated?

A

By transiently blocking AV nodal conduction

34
Q

What is the first line treatment for SVTs?

A

vagal manoeuvres e.g. breath holding, carotid massage (done in young patients, due to stroke risk, auscultate for bruit)

35
Q

What medication can be given for SVTs and has a 90% success rate?

A

adenosine by rapid IV bolus and a saline flush, have crash trolley incase of bradyarrhytmias or tachyarrhythmias

36
Q

What other medications can be given in SVT?

A

Verapamil unless on B blocker or LV dysfunction, electrical cardioversion, flecainide

37
Q

What is the treatment for VT?

A

defibrillation , amiodarone and adrenaline

Cardiovascular Medicine (6 decks)

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