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Cardiology > arrhythmias > Flashcards

arrhythmias Flashcards

1
Q

supraventricular tachycardia

A

atrial fibrillation
atrial flutter
ectopic atrial tachycardia

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2
Q

supraventricular bradycardia

A

sinus bradycardia

sinus pause

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3
Q

ventricular arrhythmias

A

ventricular ectopics or premature ventricular complexes PVC
ventricular tachycardia VT
ventricular fibrillation VF
asystole

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4
Q

atrio-ventricular node arrhythmias

A

AVN re-entry tachycardia AVNRT
AV reciprocating or AV re-entrant tachycardia AVRT
AV block - 1st, 2nd, 3rd degree

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5
Q

clinical causes

A 
abnormal anatomy 
autonomic nervous system 
metabolic 
inflammation 
drugs 
genetic
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6
Q

ectopic beats

A

beats or rhythms that originate in places other than SA node

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7
Q

re-entry

A

requires more than one conduction pathway with different speed of conduction and recovery of excitability

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8
Q

symptoms

A 
palpitations 
SOB
dizziness 
syncope 
presyncope 
sudden cardiac death 
angina 
heart failure
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9
Q

investigations

A 
ECG 
CXR
echocardiogram 
stress ECG 
24 hour ECG 
event recorder 
electrophysiological study
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10
Q

normal sinus arrhythmia

A

variation in heart rate, due to reflex changes in vagal tone during the resp cycle
inspiration reduces vagal tone and increases heart rate

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11
Q

sinus bradycardia

A

<60 beats/min
physiological athlete
drugs - beta blocker
ischaemia - common in inferior STEMI

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12
Q

sinus bradycardia treatment

A

atropine

pacing if haemodynamic compromise

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13
Q

sinus tachycardia

A

> 100 beats/min
physiological anxiety, fear, hypotension, anaemia
inappropriate drugs

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14
Q

sinus tachycardia treatment

A

underlying cause

beta adrenergic blockers

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15
Q

atrial ectopic beats

A

asymptomatic, palpitation
no treatment
beta adrenergic blockers may help
avoid stimulants

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16
Q

regular supraventricular tachycardia

A

AVN re-entrant tachycardia
AV reciprocating tachycardia/ AV re-entrant tachycardia
ectopic atrial tachycardia

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17
Q

regular supraventricular management

A

acute - increased vagal tone (valsalva, carotid massage), slow conduction in the AVN
chronic - avoid stimulants, electrophysiologic study and radiofrequency ablation, beta blocker, antiarrhythmic drugs

18
Q

causing of heart block

A 
age
acute MI
myocarditis 
infiltrative disease - amyloid
beta adrenergic blockers, CCB
calcific aortic valve surgery 
genetic - Lenergre's disease, myotonic dystrophy
19
Q

first degree AV block

A

conduction after P wave takes longer
PR interval longer than normal
no treatment

20
Q

second degree block Mobitz 1

A

progressive lengthening of PR interval

usually vagal in origin

21
Q

second degree block

Mobitz 2

A

pathological, my progress to third degree
permanent pacemaker indicated
some action potentials fail to make it through the AV node

22
Q

third degree block

A

complete heart block
no action fro the SA node gets through the AV node
ventricular pacing

23
Q

ventricular ectopics

A

causes - structural, metabolic, may be marker for inherited cardiac conditions
beta blocker, ablation of focus

24
Q

ventricular tachycardia

A 
life threatening 
coronary artery disease 
previous MI
cardiomyopathy 
inherited/familial arrhythmia syndromes
25
Q

ventricular fibrillation

A

chaotic ventricular electrical activity which causes the heart to lose the ability to function as a pump
defibrillation, cardiopulmonary resuscitation

26
Q

atrial fibrillation

A

chaotic and disorganised atrial activity
irregularly irregular
symptomatic or assymptomatic
incidence increases with age

27
Q

mechanisms of AF

A

ectopic foci muscle sleeves in the ostia of the pulmonary veins

28
Q

AF termination

A

pharmacologic cardioversion with anti-arrhythmic drugs
electrical cardioversion by direct current DCCV
spontaneous reversion to sinus rhythm

29
Q

paroxysmal AF

A

lasting less than 48 hours

often recurrent

30
Q

persistent AF

A

episode of AF longer than 48 hours which can still be cardioverted to NSR
unlikely to spontaneously revert to NSR

31
Q

permanent AF

A

inability of pharmacologic or non-pharmacologic methods to restore NSR

32
Q

AF associated disease/cause

A 
hypertension 
congestive heart failure 
sick sinus syndrome 
coronary heart disease 
obesity 
thyroid disease 
familial 
cardiac valve disease
alcohol abuse 
congenital heart disease 
cardiac surgery 
COPD, pneumonia 
septicaemia 
pericarditis, tumours 
vagal cause - high endurance atheletes
33
Q

lone (idiopathic) AF

A

absence of any heart disease and no evidence of ventricular dysfunction
could be genetic
symptoms - palpitations, pre-syncope, syncope, chest pain, dyspnoea, sweatiness, fatigue

34
Q

AF with slow ventricular rate

A

may co-exist with periods of fast VR

a pacemaker may be required

35
Q

rate control of AF

A

digoxin
beta blocker
verapamil
diltiazem

36
Q

rhythm control of AF

A 
pharmacological cardioversion 
direct current cardioversion 
anti-arrhythmic drugs 
catheter ablation of atrial focus/pulmonary veins 
maze procedure
37
Q 
anti-arrhythmic drugs 
class 1
A

reducing Na channel current

lignocaine, quinidine, flecainide, propafenone

38
Q 
anti-arrhythmic drugs 
class 2
A

beta adrenergic antagonists

verapamil

39
Q 
anti-arrhythmic drugs 
class 3
A

action potential prolongation

amiodarone, sotalol, dronedarone

40
Q 
anti-arrhythmic drugs 
class 4
A

Ca channel antagonists

verapamil

41
Q

CHA2DS2VASc score

A 
congestive heart failure 
hypertension 
>75 
diabetes mellitus 
stroke 
valscular disease
65-74 
sex - female
42
Q

atrial flutter

A 
rapid and regular form of atrial tachycardia 
usually paroxysmal 
macro-reentrant circuit 
may result in thromboembolism 
saw tooth f wave

Cardiology (14 decks)

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