Brainscape's Knowledge GenomeTM

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


See full index

Cardiology Disease Profiles > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What is an arrhythmia?

A

Abnormal heart rhythm

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

Why do arrhythmias occur?

A

Result of an interruption to the normal electrical signals that coordinate contraction of the heart muscle

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

How many cardiac arrest rhythms are there?

A

4

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

What type of patients are cardiac arrest rhythms seen in?

A

Pulseless, unresponsive ones

-Can be categorized as shockable or non-shockable

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

Types of shockable cardiac arrest rhythms?

A

Ventricular tachycardia

Ventricular fibrillation

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

Types of non-shockable cardiac arrest rhythms?

A

Pulseless electrical activity

Asystole

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

Treatment of tachycardia in an unstable patient?

A

3 synchronized shocks

-Consider amiodarone infusion

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

Categories of stable patients with tachycardia and their treatments?

A

Narrow complex QRS:

  • A fibrillation= Rate control (beta blocker/diltiazem)
  • Atrial flutter = Rate control with beta blocker
  • Supraventricular tachycardia= vagal manoevres and adenosine

Broad complex QRS:

  • Ventricular tachycardia = amiodarone infusion
  • SVT with bundle branch block= treat as normal SVT
  • Irregular= seek help
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes an atrial flutter?

A

Re-entrant rhythm in either atrium
-E. signal circulates in self-perpetuating loop due to an extra electrical pathway in atria
without interruption

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

What is the atria contraction BPM in atrial flutter?

A

300bpm

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

What causes a ventricular contraction of 150bpm in atrial flutter?

A

The electrical signal makes its way out of atria into ventricles every 2nd loop due to long refractory period of AV node

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

What does an ECG of atrial flutter look like?

A

Sawtooth appearance

P wave after p wave

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

Conditions associated with atrial flutter?

A

Hypertension
IHD
Cardiomyopathy
Thyrotoxicosis

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

Treatment of atrial flutter?

A

Rate/rhythm control: B blockers
Treat reversible underlying condition (eg HT)
Radiofrequency ablation of reentrant rhythm
Anticoagulation based on CHA2DS2Vasc score

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

How long is a broad QRS complex?

A

> 0.12s

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

How long is a narrow QRS complex?

A

<0.12s

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

What causes supraventricular tachycardia?

A

Electrical signal re-entering atria from ventricles

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

Journey of signal in supraventricular tachycardia?

A

-Signal finds way back into atria
-Once in, it travels back through AV node & causes another ventricular contraction
-Causing elf-perpetuating loop without an end point
=
Resulting in narrow complex tachycardia

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

What doe SVT look like on an ECG?

A

QRS complex followed immediately by T wave

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

What is paroxysmal supraventricular tachycardia?

A

Where SVT reoccurs and remits over time

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

3 main types of SVT?

A

Atrioventricular nodal re-entrant tachycardia
Atrioventricular re-entrant tachycardia
Atrial tachycardia

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

What is AV nodal re-entrant tachycardia?

A

Re-entry point is back through the AV node

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

What is AV re-entrant tachycardia?

A

Re-entry point is an accessory pathway (Wolff-parkinson-white syndrome)

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

What is atrial tachycardia?

A

Electrical signal originates in atria somewhere other than SA node (not caused by signal re-entry from ventricles). Instead from abnormally generated electrical activity in atria

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

What does atrial tachycardia cause atrial rate to become?

A

> 100bpm

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

What to ensure when treating SVT patients?

A

That they are continuously monitored on ECG

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

Treatment of SVT?

A
  • Valsalvia manouevre
  • Carotid sinus massage
  • Verapamil (CCB) (alternative to adenosine)
  • Adenosine
  • Direct current cardioversion
28
Q

What is the valsavia manouevre?

A

Patient blows hard against resistance eg plastic syringe

29
Q

What is carotid sinus massage?

A

Massage carotid on one side gently with 2 fingers

30
Q

What does adenosine do in SVT?

A

Slows cardiac conduction through AV node. Interrupts AV node/accessory pathway during SVT and resets to sinus rhythm

31
Q

How would adenosine be given in SVT?

A

Rapid IV bolus

32
Q

What can adenosine sometimes cause when treating in SVT?

A

Brief period of asystole or bradycardia however sinus rhythm will be restored in time

33
Q

When to avoid prescribing adenosine?

A

-Patient has asthma, COPD, HF, heart block, hypertension

34
Q

How to treat paroxysmal SVT?

A

Medication (Bb, CCB, or amiodarone)

Radiofrequency ablation

35
Q

What causes wolff-parkinson-white syndrome?

A

Extra electrical pathway connecting atria and ventricles. Normally only 1 pathway called AV node but extra in this syndrome called the bindle of Kent

36
Q

Treatment of WPWS?

A

Radiofrequency ablation of accessory pathway

37
Q

What WPWS looks like on an ECG?

A
  • Short PR interval
  • Wide QRS complex
  • Delta wave (slurred upstroke on QRS complex)
38
Q

What consists of a short PR interval?

A

<0.12s

39
Q

What is a delta wave?

A

Slurred upstroke on QRS complex

40
Q

When are anti-arrhythmatic drugs contraindicated?

A

Patients with WPWS + AF/Aflutter

-increases risk of torsades de pointes

41
Q

Which conditions is radiofrequency ablation curative for?

A

AF
A flutter
SVT
Wolff-parkinson-white syndrome

42
Q

What is Torsades de pointes?

A

Polymorphic ventricular tachycardia

43
Q

What does Torsades de Pointes look like on ECG?

A

Normal ventricular tachycardia except there is the appearance of the QRS complex twisting around base line
QRS height gets progressively shorter the larger then repeats

44
Q

Physiology of torsades de pointes?

A
  • Prolonged repolarization of muscle cells in heart after contraction
  • Repolarization is period of recovery before myocytes are ready to depolarize again
45
Q

What can longer repolarization result in?

A

Random spontaneous depolarization in some areas = afterdepolarisations
These spread through ventricles leading to another ventricular reaction prior to proper repolarization occurring

46
Q

What causes prolonged QT waves?

A
  • Long QT syndrome (inherited)
  • Medication (antipyschotics, citalopram, flecainide, sotalol, amiodarone, macrolide ABs)
  • Electrolyte disturbances eg hyperkalaemia, hypomagnesamia, hypocalcaemia
47
Q

Acute management of torsades de pointes?

A

Correct cause eg EL disturbance/meds
Mg infusion
Defibrillation if VT occurs

48
Q

Chronic management of TDP?

A

Avoid meds that prolong QT
Correct electrolyte disturbance
B blockers
Pacemaker/implantable defibrillator

49
Q

What are ventricular ectopics?

A

Ventricular premature beats

50
Q

Why do ventricular ectopics happen?

A

Random electrical charges from outside atria

51
Q

Presenting complaint of someone with ventricular ectopics?

A

Random brief palpitations

52
Q

What an ECG of ventricular ectopics shows?

A

Individual, abnormal, QRS complexes on background of normal ECG

53
Q

What is bigeminy?

A

When ventricular ectopics occur after every sinus beat

54
Q

Management of ventricular ectopics?

A

Check bloods for anaemia, EL disturbances & thyroid weirdness
-Reassurance and no treatment in otherwise healthy patients

55
Q

1st degree AV node heart block?

A

Delayed AV conduction through AV node
Every atrial impulse leads to V contraction (every P gives a QRS)
ECG shows PR interval as more than 0.2s

Husband coming home late every night same time

56
Q

What is a prolonged PR interval?

A

0.2s

57
Q

2nd degree AV node heart block?

A
  • Some atrial impulses do not make it through AV node to ventricles
  • Some p waves don’t lead to QRS complexes

The husband keeps coming home progressively later and later until he doesn’t come home at all

58
Q

3 types of 2nd degree heart block?

A
  1. Wenckebach’s phenomenon: Mobitz 1
  2. Mobitz type 2
  3. 2:1 Block
59
Q

Describe Mobitz 1?

A

Atrial imput becomes gradually weaker until doesn’t pass through AV node
After failing to stimulate V contraction the P wave returns to strength again

60
Q

What does an ECG show in Mobitz 1?

A

Increasing PR intervals until P wave no longer conducts to ventricles (absent QRS)

61
Q

What is Mobitz type 2?

A

Intermittent heart failure
Results in missing QRS complexes
Ratio of P waves to QRS complexes is usually 3:1 block
PR interval remains normal

62
Q

What is 2:1 block?

A

2 p waves for every 1 QRS complex
Every 2nd P is not strong enough
Can be caused by M1 or M2

63
Q

3rd degree heart block?

A

Complete heart block

No observable relationship between P waves and QRS complexes

64
Q

Which two types of heart block have significant risk of asystole?

A

3rd degree AV nodal heart block

2:1 block

65
Q

Treatment of bradycardia in an unstable patient?

A 
1st line: atropine 500mcg IV 
*no improvement*
Atropine 500mcg 
Other inatropes (noradrenalin)
Defibrillator
66
Q

Side effects of atropine?

A

Dilated pupils
Urine retention
Constipation
Dry eyes

67
Q

How does atropine work?

A

Antimuscarinic

-Inhibits parasympathetic nervous system

Cardiology Disease Profiles (12 decks)

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