Arrhythmias

Question 1

What is an arrhythmia?

Answer 1

Disturbances of cardiac rhytms

Question 2

How do you treat an unstable patient?

Answer 2

3 shocks

Amiodarone injection

Question 3

What could a narrow QRS complex (<0.12s) indicate?

Answer 3

Atrial fibrilation
Atrial flutter
Supraventricular tachycardia

Question 4

how would you treat supraventricular tachycardia?

Answer 4

Vagal manoeuvres

Adenosine

Question 5

What would a wide QRS complex (>0.12s) indicate?

Answer 5

Ventricular tachycardia

Question 6

How would you treat Ventricular tachycardia?

Answer 6

Amiodarone infusion

Question 7

What is atrial flutter?

Answer 7

Electrical signals re-enter atria in a self-perpetuating loop

Question 8

What happens in ventricular fibrillation?

Answer 8

• The electrical signals in the ventricles are not coordinated causing a loss of contractual ability
• Ventricular walls spasm, causing blood to stay in ventricles and not be pumped to the rest of the body

Question 9

What can cause ventricular fibrilation?

Answer 9

Oxygen deprivation

Conduction abnormality

Question 10

What are the symptoms of ventricular fibrilation?

Answer 10

Unconsciousness
- no blood going to the brain
No pulse
- no forward movement of blood

Question 11

What are the risk factors for ventricular fibrilation?

Answer 11

• CAD
• Electrolyte imbalance
• MI
• Cardiomyopathy

Question 12

What is ventricular tachycardia?

Answer 12

Heart beats so fast that the heart does not have enough time to fill properly causing a reduced volume of blood being ejected from the heart

Question 13

What is focal ventricular tachycardia?

Answer 13

Ventricular cells become irritated causing them to over-fire, sending more impulses to the ventricular conduction system
Ventricles contract rapidly

Question 14

What is reentrant ventricular tachycardia?

Answer 14

Scar formation means that electrical current cannot pass through dead cells, it has to go around them and it does so continuously
Every time electrical signal goes around it spreads the signals to the cells causing them to contract

Question 15

What are the symptoms of ventricular tachycardia?

Answer 15

• Shortness of breath
• Dizziness / faint
• Chest pain
• Palpitations

Question 16

What does ventricular tachycardia show up like on an ECG?

Answer 16

• Wide QRS complexes (>0.12s / >3 small boxes)

- HR >100bpm

Question 17

What are the causes of ventricular tachycardia?

Answer 17

• CAD
• Electrolyte imbalance ( high K, low Ca, low Mg)
• MI
• Hypertrophic cardiomyopathy
• Dilated cardiomyopathy

Question 18

What is a cardiomyopathy?

Answer 18

Disease of heart tissue that causes loss of heart function

Question 19

What is supraventricular tachycardia?

Answer 19

Abnormally high heart rate origination from or above the AV node

Question 20

What happens in supraventricular tachycardia?

Answer 20

Electrical signals re-enters atria from ventricles -> AV node -> stimulates ventricular contraction

Question 21

What are the symptoms of supraventricular tachycardia?

Answer 21

• Palpitations
• Chest pain
• Anxiety
• Shortness of breath
• Dizziness

Question 22

What does supraventricular tachycardia show up like on an ECG?

Answer 22

Narrow QRS complex (<0.12s / < 3 small boxes)

Question 23

What are the risk factors for supraventricular tachycardia?

Answer 23

• COPD
• Pulmonary embolism
• Alcoholism
• Hyperthyroidism

Question 24

What is atrial fibrilation?

Answer 24

Loss of unified electrical signals causing atrial spasming

Question 25

What does atrial fibrillation show up like on an ECG?

Answer 25

• Irregularly irregular heart rhythm

- No distinct P-waves

Question 26

What are the risk factors for atrial fibrillation?

Answer 26

• Increased age
• Inflammation
• Enlarged atria caused by…
  High BP
  Valve disease (mitral stenosis)
  Lung disease
• Hormonal abnormalities (thyroid)
• Alcoholism

Question 27

Why do people with atrial fibrillation have a high risk of stroke?

Answer 27

• Blood pools in the atria and forms clots
• Clot escapes and goes to ventricle
• Pumped out to body causing a blood clot in the brain