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Arrhythmias Flashcards

(58 cards)

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1
Q

Sinus tachycardia characteristics

A

Regular
100-150 bpm
Normal intervals

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2
Q

Sinus tachy causes

A 
Fever
Activity
Hemorrhage
Stimulants
Anxiety
Injury
Hypoxia
Anemia
Low BP
COPD
Meds
MI
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3
Q

S/S hypoperfusion

A 
Dizziness
Weakness
Syncope
Disorientation
Chest pain
SOB
Diaphoresis
Pallor
Hypotension
Weak pulses
Palpitations
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4
Q

Sinus tachy tx

A

Treat cause (anxiolytics, bolus fluids, digoxin, beta blockers, calcium channel blockers)

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5
Q

Sinus brady characteristics

A

Regular
<60 bpm
Normal intervals

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6
Q

Sinus brady d/t

A

hypothermia
hypoxia
Digoxin, beta blockers/calcium channel blockers
Acute MI
Vagal stimulation (vomiting/suction/rectal exam)
Athletes

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7
Q

Sinus brady tx

A

Atropine
Epinephrine
Pacemaker (rare)

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8
Q

Normal sinus rhythm

A

Regular
60 bpm
Normal intervals

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9
Q

Rhythm strip interpretation

A

1) Regularity
2) Rate
3) P wave : QRS complex ratio
4) PR interval
5) QRS complex
6) QT interval
7) INTERPRETATION :)

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10
Q

Normal values

A

PR: 0.12-0.20 s
QRS: 0.06-0.12 s
QT interval: 0.36-0.44 s

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11
Q

Sinus arrhythmia

A

Irregular HR
60-100 bpm
Normal intervals

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12
Q

Sinus arrhythmia d/t s/s tx

A

Normal pressure changes in chest cavity during breathing
No s/s
No tx

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13
Q

Sinus pause

A 
Regular except for pauses
60-100 bpm
Normal intervals 
Calculate pause (b/t QRS complexes)
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14
Q

Sinus pause d/t

A

Ischemic, inflammatory or degenerative disease of SA node
Sleep apnea
Cardiac meds
Excessive vagal tone

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15
Q

Sinus pause s/s tx

A

Longer, more frequent pauses –> decreased CO –> s/s hypoperfusion
Atropine, epi, dopamine if symptomatic

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16
Q

SVT

A

Regular or irregular
150-250 bpm
Undefined P/T waves
Narrow QRS

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17
Q

SVT causes

A

Sinus tachy, a fib, a flutter, junctional tachy
Severe anxiety
Stimulants (coke, caffeine, amphetamines)
Alcohol, narcotics

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18
Q

SVT treatments

A

Stable: adenosine, vagal maneuvers
Unstable: Synchronized cardioversion

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19
Q

A fib

A

Irregular
60-180 bpm
Undefined P/T waves - multiple P waves
QRS complex narrow

Slow <60 bpm
Fast >100 bpm

State rate as a range

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20
Q

A fib causes s/s

A

MI, longstanding CAD, COPD, atrial septal defects
Cardiac insufficiency, valve regurgitation, hypertrophy
S/S possible: hypoperfusion

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21
Q

A fib tx

A

New onset: IV heparin, IV amiodarone
Stable, fast: amiodarone, beta blockers, calcium channel blockers
Unstable (>180 bpm, hypotension, chest pain): synchronized cardioversion

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22
Q

A flutter

A 
Regular or irregular
Saw-toothed appearance: similar F-waves (one or two ectopic pacemakers bombard AV node) 
Undefined PR interval
Undefined QT interval
Narrow QRS complex
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23
Q

A flutter causes

A 
Antiarrhythmic drugs (to suppress a fib)
Obesity
Obstructive sleep apnea
Sick sinus syndrome
Pericarditis
Pulmonary disease
PE
Cardiomyopathy
Thyrotoxicosis
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24
Q

PAC

Study These Flashcards
A

Irregular overall (regular other than PAC)
P wave for premature beat different than regular P waves
Normal QRS complex
Normal QT interval

25
PAC causes
``` Possible cardiac history Food or meds Anxiety Caffeine Exercise Tobacco ETOH Electrolyte ```
26
PAC s/s
Often no symptoms | Might feel palpation or skipped beat if frequent
27
PAC treatments
Not usually treated Eliminate ingested causes if d/t toxicity Correct electrolyte imbalances
28
Junctional rhythm
Regular 40-60 bpm P wave: inverted (superior AV node), absent (mid AV node), after QRS complex (inf AV node) QRS complex narrow
29
Accelerated junctional rhythm
Regular rhythm 60-100 bpm P wave: inverted, absent or after QRS complex QRS complex narrow
30
Accelerated junctional rhythm causes, s/s, tx
D/T: digoxin toxicity, electrolyte imbalances, ischemia S/S: None or hypoperfusion TX: Remove cause of SA node suppression (adjust meds)
31
Junctional tachycardia
``` Regular 100-180 bpm P wave: inverted, absent, after QRS complex QRS complex narrow Basically could also be SVT ```
32
Junctional tachy causes, s/s, tx
D/T: anxiety, exercise, heart disease, caffeine, CNS stimulants S/S: depends on rate - hypoperfusion TX: stable: vagal maneuvers, calcium channel blockers, digoxin Unstable: Synchronized cardioversion
33
1st degree AV block
``` Regular 60-100 bpm but may be brady/tachy PR interval > 0.2 s + constant QRS complex narrow QT interval normal ```
34
1st degree AV block causes s/s tx
D/T: aging, cardiomyopathies, myocarditis, congenital defects, ischemic heart disease, meds (digoxin, beta blocks, calcium channel blocks) S/S: none TX: reduce/eliminate meds if d/t intox
35
2nd degree AV block type I (Wenkenbach)
Regular P waves PR intervals get progressively longer until QRS complex is dropped QRS complex narrow QT interval normal
36
2nd degree AV block type II
Regular P waves PR interval regular and constant QRS complex narrow and periodically absent
37
2nd degree AV block type I causes
``` Cardiomyopathies Myocarditis Congenital defects Ischemic heart disease Meds (dig, beta, calcium) ```
38
2nd degree AV block type II causes
Cardiomyopathies Myocarditis Ischemic heart disease Meds
39
2nd degree AV block s/s, tx
S/S: none or hypoperfusion | TX: IV atropine, epinephrine and dopamine, pacemaker
40
3rd degree AV block
20-60 bpm P waves regular amongst themselves or hidden QRS complexes regular amongst themselves P waves and QRS complexes not in sync Atrial rate > ventricular rate
41
3rd degree AV block causes
``` Cardiomyopathies Myocarditis Ischemic heart disease Long term degenerative heart disease CHF Meds ```
42
3rd degree AV block s/s
``` None or hypoperfusion Cheyne-Stokes breathing Seizures Apnea Death ```
43
3rd degree block tx
IV atropine, epi or dopamine | Pacemaker (transvenous)
44
Bundle branch block
Reg or irregular depending on underlying rhythm (sinus rhythm with BBB, a fib with BBB) Wide, irregular QRS complex (V1 = right, V6 = left)
45
PVC
Irregular overall, regular other than PVCs QRS complex wide and weird P wave may be absent with premature beat Run of 5 or more = v tach
46
PVC causes
``` MI, CHF, CAD Anxiety, exercise Caffeine, tobacco, etoh, drugs, meds Electrolyte imbalance (potassium) Hypoxia (COPD) Normal following angio (reperfusion) ```
47
PVC s/s, tx
S/S: often none, palpitations TX: may not be treated Treat cause Antiarrhythmic meds
48
Ideoventricular rhythm
Regular or irregular 20-40 bpm Wide QRS complex Often no P-wave - undefined PR interval
49
Ideoventricular rhythm causes
Vagal stimulation Cardiac depressant meds MI, rheumatic heart disease, septal defects Large dose of CNS depressants
50
Ideoventricular rhythm s/s, tx
S/S: May be asymptomatic, or s/s hypoperfusion | TX: Atropine, epi drip
51
Ventricular tachycardia
``` Regular 110-250 bpm Wide weird QRS complex With/out pulse Sustained >30 seconds ```
52
Vtach causes
Heart disease, ischemia, MI, CAD, congenital defects Ventricular aneurysm, PVC on T wave , defib on T wave Epi, thyroid meds, amphetamines, cocain, cardiac meds Electrical shock
53
Vtach s/s
Short runs = asymptomatic | Longer runs = s/s hypoperfusion --> changes in LOC, seizure, pupil dilation, no BP, no HR
54
Vtach tx
VT with pulse: amiodarone, synchronized cardioversion | VT without pulse: CPR, defib
55
Ventricular fibrillation
No CO = arrest No rate No QRS complex
56
V fib causes, s/s, tx
D/T: Electric shock, PVC on T wave, defib on T wave, massive MI S/S: No pulse, no BP, no RR TX: CPR defib
57
Torsades de pointes
Type of v tach with polymorphous QRS complexes 150-250 bpm D/T: long QT syndrome (congenital or acquired) Drug induced, eating disorders, electrolyte imbalance S/S: short term palpitations long term no pulse, no BP, no RR Tx: IV Mg
58
Artifact
What to do: Go to bedside: verify replace reposition electrodes, wires Ask patient to minimize movements Ensure chest is shaved

Arrhythmias (1 decks)

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