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Cardiology > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What are the shockable cardiac arrest rhythms? (2)

A

VT

VF

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2
Q

What are the non-shockable rhythms in cardiac arrest? (2)

A

Asystole (no significant electrical activity)

Pulseless electrical activity (all electrical activity except VF and VT)

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3
Q

What is the treatment for tachycardia in an unstable patient? (2)

A

Consider up to 3 synchronised shocks

Consider an infusion of amioderone

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4
Q

What is the treatment of tachycardia caused by AF (narrow complex tachy)

A

Rate control with beta blocker or diltiazem (CCB)

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5
Q

What is the treatment of tachycardia caused by Atrial flutter (narrow complex tachy)?

A

Rate control with a beta blocker

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6
Q

What is the treatment of tachycardia caused by Supraventricular tachycardia (narrow complex tachy)? (4)

A

Treat with valsalva manoeuvres ,

adenosine (or verapamil),

carotid sinus massage,

direct current cardioversion

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7
Q

What is the QRS duration in a narrow complex tachycardia?

A

Under 0.12 seconds

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8
Q

What are the three narrow complex tachycardias?

A

AF

Atrial flutter

SVT’s

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9
Q

What is the QRS duration of a broad complex tachycardia?

A

Over 0.12 seconds

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10
Q

What is the treatment of tachycardia caused by VT(broad complex tachy)?

A

Amioderone infusion

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11
Q

What is the treatment of tachycardia caused by SVT with bundle branch block(broad complex tachy)?

A

Treat as normal SVT (cavalry manoeuvres and adenosine)

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12
Q

What should you do if the patient has a broad complex tachycardia which is irregular and may be an AF variation?

A

Seek expert help

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13
Q

What is the treatment of atrial flutter? (4)

A

Rate/rhythm control with beta blocker or cardioversion

Treat reversible underlying condition (hypertension, ischaemic heart disease, cardiomyopathy, thyrotoxicosis)

Radio frequency ablation of the re-entrant rhythm

Anticoagulant based on chadsvasc score

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14
Q

What conditions should you avoid giving adenosine in? (5)

A 
COPD
Asthma
HF
Heart block
Severe hypotension
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15
Q

What should you warn patients of before administering adenosine?

A

They may feel like they are dying/ impending doom

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16
Q

What ECG changes are seen in WPW syndrome? (3)

A

Short PR interval (under 0.12 seconds)

Wide QRS complex (over 0.12 seconds)

Delta wave (slurred I patrol of QRS complex)

17
Q

What groups of medications are contraindicated in WPW patients who develop AF or flutter?

A

Antiarrhythmics

They promote bypass of the AV nose down accessory pathway

18
Q

What are causes of prolonged QT interval? (3)

A

Long QT syndrome (inherited)

Medications (antispsychotics, citalopram, flecanide, sotalol, amioderone, macrolides)

Electrolyte disturbances (hypokalaemia, hypomagnesia, hypocalcaemia)

19
Q

What is the acute management of torsades de pointes (polymorphic VT)? (3)

A

Correct cause

Magnesium infusion (even if normal serum magnesium)

Defibrillation if VT occurs

20
Q

What is the long term management of prolonged QT? (4)

A

Avoid meds that do it

Correct electrolyte disturbances

Beta blockers (but not sotalol)

Pacemaker or ICD

21
Q

What is the management for ventricular ectopics? (3)

A

Check bloods for anaemia, electrolyte disturbances to thyroid abnormalities

Reassure and no treatment in otherwise healthy people

Seek expert advice in patients with heart conditions or other concerning features

22
Q

What is the PR interval in first degree heart block?

A

Greater than 0.2 seconds

23
Q

Which heart block has wickenback appearance on ECG?

A

Second degree heart block Mobitz type 1

24
Q

What heart blocks has a risk of asystole? (2)

A

Second degree mobitz type 2

third degree heart blocks

25
Q

What is the medication given for patients with a bradycardia or heart block who are unstable or at risk of asystole? What if there is no improvement?

A

Atropine

If no improvement then other inotropes such as noradrenalin and transcutaneous cardiac pacing

If asystole risk then temporary trans venous cardiac pacing, and permanent implantable pacemaker when available

26
Q

What do you give for the management of hyperkalaemia? (2)

A

Calcium Gluconate (if K+ is over 6.5 or ECG changes)

Then insulin/dextrose infusion

Cardiology (13 decks)

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