Arrhythmias- Batten Flashcards
early after depolarizations (EADs)
delayed after depolarizations (DADs)
sinus arrhythmia (same p wave)
Wandering atrial pacemaker (different p’s, normal rate)
narrow QRS, upright T
PAC (premature atrial contractions)
wide QRS, inverted T
PVC (premature ventricular contraction)
long PR
First degree heart block
this heart block is benign unless doing a workup for Rheumatic Fever
first degree
second degree heart block: Wenckebach
second degree heart block: Mobitz type II
this is due to delayed conduction through AV node
Mobitz type I: Wenckebache
this is due to impaired His-Purkinje conduction
Mobitz type II
atria and ventricles beat independently of each other
third degree heart block (CHB)
causes of this include:
aging
hypothyroidism
high vagal tone (athletes)
medications
sinus bradycardia (causes bradyarrhythmias)
causes of this include:
sick sinus syndrome
sinus node dysfunction (causes bradyarrhythmias)
MI and Lyme disease can cause what
bradyarrhythmia
can cause complete heart block; syncopal episodes; stokes adams attacks; bull’s eye rash
Lyme Disease
symptoms of this include:
most asymptomatic
dizziness
fatigue
confusion
syncope
bradyarrhythmias
causes of this include:
Atrial Enlargement
alcohol
thyrotoxicosis
AFib
wavy baseline
AFib
“irregularly irregular”
AFib
sawtooth p waves
Atrial flutter
caused by:
pre-existing heart disease
atrial scarring
previous ablation
Atrial flutter
conduction is forward (anterograde) down AV node and His bundle; QRS narrow
orthodromic (AV nodal reentry tachycardia)
conduction is backwards (retrograde) up AV node (going down accessory pathway); QRS wide—-looks like VTach
anti-dromic (AV reentry tachycardia)
2 main types of SVTs (supraventricular tachycardia)
AV nodal reentry tachycardia
AV reentry tachycardia
p wave hidden in QRS
AV nodal reentry tachycardia
AV nodal reentry tachycardia
retrograde p wave (behind QRS)
AV reentry tachycardia
AV reentry tachycardia
bypasses tract b/t atria and ventricle through Bundle of Kent (faster than going through AV node)
WPW syndrome (Wolff-Parkinson-White)
short PR
delta wave
wide QRS
t wave abnormalities
WPW syndrome
WPW syndrome
causes of this:
fever, hypoxemia, anemia
hyperthyroidism, CHF
sinus tachycardia
causes of this:
reentry, triggered, automaticity
SVT (supraventricular tachycardia)
this syndrome is associated with sudden death
WPW syndrome
sx’s of this:
palpitations
sob
dizziness
exercise intolerance
syncope
sinus tachycardia and SVT
VTach (ventricular tachycardia)
caused by:
DADs or reentry into ventricle
VTach
3 or more PVC’s in a row
VTach
VFib (ventricular fibrillation)
heart looks like bag of worms due to lack of organized contractions
VFib
Torsades de Pointes
twisting of the points; polymorphic Vtach
Torsades de Pointes
due to EADs
TdP
what is prolonged
QT interval
2 kinds of QT intervals
acquired
congenital
what can cause acquired QT intervals
drugs (K+channel blockers, 1A Na+ channel blockers)
low levels of electrolytes
how do people with prolonged QT interval present
syncope, seizure, sudden cardiac arrest
AD; K+ channelopathy; long QT; no hearing deficit
Romano Ward
KCNQ1; long QT; deafness
Jervell and Lange-Nielsen
ST elevation w/ T wave inversions in leads V1-3; Na+ channelopathy
Brugada Syndrome
what causes congenital prolonged QT interval
Na+/K+ channelopathy
KCNQ1 gene involved in; and what triggers arrhythmia
LQTS type I; swimming (exercise)
KCNH2 gene involved in; and what triggers arrhythmia
LQTS type II; auditory stimuli/stress
SCN5A gene involved in; triggered by what
LQTS type III; sleep (most lethal)
syndrome caused by SCN5A (Na+ channelopathy) and very rare in US
Brugada syndrome
causes of this include:
anomalous coronary a. origin
post MI
noncompaction of LV
ventricular hypertrophy
ventricular arrhythmias
hit in heart and go into Vfib and die
Commotio cordis
symptoms of this include:
asymptomatic
palpitations
dizziness
syncope
nonsustained VTach
symptoms of this include:
pulmonary edema, CHF, death
sustained VTach
symptoms of this include:
sudden cardiac arrest, death (can happen post MI)
VFib
most common cause of multifocal atrial tachycardia
COPD
patient complaining of chest pain and passing out; EKG shows LVH (large R in V6) and inverted T
hypertrophic cardiomyopathy
Wenckbache
where to check for AFlut
II, III, aVF
bradycardic and random p waves
complete heart block
J Point
peaked p wave in lead II
R atrial enlargement
negative or biphasic p wave in V1
L atrial enlargement
3 or more PVC’s in a row
VTACH
PACs
VTACH
WPW
RBBB
tetralogy of fallot that was operated on can cause what
RBBB
LBBB
L atrial enlargement (V1)
WPW best seen in what leads
Lead I, V4-V6
WPW (L)
VFIB (R)