Arrhythmias (complete) Flashcards
Describe the EKG of sinus tachycardia
- P waves precede each QRS (everything’s pretty normal)
- Just a regular, fast HR
What are the causes of sinus tachycardia?
Sympathetic activation
- Exercise
- Emotion
- Hypotension
- Response to acute lung/abdominal pathology
- Thyrotoxicosis
What is the treatment of sinus tachycardia?
- usually none (b/c it’s a normal response)
- Beta-blockers in thyrotoxicosis
Describe the EKG of sinus bradycardia
- P waves precede each QRS (normal)
- just regular, slow HR (<60/min)
What are the causes of sinus bradycardia?
- Athletes (endurance peeps)
- Vagotonic states (fainting, sick sinus syndrome, inferior infarct)
What is tx of sinus bradycardia?
- None
- Atropine
- Pacemaker w/ symptoms
Describe the EKG of 1st degree atrioventricular block
- Prolonged PR interval
- Interval is >0.2sec (more than one heavy block)
- Increased junctional delay
What are the causes of 1st degree atrioventricular block
- drug-induced (beta-blockers, some CCB, digitalis)
- conduction system disease
- usually benign
Describe the EKG of 2nd degree AV block
An occasional missed connection
- some P waves are followed by QRS, some are not (some conduct, some don’t)
Describe the EKG of 3rd degree AV block
Oil and water! The relationship not meant to be
- P waves and QRS complexes both show regular rhythm
- HOWEVER they are at different rates w/ P rate>QRS
What are the causes of 3rd degree AV block?
- Severe conduction system disease
- Rarely drugs
- Due to AV node or junctional failure w/ aging, infarct, or disruption during cardiac surgery
What is the treatment of 3rd degree AV block?
- Pacing if ventricular rate or BP are too low
- otherwise can cause syncope or sudden death
Describe the EKG of premature atrial contraction
- Premature (early) beat
- Often preceded by abnormal P wave
- Narrow QRS resembling normally conducted beats
Describe the EKG of premature ventricular contractions
- Wide QRS, no P wave
- The above doesn’t happen all the time => once every few complexes or so
- Common in normal subjects
Can indicate:
- acute myocardial infarct
- HF
Describe the EKG of atrial flutter
Do he make your heart go pitter patter?
- P wave “sawtooth” pattern
- P waves at rate of 240-320 beats/min
- Pulse is regular or irregular
- Ventricular rates vary — rapid if untreated
What is the treatment of atrial flutter?
- Anticoagulation
- Rate control w/ drugs
- Cardioversion
- Ablation
Describe the EKG of atrial tachycardia
- Rapid HR ≥150/min
- Narrow QRS complexes
- P waves (present but abnormal)
What is the treatment of atrial tachycardia?
- Adenosine (super fast – for acute bad problems)
- Vagal maneuver
- Beta blockers
- Verapamil
- Diltiazem
Describe the EKG of atrial fibrillation
No matter how hard you look you can’t find her (P waves)
- No P waves (but atrial depolarizations at 350/min)
- Irregular QRS (like insanely irregular)
What are the causes of atrial fibrillation?
- Aging
- Post-operative (important)
- Heart Disease
- Hyperthyroidism
What are problems associated with atrial fibrillation?
Rapid HR
- Syncope
- Ischemia
- HF
Loss of Atrial Kick
- HF
Atrial Thrombi
- Embolic stroke
What are the treatments of atrial fibrillation?
- anticoagulation
- rate control with drugs
- Cardioversion
- Ablation
Describe the EKG of junctional rhythm
- Regular
- Narrow QRS (usually)
- No antecedent P waves
- Tx usually unnecessary
Describe the EKG of ventricular tachycardia
- Usually regular, fast, wide QRS complexes (100-200/min)
- mostly no P waves
- Sustained if ≥30 seconds in duration
- Often life threatening!
What are the treatments for ventricular tachycardia?
- Amiodarone (used if pt is stable)
- Lidocaine
- Cardioversion
Describe the EKG of ventricular fibrillation
- Wavy
- Irregular baseline
No P wave or QRS
Describe the EKG of asystole
Flat baseline
time to get that epinephrine and shock them!
