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Cardiovascular > Arrhythmias - Pathophysiology, presentation and investigation > Flashcards

Arrhythmias - Pathophysiology, presentation and investigation Flashcards

1
Q

What are the different parts of the ECG?

A 
P wave 
P-R interval 
QRS complex 
S-T segment 
T wave
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2
Q

What are the possible presentations of arrhythmias?

A 
Asymptomatic 
Palpitation
Dyspnoea 
Chest pain 
Fatigue 
Embolism
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3
Q

What investigations should be done?

A

ECG - 12 lead, 24 hours recording
Full blood count
Thyroid function test
Echocardiogram

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4
Q

What are the main ways to treat arrhythmias?

A

Rate or rhythm control

Anticoagulation

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5
Q

What medication is used to control rate?

A

Digoxin
Beta blockers
Ca- antagonist plus warfarin
Aspirin

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6
Q

What is used to control rhythm?

A

Class Ic/III antiarrhythmic drugs

DC cardioversion

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7
Q

What are the electrical approaches to arrhythmia treatment?

A

Pace and ablation of AV node

Substrate modification - pulmonary vein postal ablation or maze procedure

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8
Q

What is ablation?

A

When certain areas of tissue are destroyed so that the electrical signal doesn’t propagate

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9
Q

What is a maze procedure?

A

When ablation is used to create a maze so that electrical signals follow a more predictable route

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10
Q

What is necessary for patients who have had AV node ablation?

A

A pacemaker

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11
Q

What is DC cardioversion?

A

Direct current used to shock a person so that the heart rhythm is restored

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12
Q

What is supraventrivcular tachycardia?

A

AV-nodal re-entrant tachycardia - abnormally fast heart rhythm arising from improper electrical activity in the upper part of the heart.

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13
Q

What are the signs and symptoms of supraventricular tachycardia?

A

Palpitations
Dyspnoea
Dizziness

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14
Q

What is a possible treatment for supraventricular tachycardia?

A

Radio frequency ablation

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15
Q

What is atrial flutter?

A

An abnormal heart rhythm that starts in the atrial chambers of the heart.

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16
Q

What does atrial flutter usually develop into?

A

Atrial fibrillation

17
Q

How is atrial flutter treated?

A 
Control ventricular rate 
Anticoagulants 
Antiarrhythmic drugs 
RFA 
Cardiovertion
18
Q

What are the symptoms of ventricular tachycardia?

A 
Palpitations 
Dyspnoea 
Dizziness 
Syncope 
Chest pain
19
Q

What causes ventricular tachycardia?

A

Structural heart disease usually

20
Q

What can ventricular tachycardia develop into?

A

Ventricular fibrillation

Cardiac arrest

21
Q

How is ventricular tachycardia treated?

A 
Cardiac arrest protocol 
DC cardioversion 
Treating the underlying cause 
Antiarrhythmic drugs 
Implantable cardioverter-defibrillator (ICD)
22
Q

What is Torsades de Pointes?

A

A polymorphic ventricular tachycardia that exhibits distinct characteristics on the ECG

23
Q

What can Torsades de Pointes lead to?

A

Sudden death

24
Q

What can cause Torsades de Pointes?

A

Long QT syndrome
Atrial fibrillation
Complete heart block

25
Q

What are the indication for ICD therapy?

A

Cardiac arrest due to VF/VT
Sustained VT causing syncope or significant compromise
Sustained VT with poor LV function

26
Q

What are the indications for a temporary pacemaker?

A

Symptomatic bradycardia (particularly syncope)

27
Q

What is a temporary pacemaker used for?

A

Prophylactic when a patient is at high risk of developing severe bradycardia such as 2nd or 3rd degree AV block or post anterior MI

28
Q

What are the indications for a permanent pacemaker?

A

Symptomatic 2nd or 3rd degree AV block
Mobitz type 2 2nd or 3rd degree Av block
AV block associated with neuromuscular disease
After AV node ablation
Alternating RBBB/LBBB
Syncope when bifascicular/trifascicular block
Symptomatic sinus node disease
Carotid sinus hypersensitivity
Malignant vasovagal syncope

29
Q

What is alternating RBBB/LBBB?

A

Alternating right bundle branch block and left bundle branch block

30
Q

What is Bifascicular block?

A

A conduction abnormality in the heart where two of the three main fascicles of the His/Purkinje system are blocked.

31
Q

What is trifascicular block?

A

Conducting disease in all three fascicles

Cardiovascular (34 decks)

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