Arrhythmias with pics Flashcards
what does this ECG show?
-asystole
how to treat asystole?
- non shockable rhythm
- 1 mg adrenaline every 3 to 5 mins
what does this ECG show?
-atrial flutter
how does atrial flutter present on ECG?
- atrial rate>300bpm
- ventricular rate >150bpm
- regular saw tooth wave
treatment for atrial flutter?
FOR RHYTHM CONTROL:
- DCCV
- ablation
FOR RATE CONTROL:
1st line BB/CBB
2nd line digoxin
3rd line amiodarone
anticoagulants
how does atrial fibrillation present on ECG?
- irregularly irregular with no P waves
- atrial rate >300bpm
- ventricular rate varies
what does this ECG show?
atrial fibrillation
treatment for atrial fibrillation?
Same treatment as atrial flutter
FOR RHYTHM CONTROL
- DCCV
- ablation
FOR RATE CONTROL
1st line BB/CCB
2nd line digoxin
3rd line amiodarone
anticoagulants
what does this ECG show?
pericarditis
how does pericarditis present on an ECG?
- saddle shaped ST segment
- PR depression
How does Brugada syndome present on ECG?
ST elevation anf RBBB in V1-3
May have AF too
How does congenital long QT syndrome present on an ECG?
- QT prolongation (>0.44s in males and >0.45s in females)
- Torsades de Pointes (polymorphic VT)
What does this ECG show?
Torsades de Pointes (ventricular tachycardia)
How to treat congenital long QT syndrome?
- BB
- avoid QT prolonging drugs and triggers
How does first degree heart block present on an ECG?
- PR interval is prolonged (>0.2s)
- regular and no missed beats
How does Mobitz Type 1 present on an ECG?
-Progressively lengthening PR interval until a beat (QRS complex) is dropped
How does Mobitz Type 2 present?
-PR interval is constant but the P wave is often not followed by QRS complex
How does third degree/ complete heart block present on an ECG?
- there is no association between the P waves and QRS complexes
- usually more P waves than there are QRS complexes
What does this ECG show?
Long QT syndrome
What does this ECG show?
First degree heart block
what does this ECG show?
Mobitz type 1
what does this ECG show?
Mobitz type 2
what does this ECG show?
complete heart block
management for first degree heart block?
-monitoring in case of progression
management of Mobitz type 1?
-monitoring
treatment for Mobitz type 2?
-pacing
management for complete heart block?
-pacing
How does supraventricular tachycardia present on an ECG?
rate>100bpm
QRS complex duration <120ms (narrow complex)
what is shown on this ECG?
supraventricular tachycardia
management of acute and chronic supraventricular tahcycardia
ACUTE:
- valsalva/carotid massage
- IV adenosine/IV verapamil
- if compromised DCCV
CHRONIC:
- avoid stimulants
- radiofrequency ablation therapy
- BB
How does ventricular fibrillation present on an ECG?
- irregularly irregular
- no QRS
what is shown on this ECG?
ventricular fibrillation
how to manage ventricular fibrillation?
- defib
- CPR
how does ventricular tachycardia present on an ECG?
- rate>100bpm
- QRS duration>1.2s (borad complex)
what is shown on this ECG?
ventricular tachycardia
how to treat acute ventricular tachycardia?
Unstable- DCCV
Stable- consider pharmacologic cardioversion with AAD, in meantime prepare for DCCV
what to do if unsure if it is VT or something else?
test using adenosine
management for chronic ventricular tachycardia?
- correction ischaemia if possible (revascularisation)
- optimise congestive heart failure therapies
- ICD if life threatening
- VT catheter ablation
anti arrhythmic drugs given for VT?
none, data has shown them to be ineffective and associated with worse outcomes
how does Wolff-Parkinson White Syndrome present on ECG?
- delta waves (slurred upstroke)
- short PR interval
- secondary ST changes
what does this ECG show?
Wolff-Parkinson White syndrome
what to do if patient has supraventricular tachycardia, valsalva failed and BP is 85/65mmHg?
-DCCV for tachyarrhythmias when systolic BP<90mmHg
