arrythmia Flashcards
why is the P wave low in amplification?
because the heart muscle of the atrium is very thin
if a patient complains about irregular or missed beats, or strong pulse what could this indicate?
atrial ectopics could be the explanation
what are ectopic heart beats?
small changes in a heartbeat that is otherwise normal?
can be caused by the usual smoking, drink, and caffeine
what is the most common and important rhythm disturbance we have to manage?
atrial fibrillation - occurs when the atria no longer depolarises in an orderly fashion so the cells have chaotic electrical signals and the SA node can no longer control it
on EGC, no P wave present
to confirm diagnosis, why is it important to do an ECG on top of a pulse check?
if we do a pulse check and ectopic beats happen regularly, it might appear as a regular pulse
what are one of the clinical clues when picking up atrial fibrillation?
the patients pulse is irregularly irregular
what can be the first presentation for patients with atrial fibrillation?
thromboembolism - important to make diagnosis so we can reduce the risk of stroke
many of the patients may have symptoms, particularly if the ventricular response to the fibrillation is rapid, what do these include?
palpitations, different versions depending of the version of palpitation
what is atrial fibrillation echocardiography important for?
helping to understand who is at risk and deciding if patient should be on anticoagulants
in terms of treatment after AF diagnosis, what do we have to ensure?
do we control rate or rhythm?
in primary care, best to control rate with a beta blocker or calcium channel blocker
when might we use a pacemaker?
when patient cannot be controlled by drugs so we cant bring the rate down, then once the pacemaker is installed, we destroy the AV node (stopping the ventricles from depolarising rapidly)
if a patient with AF is at risk of a stroke, what should we prescribe?
anticoagulation (e.g. NOAC’s or warfarin)
if the patient comes in with very often recurring supraventricular tachycardia, what should we offer?
catheter ablation
why is the QRS complexes broad in some cases?
because the depolarization is outwith the his-perkinje system
