Arrythmias Flashcards
Tx of acute, stable afib?
Tx of acute, unstable afib?
Tx of chronic afib?
acute, stable = anticoagulate + rate control w/ Ca-blockers, then cardioversion
acute, unstable = immediate cardioversion
Chronic = anticoagulate + rate control w/ Ca-blockers
Management of WPW?
EKG finding?
ablation
delta wave
Tx of sustained VTach?
Tx of nonsustained VTach?
Tx of torsades?
sustained (> 30s) = IV amiodarone
nonsustained (<30s)= reassurance
torsades (rapid, polymorphic Vtach due to QT prolongation) = IV Mg sulfate
Tx of sinus brady (if sx)?
atropine (blocks vagus)
Sick sinus syndrome sigs and smx?
tx?
persistent sinus bradycardia; presents as dizziness, syncope, fatigue 
tx = pacemaker
Disease location of:
2° AV block (Mobitz type 1)?
2° AV block (Mobitz type 2)?
1 = AV node
2 = bundle of HIS
Tx of:
2° AV block (Mobitz type 1)?
2° AV block (Mobitz type 2)?
1 = reassurance
2 = pacemaker (can convert to 3° w/o Tx)
What do you expect to see on EKG for pt with premature atrial contraction?
Sx? Tx?
early P wave that looks diff than other p waves
*due to premature heartbeats arising in the atria that trigger depolarization before the SA node
ususally asmx, but can be persived as skipped beat
reassurance
What do you expect to see on EKG for pt with PVC?
wide QRS without P wave
Couplet: 2 PVCs
Bigeminy: sinus beat + PVC
Trigeminy: sinus beat + 2 PVCs
sawtooth with baseline HR of 150
AFlutter
treatment of A flutter?
same as Afib:
acute, stable = anticoagulate + rate control w/ Ca-blockers, then cardioversion
acute, unstable = immediate cardioversion
Chronic = anticoagulate + rate control w/ Ca-blockers
looks like AFib but P waves are variable, need 3 diff P waves for dx
MAT (multifocal atrial tachycardia), type of SVT
cause of MAT
lung dz/hypoxia, MCC = COPD exacerbation or end stage COPD
also occurs after MI, hypoK and hypoMg
Vfib tx?
immediate defib + CPR then continue IV amiodarone
EKG shows activity but no pulses felt
pulseless electrical activity which is a type of vfib
what does 1° AV block look like on EKG? Tx?
PR interval >0.2s
reassurance
progressive PR prolongation until QRS drops, dz in AV node
2° AV block (Mobitz type 1)
random QRS drop, dz in bundle of His
2° AV block (Mobitz type 2)
P waves and QRS complexes function independently
3° AV block (complete)
how to determine axis? and right vs left deviation
look at leads I and II
• I+/II+: normal
• I+/II–: left-axis deviation
• I–/II+: right-axis deviation
normal PR interval
< 0.2 s (heart block if > 0.2)
normal QRS
<0.12 sec
what does LBBB look like
WiLLiaM – W shape in V1-V2, M in V3-V6
what does RBBB look like
MaRRoW – M in V1-V2, W in V3-V6
lead II wide P-wave (>0.12 sec)
left atrium enlargement
lead II tall P-wave (>2.5 mm)
right atrium enlargement
left-axis deviation + V1/V2 and V5/V6 overlapping
LVH
right-axis deviation + lead V1 R-wave >7 mm
RVH
T-wave inversion, ST elevation or depression
ischemia
: T-wave inversion, ST elevation, significant Q waves
infarction
