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Cardio > Arrythmias > Flashcards

Arrythmias Flashcards

1
Q

Where do supraventricular arrythmias originate?

A

Above the ventricle, e.g.: SA node, Atrial muscle, AV Node, the origin of the bundle of His.

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2
Q

What does the Bachmann’s bundle supply?

A

Supplies electrical activity to the left atrium.

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3
Q

What are ectopic beats?

A

Heart beats that originate outside the SA node

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4
Q

Name as many supraventricular arrythmias as you can.

A 
TACHY
Atrial fibrillation 
Atrial flutter
Ectopic atrial tachycardia
BRADY
Sinus bradycardia
Sinus pauses
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5
Q

Name as many AV node arrythmias as you can.

A

AVN re-entyr
Accessory pathways - Wolff-Parkinson White
AV block - 1,2+3

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6
Q

Name as many ventricular arrythmias as you can.

A

Premature ventricular complex (PVC)
Ventricular Tachycardia
Ventricular Fibrillation
Asystole

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7
Q

What can cause arrythmias?

A 
Congenital defects of the heart
Sympathetic stimulation and increased vagal tone
Hypoxia
Ischaemia
Electrolyte imbalance
Inflammation
Drugs
Genetics
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8
Q

What is the basic cause of arrythmias?

A

A change in automaticity.

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9
Q

Does hypothermia cause bradycardia or tachycardia?

A

Bradycardia

It decrease the phase 4 slope

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10
Q

Does hyperthermia cause bradycardia or tachycardia?

A

Tachycardia

It increases the phase 4 slope

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11
Q

Does hypercapnia cause bradycardia or tachycardia?

A

Tachycardia

It increases the phase 4 slope

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12
Q

Does hypoxia cause bradycardia or tachycardia?

A

Tachycardia

It increases the phase 4 slope

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13
Q

Does cardiac dilation cause bradycardia or tachycardia?`

A

Tachycardia

It increases the phase 4 slope

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14
Q

Does hypokalaemia cause bradycardia or tachycardia?

A

Tachycardia
It increases the phase 4 slope
Also increases the presence of ectopics and prolongs repolarisation.

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15
Q

Does hyperkalaemia cause bradycardia or tachycardia?

A

Bradycardia
It decrease the phase 4 slope
It slows conduction and blocks

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16
Q

What does Digoxin toxicity cause?

A

Palpitations and irregular pulse. (Small depolarisation after phase 3)

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17
Q

What are the symptoms of ischaemia and re-entry arrythmia?

A 
Palpitations
Dizziness
Dyspnoea
Syncope
Sudden cardiac death
Worsening of current conditions
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18
Q

Name the investigation for structural heart disease

A

Echocardiogram

19
Q

Name the investigation to assess rhythm, signs of previous MI and pre-excitation

A

ECG

20
Q

Name the investigation to assess ischaemia and exercise induced arrythmias.

A

Exercise ECG

21
Q

Name the investigation to assess for paroxysmal arrythmias

A

24hr Holter ECG

22
Q

What kind of symptoms would you see in atrial ectopic beats

A

Often none or palpitations

23
Q

How would you treat Atrial ectopic beats?

A

Generally no treatment
Avoids stimulants like caffeine and cigarettes
B blockers can help

24
Q

How would you treat bradycardia?

A

Atropine

25
Q

What is sinus bradycardia?

A

Heart rate

26
Q

What is sinus tachycardia?

A

Heart rate >100bpm

27
Q

How would you treat tachycardia?

A

Treat underlying pathology

B blockers

28
Q

What is the treatment for SVT (Supraventricular tachycardia)

A

Vagal manoeuvres e.g carotid massage
IV Adenosine -A1 blocker
IV Verapamil - Calcium Channel Blocker

29
Q

What is the chronic treatment for SVT?

A

Avoid stimulants

B blockers &/or Calcium channel blocker

30
Q

What is ablation?

A

Selective cautery of cardiac tissue to prevent tachycardia, targeting either an automatic focus or part of a re-entry circuit.

31
Q

Describe 1st degree heart block

A

Longer PR interval than normal (>0.2 sec)
No treatment
But long term follow up as it could get worse

32
Q

What is Mobitz I heart block?

A

2nd degree heart block
Causes progressive lengthening of PR interval resulting in a dropped beat
Usually vagal in origin

33
Q

What is Mobitz II heart block?

A 
2nd degree heart block
Pathological
May progress to complete heart block
Its normally 2 beats to 1 dropped beat e.g 2:1 or can be 3:1
Permanent pacemaker needed
34
Q

Describe 3rd degree heart block

A

No action potential from the SAN get to through the AVN

Random P waves with no association to QRS

35
Q

List the options for acute pacing

A

Transcutaneous - Emergency until venous access is achieved.

Tranvenous pacer - Via main vein.

36
Q

What are the two types of pacemakers?

A

Single chamber - Used for arrythmias involving SAN

Dual chamber - Used for AVN disease

37
Q

How would you treat Premature ventricular ectopics?

A

B-Blockers

If they are worse on exercise you need to investigate further.

38
Q

What is a ventricular tachycardia caused by?

A 
Life threatining condition caused by
Coronary artery disease
Previous MI
Cardiomyopathy
Inherited arrythmias
39
Q

What is ventricular fibrillation?

A

Chaotic ventricular electrical activity

Heart loses its ability as a pump`

40
Q

What is the treatment for VF?

A

Defib and resuscitation.

41
Q

What is the treatment for VT?

A

DC Cardioversion in acute unstable cases

If stable consider pharmacological cardioversion

42
Q

What is the long term treatment for VT?

A

Correct ischaemia
ICD (Implantable cardioverter defibrillator)
Optimise CHF therapies

43
Q

What can cause Torsades de Pointes

A

Digitalis toxicity

Cardio (10 decks)

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