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Cardiology > Arrythmias > Flashcards

Arrythmias Flashcards

1
Q

Define arrhythmia.

A

A disturbance in the normal rhythmic beating of the heart.

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2
Q

Give 2 symptoms of arrhythmias.

A

Palpitations, breathlessness, dizziness.

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3
Q

What is the absolute refractory period?

A

Is the period of time during which a second action potential ABSOLUTELY cannot be initiated

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4
Q

What is the relative refractory period?

A

Is the interval immediately following the Absolute Refractory Period during which initiation of a second action potential is INHIBITED, but not impossible.

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5
Q

Give 3 ways to classify an arrhythmia.

A

By rate, by location, by cause.

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6
Q

Which two ways can arrhythmias be distinguished by rate?

A

Inappropriate bradyarrhythmia (<60bpm), inappropriate tachyarrhythmia (>100bpm).

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7
Q

Which two ways can arrhythmias be distinguished by location?

A

Atrial (supraventricular), ventricular.

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8
Q

Which two ways can arrhythmias be distinguished by cause?

A

Disorders of impulse generation, disorders of impulse conduction.

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9
Q

Give 3 types of arrhythmias.

A

Atrial fibrillation, complete heart block, ventricular tachycardia, ventricular fibrillation, long QT syndrome, bradyarrhythmia (bradycardia), tachyarrhythmia (tachycardia), atria flutter.

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10
Q

Define atria fibrillation.

A

Common abnormal heart rhythm due to disorganised waves from different places in the atria

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11
Q

Give 2 things you would see on an atrial fibrillation ECG.

A

Lack of p waves. Small fibrillatory (‘f’) waves of varying amplitude. High frequency QRS complexes causing tachycardia.

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12
Q

How many classes of anti-arrhythmic drugs are there?

A

4

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13
Q

Classes 1 and 3 do what to tackle AF?

A

Target source of arrhythmia to suppress re-entry.

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14
Q

Give an example of a class 3 drug.

A

Amiodarone.

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15
Q

Give an example of a class 2 drug.

A

Bisoprolol (Beta receptor blocker inhibits AVN conduction).

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16
Q

Give an example of a class 1 drug.

A

Flecainide (Na ion channel blocker suppresses conduction).

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17
Q

What does adenosine do?

A

Slows AV nodal conduction.

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18
Q

What does digoxin do?

A

Stimulates vagus and slows AV nodal conduction.

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19
Q

Give an example of a class 4 drug.

A

Verapamil (Ca ion channel blocker inhibits AVN conduction)

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20
Q

Classes 2 and 4 do what to tackle AF?

A

Reduce the ability of impulses conducted through AV (rate control).

21
Q

What does re-entry mean?

A

Re-excitation of the heart after the refractory period has ended, as the propagating impulse has failed to die out.

22
Q

All parts of the conduction system are latent pacemakers, what does that mean?

A

They can cause premature, ectopic heart beat outside the normally functioning SA node of the heart.

23
Q

Bradycardia can have two causes. List them.

A

SAN slows down. Impulse from SAN blocked.

24
Q

Tachycardia can have two causes. List them.

A

Disorders of impulse generation. Disorders of impulse conduction (re-entry).

25
Q

What is a complete (3rd degree) heart block?

A

Blocked connection between the atria and ventricles.

26
Q

What is the effect of a complete (3rd degree) heart block

A

Bradyarrhythmia.

27
Q

What is the cause of a complete (3rd degree) heart block

A

Atherosclerotic coronary heart disease.

28
Q

What would you see on an ECG for a complete (3rd degree) heart block?

A

QRS complex dissociates from the p wave as the atria and ventricles beat independently.

29
Q

What is the treatment for a complete (3rd degree) heart block?

A

Implantation of a permanent pacemaker to generate cardiac rhythm.

30
Q

Name 2 things tachyarrhythmias can be caused by.

A

Ischaemia, myocardial scarring, congenital conditions.

31
Q

Define ventricular tachycardia.

A

Rapid ventricular beats caused by an ectopic site in one of the ventricles.

32
Q

What is radiocatheter ablation?

A

It is a procedure that uses radiofrequency energy to destroy a small area of heart tissue that is causing rapid and irregular heartbeats.

33
Q

Symptoms of ventricular tachycardia.

A

Chest pain, shortness of breath.

34
Q

What is the hallmark of ventricular tachycardia on an ECG.

A

Don’t see p waves, as they are insignificant (ventricles contracting too fast). AV dissociation (independent atrial contraction to ventricles).

35
Q

What do class 1 drugs do?

A

Suppress conduction completely.

36
Q

What do class 2 drugs do?

A

Reduce excitability to inhibit AVN conduction.

37
Q

What do class 3 drugs do?

A

Prolong the refractory period to slow conduction.

38
Q

What do class 4 drugs do?

A

Inhibit AVN conduction.

39
Q

What do implantable defibrillators do?

A

They sense and differentiate arrhythmias to return the cardiac system to sinus rhythm.

40
Q

Give 2 ways ventricular tachycardia is treated?

A

Class 1/3 drugs to suppress conduction/slow conduction. Class 2 drugs can reduce excitability. Implantable defibrillators.

41
Q

Define ventricular fibrillation.

A

Disorganised activity of the heart due to disorganized electrical activity in the ventricles.

42
Q

Give a cause one cause of ventricular fibrillation.

A

Ischaemic heart disease. Cardiomyopathy.

43
Q

Give a symptoms of ventricular fibrillation.

A

Unconsciousness. Death.

44
Q

What is the hallmark of ventricular fibrillation?

A

Disorganised electrical activity, which fades as heart dies.

45
Q

What is used to treat ventricular fibrillation?

A

Defibrillation - stops the heart and allows SAN to restart.

46
Q

Define long QT syndrome.

A

It’s a condition which affects repolarization of the heart after a heartbeat.

47
Q

What is the hallmark ECG for a patient with Long QT syndrome?

A

A long distance between Q and the next T wave.

48
Q

Give 2 causes of ventricular tachycardia.

A

Cardiac scarring. Congenital e.g. Brugada syndrome. Re-entry.

Cardiology (8 decks)

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