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Cardiology > Arrythmias > Flashcards

Arrythmias Flashcards

1
Q

What is an AV block?

A

a condition where there is slowed or blocked conduction from atria to ventricles

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2
Q

What can be noticed on a ECG with a AV block?

A

prolonged PR interval

non-conducted P wave (in severe blockages; doesnt result to a QRS complex)

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3
Q

AV blocks can cause what symptoms?

A

Bradycardia –> fatigue, dizziness, syncope (happen when many or all p waves are not conducted)

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4
Q

What is a treatment of AVB?

A

pacemaker

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5
Q

T or F: AV node disease is more dangerous thant HIS-Purkinje disease

A

F:
HIS-Purkinje disease bc:
does not improve with sympathetic activation an dprogress to total heart block and requires a pacemaker

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6
Q

What are the 4 types of AV blocks and their associated ECG characteristics?

A

Type 1:

  • prolonged PR interval
  • all p-waves conducted
  • usually the AV node
  • causes: beta blockers, calcium channel blockers, athletes (cuz high parasymp tone at rest)

Type 2:

  • some p-waves conducted
  • sub-types:
  • -> Mobitz 1 (Wenckebach)
  • AV node block
  • progressive PR elongation to dropped beat (no conduction)
  • grouped beating (group of PQRS separated with no beat)
  • RR intervals not regular (but irregular regular)
    causes: similar to type 1
  • -> Mobitz 2
  • usually in HIS-Purkinje system
  • usually associated with bundle branch block (leads to prolongued QRS interval)
  • dizziness and syncope (often symptomatic)
  • absence of PR elongation with missed conduction

Type 3:

  • no impulse from atria to ventricles
  • usually in HIS-Purkinje system
  • no conduction of electrical impulses from atria
  • RR intervals are regular
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7
Q

T or F: lyme disease can cause AV blocks

A

T via carditis

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8
Q

What happens in ventricular tachycardia?

A

dissociation of AV in the absence of heart block

-p-waves are still present

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9
Q

What is escape rhythm?

A

SA cannot send impulses to ventricles and lower pacemaker deploarises the ventricles

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10
Q

What are the symptoms of escape rhythm?

A

very slow: dizziness, syncope, hypotension

less slow: fatigue, exercise intolerance (bc lower pacemaker are insensitive to sympathetic activation)

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11
Q

What are some causes of heart block?

A

Drugs:
- beta blockers, Ca channel blockers, digoxin

High vagal Tone

Fibrosis and sclerosis of conduction system

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12
Q

True or False: if one bundle branch is blocked it leads to AV block

A

False: both bundle need to be blocked to have AV block
one bundle block creates a normal PR interval but a prolongued QRS (bc will longer for one of the ventricles to depolarise)

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13
Q

How to distinguish left and right branch bundle blocks on ECGs?

A

Look at V1–> left has a downward QRS deflection

right has two R waves

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14
Q

What are some causes of bundle branch blocks?

A
  • usually slowly progressive fibrosis/sclerosis (more common in older patients)
  • LBBB –> prior MI, cardiomyopathy
  • RBBB –> right heart failure
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15
Q

What is PSVT?

A

Paroxysmal Supraventricular Tachycardia

  • intermittent tachycardia (greater than 100 bpm)
  • sudden onset/offset
  • electrical activity originates above ventricle
  • produces narrow QRS complex
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16
Q

What are symptoms of PSVT?

A

sudden-onset palpitations

chest discomfort

17
Q

What are causes of PSVT?

A

AVNRT (atrioventricular nodal reentrant tachycardia)
–> most common cause
more common in young women
there is a presence of dual AV nodal pathway (ie both slow (short RP can conduct faster rate) and fast (long RP) conduction pathways present)
–> requires a PAC [premature atrial contraction]

18
Q

What are ECG features in AVNRT?

A
  • retograde P waves (comes after the QRS complex bc of the short conduction pathway going retrogade)
19
Q

What are the 3 main ways to reduce AV conduction in AVNRT?

A
  • carotid massage
  • -> press on carotid sinus –> stretch baroreceptors –> CNS think high BP –> increase vagal tone –> decrease AV node conduction

-vagal maneuvers
vasalva, breath holding, coughing, deep respirations, swallowing
- adenosine

20
Q

What is the treatment for AVNRT?

A

beta blockers, verapamil/diltiazem

21
Q

What is WPW?

A

Wolff-Parkinson White Syndrome:

  • presence of accessory atrioventricular pathway (ie bundle of kent)
  • -> bypasses the AV node
  • causes pre-excitation (ie. ventricular depol. before AV nodal impulse)
  • may lead to arrythmias
22
Q

What are the 2 classic ECG findings in WPW?

A
  • delta waves (additional wave between P and R –> pre-excitation)
  • short PR
23
Q

What are the 2 types of AVRT?

A

orthodromic –> normal AV node conduction followed by impulse going to accessory pathway
antidromic –> from bypass tract to AV node
-wide QRS complex

24
Q

What is the difference between WPW pattern and syndrome?

A

pattern –> asymp, delta waves

syndrome –> tachycardias, palpitations, AVRT

25
Q

What is the treatment of AVRT?

A

ablation of accessory pathway

Cardiology (29 decks)

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