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Pharmacology 3805 > Arthythmias (patho) > Flashcards

Arthythmias (patho) Flashcards

THIS IS PATHO, ADDED HERE BY ACCIDENT

1
Q

What is defined as: lack of coordination between the beat of the atria and the beat of the ventricles?

A

Cardiac arthymia

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2
Q

An arrhythmia is caused by 1 or more of the following:

A

-abnormal rhythmicity of the pacemaker
-Shift of the pacemaker from the sinus node to another place in the heart
-Blocks at different points in the spread of the impulse through the heart
-Abnormal pathways of impulse transmission through the heart
-Spontaneous generation of spurious impulses in almost any part of the heart

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3
Q

What is the heart rate of someone with tachycardia?

A

Usually faster than 100 beats/min in an adult

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4
Q

What are 3 causes of tachycardia?

A

-Increased body temperature
-Stimulation of the heart by the sympathetic nerves
-Toxic conditions of the heart, ex: drugs

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5
Q

What is the heart rate of someone with bradycardia?

A

Usually slower than 60 beats/min

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6
Q

What are some causes of bradycardia?

A

-Vagal stimulation
-Carotid sinus syndrome
-Drugs: ex beta blockers

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7
Q

What are 4 conditions that can lead to an AV Block?

A

-Ischemia of the AV node or AV bundle (due to coronary insufficiencies)
-Compression of the AV bundle (scar tissue or calcification)
-Inflammation of the AV node or AV bundle (diphtheria or rheumatic fever)
-Extreme stimulation of the heart by the vagus nerves (carotid sinus syndrome)

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8
Q

A first degree block causing a prolonged PQ interval can be defined as, the PR interval increases to greater than ___

A

0.20 seconds

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9
Q

What is the normal length of time for a PQ interval?

A

0.16 seconds

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10
Q

A second-degree block causing a prolonged PR interval increases the PR interval to _____

A

0.25-0.45 seconds

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11
Q

A complete AV block (third-degree block) occurs when the condition causing poor circulation in the AV node or AV bundle becomes _____

A

severe

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12
Q

What are the two types of escape rhythms?

A

Junctional escape and Ventricular escape

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13
Q

Where does a junctional escape rhythm originate?

A

In the AV node

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14
Q

What is the heart rate of someone with a junctional escape rhythm?

A

40-60 beats/min

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15
Q

Where does a ventricular escape rhythm originate?

A

In the Purkinje fibers

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16
Q

What is the heart rate of someone with a ventricular escape rhythm?

A

15-40 beats/min with an abnormally wide QRS

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17
Q

What is Stokes-Adams syndrome?

A

It is a condition that can cause individuals to feel faint and/or pass out due to a total AV block coming and going.
Impulses are conducted from the atria to the ventricles for a period of time then suddenly impulses are not being conducted at all.

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18
Q

What types of hearts are subjected to Stokes-Adams syndrome?

A

Hearts with borderline ischemia of the conductive system

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19
Q

What is an incomplete intraventricular block ( Electrical Alternans)?

A

-A block in the peripheral ventricular Purkinje system
-A partial intraventricular block everywhere else

20
Q

What is an incomplete intraventricular block usually caused by?

A

Tachycardia, ischemia, digitalis myocarditis

21
Q

What is a premature contraction?

A

A contraction of the heart before the time that a normal contraction would have been expected.
It shortens the PR interval

22
Q

What is a premature contraction also known as?

A

Ectopic beat

23
Q

What causes premature contractions?

A

Most result from ectopic foci in the heart:
-Local areas of ischemia
-Small calcified plaques
-Infection,drugs,nicotine, caffeine
-Mechanical stimulation: example- cardiac catheterization

24
Q

A premature ventricular contraction can have what effect on the QRS waves:

A

-Prolonged QRS
-High voltage QRS
-Inverted T wave

25
Q

What is Torsades de Pointe?

A

A premature beat, a pause, then another beat with a long QT interval

26
Q

Torsades de Pointe can trigger:

A

Arrhythmias, tachycardia and in some instances, ventricular fibrillation

27
Q

Does an individual with a long QT syndrome have a high or low risk of having Torsades de Pointe?

A

HIGH

28
Q

What are congenital causes of long QT syndrome?

A

Mutations in Na and K channels

29
Q

What are the electrolytic causes of long QT syndrome?

A

Hypomagnesemia, hypokalemia, hypocalcemia

30
Q

What drugs can cause long QT syndrome?

A

Antiarrhythmic drugs: ex- quinidine
Antibiotics: fluoroquinolones, erythromycin

31
Q

What are the symptoms of long QT syndrome?

A

-May not show any symptoms
-Fainting
-Ventricular arrhythmias
-Fibrillations and sudden death

32
Q

What is the treatment of long QT syndrome?

A

-Magnesium sulfate for ACUTE LQTS
-Beta blockers for LONG TERM LQTS
-Cardiac defibrillator for LONG TERM LQTS

33
Q

What is paroxysmal tachycardia?

A

Abnormalities in the atria, the Purkinje system, or the ventricles.
It can cause rapid rhythmical discharge of impulses that spread in all directions throughout the heart

34
Q

What is paroxysmal tachycardia often caused by?

A

Re-entrant “circus movement”

35
Q

What are the 2 reasons why ventricular paroxysmal tachycardia is a serious condition?

A
  1. Does not occur unless considerable ischemic damage is present in ventricles
  2. It frequently initiates ventricular fibrillation
36
Q

What are the causes of V.P tachycardia?

A

Digitalis intoxication

37
Q

What is the treatment of V.P tachycardia?

A

Amiodarone, lidocaine or Cardioversion (AED)

38
Q

Is ventricular fibrillation the least serious or most serious cardiac arrhythmia?

A

MOST

39
Q

How many minutes does V.Fib last?

A

1 to 3 minutes

40
Q

What does V.Fib result from?

A

Cardiac impulses that have gone “berserk”
It occurs suddenly

41
Q

What effect does V.Fib have on the body?

A

-Lack of coordination of muscle contraction
-Negligible or no amount of blood pumped
-Fainting occurs within 4 to 5 seconds
-Tissue death begins within minutes

42
Q

What are the triggers of V.Fib?

A

-Sudden electrical shock of the heart
-Ischemia of the heart muscle, conducting system, or both

43
Q

Conditions leading to re-entry ( the basis for V.Fib):

A

-The impulse pathway is much longer than normal
-Decreased velocity of impulse conduction
-Shortened refractory period

44
Q

During the absolute refractory period can impulses be fired?

A

No, all the cells are depolarized so when the impulse returns it cannot be restimulated and dies

45
Q

What is the most common cause of Atrial Fibrillation?

A

Atrial enlargement- causing valve lesions and ventricular failure

46
Q

What are the characteristics of atrial flutter?

A

-The electrical signal travels as a single large wave always in one direction around and around
-Causes a rapid rate of contraction of the atria, usually between 200-350 beats per minute
-The amount of blood pumped to the atria is small
-Not all impulses go through the AV node

47
Q

What is the difference between atrial fibrillation and atrial flutter?

A

Atrial flutter is a macroreentrant circuit, one impulse is travelling up the septum, down the walls of the heart and activating the atria as normal but at approx. 300bpm.
Atrial fibrillation is multiple microreentrant circuits leading to chaotic activation of the atria. Causes ventricular depolarization to be irregular.

Pharmacology 3805 (5 decks)

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