Arythmia's- pathophysiology, presentation and investigation Flashcards
When may you notice someone has an arythmia?
On an ECG
What is one of the more common heart issues seen on an ECG?
Atrial fibrillation
What is atrial fibrillation?
Atria does not depolarise in an orderly fashion
Abnormal electrical impulses start to fire in the atria.
What will a patient with atrial fibrillation pulse feel like?
Irregularly irregular
What is the presentation of atrial fibrillation?
May be asymptomatic
But have have- palpitations, dyspnoea, chest pain, fatigue
What can atrial fibrillation be an indication of and why is this significant?
Can be a sign of an embolism which could lead to a stroke
What are some investigations carried out in someone with atrial fibrillation?
24 hr 12 lead ECG
Bloods
Echocardiogram
What is important to check when checking bloods of someone with atrial fibrillation?
Thyroid function
ECG=?
Electrocardiogram
In terms of control, what consideration needs to be made in patients with atrial fibrillation?
If you want to control the HR or the rhythm
What is the usual response to those with atrial fibrillation?
Usually control the rate
Which drugs can help to control heart rate?
Beta blockers
Calcium channel blocker
What may be given to patients when their HR cannot be controlled, even with drugs?
Pacemaker
Why may a patient with AF be given anticoagulants?
Patients with AF are at a higher risk of stroke so anticoagulants given in attempt to combat this.
Why should anticoagulants should only be given to patients with a higher risk of stroke?
If they are not at risk of stroke, anticoagulants can increase risk of bleeding
What is supraventricular tachycardia?
Abnormally fast HR arising from the atria
What are some of the symptoms of supraventricular tachycardia?
Palpitations
Dyspnoea
Dizziness
What is the prognosis like for supraventricular tachycardia?
Good so no treatment
What is a catheter ablation procedure?
A catheter ablation involves passing thin, flexible tubes, called catheters, through the blood vessels to the heart.
What is a catheter ablation procedure used to determine?
Records the heart’s electrical activity and can pinpoint where the arrhythmia is coming from.
What as atrial flutter?
Large circulating wavefront going around and round the atrium, causing atria to pump rapidly
What is the treatment recurrent atrial flutter?
Atrial flutter ablation
What happens in atrial flutter ablation?
Procedure to create scar tissue within an upper chamber of the heart in order to block the electrical signals that cause a fluttering heartbeat
What other treatment may be given to patients with atrial flutter and why?
Anticoagulants as also at increased risk of a stroke
Which arrhythmia kills you?
Ventricular defibrillation
What is ventricular tachycardia?
Fast HR arising from the ventricles
What are some of the presenting symptoms for ventricular tachycardia?
Palpitations, CP, dyspnoea, dizziness, syncope (passing out)
What are the routine investigations for someone with ventricular tachycardia?
Bloods
Echocardiogram
What’s the common underlying cause of ventricular tachycardia?
Ischaemic heart disease
Which inherited condition can cause arythymias/fast HR?
Long QT syndrome
What is ICD therapy?
Implantable Cardioverter Defibrillator therapy involves implanting a defibrillator which deliver a shock to the heart if they recognise the patient to be in ventricular defibrillation/tachycardia
When is AV block common in everyone?
During sleep
What does AV block look like on an ECG?
PR interval gets increasingly longer
What would you see on an ECG in a patient with complete AV block?
No QRS complexes following P wave
What is pacing?
Actof regulating or changing the timing or intensity of cardiac contractions
Which patients would get pacing?
Patients with symptomatic profound 2nd or 3rd degree AV block
