AV block

Question 1

major causes of AV block

Answer 1

increased vagal tone
fibrosis and sclerosis of conduction system
IHD
cardiomyopathy and myocarditis
congenital heart disease
familial AV block

Question 2

other causes of AV block

Answer 2

hyperkalemia
inflitrative malignancies, 
neonatal lupus
severe hypo or hyperthyroidism
trauma
degenerative neuromuscular disease

Question 3

drugs that can cause AV block

Answer 3

digitalis 
CaCh blockers
beta blockers
amiodarone
adenosine

Question 4

other AV block latrogenic

Answer 4

cardiac surgery
catheter ablation
transcatherter VSD closure
alcohol spetal ablation for HOCM
TAVr (transcatheter AV replacement)

Question 5

AV block

Answer 5

delay or interruption in transmission of an impulse from atria to ventricles due to an anatomic or fnxal impairment in conduction system

Question 6

firborsis and sclerosis

Answer 6

acounts for 50% of cases of AV block
may be induced by several different conditions
frequently progressive to complete heart block

Question 7

IHD

Answer 7

40% of AV block

conduction disturbances range from 1st degree to complete with both chronic IHD and acute MI

Question 8

familial AV block

Answer 8

autosomal dominant

Question 9

types

Answer 9

1st degree
2nd degree type I
2nd degree type II
3rd degree

Question 10

2nd degree type I

Answer 10

mobitz I

progressive PR interval prolongation followed by non conducted p wave

Question 11

Ist degree

Answer 11

pr interval >.2

Question 12

2nd degree type II

Answer 12

mobitz II

PR interval remains unchanged prior to p wave that fails to conduct to ventricles

Question 13

3rd degree

Answer 13

complete heart block

Question 14

AF

Answer 14

most common cardiac arrhythmia
RR interval no pattern
no distinct P waves
atrial rate 300-600
more common in men

Question 15

AF risk factors

Answer 15

HTN
CH
RF in underdeveloped countries

Question 16

paroxysmal AF

Answer 16

terminated spontaneously or w/intervention w/in 7 days

episodes may recurr

Question 17

persistant AF

Answer 17

fails to self-terminate w/in 7 says

episodes often require pharmacological and electrical cardioversion

Question 18

long-standind persistant AF

Answer 18

lasted more then 12 months

Question 19

permanent AF

Answer 19

persistant with decision made to no longer try to treat

Question 20

low risk AF

Answer 20

15-30%
younger males
frequently familial, low risk of thromboembolus

Question 21

recurrent AF

Answer 21

90%

asymptomatic recurrent episodes lasting up to 48hrs

Question 22

subclinical AF

Answer 22

detected asymptomatic w/o prior diagnosis

many have paroxysmal AF

Question 23

AF Hx

Answer 23

palps
syncope
dyspnea
fatigue
precipitating events: exercise, emothional, alcohol

Question 24

AF PE

Answer 24

mitral valve disease, especially MS, CHF, findings etc

Question 25

AF echo

Answer 25

chamber sizes and fnx, valvular fnx, pulmonary aa pressures

Question 26

AF rate control

Answer 26

anti-coagulants and AV blockers

Question 27

rhythem control

Answer 27

anti-coagulate and restore NSR via meds, electrical cardioversion
TEE may be used to rule out LA thrombus prior to cardioversion

Question 28

CHADS2

Answer 28

CHADS2: 
C-CHF 
H- HTN 
A-Age (76+) 
D- diabetes 
S-stoke/tia (2) 
2+ give anticoagulate

Question 29

CHADS-vasc

Answer 29

CHA2DS2vasc: 
C- CHF 
H-HTN 
A-  65-74 (1) 75+ (2) 
D- diabetes 
S-stoke/tia (2),
also add 1 for female
9=15% chance of stoke, 
3= 3% 
3+ give anticoagulate

Question 30

PVC

Answer 30

common cadio complaint
present w/palpitatios
syncope is an alarm that it is serious
almost always of no significance
often over emphasized by patient and occasionally by PCP

Question 31

prognosis of PVC

Answer 31

dependent on severity of LV fnx, not frequency or complexity of PVC