Blocks Flashcards
First degree
A block in the conduction system from the SA node to the AV node
causing a delay in the time it takes for blood to reach the ventricles from the atria
Each wave is conducted to the ventricles though
No treatment needed
Second degree
Wenkebach
Conduction from the atria through the AV node is impaired (due to a conduction block at the AV node) and creates a Progressive lengthening of the Pr interval as the Av node cells become fatigued
then failure of the conduction of an atrial beat to the ventricles occurs (drop of qrs) due to the p wave reaching the av node when it is still refractory(so it’s unable to conduct)
Drugs can be given to increase hr
Second degree
Mobitz type 2
Degeneration of the conduction system below the av node results in the tissue not recovering in time to generate some impulses
Cells of the his purkinje system fail suddenly
(The distal conducting system fails to recover in time to conduct every impulse from the atria)
Long PR interval that is constant
Need a pacemaker
Mobitz type 2- 2.1 block
When there is alternate conducted and non-conducted atrial beats to the ventricle (or a ratio of 2:1 or 3:1 etc) giving 2x or more as many p waves to qrs complexes
The distal conducting system fails to recover in time to conduct every impulse from the atria
(Alternate conducted and non-conducted atrial beats eg p p qrs p p qrs = 2.1)
Third degree
Atrial contraction is normal but no beats are conducted to the ventricles due to a loss of conduction
The atria and ventricles contract at independent rates
Varied/ inconsistent PR intervals in every lead Constant PP intervals Constant QQ intervals Abnormal shaped QRS Often has severe bradycardia
Need permanent pacemaker. Consider atropine
Right BBB
No conduction occurs down the RBB so all Electrical signals conduct down the Lbbb due to this
The septum is activated from L to R
Left BBB
Delayed or absent conduction in either the L main bundle branch before it splits or in both of the fascicles of the his purkinje system
Septum activated from R to L
Treat as ACS, drugs and cath lab
Stemi
Caused by a total blockage of the coronary artery
Manage ABC Aspirin GTN Clopidogrel Entonox paracetamol left arm morphine Onsansetron if needed Cath lab
Nstemi/ unstable angina
Caused by a partial blockage of the coronary artery
St depression or t wave inversion
Cardiac symptoms and raised troponin levels
Cath lab
N stemi
Stemi
lBBB
Arrhythmia centre
3rd degree block
3 shocks for an implantable cardioverter debif
Vt with a pulse
