Cardiac Arrhythmia

Question 1

what is the normal cardiac rhythm known as ?

Answer 1

sinus rhythm

Question 2

how many bpm is considered normal?

Answer 2

60-100 bpm

Question 3

what is the pathway for the cardiac conduction system?

Answer 3

SA node in RA —–> AV node in RA —–> L and R ventricles

Question 4

Draw the normal ECG rhythm

Answer 4

Question 5

what are the symptoms of cardiac arrhythmias?

Answer 5

-asymptomatic
-palpitations (fast HR)
-chest pain (fast HR)
-syncope (fainting)
-heart failure

Question 6

what is atrial fibrillation?

Answer 6

causes irregular cardiac rhythm

Question 7

what does atrial fibrillation cause?

Answer 7

-uncoordinated electrical activity
-irregularly spaced heart beat
-insufficient blood flow
-may cause clots
-an increased risk of stroke

Question 8

draw atrial fibrillation rhythm that would be seen on an ECG

Answer 8

Question 9

what treatment options are there for atrial fibrillation?

Answer 9

-beta blockers (slow HR)
-anticoagulants
-rarely surgery

Question 10

what is a fast heart rate known as?

Answer 10

tachyarrhythmia

Question 11

what is the most common type of tachyarrhythmia?

Answer 11

SVT- supraventricular tachycardia

Question 12

what are the symptoms of tachyarrhythmia?

Answer 12

-150/160 bpm at rest
-chest pain
-palpitations
-unwell
-breathlessness

Question 13

what are the treatment options for tachycardia?

Answer 13

adenosine- temporarily blocks AV node
vagus manoeuvres- vagus nerve slows HR

Question 14

Draw the tachyarrhythmia rhythm you would see on an ECG

Answer 14

Question 15

what is a slow heart rate known as?

Answer 15

bradyarrhythmia

Question 16

what heart rate is considered too slow?

Answer 16

<60 bpm at rest

Question 17

what would bradycardia look like on an ECG?

Answer 17

Question 18

what is the exception to a slow heart rate at rest?

Answer 18

athletes

Question 19

what would occur when HR drops to <40 bpm?

Answer 19

symptoms- syncope (dizziness and blackouts)

Question 20

what is asystole?

Answer 20

-flatline
- total absence of electrical activity
- long pause seen in ECG
-seen during cardiac arrest

Question 21

what does a pacemaker do?

Answer 21

sends electrical pulse to RA- 60-70 bpm

Question 22

where would a pacemaker be found?

Answer 22

under the left clavicle

Question 23

do you need ab prophylaxis for routine dental tx with a pacemaker?

Answer 23

no

Question 24

what would you do if there was electrical interference during tx and the pt collapses?

Answer 24

turn off any electronic devices used

Question 25

is ventricular arrhythmia a medical emergency?

Answer 25

YES- it causes ischemic heart disease

Question 26

what happens during ventricular tachycardia?

Answer 26

no cardiac output- use beta blockers and implanted defibrillator if pt survives

Question 27

what happens during ventricular fibrillation?

Answer 27

cardiorespiratory arrest- CPR and DEFIB

Question 28

should you provide dental tx with unstable arrhythmias ?

Answer 28

no- postpone and refer to gp

Question 29

should you use LA containing adrenaline?

Answer 29

you must seek advice

Question 30

how would you recognise an unwell pt?

Answer 30

hr <40 or hr >150, chest pain, breathlessness