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Cardiology+Haematology 3 > Cardiac arrhythmias > Flashcards

Cardiac arrhythmias Flashcards

1
Q

Define bradyarrhythmia.

A

Resting heart rate of <60 bpm

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2
Q

Define tachyarrhythmia.

A

Resting heart rate of >100 bpm

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3
Q

Define supraventricular arrhythmia.

A

Arrhythmias that originate in the sinoatrial node, atrial myocardium, or atrioventricular node (with a regular QRS complex)

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4
Q

Define ventricular arrhythmia.

A

Arrhythmias that originate below the atrioventricular node (with a wide QRS complex)

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5
Q

List the types of bradyarrhythmias with an atrial origin.

A
  1. Respiratory sinus arrhythmia
  2. Sinus bradycardia
  3. Sinus pause or arrest
  4. Tachycardia-bradycardia syndrome
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6
Q

What is the cause(s)/mechanisms of respiratory sinus arrhythmia?

A

Physiological, particularly in youths

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7
Q

What are the main ECG findings in respiratory sinus arrhythmia?

A
  1. Minor changes in R-R interval during respiration

(Reduction during inspiration and increase during expiration)

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8
Q

What is the cause(s)/mechanisms of sinus bradycardia?

A
  1. Physiological (athletes)
  2. Sinus node dysfunction
  3. Drugs: beta blocks, CCBs
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9
Q

What are the main ECG findings in sinus bradycardia?

A
  1. Rate <60 bpm

2. Normal p wave before every QRS complex

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10
Q

What is the cause(s)/mechanisms of sinus pause/arrest?

A
  1. Physiological

2. Underlying cardiovascular disease (sick sinus syndrome)

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11
Q

What are the main ECG findings in sinus pause/arrest?

A
  1. Transient (sinus pause) or complete (sinus arrest) absence of P wave
  2. Often with an escape rhythm
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12
Q

What is the cause(s)/mechanisms of tachycardia-bradycardia syndrome?

A
  1. Abnormal supraventricular impulse generation and conduction (sick sinus syndrome)
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13
Q

What are the main ECG findings in tachycardia-bradycardia syndrome?

A
  1. Intermittent tachyarrhythmias and bradyarrhythmias
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14
Q

List the types of bradyarrhythmias with an AVN origin.

A
  1. 1st degree AV block
  2. 2nd degree (type I) AV block
  3. 2nd degree (type II) AV block
  4. 3rd degree AV block
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15
Q

What are the causes/mechanisms of 1st degree AV block?

A
  1. Physiological
  2. Increased vagal tone
  3. Drugs: beta blockers, CCBs
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16
Q

What are the ECG findings in 1st degree AV block?

A

PR interval >200ms

17
Q

What are the causes/mechanisms of 2nd degree AV block?

A
  1. Drugs: digoxin, beta blockers, CCBs
  2. Increased vagal tone
  3. Sinoatrial conduction disease
  4. Right coronary infarction
18
Q

What are the ECG findings in 2nd degree (type I) AV block?

A

Progressive lengthening of the PR interval until a beat is dropped

19
Q

What are the ECG findings in 2nd degree (type II) AV block?

A

Irregular dropped beats

20
Q

What are the causes/mechanisms of 3rd degree AV block?

A

Complete block: no communication between atria + ventricles (contraction occurs independently without organised electrical transmission via AVN)

21
Q

What are the ECG findings in 3rd degree AV block?

A

AV dissociation - no relationship between P waves and QRS complexes

22
Q

List the types of supraventricular tachyarrhythmias with an atrial origin.

A
  1. Supraventricular premature beats
  2. Sinus tachycardia
  3. Atrial flutter
  4. Atrial fibrillation
  5. Focal atrial tachycardia
  6. Multifocal atrial tachycardia
23
Q

What are the causes/mechanisms of supraventricular premature beats?

A
  1. Physiological
  2. Electrolyte imbalances
  3. Underlying cardiovascular disease
24
Q

What are the ECG findings in supraventricular premature beats?

A

P wave abnormalities or absent P waves

25
Q

What are the causes/mechanisms of sinus tachycardia?

A

Sympathetic activation or vagal withdrawal on the SA node, e.g.:

  1. exercise
  2. fever
  3. hypovolaemia
  4. anaemia
  5. hyperthyroidism
  6. conditions associated with catecholamine release (phaeochromocytoma)
26
Q

What are the ECG findings in sinus tachycardia?

A
  1. Gradual onset
  2. Regular rhythm
  3. Rate: max is usually 180 bpm
  4. Normal P wave
  5. Narrow QRS complex
27
Q

What are the causes/mechanisms of atrial flutter?

A

Macroreentrant rhythms within atria

28
Q

What are the ECG findings in atrial flutter?

A
  1. Regular rhythm
  2. Atrial rate of 250-350; Ventricular rate of <200
  3. P waves: sawtooth appearance of regular P waves, especially in leads II, III, and aVF
  4. Narrow QRS complex
29
Q

What are the causes/mechanisms of atrial fibrillation?

A

There are multiple conditions (cardiac, non-cardiac) and lifestyle factors that can predispose an individual to AF

30
Q

What are the ECG findings in atrial fibrillation?

A
  1. Irregularly irregular rhythm
  2. Atrial rate of 350-450; Ventricular rate <200
  3. P waves are indiscernible
  4. Narrow QRS complex
31
Q

What are the causes/mechanisms of focal atrial tachycardia?

A

Discharge from a single ectopic focus in the atrium

32
Q

What are the ECG findings in focal atrial tachycardia?

A
  1. Very abrupt onset
  2. Regular rhythm
  3. Rate 150-250 bpm
  4. P wave morphology depends on the site of the ectopic focus
  5. Narrow QRS complex
33
Q

What are the causes/mechanisms of multifocal atrial tachycardia?

A
  1. Discharge from multiple ectopic foci in the atrium
  2. Associated with pulmonary disorders (COPD exacerbation, PE), cardiac conditions (CHF exacerbation), and treatment with theophylline
34
Q

What are the ECG findings in multifocal atrial tachycardia?

A
  1. Very abrupt onset with rate variation
  2. Irregularly irregular rhythm
  3. Rate 150-250 bpm
  4. Discernible P waves with ≥3 different morphologies
  5. Narrow QRS complex

Cardiology+Haematology 3 (44 decks)

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