Cardiac Arryhythmias

Question 1

Cardiac Arrhythmias

Answer 1

They are deviations from normal cardiac rate and rhythm

Question 2

causes of cardiac arrhythmias

Answer 2

damage to the heart’s conduction system or systemic causes such as electrolyte imbalance
fever, hypoxia, stress, infection or drug toxicity

Question 3

_____________ reduce the efficiency of the heart’s pumping cycle

Answer 3

Dysrhythmias

Question 4

Bradycardia

Answer 4

refers to a regular but slow heart rate (less than 60 beats/min). It often results from parasympathetic stimulation

Question 5

Tachycardia

Answer 5

is a regular rapid heart rate (greater than 100-160 beats/min). This may be a normal response to sympathetic stimulation

Question 6

Sick sinus syndrome

Answer 6

is a heart condition marked by alternating bradycardia and tachycardia, often requiring a mechanical pacemaker

Question 7

____________________ are the most common dysrrhythmias

Answer 7

• Atrial conduction abnormalities

Question 8

__________________________ are extra contractions of the atria

Answer 8

• Premature atrial contractions/beats (PAC/PAB)

Question 9

cause of Premature atrial contractions/beats (PAC/PAB)

Answer 9

PACs occur when another region of the atria depolarizes before the sinoatrial node and thus triggers a premature heartbeat

Question 10

Atrial Flutter

Answer 10

refers to atrial rate of 160-350 beats/min (less filling time so less output)

Question 11

• Atrial Fibrillation

Answer 11

is a rate over 350 beats/min

Question 12

____________ causes pooling of blood in the atria and is treated with anticoagulant medications to prevent clotting and stroke (no filling)

Answer 12

• Fibrillation

Question 13

What causes heart blocks

Answer 13

• Atrioventricular node abnormalities cause heart blocks

Question 14

AV conduction is prolonged.
There is a slight delay in getting the electrical signal from SA to AV node, but heart functions normally
It is recognized on the electrocardiogram by a prolonged P-R interval.

Answer 14

First degree heart block

Question 15

First degree heart block

Answer 15

• A heart block in which the conduction of impulses through the atrioventricular node is delayed but all atrial beats are followed by ventricular beats.

Question 16

Second degree heart block (Mobitz type I)

Answer 16

the PR intervals become progressively longer until a QRS complex is dropped every 2nd or 3rd or 4th beat

Question 17

treatment for second degree heart block

Answer 17

Treatment is a cardiac pacemaker implantation

Question 18

ventricular rhythm is irregular

Atrial rhythm is regular

Answer 18

Second degree AV block

Question 19

Third Degree Heart Block

Answer 19

no impulse sent from the atria to the ventricles

Question 20

The ventricles spontaneously contracts independent of the atria contraction (which is normal)

Answer 20

Third Degree Heart Block

Question 21

Bundle branch block

Answer 21

interference with conduction in one of the bundle branches (right or left)

Question 22

How does a Bundle branch block appear on the ECG

Answer 22

wide QRS wave

Question 23

Ventricular tachycardia

Answer 23

a fast heart rhythm (greater than 100 beats/min), that originates in one of the ventricles of the heart

Question 24

Ventricular fibrillation

Answer 24

muscle fibers contract independently and rapidly (uncoordinated quivering) and therefore are ineffective in ejecting blood

Question 25

ventricular fibrillation causes what?

Answer 25

severe hypoxia in the myocardium and contraction ceases

Question 26

Treatment of Cardiac Dysrhythmias

Answer 26

Antiarrhythmic drugs are effective in many cases. Atrial dysrhythmias often respond to digoxin
SA nodal problems or heart block problems requires a pacemaker
Serious life threatening dysrhythmias require defibrillators and other cardioversion devices (shocking the heart to interrupt the disorganized electrical activity and allow the SA node to take control and return the heart to sinus rhythm)

Question 27

_______________ is an acute systemic inflammatory condition that appears to result from an abnormal immune reaction occurring a few weeks after an untreated group A beta-hemolytic Streptococcus

Answer 27

Rheumatic fever

Question 28

When do we see rhuematic fever occur

Answer 28

in children 5-15y/o

Question 29

Preceding Rheumatic fever, what is seen?

Answer 29

upper respiratory tract infection, tonsillitis, pharyngitis or strep throat

Question 30

Preceding Rheumatic fever

Antibodies to the streptococcus organisms form as usual, then what happens

Answer 30

then react with connective tissue in the skin, joints, brain and heart causing inflammation

Question 31

Acute Rheumatic Fever is often clinically diagnosed based on Jones Criteria, which include:

Answer 31

pancarditis
migratory polyarthritis of large joints 
subcutaneous nodules 
erythema marginatum 
sydenham chorea (involuntary, purposeless movement)

Question 32

In diagnosis rheumatic fever, what is the most common clinical finding?

Answer 32

is a migratory arthritis involving multiple joints

Question 33

Pancarditis

Answer 33

during acute stage infection

Inflammation of the outer layer, may include effusion which impairs filling

Question 34

Endocarditis

Answer 34

affects the valves of the heart. The mitral valve is the most commonly affected valve. Recurrent inflammation increase risk for infective endocarditis

Question 35

Myocarditis

Answer 35

inflammation develops as localized lesions in the heart muscle, called Aschoff bodies, may interfere with condution

Question 36

Other sites of inflammation in patients with rheumatic fever

Answer 36

Large joints esp knees, migratory pain, skin - non-pruritic rash known as erythema marginatum; Wrists, elbows, knees or ankles may have small, non-tender subcutaneous nodules usually on the extensor surfaces; • Involuntary jerking movements of the face, arms and legs are called Sydenham’s Chorea or Saint Vitus’ dance

Question 37

What are some of the signs and symptoms of inflammation due to rheumatic fever

Answer 37

Fever; Arthralgia: Joint pain without swelling; Raised erythrocyte sedimentation rate or C reactive protein; Leukocytosis; ECG showing features of heart block, such as a prolonged PR interval; Previous episode of rheumatic fever or inactive heart disease

Question 38

The diagnosis of rheumatic fever can be made when ________________________________ are present along with evidence of streptococcal infection

Answer 38

two of the major criteria, or one major criterion plus two minor criteria,

Question 39

Treatment of rheumatic fever

Answer 39

long term antibacterial agents, prompt treatment of any future streptococcal infection, anti-inflammatory agent; When valve damage has occurred, prophylactic penicillin may be given prior to surgical intervention