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FA Step2 CK Cardiology > Cardiology: TachyArrhythmias > Flashcards

Cardiology: TachyArrhythmias Flashcards

1
Q

what is etiology of sinus tachycardia? (6 causes)

A 
normal physiologic response to fear, pain, and exercise
hyperthyroidism
volume contraction
infection
pulmonary embolism
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2
Q

name 4 types of atrial supraventricular tachyarrhythmias

A

sinus tachy
a fib
a flutter
multifocal atrial tachy

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3
Q

name 3 types of supraventricular AV junction tachyarrhythmias

A

AVNRT (atrioventricular nodal reentry tachycardia)
AVRT (atrioventricular reciprocating tachy)
paroxysmal atrial tachycardia

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4
Q

what are signs and symptoms of sinus tachy

A

palpitations and SOB

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5
Q

what are ECG findings in sinus tachycardia

A

sinus rhythm

ventricular rate >100bpm

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6
Q

what is treatment for sinus tachycardia?

A

treat underlying cause

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7
Q

what is etiology of atrial fibrillation? acute: use PIRATES mnemonic/ chronic

A 
ACUTE:
pulmonary disease
ischemia
rheumatic heart disease
anemia/atrial myxoma
thyrotoxicosis
ethanol
sepsis
CHRONIC: HTN and CHF (due to left atrial enlargments)
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8
Q

what are symptoms of atrial fib

A 
often asymptomatic
SOB
chest pain
palpitation
irregularly irregular pulse
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9
Q

what is see on ECG?

A

no discernible p waves

variable and irregular QRS response

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10
Q

what is treatment for a fib?

A

estimate risk of stroke (CHADS2 score). anti coagulate if >=2
anticoagulation if >48hrs (to prevent CVA)
rate control: beta blockers, CCB, digoxin
cardiovert only if new onset (<48 hrs) or TTE (transesophageal echo) shows no left atrial clot or after 3-6 wks of warfarin treatmtment with satisfactory INR (2-3)

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11
Q

what is etiology of atrial flutter

A

circular movement of electrical activity around the atrium at a rate of 300x per minute

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12
Q

what is symptoms of atrial flutter

A

usually asymptomatic

palpitations, syncope, lightheadedness

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13
Q

what is seen on ECG in atrial flutter?

A

regular rhythm, “sawtooth” appearance of p waves can be seen
atrial rate is 240-320 bpm
ventricular rate 150 bpm

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14
Q

what is used to treat atrial flutter

A

anticoagulation, rate control, cardioversion similar to atrial fib
estimate risk of stroke (CHADS2 score). anti coagulate if >=2
anticoagulation if >48hrs (to prevent CVA)
rate control: beta blockers, CCB, digoxin
cardiovert only if new onset (<48 hrs) or TTE (transesophageal echo) shows no left atrial clot or after 3-6 wks of warfarin treatmtment with satisfactory INR (2-3)

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15
Q

what is etiology of multifocal atrial tachycardia?

A

multiple atrial pacemakers or reentrant pathways
COPD
hypoxemia

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16
Q

what are symptoms of multifocal atrial tachy

A

may be asymptomatic

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17
Q

what is seen on ECG for multifocal atrial tachy

A

three or more unique p-wave morphologies

rate >100bpm

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18
Q

how is mutifocal atrial tachy treated?

A

treat underlying disorder
verapamil or beta-blockers for rate control
suppression of atrial pacemakers (not vry effective)

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19
Q

what is etiology of AVNRT (atrioventricular nodal reentry tachy)

A

a reentry circuit in the AV node depolarizes the atrial and ventricle nearly simultaneously

20
Q

what is symptoms of AVNRT (atrioventricular nodal reentry tachy)

A

palpitations, SOB, angina, syncope, lightheadedness

21
Q

what are ECG findings of AVNRT (atrioventricular nodal reentry tachy)

A

rate 150-250 bpm

p wave is often buried in QRS or shortly after

22
Q

what is treatment for AVNRT (atrioventricular nodal reentry tachy)

A

cardiovert if hemodynamically unstable

carotid massage, valsalva or adenosine can stop arrhythmia

23
Q

what is etiology of AVRT (atrioventricular reciprocating tachy)

A

and ectopic connection between atrium and ventricle that causes a reentry circuit. seen in WPW

24
Q

what are symptoms of AVRT (atrioventricular reciprocating tachy)

A

palpitations, SOB, angina, syncope, lightheadedness

25
Q

what are ECG findings in AVRT (atrivoentricular reciprocating tachy)

A

a retrograde p wave is seen after normal QRS

a preexcitation delta wave with WPW

26
Q

how do you treat AVRT? atrioventricular reciprocating tachy

A

cardiovert if hemodynamically unstable
carotid massage
Valsalva, and adenosine can stop arrhythmia

27
Q

what is etiology of paroxysmal atrial tachy

A

rapid ectopic pacemaker in atrium no in sinus node

28
Q

what are symptoms of paroxysmal atrial tachycardia?

A

palpitations, SOB, angina, syncope, lightheadedness

29
Q

what ecg findings in paroxysmal atrial tachy

A

rate>100 bpm; p wave with unusual axis before each normal QRS

30
Q

what is treatment for paroxysmal atrial tachy

A

adenosine can be used to unmask underlying atrial activity

31
Q

name the 4 types of ventricular tachy?

A

premature ventricular contraction
ventricular tachy
ventricular fibrillation (VF)
torsades de pointes

32
Q

name the etiology of premature ventricular contraction (PVC)? what 3 things is it associated with?

A

ectopic beats arise from ventricular foci.

associated with hypoxia, electrolyte abnormaltiies, and hyperthyroidism

33
Q

what are symptoms of PVCs?

A

usually asymptomatic

my lead to palpitations

34
Q

what are ECG findings in premature ventricular contractions?

A

early, wide QRS not preceded by a p wave. PVCs are usually followed by a compensatory pause

35
Q

what is treatment for PVCs?

A

treat the underlying cause. if symptomatic give beta blockers or occasionally other antiarrhythmics

36
Q

what is etiology of ventricular tachy? 3

A

can be associated with CAD, MI and structural heart disease

37
Q

what are symptoms of ventricular tachy?

A

non sustained VT is often asymptomatic
can lead to palpitations, can lead to hypotension, angina, and syncope.
can progress to VF and death

38
Q

what ECG are in ventricular tachy

A

three or more consecutive PVCs

wide QRS complexes in regular rapid rhythm, may see AV dissociation

39
Q

what is treatment for ventricular tachy?

A

cardioversion and antiarrhythmics (amiodarone, lidocaine, procainamide)

40
Q

what is etiology of ventricular fibrillation (VF) 4 associations?

A

assocaited with CAD and structural heart disease

also associated with cardiac arrest together with asystole

41
Q

what is symptoms of ventricular fib?

A

syncope
absence of BP
pulselessness

42
Q

what are ecg finding in v fib?

A

totally erratic wide complex tracing

43
Q

how is v fib treated?

A

immediate electrical cardioversion and ACLS protocol

44
Q

what is etiology of torsades de pointes? (5 assocaitions)

A

associated with long QT syndrome, proarrhythmic response to medications, hypokalemia, congenitial deafness, and alcoholism

45
Q

what is symptoms of torsdes de pointes?

A

can present with sudden cardiac death

typically associated with palpitations, dizziness, an syncope

46
Q

what ECG findings are associated with torsades de pointes

A

polymorphous QRS

VT with rates between 150-250 bpm

47
Q

what is treatment for torsades de pointes?

A

give magnesium initially
cardiovert if unstable
correct hypokalemia
withdrawal offending drugs

FA Step2 CK Cardiology (17 decks)

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