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kine 4600- EKG > ch.5 > Flashcards

ch.5 Flashcards

1
Q

why do arrhythmias happen?

A

Hypoxia (low O2)
Ischemia (lack of blood flow)
Sympathetic stim
Drugs
Electrolyte disturbances
Bradycardia
Myocardial stretch

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2
Q

WAP

A

Wandering Atrial Pacemaker

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3
Q

what is a WAP?

A
  • pacemaker activity WANDERS from SA Node to Atrial Automaticity Foci
  • VARIATION shape of P wave
  • HR within normal range (60-100 BPM)
  • P prime or P’
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4
Q

MAT

A

Multifocal Atrial Tachycardia

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5
Q

what is MAT?

A
  • seen in ppl with COPD
  • HR >100
  • P’ waves of VARIOUS shapes
  • 3 or more atrial foci
  • associated with Digitalis Toxicity
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6
Q

Atrial Flutter

A
  • SINGLE strong automaticity foci
  • 250-350 cycles per min
  • consistent # of P waves before QRS
  • 2 P waves to 1 QRS
  • R to R evenly spaced out
  • HR 60-100 BPM
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7
Q

Atrial Fibrillation

A
  • quivering/shaking
  • irregular ventricular rhythm
  • MULTIPLE atrial automaticity foci fire
  • 0 observable P waves
  • no full contraction
  • random, no consistent R-R int
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8
Q

T/F: If one lead is atrial flutter, then all leads have atrial flutter?

A

True. It is the same heart

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9
Q

Escape Rhythm

A
  • automaticity foci escapes overdrive
    suppression to pace (any random)
  • atrial, junctional, ventricular
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10
Q

Escape beat

A
  • happens once
  • emit one beat
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11
Q

Sinus Arrest

A
  • SA node stops pace
  • Sick Sinus Syndrome (S.S.S.)
  • SA node doesn’t consistently work
  • Atrial Escape Rhythm
  • Atrial foci take over
  • 60-80 BPM
  • P’ waves not identical to P waves
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12
Q

Atrial Escape Rhythm

A
  • Atrial foci take over
  • 60-80 BPM
  • P’ waves not identical to P waves
  • P’ are identical
  • flat line then escape beat/rhythm
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13
Q

T/F: You can tell the difference between a sinus arrest and a sinus block on EKG?

A

No. looks the same with a long pause/break between

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14
Q

Sinus Block

A
  • Normal sinus rhythm (NSR)
  • pause in pacing
  • atrial automaticity foci escapes overdrive suppression and takes over pacing
  • escape beat
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15
Q

Junctional Escape Rhythm

A
  • between atria and ventricles
  • absent pacing from above (Sinus arrest)
  • 40-60 bpm (lower HR)
  • 0 P wave or inverted P wave
  • still a rhythm, R-R consistent
  • junctional automaticity foci escapes to pace
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16
Q

T/F: In a junctional escape rhythm, the wave of depolarization is going in the opposite direction?

A

True

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17
Q

(AV) Junctional Escape Beat

A
  • misses ONE cycle
  • transient block at SA node
  • may produce retrograde (upside down) atrial depolarization
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18
Q

ventricular escape rhythm

A
  • ventricular automaticity foci not stimulated from above
  • purkinje fibers not stim
  • 20-40 cycles per min
  • doesn’t last long
  • total failure of all automaticity foci above
  • complete conduction block (atria to ventricles)
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19
Q

T/F: In order to be a rhythm, there has to be back to back consistent rhythms

A

True

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20
Q

Ventricular escape beat

A
  • severe
  • WIDE QRS complex (from ventricles)
  • may not have a P wave
  • autonomic/ parasympathetic stim
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21
Q

What are the 3 premature beats/contraction?

A
  • Premature atrial (PAC)
  • premature junctional (PJC)
  • premature ventricular (PVC)
22
Q

what happens on an EKG when a premature beat occurs?

A

the R-R interval shortens quickly

23
Q

what irritates the Atrial and junctional foci?

A
  • adrenaline (normal in stress test)
  • low O2 (normal in stress test)
  • caffeine, amphetamines, cocaine, beta 1 receptor stims
  • hyperthyroidism
  • stretch
24
Q

Premature atrial beat (PAB/C)

A
  • produce P’ waves
  • earlier than expected
  • P’ wave is unusually shaped
  • can be embedded or on top of T wave
  • T wave looks larger
25
Q

Premature Junctional Beat

A
  • 0 P wave
  • inverted P wave
  • irritable automaticity foci in the AV junction
26
Q

Premature ventricular contraction (PVC)

A
  • produces premature QRS
  • WIDE (>0.12 sec or 3 small boxes)
  • enormous amplitude
  • usually opposite polarity of normal QRS
  • shouldn’t happen @ rest
  • low O2 or airway obstructed
27
Q

PVCs and blood flow

A
  • w/a single PVC the heart will still pump 80% of normal stroke volume (SV)
  • w/a second PVC the heart will pump about 58% of normal SV
28
Q

PVC

A
  • ventricular bigeminy
  • ventricular trigemini
  • ventricular quadrigeminy
  • unifocal
  • multifocal
    -PVC couplet
  • run of ventricular tachycardia
29
Q

Ventricular bigeminy

A
  • one normal beat
  • one PVC
  • has to happen for @ least 2 cycles (back2back)
30
Q

Ventricular trigeminy

A
  • 2 normal beats
  • one PVC
  • @ least 2 cycles for it to occur
31
Q

Ventricular quadrigeminy

A
  • 3 normal beats
  • one PVC
  • @ least 2 cycles
32
Q

PVC Couplet

A

2 PVCs in a row
- consecutive w/ no normal beat between

33
Q

Run of ventricular tachycardia (V tach)

A
  • 3 or more PVCs in a row
  • longer than 30 sec
34
Q

Univocal PVC

A

if PVCs look the same

35
Q

multifocal PVC

A

if PVCs look different

36
Q

Rules of malignancy

A
  • frequent PVCs
  • 6 or more per min
  • run of consecutive PVCs is V tach
  • multiform or multifocal
  • PVC on T wave (R on T)
  • more severe, deadly arrhythmia
37
Q

R on T phenomenon

A
  • PVC falls on T wave
  • vulnerable period
  • dangerous rhythms
  • purkinje fibers still in repolarization
38
Q

MVP

A

mitral valve prolapse

39
Q

What is MVP?

A
  • Barlow syndrome
  • more common in females
  • 6%-17% in female
  • 1.5% in male
40
Q

Tachy-arrhythmias

A
  • Paroxysmal Tachycardia (150-250)
  • Flutter (250-350)
  • Fibrillation (350-450)
41
Q

Paroxysmal Tachycardia

A

-150-250
- sudden fast HR
- from NSR to Parox. V Tach

42
Q

Supraventricular Tachycardia

A
  • fast HR that happens above ventricles
  • QRS normal
  • may or may not see P waves
  • R-R intervals close together
  • sinus tach is form of this
43
Q

Paroxysmal Supraventricular Tachycardia

A
  • common arrhythmia
  • may occur in perfect norm heart
  • excitement, coffee, alcohol
  • Carotid Massage used to slow HR
44
Q

Torsades de Pintes

A
  • Twist of points
  • very rapid ventricular rhythm
  • Low K+
  • long QT segment
  • Rate 250-350
  • brief bursts
  • amplitude of QRS changes
45
Q

Ventricular Flutter

A
  • SINGLE ventricular autom. foci
  • Rate 250-350
  • smooth sine-wave pattern
  • amplitude changes minimally
46
Q

Ventricular Fibrillation

A
  • ventricles quiver
  • follows v flutter
  • seen in dying heart
  • NO P waves
  • NO identifiable QRS waves
  • “bag of worms”
47
Q

Asystole

A
  • flat line
  • w/o rhythm
48
Q

WPW

A

Wolff-Parkinson-White Syndrome

49
Q

What is WPW?

A
  • Goes down “Bundle of Kent”
  • creates Delta Wave (U shape)
  • P wave doesn’t hit baseline
50
Q

AED

A
  • automated external defibrillator
  • small and portable
  • place electrodes, machine does work
51
Q

ICD

A
  • implantable cardioverter defibrillator
  • implanted under chest
  • detects VF
  • delivers defibrillating shock

kine 4600- EKG (8 decks)

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