Chapter 10 PowerPoint Flashcards
Where and what are premature beats generated by?
Generated by ectopic stimulation or irritable foci in either the Atria, AV junction, and Ventricle.
What other terms for premature beats are used?
“Skipped beats” rather than early beats
“Palpitations”
What are the three general causes of PVC?
-Absence of organic Heart disease
Idiopathic – caffeine, stress, exhaustion, smoking
Hypoxia – alcohol, cocaine, hypoxemia, hypercapnia
-Presence of Organic Heart Disease
Myocardial ischemia, myocardial infarction, mitral valve prolapse, cardiomyopathy
-Electrolyte Disturbance
Hypokalemia, hyperkalemia, hypomagnesemia, hypocalcemia
What occurs in the absence of organic heart disease in premature beats?
Idiopathic – caffeine, stress, exhaustion, smoking
Hypoxia – alcohol, cocaine, hypoxemia, hypercapnia
What occurs in the presence of organic heart disease in premature beats?
Myocardial ischemia, myocardial infarction, mitral valve prolapse, cardiomyopathy
What occurs in electrolyte disturbances in premature beats?
Hypokalemia, hyperkalemia, hypomagnesemia, hypocalcemia
What are four treatments for premature beats?
Benign – work on life style management
Pharmacologic management
Catheter ablation
Electrolyte replacement therapy
Premature atrial contractions are very ____ and generally ____?
Premature atrial contractions are very common and generally benign
What is the appearance of premature atrial contractions?
Appearance – looks similar to normal sinus beat
-Morphology of P wave is different
-P waves can hide in ST seg and T wave
-Most PAC’s conduct a beat some do not.. showing lone P wave
-Each PAC resets the SA node
PAC patterns are the same as ____?
PVC
Causes of PAC?
Causes – stress, caffeine, fatigue, electrolyte balance, oxygenation
What are treatments for PAC?
Treatments – none at first, Meds, Catheter ablation
Premature junctional contractions occur in the ____?
AV node “junction”
How do premature junctional contractions appear on an ECG?
ECG Appearance – QRS usually narrow
P wave maybe absent, inverted or retrograde
Lack of atrial depol or atrial depol out of sequence
Also happens in couplets, bigeminy
What are causes of PJC?
Causes – hypoxemia, electrolyte imbalances
What are treatments for PJC?
Treatments – benign. Or medication
In a PVC the ventricles depolarize out of sync with the ____ ____?
SA node
PVC is associated with enhanced ____ of ventricles?
Automaticity
During a PVC when does the atria contract?
No atrial depol or simultaneous or retrograde to PVC
How does a PVC appear on an ECG?
ECG appearance
Large / obtuse
Wide QRS complex – slower ventricular depol than normal
T wave opposite of main QRS deflection
No visible p wave
Following PVC is a short no electrical activity
What is a PVC couplet?
Couplets – 2 identical PVC’s in a row
What is non-sustained ventricular tachycardia?
A run of PVC’s lasting < 30 sec
3 or more unifocal PVC’s in a row
A run of 3 PVC’s – burst
What are multifocal PVCs?
Multifocal – PVC’s with different morphologies
What is ventricular bigeminy?
Ventricular Bigeminy – alternating sinus beat and PVC
What is ventricular trigeminy?
Ventricular Trigeminy – PVC beats every 3rd beat
What is R on T premature ventricular contraction?
R wave of PVC falls on T wave
Very unstable and can lead to Vtach
What are three classifications of tachyarrhythmias?
Paroxysmal
200+/- 50
Flutter
300 +/- 50
Fibrillation
400 +/- 50
What is Supraventricular Tachycardia (SVT) Rhythms?
HR above 100 coming from above the ventricles
What can SA node dysfunction cause?
Sinus Tachycardia
What can irritated atria cause?
Focal Atrial tachycardia
Multifocal Atrial Tachycardia
Atrial flutter
Atrial fibrillation
What can paroxysmal supraventricular tachycardia cause?
AV node reentrant tachycardia
AV reentrant tachycardia
S/S of typical supraventricular tacycardia?
Signs/Symptoms
Palpitations
Chest Pain
Anxiety
Shortness of Breath
Dizziness
(Rare Syncope)
What are risk factors for typical supraventricular tachycardia?
Risk Factors
Genetics
Structural Abnormality
CAD or Heart Disease
COPD
Pulmonary Embolism
Hyperthyroidism
Alcoholism
Medication
What are three different mechanisms for atrial tachycardia?
Automaticity
Reentry
Triggered
What are causes for supraventricular tachycardia?
Causes
Ischemia
Cardiomyopathy
Congestive heart failure
Hypertension heart disease/ventricular hypertrophy
Electrolyte imbalances
Severe pulmonary disease
What is atrial flutter?
250-350 BPM, non lethal
How does atrial flutter appear?
Known for “Saw tooth” pattern
Look at P waves carrying on pace with QRS at another pace
Still see ventricular pattern 2:1 or 3:1
