Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Case 12 > Clinical Presentation Arrhythmias > Flashcards

Clinical Presentation Arrhythmias Flashcards

1
Q

What is sinus rhythm?

A
  • Normal heart rhythm

- Each p wave followed by QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is there slow AVN conduction?

A
  • Safety feature - conduction of very rapid rhythm direct to ventricles prevented
  • Accessory pathways can bypass AVN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms of an arrhythmia?

A
  • None
  • Palpitations
  • Breathlessness (dyspnoea)
  • Chest pain
  • Dizziness/lightheadedness
  • T-LOC/syncope
  • Sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can palpitations be exacerbated by?

A

Stress, alcohol, caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes breathlessness?

A
  • Due to low CO
  • Tachyarrhythmias = low SV
  • Bradyarrhythmias = low HR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes dizziness/light-headedness?

A

Fall in CO may = drop in BP = lower cerebral perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What arrhythmias can cause sudden cardiac death?

A
  1. Ventricular tachyarrhythmias
  2. Bradyarrhythmias
  3. Acute pump failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes anginal chest pain?

A
  • When myocardial demand for O2 exceeds supply
  • Demand may increase due to increased HR
  • Supply may decrease due to decreased CO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of sudden cardiac death?

A 
2/3 = structurally abnormal heart - CAD, cardiomyopathy
1/3 = structurally normal heart - primary arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you investigate intermittent arrhythmias?

A
  • Week long cardiac event recorders

- Implantable loop recorders - reserved for T-LOC, not palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the types of ectopic beats?

A
  1. Ventricular = broad QRS complex
  2. Atrial = narrow QRS complex

Often followed by compensatory pause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are ectopic beats managed?

A

Lifestyle

  • smoking
  • alcohol
  • caffeine
  • chinese food - monosodium glutamate

Avoid culprit drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is AF?

A

Irregularly irregular rhythm

No p waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the categories of AF?

A
  1. Paroxysmal episodes < 48 hours
  2. Persistent episodes > 48 hours and < 1 week
  3. Permanent episodes permanent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are cerebral thromboembolic events?

A

Stroke

TIA’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is AF treated?

A
  • Rate vs rhythm
  • Assessment of risk of stroke - CHADVASC
  • Assessment of risk for anti-coagulation - HASBLED
  • Should not use aspirin
17
Q

How is AF rate controlled?

A
  • Drugs target AVN to slow conduction to ventricles
  • Useful for persistent/permanent AF
  • B blocker, digoxin, Ca channel blockers
  • Keep you in AF but slow it down
  • Extreme = ablate + pace
18
Q

How is AF rhythm controlled?

A
  • Atrial stabilising drugs
  • VW class IC (flecainide, propafenone)
  • Class III (amiodarone, dronedarone)
  • DC cardioversion
  • Radiofrequency ablation
19
Q

How is stroke prevented in AF?

A
  • AF = thrombus formation in LA
  • NOT aspirin
  • Warfarin vs DOACs
20
Q

What is the LT management of AF?

A
  • Manageable rather than curable

- Episodes become more frequent + permanent

21
Q

What is an accessory pathway?

A
  • Enables conduction to bypass AVN

- ECG = short PR + delta wave

22
Q

What is first degree heart block?

A
  • Conduction from atria > ventricles pathologically slowed
  • Due to slow conduction within AVN
  • Long PR interval
  • Usually no symptoms
  • Often due to AVN blocking drugs
23
Q

What is second degree heart block?

A
  • Conduction from atria > ventricles intermittent
  • ECG: non-conducted p waves (not followed by QRS)
  • No palpitations
  • Breathlessness, T-LOC + chest pain due to low CO
  • Symptoms intermittent or none
24
Q

What is third degree heart block?

A
  • Conduction from atria > ventricles fails
  • Heart beats escape rhythm due to severals sites of intrinsic pacemaker activity
  • No palpitations
  • Breathlessness, T-LOC + chest pain due to low CO
  • Complete AV dissociation = dissociated p waves
25
Q

What are the causes of heart block?

A
  • Age-related degeneration
  • Acute ischaemia
  • AVN blockers
  • Hyperkalaemia
  • Hypothyroidism
  • Hypothermia
  • Raised ICP (cushings reflex)
  • Congenital
26
Q

How is heart block treated?

A
  • Primary = none
  • Symptomatic 2nd + 3rd = treatment of reversible causes (drugs etc) + permanent pacemaker
  • Lifestyle changes
27
Q

What is regular broad complex tachycardia?

A
  • Fast, regular abnormal heart rhythm with QRS duration
  • Most life threatening = VT
  • All BCT’s VT until proven
28
Q

What is ventricular tachycardia?

A
  • Fast arrhythmia arising from ventricles
  • Common with history of structural HD
  • Can be inherited
29
Q

What investigations are used for ventricular tahchycardia?

A
  • Echo + coronary angiogram
  • Cardiac MR or electrophysiological studies
  • Looks for treatable cause
30
Q

What is an implantable cardiac defibrillator?

A

ICD

Delivers shock to defibrillate if abnormal heart rhythm develops

31
Q

What are past medical history alarm features?

A
  • MI
  • HF
  • IHD
  • Cardiac surgery
  • Congenital + Valvular HD
32
Q

What are family history alarm features?

A
  • Young IHD
  • Death < 40 yrs
  • Known heritable HD
33
Q

What are clinical alarm features?

A
  • T-LOC, Chest pain, Breathlessness
  • Abnormal ECG
  • Heart murmur
  • Signs of HF
34
Q

What inherited cardiomyopathies are there?

A
  1. Hypertrophic cardiomyopathy
  2. Dilated cardiomyopathy
  3. Arrhythmogenic RV cardiomyopathy
35
Q

What inherited primary arrhythmias are there?

A
  1. LQTS
  2. Brugada syndrome
  3. WPW syndrome

Case 12 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions