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Clin Med - Cardio Exam #2 > ConductionBlocks > Flashcards

ConductionBlocks Flashcards

1
Q

define conduction block

A

delay or disruption in transmission of an impulse from atria to ventricle

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2
Q

What are the types of AV conduction blocks and describe them?

A
  • 1st degree: AV synchrony is maintained (every p goes with a QRS)
  • 2nd degree: intermittent loss of AV conduction (not every p has a QRS)
  • 3rd degree: complete AV dissociation
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3
Q

etiology of AV conduction blocks

A
  • MC = progressive heart conduction disease
  • incr. vagal tone
  • ischemic heart dz
  • infiltrative process (amyloid/sarcoid)
  • myocarditis
  • congenitl heart dz
  • familial dz
  • malignancies
  • drugs
  • heart surgery
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4
Q

define 1st degree AV conduction block

A
  • prolonged PR interval (greater than 0.2s)
  • every p goes with every QRS
  • not likly to progress to 2nd degree
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5
Q

etiology of 1st degree AV conduction block

A
  • structural abnormalities
  • increased vagal tone
  • drugs that impair/slow AV conduction
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6
Q

epidemiology of 1st degree AV conduction block

A

increased in trained athletes

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7
Q

clinical presentation of 1st degree AV conduction block

A

ususally asx

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8
Q

management of 1st degree AV conduction block

A
  • if PRI under 300ms ==> no intervention
  • if wide QRS ==> refer
  • tx underlying cause
  • avoid AV nodal blocking meds
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9
Q

define 2nd degree AV conduction block (generally speaking)

A
  • not every QRS has a p

- two types

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10
Q

epidemiology of 2nd degree AV conduction block

A

increased in trained athletes

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11
Q

etiology of 2nd degree AV conduction block

A
  • heart drugs
  • lithium
  • inflammatory dz
  • infiltrative dz
  • malignancies
  • collagen vascular dz
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12
Q

diagnostics for 2nd degree AV conduction block

A
  • EKG
  • electrolytes
  • digoxin
  • biomarkers
  • Lyme titers
  • echo
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13
Q

define type I 2nd degree AV conduction block

A
  • progressive slowing of subsequent AV node impulses until node fails to conduct
  • cycle repeats
  • Wenchback Walk
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14
Q

clinical presentation of type I 2nd degree AV conduction block

A
  • asx

- decr CO = fatigue, lightheadedness, syncope, angina, heart failure

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15
Q

treatment of type I 2nd degree AV conduction block

A
  • tx underlying cause
  • no specific tx when asx
  • monitor EKG
  • refer when sxatic
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16
Q

define type II 2nd degree AV conduction block

A
  • PR interval remains equal until dropped beat
  • no change in PR interval
  • frequently progresses to 3rd degree
17
Q

clinical presentation of type II 2nd degree AV conduction block

A
  • ranges from asx to many

- if decr HR or many dropped beats = decr. CO ==> fatigue, lightheadedness, syncope

18
Q

treatment of type II 2nd degree AV conduction block

A
  • tx underlying cause
  • avoid AV blocking drugs
  • pacemaker
19
Q

define 3rd degree AV conduction block

A
  • complete failure of AV node to conduct any impulse from atria to ventricles
  • variable PR interval
  • with escape rhythm
20
Q

possible sites of 3rd degree AV conduction block

A
  • AV node = narrow QRS
  • Bundle of His = narrow QRS
  • Proximal (B) Bundle Branches = wide QRS
  • R bundle w/ L fasicles = wide QRS
21
Q

clinical presentation of 3rd degree AV conduction block

A
  • more distal block = decr. rate
  • distal blocks = syncope
  • chest pain (in MI)
  • lightheadedness
  • DOE
  • bradycardia
  • vtach/fib/ventricular brady
  • asystole
22
Q

diagnostics for 3rd degree AV conduction block

A

same as 2nd degree

  • EKG
  • electrolytes
  • digoxin
  • cardiac biomarkers
  • Lyme titers
  • echo
  • CBC & blood cx to r/o endocarditis
23
Q

treatment of 3rd degree AV conduction block

A
  • temporary then pacemaker
  • refer
  • treat underlying cause
  • avoid rx that block AV node
24
Q

define LBBB

A
  • wide QRS (greater than 0.12s)

- broad R waves in V1-6 & broad S waves in AVR

25
Q

LBBB is difficult to ddx with _____ d/t _____.

A
  • myocardial ischemia & infarction

- ST-T abnormalities

26
Q

New LBBB is _____ until proven otherwise.

A

MI

27
Q

diagnostics for LBBB

A
  • echo

- stress testing (CAD)

28
Q

treatment for LBBB

A
  • if young + asx w/o CAD ==> no tx
  • tx underlying condition
  • reduce risks
  • consider pacemaker
29
Q

clinical presentation of RBBB

A

asx

30
Q

associated conditions of LBBB

A
  • HTN
  • CAD
  • valve dz
  • cardiomyopathies
31
Q

associated conditions of RBBB

A
  • cor pulmonale

- PE

32
Q

diagnostics for RBBB

A
  • no further needed
33
Q

treatment of RBBB

A
  • pacemaker if syncope occurs

Clin Med - Cardio Exam #2 (12 decks)

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