CV - arrhythmias Flashcards
in arrhythmias, look for the ____________!
P wave
in arrhythmias, look for the ____________!
P wave
sinus tachycardia is defined as a regular, fast heart rate of ____________ bpm.
> 100
name 5 examples of sympathetic activation
exercise emotion hypotension response to acute lung or abdominal pathology thyrotoxicosis
sinus bradycardia is defined as a regular, slow heart rate of ____________ bpm
bradycardia may occur due to high parasympathetic or vagal activity, as in what three vagotonic states?
faintness
sick sinus syndrome
inferior myocardial infarct
bradycardia may occur due to high parasympathetic or vagal activity, as in what three vagotonic states?
faint
sick sinus syndrome
inferior myocardial infarct
what is the treatments for sinus bradycardia?
none (typically)
atropine
pacemaker if symptomatic
what is the treatments for sinus bradycardia?
none
atropine
pacemaker if symptomatic
sinus tachycardia is defined as a regular, fast heart rate of ____________ bpm.
> 100
name 5 examples of sympathetic activation
exercise emotion hypotension response to acute lung or abdominal pathology thyrotoxicosis
what are the ECG findings of a first-degree AV block?
prolonged PR interval
increased junctional delay
bradycardia is typically seen in what group of healthy people?
athletes
bradycardia may occur due to high parasympathetic or vagal activity, as in what three vagotonic states?
faint
sick sinus syndrome
inferior myocardial infarct
what is the treatment for sinus tachycardia?
usually none
beta-blockers in thyrotoxicosis
what is the treatments for sinus bradycardia?
none
atropine
pacemaker if symptomatic
define sick sinus syndrome
also called sinus dysfunction or sinoatrial node disease, a group of abnormal heart rhythms presumably caused by a malfunction of the sinoatrial node
typically 20% of atrial filling occurs during ____________.
ventricular contraction
QRS width indicates the location of the block - if the QRS is ____________, the block is likely higher in the conduction system, and if the QRS is ____________, the block is likely lower in the conduction system.
narrow
broad
what is the general appearance of a premature ventricular contraction (PVC) on an ECG?
wide and abnormal QRS deflection,
do not affect the P wave - may skip a P wave
do not affect the sinoatrial node
define a second degree AV block
some P waves conduct but some do not
what are the subtypes of second degree AV block?
mobitz 1
describe a mobitz 1 (wenckebach) second degree AV block
progressive lengthening of the PR interval followed by a nonconductive P wave
usually benign, usually does not progress
frequently seen in small, inferior infarcts
define a third degree AV block (complete heart block)
none of the P waves conduct
there is no relationship between P waves and QRS - P wave rate is faster than QRS rate
what is a high-risk complication of atrial flutter?
clots in the atria
what are the treatments for atrial flutter?
anticoagulation
rate control with drugs (beta blockers, calcium blockers, digitalis compounds i.e. digoxin)
cardioversion (electrical shock)
ablation
QRS width indicates the location of the block - if the QRS is ____________, the block is likely higher in the conduction system, and if the QRS is ____________, the block is likely lower in the conduction system.
narrow
broad
what is the general appearance of a ventricular premature beat on an ECG?
wide beat, ventricular in origin
do not affect the P wave
do not affect the sinoatrial node
what are other treatments for atrial tachycardia?
vagal maneuver (carotid massage)
beta blocker
verapamil or diltiazem
define atrial fibrillation
abnormal, completely irregular heart rhythm characterized by rapid and irregular beating potentially leading to ischemia and heart failure
“irregularly irregular” ventricular rhythm
what are the ECG findings associated with atrial fibrillation?
no P waves
chaotic atrial depolarizations at >/=350 bpm creating an undulating baseline
“irregularly irregular” QRS
who typically presents with atrial fibrillation?
NI subjects ("lone Afib")
aging
emotional stress
post-operative
heart disease
hyperthyroidismwhat complications are associated with atrial fibrillation?
rapid heart rate - ischemia, heart failure
loss of atrial kick - heart failure
atrial thrombi - embolic stroke
what are the treatments for atrial fibrillation?
anticoagulation
rate control with drugs
cardioversion
ablation
atrial tachycardia is a rapid heart rate of ____________ displaying a ____________ QRS segment and ____________ P waves.
> /= 150 bpm
narrow
present but abnormal
what is the typical treatment for atrial tachycardia?
adenosine
what are other treatments for atrial tachycardia?
vagal maneuver (carotid massage)
beta blocker
verapamil or diltiazem
define atrial fibrillation
abnormal, completely irregular heart rhythm characterized by rapid and irregular beating
what are the ECG findings associated with atrial fibrillation?
no P waves
chaotic atrial depolarizations at >/=350 bpm creating an undulating baseline
“irregularly irregular” QRS
who typically presents with atrial fibrillation?
NI subjects ("lone Afib")
aging
emotional stress
post-operative
heart disease
hyperthyroidismwhat is “larry’s awesome algorithm” for interpreting ECGs?
1 look for the P wave
2 does each P wave precede a QRS?
3 is AV heart block present? is it 1st, 2nd or 3rd degree AV block?
4 are occasional early QRS complexes present?
5 are very fast, abnormal P waves present?
6 no P waves but QRS complexes present
7 no P wave and no QRS?
define first degree AV block
P waves conduct but more slowly than is typical
define a junctional rhythm
abnormal heart rhythm resulting from electrical activation of the heart originating near or within the AV node rather than the SA node
what are the ECG findings associated with junctional rhythms?
regular rhythm
narrow QRS
no antecedent P waves
define ventricular tachycardia
rapid heart beat arising from improper electrical activity of the heart beginning in the ventricles
ventricular tachycardia presents on ECG as regular, wide complexes with a rate of ____________ bpm.
100-200
in most cases of ventricular tachycardia, are P waves visible?
no
define “sustained ventricular tachycardia”
ventricular tachycardia >/= 30 seconds in duration
often life threatening
what is “larry’s awesome algorithm” for interpreting ECGs?
1 look for the P wave
2 does each P wave precede a QRS? if yes, “sinus rhythm”
3 is AV heart block present? is it 1st, 2nd or 3rd degree AV block?
define first degree AV block
P waves conduct but more slowly than is typical
