CVS - cardiac arrythmias

Question 1

What is arrhythmia?

Answer 1

when heart beats too fast, too slowly or irregurlary

Question 2

What are the ranges of BPM ; normal sinus, sinus tachycardia and sinus bradycardia

Answer 2

• 60-100bpm
  >100 BPM
  <60 BPM

Question 3

List the mechanism of arrhythmia:

Answer 3

1. The heart’s natural pacemaker (the sinus node) becomes diseased and slows down
2. The normal conduction pathway is interrupted
3. Another part of the heart takes over as pacemaker

Question 4

How to develop a systemic approach to assessing patients symptoms and ECG:

Answer 4

1. Know a normal ECG
2. good classification system to narrow down the diagnosis

Question 5

What are the symptoms of arrhythmia?

Answer 5

palpitations
signs of hypotension
signs of dec. brain perfusion

tachycardia > angina
sudden cardiac death

Question 6

What are the main causes of arrhythmias?

Answer 6

Ischemia
Hypoxia
Acidosis or alkalosis
Electrolyte abnormalities
Excessive catecholamine exposure
Autonomic influences
Drug toxicity (eg digitalis or antiarrhythmic drugs)
Overstretching of cardiac fibres
The presence of scarred or otherwise diseased tissue

Question 7

Most important types of arrhythmia?

Answer 7

1. Superventricular
   Atrial fibrillation
   Atrial Flutter
   Paroxysmal superventricular tachycardia
   Heart blocks
2. Ventricular
   Ventricular fibrillation
   Ventricular tachycardia

Question 8

Sinus Tachycardia
- how to identify?

Answer 8

Regular rhythm
Normal P waves
Normal QRS
But HR>100bpm

Question 9

Sinus Bradycardia
- how to identify? can be normal when sleeping or an athlete

Answer 9

Regular rhythm
Normal P waves
Normal QRS
But HR<60bpm

Question 10

Supraventriculararrhythmias’

Answer 10

1. Atrial fibrillation
2. Atrial Flutter
3. Paroxysmal superventricular tachycardia

Question 11

What does wavy isoelectric line suggest in the atrial dysrhythmias ECG?

Answer 11

P wave is inconsistent

Question 12

Supraventricular tachycardia (SVT)

Answer 12

Extremely fast electrical activity in the ventricles
Regular
>150bpm
No P waves (?hidden)
Narrow or normal QRS
Cant measure

Question 13

Ventriculararrhythmias’

Answer 13

1. Ventricular fibrillation
2. Ventricular tachycardia

Question 14

Ventricular tachycardia

Answer 14

Extremely fast electrical activity in the ventricles
Rhythm is usually regular
Fast rate 120-200bpm
P wave is blurred in the QRS complex but the QRS complex has no associate with P wave
QRS complex is wide and bizarre; T wave is in the opposite direction
PR Interval is not present

Question 15

When are waves fatal? what can be seen on ECG?

Answer 15

rapid, ineffective quivering of ventricles

Question 16

How can arrhythm,ia be treated?

Answer 16

• medication
• cardioversion
• catheter ablation