Dysrhythmias Flashcards
normal electrical conductivity of heart
Rate 60-100 Regular rhythm P waves: upright and round, one before every QRS, regular rhythm PR interval 0.12-0.20 sec QRS: <0.12 sec
sinus arrythmia
normal
variability in HR 60-100bpm
common in young people
HR fluctuates with respiration or Autonomic nervous system
what is a dysrhythmia
abnormality of cardiac rhythm
problems with impulse generation or conduction
what causes dysrhythmia’s?
inappropriate automaticity
triggered activity re-entry
what are the different types of sinus rhythms?
sinus rhythmmia sinus arrhythmia sinus tachycardia sinus bradycardia paroxysmal supraventricular tachycardia
sinus bradycardia
SA node
regular rate less than 60
normal rhythm
normal PR (.12-.20) and QRS interval (< 0.12)
causes of sinus brady
hyperkalemia vagal response digoxin toxicity late hypoxia meds MI
manifestations of sinus brady
lightheadedness/ dizziness with exertion easily tired syncope or near syncope dyspnea chest pain/discomfort confusion
treatment of symptomatic bradycardia
atropine: anticholenergic
if drug not effective: pacemaker
sinus tachycardia
SA node HR: 100-150 regular rhythm p wave similar or partially hidden normal PR (.12-.20)interval and QRS (<0.12)
causes of tachycardia
catecholamines: (exercise, pain, strong emotions) fever fluid volume deficit meds (epi, albuterol, beta agonists) substances (caffeine, nicotine, cocaine) hypoxia
treatment for sinus tachycardia
based on cause
hypovolemia= fluids
fever= anti-pyretic
pain= analgesics
paroxysmal supraventricular tachycardia (PSVT)
caused by re-entry phenomenon begins and ends suddenly "feel like my heart is racing" HR 150-250 AV node usually no P wave if present, abnormal QRS looks normal (<0.12)
causes of PSVT
over exertion emotional stress stimulants digitalis toxicity rheumatic heart disease CAD Wolff- Parkinson-White right sided heart failure ( Cor pulmonale)
clinical signs and symptoms of PSVT
palpitations chest pain fatigue lightheaded/dizziness dyspnea
premature atrial contractions (PACs)
early P waves that look different normal PR interval (12-20) QRS does follow PAC usually not a problem but frequent PAC's cause pt high risk for dysrhythmia's check electrolytes may need O2
two types of atrial dysrhythmias
atrial flutter
atrial fibrillation
atrial flutter
AV node, overrides SA node re-entry impulse that is repetitive and cyclic Atrial pulse Rate >250 bpm, regular atrial rhythm ventricular rate is slower P was "SAWTOOTH" QRS narrow may be 2:1, 3:1, or 4:1 ( ex: 2 p wave per 1 QRS complex)
causes of atrial flutter
CHD cardiomyopathy heart valve disease congenital heart disease inflammation of heart (myocarditis) high BP overactive thyroid, lung disease electrolytes
atrial fibrillation
multiple irritable spots in atria (all sending signals)
irregularly irregular (atrial and ventricular)
HR 100-175
no identifiable P wave
fibrillation waves
clinical manifestations of Atrial Fibrilation
palpitations heart racing fatigue dizziness chest discomfort sob may be asymptomatic
complications and causes of Afib
electrolytes hypoxia cardiovascular disease decreased cardiac output heart failure embolus/ stroke
untreated a-fib doubles your risk of heart-related ____, and causes a 4-5 times greater risk of ____
death, stroke
treatment of Afib
beta blockers, CCB, digitalis, amiodarone
stroke prevention: anticoagulants, antiplatelets
ablation
cardioversion
