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M15: Cardiorespiratory > ECG: Arrhythmias in SA > Flashcards

ECG: Arrhythmias in SA Flashcards

1
Q

List the uses of an ECG

A
  • dx of arrhythmias
  • rule out arrhythmia in patients with hx of collapse
  • chamber enlargement?
  • electrolyte disturbances?
  • dx pericardia effusion?
  • monitor effectiveness of anti-arrthymic therapy
  • monitor heart rhythm under GA
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2
Q

What are common P wave changes?

A
  • absent = pathology in atria/SAN
  • wide
  • tall
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3
Q

What are common QRS changes?

A
  • tall R = LV pathology
  • deep S = RV pathology
  • deep and wideS = dilated RV
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4
Q

What do small QRS complexes indicate?

A

Fluid in pericardium/fat animal/barell chested

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5
Q

What can a prolonged QT interval cause?

A

Excessive intracellular Ca and rapid fatal ventricular tachycardia

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6
Q

What abnormalities can be seen in the ST segment?

A
  • decreases below baseline = hypoxia

- slopes into T wave = LV enlargement

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7
Q

How are arrhythmias classified?

A

Normal rhythm, bradyarrhythmias, tachyarrhythmias

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8
Q

List common bradyarrhythmias

A

Sinus arrest, sick sinus syndrome, sinus bradycardia, atrial standstill, AV blocks

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9
Q

What are the causes of sinus arrest?

A
  • meds = sedatives, B blockers, Ca channel blockers, digoxin
  • disease = high vagal tone, atrial disease, hypothyroidism
  • metabolic = hypothermia
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10
Q

Describe the pathogenesis of sick sinus syndrome

A

SAN stops for period of time. Ectopic rescue beats come from the ventricles at a rate much lower than sinus rate, >20bpm). Animal may be okay, hypotensive, faint at rest.

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11
Q

What are the causes and tx of sick sinus syndrome>

A

Causes - hereditary (min Schnauzer, Westie), idiopathic disease

Tx - pacemaker, sympathomimetics, parasympatholytics

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12
Q

What are the causes of sinus bradycardia?

A 
Meds = sedatives, anti-tachyarrhythmics
Disease = hypothyroidism, increased ICP, dysautonomia
Metabolic = hypothermia, hyperkalaemia
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13
Q

What are the causes of atrial standstill?

A 
Persistent = idiopathic atrial cardiomyopathy, muscular dystrophies
Temporary = hyperkalaemia, hypoadrenocorticism, oliguric renal failure
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14
Q

Describe the pathogenesis of AV blocks

A

Decreased PQ interval duration and slow conduction

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15
Q

What are the causes of primary AV block?

A

Can be normal in dogs with slow HR.
Drugs = sedatives, anti-tachyarrhythmics
Disease = high vagal tone, AVN fibrosis
Metabolic = hyperkalaemia

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16
Q

What are the causes of secondary AV block?

A

Can be normal in dogs with high vagal tone

Disease = vagally mediated, fibrosis/infiltration of AVN

17
Q

Describe the pathogenesis adn tx of a third degree AV block

A

Pathogenesis - P and QRS completely dissociated. Ectopic beats ~ 50bpm, P waves ~100bpm
Tx = pacemaker, sympathomimetics, prasympatholytics

18
Q

List tachyarrhythmias

A

Sinus tachycardia, supraventricular premature beat, supraventricular tachycardia, atrial fibrillation, ventricular prematire complex, VT, rapid VT

19
Q

What are the causes of tachyarrhythmias?

A

Can be normal in nervous/excitable dogs
Drugs = anti-bradyarrhythmics
Disease = anaemia, pain, shock, dehydration, septicaemia, low CO2, hyperthyroidism

20
Q

Describe the pathology of supraventricular premature beat

A
  • electrical activity initiated from the atria, not SAN
  • beats are premature, identical to sinus beats
  • Disease = atrial dilation, atrial infiltration, atrial fibrosis, systemic disease
21
Q

What are the causes and tx of supraventricular tachycardia?

A

Causes - congenital (bypass tract), disease (atrial dilation, atrial infiltration, atrial fibrosis, systemic disease)
Tx - digoxin, diltiazem, atenolol, solatol

22
Q

Describe the pathogenesis of atrial fib

A
  • associated with cardiomyopathy
  • lose definitive P wave
  • diff parts of atria fire at same time, AVN filters signals (300-500bpm)
23
Q

What are the causes and tx of atrial fib?

A

Causes - atrial dilation, atrial infiltration, atrial fibrosis, occult DCM
Tx - digoxin, diltiazem, atenolol (slow AVN conduction)

24
Q

What are the causes of VPC?

A 
Disease = ventricular mycocardial dilation, inflammation, infiltration, fibrosis
Systemic = anaemia, septicaemia, splenic mass, GDV, pyometra
Metabolic = electrolyte imbalance
Drugs = digoxin, atropine
25
Q

What are the causes of ventricular tachycardia?

A 
Disease = ventricular myocardial dilation, inflammation, infiltration, fibrosis
Systemic = anaemia, septicaemia, splenic mass, GDV, pyometra
Drugs = digoxin, atropine
26
Q

What are the tx options for VT?

A

Lidocaine (IV in emergency), mexilitine, sotalol, amiodarone (long time to reach steady state)

27
Q

What are the causes and tx options of rapid VT?

A 
Causes = ventricular myocardial dilation, inflammation, infiltration, fibrosis, trauma, hypoxia
Tx = lidocaine, mexilitine, sotalol, amidarone

M15: Cardiorespiratory (5 decks)

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