ECG Arrthymias Flashcards
What are the adverse signs of arrthymia?
- Shock
- Syncope
- Heart failure
- Myocardial ischemia
- Extremes of heart rate
What is sinus bradycardia?
Where the electrical signal comes from the sino atrial node at a rate of less than 60.
What are the key 3 lead characteristics of Sinus Bradycardia?
- Rate <60
- Regular
- Normal P wave andd PR interval
- Normal QRS complex.
What are the potential causes of Sinus Bradycardia?
- Physiological
- Cardiac Origin (Sinus node disease)
- Drug induced
What is sinus tachycardia?
When the electrical signal originates from the sino-atrial node at a rate greater than 100.
What are the causes of sinus tachycardia?
- A Physiological response (Pain, fever or haemorrhage)
What does SVT indicate?
A pacemaker site that is above the ventricles but is not the SAN.
What are the likely pacemaker sites in SVT?
Atria/ Atrio-ventricular node.
What wave isn’t present in an SVT ECG?
P waves
Is SVT always constant throughout patient assessment?
- False
- SVT may be paroxysmal, Pt may have runs of SVT before returning to normal sinus.
What are the key features of an SVT rhythm?
- Rate 150-220
- Regular Rhythm
- Abnormal/ Abscent P waves
- P-R interval can’t be seen
- Normal QRS interval
What is an Atrial Tachycardia?
Ectopic atrial Rhythm that is more than100 bp,.
What is the maximum rate of SVT in infants?
300
What is the rate of SVT in Adults?
150-220
What is the pulse rate of Atrial Tachycardia?
110 - 180
What are the features of atrial tachycardia?
- 100-180
- Regular Rhythm
- Different P wave morphology, may merge into the previous T Wave
- P-R interval often in normal range
- Normal QRS.
What is a common ECG feature of Sinus Tachycardia, Supraventicular Tachycardia and Atrial Tachycardia?
- Normal QRS complex
- Rate over 100
What changes in the AV node during Atrial Tachycardia?
- It doesn’t hold the electrical impulse
What are the likely outcomes of Patients in Atrial Tachycardia?
- Hypotension
- Poor Perfusion
- Cerebral Hypoxia
Where is firing as a pacemaker during a PAC?
- the Myocites in the left atrium, not the SAN.
What are the common causes of PACS?
- Stress
- ischemia
- Atrial Enlargement
- Caffine/ Nicotine
What are the features of PACs ?
- Rate may be normal,
- irregular Rhythm
- P waves normal, but those before the PAC differ in morphology
- QRS normal
What is affected if a PT is presenting with frequent PACs?
Reduced Cardiac output.
What is a common symptom of a PT presenting with PACs?
Palpitations
What is Atrial flutter?
When the SAN is firing off at a rapid rate, but the AVN blocks them (As the ventricles can’t respond to the rapid rate of signals) and sends the impulse back across the right atrium.
What shape is given in Atrial flutter?
- Saw tooth appearance.
What are the causes of Atrial flutter?
Damage to the heart, increased sympathetic tone.
What are the features of Atrial flutter?
- Atrial rate = 300+ per minute
- No P waves
What may occur to a PT who is in Atrial flutter?
- A reduced Cardiac output
- Chest pain due to increased workload and reduced oxygenation
- increased risk of stroke.
What is Atrial Fibrillation?
When electrical impulses fire off from around the atria.
What causes the irregular ventricular rates in patients with AF?
The inconsistent conduction at the AV node.
What are the causes of AF?
- Heart disease
- Congestive heart failure
- Mitral Stenosis
- Atrial infarction
What are the features of an AF Rhythm?
- Atrial rate >360
- Irregular rhythm
- P waves not present
- No identifiable PR interval
- Normal QRS