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Cardiovascular Pathophysiology > ECG Part III > Flashcards

ECG Part III Flashcards

1
Q

what are the effects of cardiac arrhythmias?

A

syncope
weakness
decompensation of CHF
reduced blood flow
death

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2
Q

arrhythmias are more concerning in animals with ________________________________

A

advanced heart disease

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3
Q

how can you identify arrhythmias?

A

auscultation
ECG

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4
Q

what are the three mechanisms of arrhythmia?

A

altered automaticity
triggered activity
re-entry

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5
Q

where do all sinus rhythms originate?

A

sinoatrial node

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6
Q

what is normal sinus rhythm?

A

normal P wave coming in regular intervals
typically normal P-QRS-T complexes
normal heart rate
normal relationship between the P-QRS-T complexes

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7
Q

in sinus arrhythmia, there is cyclic/rhythmic variation in _______________________

A

P-P intervals

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8
Q

in whom is sinus arrhythmia normal?

A

dog
horse

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9
Q

what is the P-QRS-T complex like in sinus arrhythmia?

A

typically normal

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10
Q

what are the cutoffs for sinus bradycardia in dogs, cats, bovine, and equine in rates?

A

dog: 60/min
cat: 160/min
bovine: 46/min
equine: 24/min

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11
Q

what are the rate cutoffs for sinus tachycardia in dogs, cats, and equids?

A

dog: 160/min
cat: 240/min
equine: 60/min

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12
Q

what is the rhythm like typically with sinus tachycardia?

A

regular, with normal P-QRS-T complex

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13
Q

what happens in supraventricular premature depolarizations?

A

regular rhythm is interrupted by a premature depolarization from the atria or AV junctional tissue

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14
Q

what is the appearance of the supraventricular premature depolarization?

A

fairly normal QRS-T appearance

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15
Q

what is a compensatory pause?

A

pause during premature beat is equal to twice the normal R-R interval

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16
Q

what is supraventricular tachycardia?

A

runs or paroxysms of ectopic complexes
>= 3 in number
originate from atria or AV junctional tissue

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17
Q

what is atrial tachycardia?

A

atrial tissue alone is utilized for origination and maintenance of arrhythmia

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18
Q

____________________ is an unstable rhythm that often leads to atrial fibrillation

A

atrial flutter

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19
Q

what is atrial fibrillation?

A

chaotic, disjointed atrial activation

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20
Q

what is the heart rate in atrial fibrillation?

A

usually a rapid rat

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21
Q

what is the morphology of the QRS-T in atrial fibrillation?

A

usually fairly normal
often some beat-to-beat variation in QRS height

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22
Q

what are ventricular premature depolarizations?

A

premature ectopic impulses originating from the ventricles

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23
Q

what is the appearance of the ECG with ventricular premature depolarizations?

A

wide and bizarre appearance of QRS-T
large T wave in opposite direction of QRS
ST segment slurring
compensatory pause

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24
Q

what happens in ventricular premature depolarizations?

A

spontaneous depolarization in the ventricle
fires before sinus node impulse reaches ventricle

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25
Q

what is a fusion beat?

A

complex formed when the normally conducted impulse and a ventricular ectopic beat simultaneously depolarize the ventricle

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26
Q

what is coupling?

A

fixed relationship between a premature beat and the beat that precedes it

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27
Q

how can you differentiate between unifocal and multifocal?

A

unifocal: all premature beats look the same

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28
Q

what is ventricular tachycardia?

A

a run or paroxysm of >= 3 premature ectopic impulses originating from the ventricles

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29
Q

what is a compensatory pause?

A

pause during premature beat is equal to 2x the normal R-R interval

30
Q

what is sustained ventricular tachycardia?

A

ventricular tachycardia lasting more than 30 seconds

31
Q

why are VPCs not good?

A

do not generate a good blood pressure

32
Q

what is accelerated idioventricular rhythm?

A

ventricular origin beats that are not tachycardia

33
Q

what is ventricular fibrillation?

A

chaotic, disorganized activation of the ventricles
irregular undulations in the baseline

34
Q

what is cardiac output in ventricular fibrillation?

A

drops to zero

35
Q

what do IKr blocking drugs cause?

A

QT prolongations, setting up lethal arrhythmias

36
Q

where do junctional escape rhythms originate from?

A

AV junction

37
Q

where do ventricular escape rhythms originate from?

A

purkinje fibers

38
Q

what is sinus arrest?

A

failure of the sinus node to discharge for a period more than twice the normal R-R interval

39
Q

what do long pauses in sinus arrest often result in?

A

syncope

40
Q

what is sick sinus syndrome?

A

syndrome often characterized by bradycardia and tachycardia resulting in clinical signs
periods of sinus arrest often followed by paroxysm of supraventricular tachycardia

41
Q

what is atrial standstill?

A

atrial activity is absent
no P waves anywhere on ECG strip

42
Q

what can atrial standstill result from?

A

severe hyperkalemia
atrial muscular dystrophy

43
Q

how can you recognize severe hyperkalemia on an ECG?

A

atrial standstill
peaked T wave
bradycardia

44
Q

what does a first degree AV block look like on an ECG?

A

minor delay in AV conduction
prolonged P-R interval

45
Q

what is happening in third degree AV block?

A

no conduction through the AV node
no P waves conducted to thee ventricles
atria and ventricles beat in independent fashion

46
Q

what can be the cause of first degree AV block?

A

physiologic
drugs
pathologic

47
Q

what is second degree AV block?

A

more advanced conduction disturbance
some P waves are not conducted to the ventricles

48
Q

what is mobitz type I second degree AV block?

A

progressive P-R prolongation before the block

49
Q

what is mobitz type II second degree AV block?

A

fixed P-R interval: often more advanced form of AV block

50
Q

who can have physiologic second degree AV block?

A

dog
horse

51
Q

what can cause third degree AV block?

A

pathologic
drugs in overdose

52
Q

what are the rates in third degree AV block?

A

atrial rate normal or fast
ventricular rate usually slow

53
Q

the ST segment should not be depressed more than ______________

A

0.2mV

54
Q

the ST segment should not be elevated more than ______________

A

0.1 to 0.15mV

55
Q

what can ST segment alterations indicate?

A

ischemia or hypoxia
electrolyte changes
conduction disturbance
myocardial infarction

56
Q

accessory pathways lead to ___________________________________

A

supraventricular tachycardia

57
Q

what does a wandering pacemaker look like?

A

variable P wave height or appearance

58
Q

what varies with respiration in respiratory sinus arrhythmia?

A

rate

59
Q

is sinus bradycardia usually a regular rhythm?

A

yes

60
Q

what type of pause do supraventricular premature depolarizations have?

A

non-compensatory

61
Q

what can supraventricular premature depolarizations have with P waves?

A

may have ectopic prior to, within, or following QRS-T

62
Q

what type of tachycardia does supraventricular tachycardia usually cause?

A

often very regular

63
Q

what does atrial fibrillation look like on an ECG?

A

irregularly irregular R-R intervals
usually baseline undulations due to atrial fibrillation
lack of organized P waves, no consistent relationship between waves and following QRS-T

64
Q

what type of pause is associated with ventricular premature depolarizations?

A

compensatory

65
Q

what are the T waves like in ventricular premature depolarizations?

A

large, opposite direction of QRS

66
Q

what is the ST like in ventricular premature depolarizations?

A

slurring: no real ST segment shelf

67
Q

what does an accelerated idioventricular rhythm look like?

A

ventricular origin beats that are not tachycardic

68
Q

what is the rate with ventricular escape rhythms?

A

24-40/min

69
Q

what is the rate with junctional escape rhythms?

A

60-100/min

70
Q

what are periods of sinus arrest often followed by?

A

paroxysm of supraventricular tachycardia

71
Q

who can have physiologic second degree AV block?

A

dogs
horses

72
Q

what is the ventricular activation usually in third degree AV block?

A

junctional or ventricular escape rhythm

Cardiovascular Pathophysiology (35 decks)

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