EKG and dysrhythmias

Question 1

normal sinus rhythm

Answer 1

• HR 60-100/min
• regular rhythm (< 0.12 sec var.)
• P waves look alike
• PR interval: 0.12-0.2 sec
• ever P followed by QRS
• QRS < 0.12 sec
• QT interval < ½(R-R interval)

Question 2

sinus bradycardia

Answer 2

HR < 60 bpm

Question 3

sinus bradycardia origin

Answer 3

SA node

Question 4

sinus bradycardia in athletes

Answer 4

• normal
• result of stronger myocardial ctx

Question 5

symptomatic sinus bradycardia

Answer 5

• → lethal ventricular dysrhythmias
• Tx
  
  • atropine
  • pacemaker

Question 6

How does atropine treat symptomatic sinus bradycardia?

Answer 6

blocks parasympathetic innervations to SA node

Question 7

sinus tachycardia

Answer 7

• HR 100-150 bpm
• → angina if ↓ CO affects coronary circulation

Question 8

sinus tachycardia Tx

Answer 8

• aimed at relieving cause of ↑ HR
  
  • imagery
  • distraction
  • meds
  • pacemaker (in atrial dysfunction)

Question 9

Tx for sinus tach

Answer 9

• anxiolytic
• analgesic
• antipyretic
• O₂
• fluids
• valsalva maneuver
• CCBs
• BBs

Question 10

atrial dysrhythmias

Answer 10

• originate from ectopic impulses in atria
• types
  
  • premature atrial ctx (PACs)
  • supraventricular tachycardia (SVT)
  • atrial flutter (Aflutter)
  • atrial fibrillation (Afib)

Question 11

PAC

Answer 11

premature atrial ctx

Question 12

premature atrial ctx

Answer 12

• common type of premature beat that originates from 1 or more ectopic pacemakers in the atria
• multifocal: > 1 ectopic pacemaker
• often changes contour of T wave

Question 13

bigeminal PAC

Answer 13

every other beat

Question 14

trigeminal PAC

Answer 14

every third beat

Question 15

couplet PACs

Answer 15

two at a time

Question 16

runs of PACs

Answer 16

multiples in a row

Question 17

causes of PACs

Answer 17

• common in normal adult d/t
  
  • stress
  • ETOH
  • caffeine
  • tobacco
• heart dz
• electrolyte disturbances
• atrial stretch (CHF)

Question 18

frequent PACs may warn of/trigger …

Answer 18

• SVT
• Afib
• Aflutter

Question 19

PACs feel like

Answer 19

occasional palpitation

Question 20

PAC Tx

Answer 20

treat underlying cause

Question 21

supraventricular tachycardia

Answer 21

• HR 150-250 bpm
• rhythm: regular
• P waves not distinguishable, buried in preceding T wave
• normal QRS = supraventricular ectopic pacemaker

Question 22

SVT Tx

Answer 22

• (varies)
• Valsalva
• antidysrhythmic: adenosine
• CCBs
• BBs
• digoxin

Question 23

paroxysmal atrial tachycardia

Answer 23

another name for SVT

Question 24

SVT

Answer 24

supraventricular tachycardia

Question 25

atrial tach causes

Answer 25

• stimulants
• infection
• electrolyte imbalances
• MI
• other heart dz
• common after CABG
• hypoxia
• meds (chemos)
• WPW
• abnormal accessory pathways

Question 26

WPW

Answer 26

Wolf-Parkinson-White

Question 27

atrial tachycardia symptoms

Answer 27

• asymptomatic
• palpitations/flutter
• chest pressure
• dizziness
• lightheadedness
• dyspnea

Question 28

atrial flutter rate

Answer 28

• > SVT
• atrial: > 250
• ventricular: depends
• looks like saw blade

Question 29

Aflutter →

Answer 29

• SR
• Afib

Question 30

Tx for Aflutter

Answer 30

• preferred: synchronized cardioversion
• CCBs
• BBs

Question 31

Chronic Aflutter is _____.

Answer 31

uncommon