Final Part 3 Flashcards
Originates in the ventricles below the bundle of HIS
ventricular arrhythmias
occurs when electrical impulses depolarize the myocardium using a different pathway from normal impulses
ventricular arrhythmias
the atrium does not depolarizes and atrial kick is lost decreasing CO
ventricular arrhythmias
may be benign but are potentially lethal because they are ultimately responsible for CO
ventricular arrhythmias
List the Dysrhythmias that orginate in the ventricles
- PVC - Premature Ventricular Contractions
- Ventricular Tachycardia
- Ventricular Fibrillation
- Ventricular Escapes Complexes and Rhyrhms
- Ventricular Asystole
- Artificial Pacemaker Rhythm
Explain the Origin of Ventricular arrhythmias
- Ventricular arrhythmias originate in the ventricles below the bundle of HIS
- They occur when electrical impulses depolarize the myocardium, using a different pathway from normal impulses
- the atrium does not depolarizes and atrial kick is lost decreasing CO
- May be benign but are potentially lethal because they are ultimately responsible for CO
CO
cardiac output
single ectopic impulse resulting from an irritable focus in either ventricle
The Etiology of Premature Ventricular Contractions
Causes may include myocardial ischemia, increased sympathetic tone, hypoxia, idiopathic causes, acid-base disturbances, electrolyte imbalances, or as a normal variation of the ECG
The Etiology of Premature Ventricular Contractions
May occur in patterns such as bigeminy, trigeminy, or quadgeminy, couplets and triplets
The Etiology of Premature Ventricular Contractions
occurs when blood flow to your heart is reduced, preventing it from receiving enough oxygen.
myocardial ischemia
The reduced blood flow is usually the result of a partial or complete blockage of your heart’s arteries (coronary arteries)
myocardial ischemia
the condition of a muscle when the tone is maintained predominately by impulses from the sympathetic nervous system and these impulses have increased`
increased sympathetic tone
deficiency in the amount of oxygen reaching the tissues
hypoxia
relating to or denoting any disease or condition that arises spontaneously for which the cause is unknown
idiopathic causes
acidosis and alkalosis refer to physiologic process that cause accumulation of loss of acid and or alkali; blood pH may or may not be abnormal. Acidemia and alkalemia refer to an abnormally acidic (pH 7045)
acid-base disturbances
serum concentrations of an electrolyte that are wither higher or lower than normal
electrolyte imbalances
state the etiology of Premature Ventricular Contraction
- Single ectopic (occurring in an abnormal position or place; displaced) impulse resulting from an irritable focus in either ventricle
- Causes may include hypoxia, electrolyte imbalances, acid-base disturbances, myocardial ischemia, increased sympathetic tone, idiopathic causes, or as a normal variation of ECG
- May occur in patterns such as; bigeminy, trigeminy, quadgeminy, couplets, and triplets
Malignant PVCs—more htan 6/minute, R on T phenomenon, couplets or runs of ventricular tachycardia, multifocal PVCs, or PVCs associated with chest pain
clinical significance of premature ventricular contraction
ventricles do not adequately fill, causing decreased cardiac output
clinical significance of premature ventricular contractions
Explain the clinical significance of Premature Ventricular Contractions
Malignangt PVCs
- More than 6 minute, R on T phenomenon, couplets or runs of ventricular tachycardia, multifocal PVCs, or PVCs associated with chest pain
Ventricles do not adequately fill, causing decreased cardiac output
Explain treatment of Premature Ventricular Contractions
- Non-malignant PVCs do not usually require treatment in patients without a cardiac history
- Cardiac patient with nonmalignant PVCs administer oxygen and establish IV access
Under rules of interpretation what is the explain the rate , rhythm, etc of PVCs
PVCs are dysrhythmias that originate in the ventricles. The Rules of interpretation for PVCs are:
Rate —underlying rhythm
Rhythm —interrupts the regular underlying rhythmn
Pacemaker site- ventricle
P waves - none
QRS -0.12 seconds bizzare
An extra ventricular contraction consist of
- an abnormally wide and bizarre QRS complex that originates in an ectopic pacemaker in the ventricles
- it occurs earlier than the expected beat of the unerling rhythm
Premature Ventricular Contraction usually is followed by a
compensatory pause
Why does a full compensatory pause follow a PVC
A full compensatory pause follows a PVC because the SA Node is not prematurely depolarized by the PVC.
How does the T wave look in a PVC
T wave often tall and the opposite direction of QRS
What does unifocal PVC’s arise from
Unifocal PVC’s arise from the same ectopic pacemaker site and have the same morphology
What does multifocal PVC’s arise from
Multifocal PVC’s arise from different sites and different morphologies (shapes)
Name the frequency and pattern of PVC’s
Infrequent - 5/min Isolated - occur singly Group - groups of two or more ,salvos (simultaneous or successive discharge) Two - paired/couplet Three >-run of VT Repetitive- bigeminy, trigeminy
An arrhythmia originating in an ectopic pacemaker in the ventricles whose rate is 110-250/min, and the QRS is wide and bizzare
Ventricular Tachycardia
What are the rules of interpretation of Ventricular Tachycardia
- Rate - 100-250
- Rhythm - usually regular
- Pacemaker Site - ventricle
- P waves - If present, it is not associated with QRS complex
- PRI - none
- QRS - >0.12 seconds, bizzare
3 or more ventricular complexes in succession at a rate of >100 and may appear monomorphic or polymorphic
The Etiology of Ventricular Tachycardia
Perfusing patient administer oxygen and establish IV access. Consider immediate synchronized cardio inversion starting at 100 for hemodynamically unstable patients
treatment for V tach
