Heart Block Dysrhythmias

Question 1

Name heart blocks with CONSTANT P-R interval and VARIABLE

Answer 1

Question 2

Name the most common heart block.

Answer 2

First Degree Heart Block
People are born with it every day. They will likely live a long and healthy life and die from some other malady.

Question 3

Describe EKG : First Degree Heart Block

Answer 3

• Will look like a typical sinus rhythm with one distinguishing feature.
• The P-R interval will be constant throughout the tracing
• P-R intervanl measure greater than 0.20 seconds.
• Rate, regularity, P wave morphology and QRS duration and morphology will be unaffected.
• NOTE: The rate will be that of the underlying rhythm. If the rate is “normal”, it will be 60 – 100 bpm. If it is bradycardia, the rate will be less than 60 bpm.

Question 4

What’s other name of Second Degree Heart Block Type I

Answer 4

Wenckebach Phenomenon

Question 5

Describe : Second Degree Heart Block Type I (2)

Answer 5

• typically stable
• and often temporary with the patient remaining asymptomatic as long as the ventricular response remains within the “normal” range.

Question 6

Describe EKG : Second Degree Heart Block Type I (6)

Answer 6

• The unique feature (hallmark) of this dysrhythmia is the presence of a **prolonging P-R interval **from one cardiac complex to the next
• until it reaches a point where the QRS complex is non-conducted ( blocked or more simply missing).
• Then the pattern starts over again.
• In this dysrhythmia, if the third QRS complex is dropped/blocked, then it will always be the third complex that is blocked before re-setting in a repetitious pattern.
• The P – P intervals are regular and the R to R intervals are irregular.
• there are more P waves than QRS complexes. Report the rate of each separately.

Question 7

What’s the hallmark of Second Degree Heart Block Type II

Answer 7

constant P-R interval with missing QRS complexes.

Question 8

Second Degree Heart Block Type II may present in a couple of different ways. Name them.

Answer 8

1. QRS complexes occurring in a specific pattern in a ratio with the P waves. This is often referred to as 2:1 or 3:1 block depending upon the ratio of P waves to each QRS complex.
2. QRS complexes occur in a more unstable, unpredictable manner.

Either presentation requires immediate reporting due to its potential for conversion to Third Degree (Complete) Heart Block.

Question 9

Third Degree Heart Block is also known as what ?

Answer 9

“Complete Heart Block”.

Question 10

Describe : Third Degree Heart Block

Answer 10

• As a result of disease or tissue death, there is a blockage preventing electrical impulses within the atria from entering the ventricular conduction system.
• The outcome of 3rd degree heart block ECG are two independently functioning pacemakers within the heart (typically one is supraventricular, the other is ventricular).
• Essentially, the atria and ventricles are electrically separated (dissociated) from one another.

Question 11

Describe EKG : Third Degree Heart

Answer 11

• Regularly occurring P waves and QRS complexes, but at two distinctly different rates.
• Complete heart block presents with Regular P to P and R to R intervals and a variable P-R interval.