Heart Issues

Question 1

With what cardiac conditions is antibiotic prophylaxis recommended?

Answer 1

Artificial heart valve
Hx of infective endocarditis
Unrepaired cyanotic congenital heart disease
Repaired congenital heart defect with prosthetic device during first 6 months of procedure
Cardiac transplant with valvulopathy

first 6 months after placement of coronary stent of CABG procedure (however, no clear guidelines exist)

Question 2

What is the P wave?

Answer 2

electrical activity associated with atrial depolarization

Question 3

what is the PR interval

Answer 3

conduction time between the atria and verntricle

Question 4

what is the QRS complex

Answer 4

contraction of the ventricles

ventricular depolarization

Question 5

what is the QT interval

Answer 5

time between activation of the ventriclesw and their return to resting state

Question 6

what is the T wave

Answer 6

repolarization of ventricles,

Question 7

what is the prevalence of arrythmia

Answer 7

adults over 65 = 12.6% of the time

most common iS Afibb

Question 8

what is sinus arrhythmia?

Answer 8

everything is normal except the rhythm is regularly irregular. heart rate changes with respirations. normal finding in healthy young people

Question 9

what is sinus tachycardia?

Answer 9

tachycardia - SA node impulses are coming at a rate of 101-180 beats per minute

Causes : anxiety, infection, hyperthyroidism, caffeine

Question 10

what is sinus bradycardia?

Answer 10

bradycardia - SA node impulses are coming at a rate of slower than 60 beats per minute

athletes, young adults, patients taking CCB, beta blockers, sedatives

Question 11

what causes afibb?

Answer 11

dysrhythmia that originates from many atrial sites, atria is making ineffective quivering movements

Question 12

What are key features of Afibb?

Answer 12

Rapid atrial rate (350-600 bpm)
Regularly irregular
No P waves (no depolarization)
looks like a wavy baseline

Question 13

What bad events does Afibb lead to?

Answer 13

Poor impulse generation can cause irregular ventricular rhythms
Blood backs up into lungs > causing CHF

More likely to have thrombus formation > 4-5x increased risk of stroke

Question 14

What is treatment for Afibb?

Answer 14

Cathereter ablation
Anti-arrythmia drugs - sotalol, procainamide, flecainide, amiodarone
CCBS
Beta blockers - slow conduction thru AV node
Anti-coagulants

Question 15

What are key features for atrial flutter?

Answer 15

Arrhythmia w/ similar etiology to a-fibb

Characterized by saw tooth flutter waves on ECG

normal QRS, rhythm is usually regular but can be irregular, AV block varies, usually the AV node is stimulated 1/2 the times the SA node fires so HR is approximately 150 BPM

Question 16

What is treatment for atrial flutter?

Answer 16

More serious

tx includes - digoxin/digitalis,, anticoagulants (coumandin),, electroshock therapy

Question 17

what is a premature ventricular contraction?

Answer 17

PVC - premature ventricular beat or extra systole

Question 18

What is the cause of a PVC?

Answer 18

anxiety, caffeine, cocaine, amphetamines, adrenaline!, digoxin, aminophylline (bronchodilator)

electrical impulse originating below bundle of His

Question 19

What are the key features of PVCs?

Answer 19

Wide QRS complex
Bizzare morphology - ST segment and T wave in opposite polarity as usual

P wave is usually obstructed by the wide QRS

irregular rhythm - PVCs may occur in singles, couplets, or triplets (bigeminy, trigeminy)

Question 20

What is something special with PVCs that you need to may attention to?

Answer 20

4-6 PVCs or more in a minute is not a good sign, as well as trigeminy