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CVM DF > Johnston- Cardiac Rhythm Disturbances (atrial, junctional, ventricular) > Flashcards

Johnston- Cardiac Rhythm Disturbances (atrial, junctional, ventricular) Flashcards

1
Q

cor pulmonale

A

right heart failure due to lung disease

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2
Q

ecg in cor pulmonale

A

low voltage
tall pointed, peaked p waves
sometimes intermitent RBBB

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3
Q

ECG in hypothyroidism

A

bradycardia
low voltage
flattening of T wave

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4
Q

wpw

A

pre excitation syndrome, congenital from extra bypass tract

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5
Q

what constitutes bradycardia

A

under 60 bpm

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6
Q

medical conditions/situations associated with bradycardia

A 
diseases of atrium or SA node
CAD
inflammation
invsive neoplasm
cardiomyoptahy 
muscular dystrophy
amyloidosis
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7
Q

drugs associated with bradycardia

A

digitalis, quinidine, hyperkalemia

drugs for hypertension

beta blockers

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8
Q

bradycardia and MI

A

acute inferior MI (RCA lesion)

-related to sinus node ischemia or to a vagal reflex initiated in the ischemic area

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9
Q

sick sinus syndrome

treatment

A

tachy alternating with bradycardia
SA node undergoing inflamation, ischemia, hypoxia

  • seen in people who have vascular disease, advanced heart disease and older pts
  • use pacemaker to treat slow rate and meds to suppress fast
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10
Q

what is the most common cause of an unexplained beat pause on ECG

A

nonconducted PAC

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11
Q

what is a nonconducted PAC

A

beat not conducted to the ventricle

atrial (p wave) is abnormal from ectopic focus

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12
Q

nonconducted atrial bigeminy

A

every other beat is from ectopic and not concducted

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13
Q

what can SSS cause

A

syncope, dizziness, fatigue, heart failure

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14
Q

treatment of sinus bradycardia

A

atropine .3–>.5—>1—>2mg IV

  • repeat 10 min
  • use caution in glaucoma
  • AE = urinary retention, abd distension

Epinephrin
isproterenol
pacemaker

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15
Q

what is automaticity

A

property of a cardiac cell to depolarize spontaneously during phase 4 of AP and leads to generation of an impulse

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16
Q

what are PAC (premature atrial contraction) associated with

A 
stress
alcohol
tobacco
coffee
COPD
CAD
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17
Q

premature atrial beat ecg

A

biphasic p wave and premature

or different morphology

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18
Q

treatment of PAC

A

if symptomatic

beta bloker
metoprolol 25-50 mg BID-TID

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19
Q

paroxysmal atrial tachycadria

A

sudden heart rate greater than 100
rate is 150-250
identify irritable focus. P’ wave

atrial tachy
junctional tachy
ventricular tachy

can have p and t waves superimposed on each other

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20
Q

PAT with block (AV block)

A

2 P’ waves for each QRS

suspect digitalis toxicity

can have T wave superimposed on P wave

P’ waves are spiked

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21
Q

multifocal atrial tachycardia

A

3 or more different P waves (3 or more diff morph in a row)
P-R interval varies
irregular ventricular rhythm
atrial rate over 100

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22
Q

MAT associated with

A

copd, pneumonia, beta agonists, electrolyte abnormalties, digitalis tox, sepsis

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23
Q

treatment for multifocal atrial tachycardia

A

CCB - nondihydropyridine

diltiazem 20 mg IV
verapamil

Magnesium sulfate
amiodarone/adenosine

caution with beta blocker (pulmonary problems)

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24
Q

A fib

A

not well defined p wave and irregular ventricular response

continuous chaotic atrial spikes

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25
Q

atrial flutter

A

saw tooth appearance

leads II,III, aVF, V best leads

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26
Q

premature junctional beat

A

may cause retrograde atrial depolarization

  • each P’ is inverted in leads with an upright qrs
  • and p’ wave can come beofre or after qrs
27
Q

paroxysmal junctional tachycardia

A

150-250 bpm

p wave may be lost, inverted before or after each qrs

28
Q

SVT

A

T wave is high and have narrow QRS complex

29
Q

svt with no p wave

A

AVNRT

30
Q

PVC ecg

A

premature bizarre wide QRS

no preceding p wave
may produce retrograde p wave in st segment

ST-T wave in opp direction of QRS

usually have full compensatory pause

31
Q

multifocal ventricular ectopics

A

each irritable focus produces its own distinctive PVC

32
Q

____ PVCs in a row is start of ____

A

3, vtac

33
Q

V tac is sutained longer than ___ seconds of fast ventricular activity

A

30 seconds

34
Q

accelerated idioventircular rhythm

A
  • rate is fast, qrs is wide
  • see this in people who have received thrombolytic therapy
  • fusion beat
35
Q

treatment of PVCs

A

if stable no rx
if symptomatic or in setting of ACS- metoprolol

if unstable then amiodarone, lidocaine, procainamide
(PAL for unstable PVCs)

36
Q

ventricular tachycardia

A 
3 or more consectutive bizarre qrs complexes
ventricular rate of 120-200
usually regular, wide qrs
p wave often lost
last longer than 30 seconds
37
Q

ventricular fibrillation cliniclal setting

A 
Acute MI
IHD
K+ disturbance
Heart failure
disorganized depolarization
38
Q

ventricular flutter

A

250-350 bpm
sine waves
leads to v fib

39
Q

torsades de pointes

A 
qrs swings from positive to negative direciton
may be inherited (prolonged QT) or acquired (class I, II,, antiarrhytmias, alcohol, tca, electrolyte imbalance
40
Q

what do you always check with torsades de pointes

A

electrolye levels

K, Ca, Mg

41
Q

treatment for torsades de pointes

A

MgSO4
overdrive pacing
isoproternol

42
Q

asystole

A

no rhythm

start cpr

43
Q

hyper or hypokalemia widens qrs

A

hyperkalemia

44
Q

low calcium causes

A

prolonged AT, triggers arrhythmias (torsades)

45
Q

high calcium

A

shortens qt interval

46
Q

low mg and qt

A

prolongs it

47
Q

high mg and qt

A

shortens it

48
Q

u waves, increased qt interval, flat or inverted t wavre

A

hypokalemia

49
Q

hyperkalemia ecg

A

tall pointed T wave
wide qrs
increased pr
loss p wave

50
Q

treatment for hyperkalemia

A 
dialysis
insulin and glucose
na hco3
albuterol 
rezin binding agents
51
Q

hypocalcemia etiology

A 
chronic renal failure
vitamin D deficiency
hypoparathyroidism
acute pancreatitis
hypomagnesium
52
Q

hypocalcemia and ecg

A

prolonged QT

53
Q

hypercalcemia etiology

A

hyperparathyroidism
malignancy
granulomatous disorders
endocrine

54
Q

ecg and hypercalcemia

A

short qt

short st

55
Q

etiology of hypomagnesemia

A

alcholosim and diuretics are big ones

56
Q

ecg of hypomagnesemia

A

prolonged PR
wide QRS
prolonged QT
decreased T wave

57
Q

hypotehemia and ecg

A

j wave
osborne wave
wide bizzarre and have a little notch in downslope of QRS

58
Q

PE and ECG

A

S1 Q3 T3 (inverted T in V1-V4)

large S in lead I
ST depression in lead II
large Q wave in III with T wave invesion

transient RBBB

59
Q

low voltage in QRS is what

A

lung disease until proven otherwise

60
Q

cerebral hemorrhage and ecg

A

t waves are prominent and followed by a funny notch
impressive ST-T changes

Widespread giant T wave inversions

61
Q

hypothyroidism ecg hallmark

A

widespread flattening or mild inversion of T waves without associated ST segment displacement

62
Q

most other constant ECG finding in myxedema (from hypothyroidism) is

A

low voltage of QRS complex

63
Q

brugada syndrome

A

people of asian decent prone to sudden death

RBBB with ST elevation in V1,V2,V3

bizarre “ski slope” to QRS

64
Q

wolff parkinson white syndrome

A

short P-R interval
slurred upstroke (delta wave) of QRS complex
accessory av conduction pathway
(bundle of kent)

CVM DF (15 decks)

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